Lower back pain is one of the most common reasons that forces a patient to seek help from a neurologist or therapist. Lumbosacral spine pain can be permanently disabling, making movement and self-care impossible. Acute low back pain affects both men and women with the same frequency.
With greater frequency in middle age and old age, lower back pain can often be observed in adolescents and young adults. This is due to rapid growth, weakness of the fragile muscles of the lower back, injuries. Therefore, lumbosacral spine pain is the most pressing problem anyone can face.
Back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can increase with coughing and sneezing, with any movement, especially when the body leans forward. Along with back pain, lumbar osteochondrosis can manifest itself as a violation of the sensitivity of certain areas of the skin or muscles of the lower half of the trunk and legs, weakening or disappearance of the tendon reflexes of the legs.
- As a rule, with osteochondrosis, there is a curvature of the lumbar spine. Depending on the plane in which the curvature occurs, scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (smoothing of the lumbar spine or even its backward curvature) are distinguished. In the event that, with osteochondrosis, the spinal cord is pinched, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.
- However, most often lumbar osteochondrosis is manifested by radicular pain, eg. developing due to pinching of nerve roots extending from the spinal cord to one level or another. Hence, one of the well-known low back syndromes is low back pain. It occurs at a time of physical stress or in an uncomfortable position of the body, and sometimes for no apparent reason. Suddenly, within minutes or hours, you feel a stabbing pain ("lumbago"), often burns and bursts ("as if a stake has stuck in the lower back").
The patient freezes in an uncomfortable position, cannot straighten up if an attack occurs when lifting the weight. Attempts to get out of bed, cough or bend a leg are accompanied by a sharp increase in pain in the lower back and sacrum. If the patient is asked to stand, a strong immobility of the entire lumbar region is revealed due to muscle tension.
Lumbosacral osteochondrosis test
These tests are used as a way to conduct preliminary diagnostics, they are named after the doctors who suggested them.
| Dejerine's symptom | if you squeeze your abs and listen to your lower back, the pain will become stronger. In this case, there is a high probability that the patient has osteochondrosis. |
| Neri's symptom | if, when the head is tilted sharply forward before touching the chest, there is pain in the lower back, this also indicates problems with the spine. |
| The symptom follows | this can be felt after the following actions: lying on your back, you need to lift each leg in turn. If, subsequently, the lower back is twisted and pain will be given along the sciatic nerve to the leg, this is evidence of the pathology of the spine. |
| Larrey's symptom | if the pain occurs in a person along the sciatic nerve, after he rises forward without bending his knees from a lying position, we are talking about manifestations of chondrosis. |
slipped disc
A herniated disc is an equally rare cause, the clinical manifestation of which is lumbosacral back pain. The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With continued exposure (overweight, trauma, progressive osteoporosis), the fibrous ring of the disc thins and defects form in it. Through these weak spots in the fibrous ring, the nucleus pulposus of the disc can move and even protrude.
Causes of back pain
Back pain is such a nonspecific symptom that it can be caused by many different reasons. From how intensely the back hurts in the lumbar region, whether it is constant or periodic, primary or secondary, there can be reasons that cause it:
Chronic pain:
- osteomyelitis;
- Ankylosing spondylitis;
- Deforming spondylosis;
- Diseases of growth - scoliosis;
- Infectious lesions of the intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Metabolic bone diseases - osteomalacia, osteoporosis;
- Primary and metastatic tumors of the spinal cord, vertebrae, retroperitoneal space;
- Non-infectious inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
- Kidney tumors
- Atherosclerosis of the abdominal part of the aorta and its branches.
Sharp pain:
- spondyloarthritis;
- Pathology of the hip joint;
- Spinal epiduritis;
- Protrusion of the intervertebral discs in the lumbar region;
- Spinal osteochondritis;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- urolithiasis disease;
- Acute sprains, vertebral fractures;
- low back pain, sciatica;
- Acute disorders of spinal circulation - stroke;
- Acute pyelonephritis.
Radiating pain in some diseases of the internal organs:
- Diseases of the pelvic organs. In women - inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, sexually transmitted diseases (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc. ). In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney disease - renal colic, kidney stones;
- Aortic dissecting aneurysm.
