Low back pain is one of the most common reasons forcing a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be permanently disabling, making movement and self-care impossible. Acute low back pain affects men and women equally often.
Most often in middle and old age, low back pain can often be seen in adolescents and young adults. This is due to rapid growth, weakness in the fragile muscles of the lower back, injuries. Therefore, pain in the lumbosacral spine is the most urgent problem that anyone can face.
Low back pain with lumbar osteochondrosis
Low back pain with osteochondrosis can increase when 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 to the left), lordosis (curvature forward) and kyphosis (smoothing of the lumbar spine or even its curvature backwards) 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, lumbar osteochondrosis is most often manifested by radicular pain, that is, it develops as a result of pinching of the nerve roots that extend from the spinal cord at one level or another. So, one of the best known lumbar syndromes is lumbago. It occurs at the time of physical stress or in an uncomfortable position of the body, and sometimes for no apparent reason. Suddenly, within minutes or hours, there is a sharp stabbing pain ("lumbago"), often burning and bursting ("as if a stake had been driven into the lower back").
The patient freezes in an uncomfortable position, cannot straighten up if an attack occurs at the time of 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, acute immobility of the entire lumbar region is revealed due to muscle tension.
Lumbosacral osteochondrosis tests
These tests are used as a way to make preliminary diagnoses, they are named after the doctors who suggested them.
| Dejerine's symptom | If you contract your abs and listen to your lower back, the pain will intensify. 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. |
| Lasegue symptom | this can be felt after the following actions: lying on your back, you need to lift each leg in turn. If, after that, the lower back is twisted and the pain will be administered along the sciatic nerve to the leg, this is evidence of the pathology of the spine. |
| Larrey's symptom | if 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. |
Disc herniation
A herniated disc is an equally rare cause, the clinical manifestation of which is pain in the lumbosacral back. The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With continuous exposure (overweight, trauma, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects form in it. Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of back pain
Back pain is such a nonspecific symptom that it can be caused by many different reasons. Due to the intensity with which the back hurts in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondyloarthritis;
- Deforming spondylosis;
- Growth diseases: scoliosis;
- Infectious lesions of intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Metabolic bone diseases: osteomalacia, osteoporosis;
- Primary tumors 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.
Acute pain:
- Spondyloarthritis;
- Hip joint pathology;
- Spinal epiduritis;
- Bulging of intervertebral discs in the lumbar region;
- Osteochondritis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis disease;
- Acute sprains, vertebral fractures;
- Lumbago, sciatica;
- Acute spinal circulation disorders - stroke;
- Acute pyelonephritis.
Radiating pain in some diseases of the internal organs:
- Pelvic organ diseases. In women: inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, STDs (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;
- Dissecting aortic aneurysm.
Physiological causes
Low back pain can occur if you:
- Have overweight;
- Additional risk for women;
- You are pregnant or have recently given birth;
- Spend a lot of time driving a car or computer;
- Lead a predominantly sedentary lifestyle (office workers) or standing (salespeople, waiters, street markers, surgeons);
- Carry out dynamic physical work with a sharp change in the position of the body (especially if your specialty is associated with intense physical activity);
- Overload at the gym or the gym. Be very careful if you started training recently;
- They like working in summer houses;
- Having reached postmenopause, which favors the development of osteoporosis.
Low back pain and pregnancy
Pregnancy aggravates the manifestations of diseases that exist in the mother's body. Due to changes in hormonal levels and increased loads, pathologies manifest themselves especially often in the second half of pregnancy. In addition to the pain that accompanies the threat of premature labor, the cause of low back pain in a pregnant woman can be:
- herniated disc;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis disease (kidney stones).
Why does the back hurt under the lower back?
When the back hurts below the lumbar area, in addition to obvious spinal diseases (sciatica, lumbago, intervertebral hernias, ankylosing spondylitis, etc. ), the possible causes are periodic pain during menstruation in women, diseases of thefemale genitalia, such as inflammation of the uterine appendages - oophoritis, salpingo-oophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (cecum appendix), in men - diseases of the prostate gland, bladder.
Pain above the lower back
If your back hurts right above the lower back, so the liver pain can radiate, with any pathological changes in the liver, hepatitis, liver failure, take toxic drugs. The pain in this case is most often localized in the right hypochondrium.
If the pain is felt to the right or to the left, just above the lower back, the cause is very likely acute kidney disease. Many chronic kidney diseases such as polycystic kidney disease, kidney malignant neoplasms, 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 itself is located a little higher (in the chest area). The pain is accompanied by sweating, episodes of vomiting and nausea, shortness of breath.
- The pain radiates to the peritoneum, chest, neck, and jaw.
- The patient is dizzy and confused.
- The 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 the low back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical analysis of urine and blood.
- Tests for tumor markers present in the blood during tumor formation.
Instrumental research methods:
- X-ray of the spine.
- Endoscopy of intestines, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance imaging.
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 medication. . .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 drugs (used for sprains and injuries, together with anti-inflammatory and analgesic effects, have a healing effect due to their constituent substances);
- anti-inflammatory painkillers (they contain medicinal substances with a cooling effect that relieve irritation: menthol, lavender and painkillers);
- chondroprotectors (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 cartilaginous surfaces of the joints);
- irritant medications (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, and increase the distance between the vertebrae. They will help to release compressed nerve roots, normalize blood flow in the affected area, and improve metabolic processes.
In order for such gymnastics to heal and not be rendered useless, all the recommendations of the attending physician should be followed.
- The 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 when exhaling he needs to return to the original position;
- The load gradually increases. First, the number of focuses is about 10 and then they are increased;
- During gymnastics, you need to monitor the well-being of her. If acute pain begins, she must stop her studies.
In addition, 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 carried out at home, in any case, the benefits will be invaluable.
Which doctor should I see?
For back pain, the cause of which is unknown, the first step is to consult a therapist. She will help determine the disease through a combination of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose in the context of pregnancy, the menstrual cycle or a chronic illness, it makes sense to immediately contact a more limited specialist.
Self-medication is only allowed in cases where the cause of the pain is precisely known.