There are many diseases that manifest themselves as painful sensations in the lumbar region. They can indicate problems with the spine, joints, muscles, internal organs: kidneys, intestines, liver. This is a rather insidious symptom, and without a visit to the doctor it is impossible to determine the true cause of pain in the lumbar region. Correct treatment is possible only after diagnosis in a medical institution.
Types of pain
During the initial examination, the doctor should ask the patient about the nature of the pain. In duration they can be:
- sharp- appear suddenly, paroxystically, differ in intensity, last less than 1 month;
- subacute- they last 2-3 months, most of the time they are recurrent: they become active for 2-5 days, then regress and return after some time;
- chronic- last more than 1 year, the course is very often recurring.
Doctors have discovered that very often chronic pain in this area is associated with the formation of local muscle spasms, compactions that present certain painful points (the so-called myofascial syndrome). The process also involves the muscles that straighten the spine, the buttock muscles, the pelvic ligaments, and the sacroiliac joint.
The nature of the pain is sharp, aching, dull. By intensity: strong, medium, weak. Depending on the location of the pain, the following types are distinguished:
- low back pain- pain in the lumbar or lumbosacral region;
- sciatica- in the lower back, radiating to the leg;
- sacralgia- in the sacred area;
- coccydynia- in the coccyx.
5 facts about back pain
- About 25% of all visits to clinics with complaints of back pain are related to sensations in the lumbar region.
- According to research, 84% of people have felt pain in the lumbar region at least once in their life.
- 44-78% of patients (depending on age and region of residence) experience repeated attacks of low back pain.
- Up to 37% of people periodically lose the ability to work due to low back pain.
- In 85% of patients who consult a doctor for pain in the lumbar region, musculoskeletal disorders are identified that become the cause of pain.
- According to statistics, about 90% of patients with acute pain in the lumbosacral region recover within 2 weeks.
Causes of back pain
Musculoskeletal disorders
In 2006, the European Federation of Neurological Societies officially adopted the following classification of the causes of pain in the lower back. They are divided into 3 main groups:
- Compression of the spinal root, peripheral nerve in the lumbar spine. It occurs due to protrusion (degenerative changes) of the intervertebral discs. Less commonly, due to dysplasia (disturbances in the formation process) of the upper articular processes of the sacrum.
- Spine diseases caused by tumors, joint damage, infections, compression fractures, allergic reactions, autoimmune inflammatory processes.
- Musculoskeletal disorders due to subluxation, sprain of spinal ligaments, muscle strain, dysfunction of intervertebral joints.
Pathologies of internal organs
- Disorders of the genitourinary system.
Diseases of the urinary system - urolithiasis, cystitis, pyelonephritis - often cause discomfort in the lumbar region.
Back pain in women may indicate dysfunction of the genital organs. Most often, the main sensations are concentrated in the lower abdomen and radiate to the sacrolumbar spine. They can appear during menstruation or after sexual intercourse.
One of the possible causes of low back pain in women is ovarian tumors, which are located at the back of the uterus. Often, discomfort in the lower back becomes a symptom of uterine fibroids. As it grows, the pain can appear strong and sharp and indicate serious disturbances in blood supply, stretching of the peritoneum and compression of the nerve plexuses in the pelvic area.
Another cause of low back pain in women is pelvic organ prolapse. In this case, the sensations are of a pulling nature. During walking and physical work, their intensity increases.
- Pathologies of the gastrointestinal tract.
Most often, pain is felt in the lumbar region due to gastric and duodenal ulcers and acute pancreatitis. Patients complain that there is pain of a girdling nature. Usually the lower back starts to hurt at the same time as the right/left hypochondrium, where the most intense sensations are concentrated. In numerous clinical cases, lower back pain accompanies an attack of acute appendicitis, although they are not the main symptoms of this disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.
10 risk factors for low back pain
- Congenital pathologies of the lumbosacral spine.
- Heavy physical work associated with stress on the lower back, frequent bending and vibration.
- Acute and chronic stress that causes muscle spasms.
- A sedentary lifestyle and prolonged stay in an unnatural position with load on the lumbar region.
- A weak muscle corset, which causes poor posture, stooping, scoliosis and kyphoscoliosis.
