Lumbar pain is one of the most common reasons why a patient is forced to seek the help of a neurologist or therapist. Pain in the lumbosacral spine can permanently disable, making movement and self-care impossible. Acute low back pain affects men and women equally often.
With a higher incidence in middle and old age, lower back pain can often be noticed in adolescents and young adults. This is due to rapid growth, weakness of the fragile muscles of the lower back, injuries. Therefore, pain in the lumbosacral spine is the most important problem anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain in osteochondrosis can be exacerbated by coughing and sneezing, with any movement, especially when the body bends forward. Along with back pain, lumbar osteochondrosis can manifest as a violation of the sensitivity of certain areas of skin or muscles of the lower half of the torso and legs, weakening or disappearance of tendon reflexes of the legs.
- As a rule, in osteochondrosis there is a curvature of the lumbar spine. Depending on the plane in which the curvature differs, there are scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (smoothing of the lumbar spine or even its curvature backwards). In the case of osteochondrosis, the spinal cord tightens, 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 - ie. they develop as a result of constriction of nerve roots extending from the spinal cord at one level or another. So, one of the well-known lumbar syndromes is lumbago. It occurs at a time of physical stress or in an awkward body position, and sometimes for no apparent reason. Suddenly, within minutes or hours, there is a sharp shooting pain ("lumbago"), often burning and shooting ("as if the stake was stuck in the lower back").
The patient freezes in an awkward position, it cannot be corrected if the attack occurs at the time of lifting the load. Attempts to get out of bed, cough or bend the leg are accompanied by a sudden increase in pain in the lower back and sacrum. If the patient is asked to stand on his feet, a sharp immobility of the entire lumbar region is revealed due to muscle tension.
Lumbosacral tests for osteochondrosis
These tests are used as a way to conduct a preliminary diagnosis, and are named after the doctors who suggested them.
| Dejerina's symptom | if you tighten your abdominal muscles 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 you tilt your head abruptly forward before touching your chest, there is pain in your lower back, this also indicates problems with your 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 part of the back is distorted and the pain will be born along the sciatic nerve to the leg, that is proof of the pathology of the spine. |
| Larrey's symptom | if a person develops pain along the sciatic nerve, after he rises forward without bending his knees from a lying position, we are talking about the manifestations of chondrosis. |
Disc herniation
Disc herniation is an equally rare cause whose clinical manifestation is lumbosacral back pain. The intervertebral disc (inner nucleus pulposus) loses its elastic properties and elastic capacity with prolonged traumatic exposure, as well as with aging.
With constant exposure (overweight, trauma, progressive osteoporosis), the annular fibrosus of the disc becomes thinner and defects occur in it. Through these weak points in the annular fibrosus, the nucleus pulposus of the disc can move and even protrude.
Causes of back pain
Back pain is such a non-specific symptom that it can be caused by many reasons. How intensely the back hurts in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons for this:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformities;
- 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 aorta and its branches.
Acute pain:
- Spondyloarthritis;
- Hip joint pathology;
- Spinal epiduritis;
- Protrusion of intervertebral discs in the lumbar region;
- Osteochondritis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, an atypical course of acute appendicitis;
- Urolithiasis disease;
- Acute sprains, vertebral fractures;
- Lumbago, sciatica;
- Acute disorders of spinal circulation - stroke;
- Acute pyelonephritis.
Radiation pain in some diseases of internal organs:
- Diseases of the pelvic organs. In women - inflammatory processes in the appendages of the uterus, 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;
- Renal diseases - renal colic, kidney stones;
- Aneurysm for aortic dissection.
Physiological causes
Low back pain can occur if:
- Are overweight;
- Additional risk for women;
- You are pregnant or have recently given birth;
- You spend a lot of time driving a car or computer;
- Leads mostly inactive (office workers) or upright (salesmen, waiters, street signatories, surgeons);
- Engage in 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 extremely careful if you have recently started training;
- You love working on summer cottages;
- They have reached postmenopause, which affects 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 load, pathologies are especially common in the second half of pregnancy. In addition to the pain that accompanies the threat of premature birth, the cause of lower back pain in pregnant women can be:
- disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones) disease.
Why the back hurts below the lower back
When the back hurts below the lumbar, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc. ), possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages - oophoritis, salpingo-oophoritisadnexitis), as well as diseases of the pelvic peritoneum, intestines, appendicitis (appendicitis), in men - diseases of the prostate, bladder.
Pain above the lower back
If the back hurts right above the lower back - so hepatic 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 right or left slightly above the lower back, it is very possible that the cause lies in acute kidney disease. Many chronic kidney diseases such as polycystic kidney disease, malignant kidney tumors, and chronic pyelonephritis are accompanied by small symptoms because the kidney capsule gradually expands.
When should you see a doctor?
- If the back pain radiates to the lower back, and they themselves are located slightly higher (in the chest area). Pain is accompanied by sweating, attacks of vomiting and nausea, shortness of breath.
- The pain radiates to the peritoneum, chest, neck, jaw.
- The patient is dizzy and confused.
- Tachycardia begins.
- Spinal trauma, followed by loss of control over defecation, urination.
- Legs weak, buttocks, genitals numb.
Diagnosis
In order to determine which disease caused the pain in the lower back, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical analyzes 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 the intestine, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance imaging.
How to treat back pain?
How to properly treat the lower back? The approach to treating the back depends entirely on the symptoms of the disease, the diagnosis made by the doctor and the stage of the disease. An integrated approach that involves several treatment methods is usually used.
Pain medications. . .The ointment helps relieve inflammation, stretching and has a warming effect if the lower back has a cold.
The following groups of fats are distinguished:
- combined drugs (used for sprains and injuries, together with anti-inflammatory and analgesic effects, have a healing effect due to the constituent substances);
- anti-inflammatory analgesics (contain drugs with cold action 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 regeneration of the cartilaginous 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, increasing the distance between the vertebrae. It will help release compressed nerve roots, normalize blood flow in the affected area and improve metabolic processes.
In order for such gymnastics to heal rather than maim, all the recommendations of the attending physician must be followed.
- The movements are performed slowly and smoothly, without sharp bends;
- 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 on exhalation he must return to his original position;
- The load gradually increases. First, the number of accesses is about 10, and then they increase;
- You should monitor your well-being during gymnastics. If sharp pain starts, you must stop the studies.
In addition, massage is great for relieving pain in the lumbar spine. The positive therapeutic effects of massage include the following:
- improving the blood supply to the diseased part of the body;
- kneading muscles, which makes them and ligaments more flexible and elastic;
- relief of acute pain;
- resolving toxins accumulated in muscle 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 of this will be invaluable.
Which doctor should I go to?
For back pain, the cause of which is unknown, the first step is to visit a therapist. It will help diagnose the disease by a combination of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose in the background of pregnancy, menstrual cycle or chronic illness, it makes sense to immediately consult a specialist.
Self-medication is allowed only in cases when the cause of the pain is exactly known.