Physiological causes
Low back pain can occur if:
- I am overweight;
- Additional risk for women;
- you are pregnant or have recently given birth;
- You spend a lot of time driving a car or computer;
- Lead a predominantly sedentary (office worker) or standing lifestyle (vendors, waiters, road signs, surgeons);
- Do dynamic physical work with a sharp change in body position (especially if your specialty is associated with heavy physical activity);
- Overload at the gym or fitness club. Be very careful if you have recently started exercising;
- I am fond of summer cottage jobs;
- They have reached postmenopause, which is conducive to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy exacerbates the manifestations of diseases that exist in the mother's body. Due to changes in hormonal levels and increased loads, pathologies especially often manifest themselves in the second half of pregnancy. In addition to the pain that accompanies the threat of premature birth, the cause of back pain in a pregnant woman can be:
- slipped disc;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis disease (kidney stones).
Why does the back hurt under the lower back?
When the back hurts under the lumbar area, in addition to obvious diseases of the spine (sciatica, low back pain, intervertebral hernias, ankylosing spondylitis, etc. ), the possible causes are periodic pains during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages - oophoritis, salpingo-oophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (appendix of the cecum), in men - diseases of the prostate gland, bladder.
Pain above the lower back
If the back hurts right above the lower back - then liver pain can radiate, with any pathological changes in the liver - hepatitis, liver failure, taking toxic drugs. The pain in this case is most often localized in the right hypochondrium.
If the pain is felt to the right or left just above the lower back, it is very likely that the cause lies in acute kidney disease. Many chronic kidney diseases such as polycystic kidney, malignant neoplasms of the kidneys, chronic pyelonephritis are accompanied by minor symptoms because the kidney capsule is gradually stretched.
When should you see a doctor?
- If the back pain radiates to the lower back and is located slightly higher (in the chest area). The pain is accompanied by sweating, bouts of vomiting and nausea, shortness of breath.
- The pain radiates to the peritoneum, chest, neck, jaw.
- The patient is dazed and confused.
- Tachycardia begins.
- Spinal trauma, accompanied by loss of control over defecation, urination.
- The legs weaken, the buttocks, the genitals go numb.
Diagnostics
To determine which disease caused back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical analysis of urine and blood.
- Test for tumor markers present in the blood during tumor formation.
Instrumental research methods:
- Spinal X-ray.
- Endoscopy of the intestine, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance.
How to treat low back pain?
How to properly treat the lower back? The approach to back treatment depends entirely on the symptoms of the disease, the diagnosis made by the doctor and the stage of the disease. Usually, an integrated approach is used that includes several treatment methods.
Pain medications. . .The ointment helps relieve inflammation, stretching and has a warming effect if the lower back has a cold.
The following groups of ointments are distinguished:
- combined medicines (used for sprains and injuries, along with anti-inflammatory and analgesic effects, have a healing effect due to their constituent substances);
- anti-inflammatory analgesics (contain medicinal substances with a cooling effect that relieve irritation - menthol, lavender and painkillers);
- chondroprotector (one of the active components of such drugs is a substance used in pathological processes in cartilage tissue, which contributes to the active restoration of the cartilage surfaces of the joints);
- irritating drugs (the effect is based on vasodilation and blood flow to the source of pain).
With the help of therapeutic exercises, the patient will be able to reduce pain, strengthen muscles, increase the distance between the vertebrae. They will help release compressed nerve roots, normalize blood flow to the affected area and improve metabolic processes.
In order for such gymnastics to heal and not paralyze, all the recommendations of the attending physician must be followed.
- Movements are performed slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothing that does not restrict movement;
- The exercise is performed when the patient inhales and during exhalation must return to the original position;
- The load gradually increases. First, the number of approaches is about 10, then they are increased;
- During gymnastics, you should monitor your well-being. If acute pain begins, then you need to stop your studies.
In addition, the massage is excellent for relieving pain in the lumbar spine. The positive therapeutic effects of massage include the following:
- improve blood supply to the diseased part of the body;
- kneading the muscles, which makes them and the ligaments more flexible and elastic;
- acute pain relief;
- get rid of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensations due to stimulation of the nerve endings of the skin;
- positive emotions.
It can be entrusted to a specialist in the clinic or done at home, in any case, the benefits that will derive from it will be invaluable.
Which doctor should I go to?
For back pain, the cause of which is not known, the first step is to consult a therapist. It will help determine the disease from a combination of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose against the background of pregnancy, menstruation or a chronic illness, it makes sense to immediately contact a narrower specialist.
Self-medication is allowed only in cases where the cause of the pain is precisely known.