- Metabolic disorders and excess body weight, which increases the load on the lower part of the spine.
- Increased physical activity and sports participation increase the risk of injury.
- Age over 50 years - due to the development of degenerative processes in the spine.
- Frequent stress, depression.
- Poor diet with deficiency of B vitamins.
Lower back pain as a symptom of various diseases
Osteochondrosis of the lumbar spine
One of the most common diseases, the symptom of which is pain in the lumbar region. In osteochondrosis, the intervertebral discs, which provide cushioning between the vertebrae, become thinner. The nerve roots are compressed, muscle spasms occur, and severe sharp pain occurs. Its intensity increases when bending, lifting heavy objects or when the patient tries to sit down from a lying position or get up from a sitting position.
In advanced cases, a hernia forms between the vertebrae, which only increases the pain. Osteochondrosis most often affects the lumbar spine, as it bears the greatest load when sitting and walking.
A serious complication of osteochondrosis is spondylosis. It is characterized by almost complete destruction of intervertebral discs and the formation of sharp bony protrusions - osteophytes. They injure nearby tissues, causing a sharp, severe pain that radiates to one or both legs.
Signs of intervertebral hernia
- The patient can rise from a sitting position only with the support of a chair/table or the knee.
- Any load on the lower back causes an attack of sharp pain.
- The patient lies on his stomach, placing only a pillow under him.
- A person can pick up an object from the floor only by slowly crouching down.
Ankylosing spondylitis
The disease occurs as a result of inflammatory processes in the spine. It is diagnosed most often in men between the ages of 20 and 35. The patient feels stiffness in the lower back and discomfort in the sacrum in the morning and at rest. Gradually during the day this feeling passes, the person "walks". Many people do not pay attention to this alarming symptom; meanwhile, ankylosing spondylitis leads to gradual fusion of the vertebrae, decreased spinal mobility, and disability. Therefore, it is necessary to consult a doctor at the first signs of disease: morning stiffness of the spine.
Spondyloarthrosis
This disease affects the cartilaginous tissue that covers the intervertebral discs. With age, it becomes thinner, destroyed, and bony growths form in places where the cartilage breaks down. Due to the fact that the intervertebral discs rub against each other, the nerve roots are irritated: this process is accompanied by severe lower back pain. The muscles in the problem area of the back are constantly tense and spasming.
Signs of spondyloarthrosis
- The pain becomes more intense after exercise and disappears after rest.
- The pain appears after standing or walking for a long time.
- Simultaneously with lower back pain, the patient feels discomfort in one of the hips and in the hip joint.
Urolithiasis disease
The pain in this pathology is paroxysmal and very intense. Typically, painful sensations arise from the inflamed kidney. It is difficult for the patient to find a position in which he feels better. After attacks, urine becomes reddish in color and its volume decreases.
Inflammation of superficial tissues and fibers
The cause of the pain can be a carbuncle or a boil. These are dense purulent formations on the skin with a diameter greater than 1 cm, easy to notice due to their purple color. The painful sensations are sharp, intense, pulsating.
Paranephritis, an inflammation of the perirenal tissue caused by an infection, is also painful. The sensations become stronger with inhalation and movement. The patient tries to lie down with bent legs: in this position the pain is less pronounced. The skin in the affected area swells and turns red.
Inflammation of the spine, spinal cord
Osteomyelitis is an inflammatory process in the bone marrow that affects all bone tissue. The acute form is characterized by increasing, excruciating and bursting pain. It is combined with signs of intoxication and fever.
Tuberculosis of the spine occurs due to infection with Koch's bacillus. The first signs of the disease can appear many years after infection. It all starts with a deep pain that appears after exercise. The infection affects the vertebrae, hindering the patient's movements and a characteristic gait is formed.
Other diseases
Lower back pain can be a symptom of numerous pathologies, including rather exotic ones. These include, for example, foot-and-mouth disease, Ebola fever, hemorrhagic fevers and Japanese mosquito encephalitis.
- Cardiovascular diseases - abdominal aortic aneurysm, Loeffler endocarditis.
- Myositis is an inflammation and muscle pain in the lower back, which can be caused by infectious diseases such as flu, sore throat and even the common ARVI.
- Benign and malignant tumors of the spine and spinal cord.
- Renal disorders - glomerulonephritis, renal vein thrombosis, pyelonephritis, cysts.
- Low back pain in men occurs with prostate cancer.
Why does my lower back hurt when I cough?
Coughing causes muscle tension in the affected area, causing pain. Often, patients first become aware of a developing disease when they notice pain when coughing. Most often, such sensations are a sign of:
- intervertebral hernia,
- osteochondrosis,
- neuralgia,
- facet arthropathy,
- kidney disease.
Diagnostics
As noted above, pain in the sacrolumbar region can be a symptom of many diseases. Therefore, to identify objective causes, it is necessary to consult a doctor at the first signs. You can make an appointment with an orthopedic doctor, neurologist or surgeon. In the future, you may need to consult a rheumatologist, urologist or gastroenterologist.
- Initial exam.The doctor evaluates tissue sensitivity, muscle function, and reflexes in the affected area.
- X-ray.The examination shows changes in the structure of bones, cartilage and joints.
- Blood and urine tests.With their help, you can determine the presence of infections and inflammatory processes.
- Functional diagnostics.It includes methods to evaluate nerve conduction and muscle performance: electroneurography, electromyography.
- CT and MRI.It allows a detailed examination of the state of bone, muscle, nervous and vascular structures.
- Ultrasoundcarried out if a pathology of the pelvic organs, prostate or kidneys is suspected.
It is important to exclude (or confirm the presence of) a tumor, to distinguish between compression of the spinal roots and painful syndrome of a musculoskeletal nature. Based on the diagnostic data, the doctor will determine the true cause of the pain and prescribe an effective treatment program.
Is bed rest necessary?
None of the recommendations for the treatment of low back pain in diseases of the musculoskeletal system contain instructions on strict bed rest. Instead, patients are advised to return to normal activities as soon as possible to prevent the formation of chronic pain syndrome. In more serious cases, i. e. in case of intense pain, rigorous immobilization for 1-3 days is advisable. For acute pain in the lower back, you can use a fixation belt. However, long-term lumbar fixation is not recommended unless there is trauma or spondylolisthesis. Gradually it is necessary to include special exercises to strengthen the spine and muscles.
Treatment of lower back pain
Most often, a combination of medicinal and non-medicinal agents is needed to resolve the problem.
Drug
The basis of drug therapy is non-steroidal anti-inflammatory drugs (NSAIDs). They influence the peripheral mechanisms of pain formation and are prescribed for exacerbation of pain syndrome. In most clinical cases, treatment is carried out in cycles - no more than 12 weeks.
In most cases, patients are prescribed B vitamins to improve nerve conduction, decongestants and sedatives. In the chronic course of the disease it is possible to take antidepressants. For severe muscle spasms and pain: muscle relaxants, weak opioids.
Non-pharmacological
Additionally, the patient may be prescribed manual therapy, acupuncture (acupuncture). The procedures are aimed at activating metabolism and blood circulation in the affected area. This allows for better tissue nutrition.
According to doctors, physiotherapy, exercises to strengthen the muscles of the lumbar region, traction therapy and transcutaneous electrical neurostimulation have little effect. Most often, these procedures are prescribed in the absence of a pronounced effect from taking the drugs for 4-6 weeks. There is no scientific evidence of the effectiveness of massage, physiotherapy or the use of various belts.
What to do for prevention
- In the morning perform exercises with simple stretching exercises for the spine and muscles.
- Eat rationally, excluding fatty, fried, smoked, salty, spicy and alcoholic foods.
- Watch your weight.
- Drink at least 1. 5 liters of fluids (preferably water) per day.
- Once every 6 months, take a classic massage course.
- Avoid staying in the same position for a long time.
Conclusion
Painful sensations in the lumbar region can be a symptom not only of pathologies of the musculoskeletal system, but also of internal organs. Many patients self-diagnose and treat, for example, a muscle strain, even though the problem may actually be kidney inflammation. Such treatment only aggravates the situation: a person focuses on a non-existent disease and triggers a serious pathology. That is why it is important to seek qualified help and identify the real cause of the pain. Self-prescribing of drugs is strictly not recommended.