Low back pain is one of the most common reasons for a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be permanently disabling, making it impossible to move and take care of yourself. Acute low back pain affects both men and women equally often.
With a greater frequency in middle age and old age, low back pain can often be noticed in adolescents and young adults. This is due to rapid growth, weakness in the fragile muscles of the lower back, injuries. Thus, lumbosacral back pain is the most pressing problem that anyone can face.
Pain in the lower back with lumbar osteochondrosis
Lower back pain with osteochondrosis can increase with coughing and sneezing, with every movement, especially when the body bends forward. Along with back pain, lumbar osteochondrosis can manifest as a violation of the sensitivity of certain skin areas or muscles of the lower half of the trunk and legs, weakening or disappearance of 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 right or left), lordosis (curvature forward) and kyphosis (softening of the lumbar spine or even its curvature backwards) are distinguished. In case, with osteochondrosis, the spinal cord is compressed, 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 - d. m. th. developing as a result of the tightening of nerve roots extending from the spinal cord to one level or another. So one of the popular lumbar syndromes is lumbago. Occurs in moments of physical stress or in a difficult body position, and sometimes for no apparent reason. Suddenly, within minutes or hours, there is a sharp shooting pain ("lumbago"), often it is burning and exploding ("as if a peg had been stuck in the lower back").
The patient rises in an uncomfortable position, can not be directed if an attack occurs at the time of weight lifting. Attempts to get out of bed, coughing or bending one leg are accompanied by a sharp increase in pain in the lower back and sacrum. If the patient is asked to stand, then a sharp immobility of the entire lumbar region is detected due to muscle tension.
Lumbosacral osteochondrosis tests
These tests are used as a way to perform preliminary diagnosis, they are named after the doctors who suggested them.
| Symptoms of Dejerine | if you squeeze the abdomen and listen to the lower back, the pain will become stronger. In this case, there is a high probability that the patient has osteochondrosis. |
| Symptoms of Nerit | 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. |
| Symptoms of lasegue | this can be felt after the following actions: lying on your back, you have to lift each leg in turn. If, after that, the lower back is twisted and pain will be given along the sciatic nerve in the leg, this is evidence of back pathology. |
| Larrey Symptoms | if pain occurs in a person along the sciatic nerve, after he rises forward without bending the knees from a supine position, we are talking about manifestations of chondrosis. |
Disc hernia
A herniated disc is an equally rare cause, the clinical manifestation of which is pain in the lumbosacral spine. The intervertebral disc (inner core of the nucleus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With constant exposure (overweight, trauma, progressive osteoporosis), the annulus fibrosis of the disc becomes thinner and defects are formed in it. Through these weak points in the ring fibrosus, the pulposus nucleus of the disc can be displaced and even protrude.
Causes of back pain
Back pain is such a non-specific symptom that it can be caused by many different reasons. From how intensely it hurts back in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Deforming spondylosis;
- Growth diseases - scoliosis;
- Infectious lesions of the 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 epididymis;
- Emergence of intervertebral discs in the lumbar region;
- Spinal osteochondritis;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis disease;
- Acute fractures, vertebral fractures;
- Lumbago, sciatica;
- Acute spinal circulatory disorders - stroke;
- Acute pyelonephritis.
Illumination of pain in some diseases of the 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;
- Kidney disease - renal colic, kidney stones;
- Dissecting aortic aneurysm.
Physiological causes
Low back pain can occur if:
- They are overweight;
- Additional risk for women;
- You are pregnant or have recently given birth;
- Spend a lot of time driving a car or computer;
- Make a lifestyle mostly sedentary (office worker) or stand-up (salesman, waiter, road signer, surgeon);
- Do dynamic physical work with a sharp change in body position (especially if your specialty is associated with strenuous physical activity);
- Overload yourself at the gym or fitness club. Be extremely careful if you have recently started training;
- They are loved for their summer cottage work;
- 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 manifest especially often in the second half of pregnancy. In addition to the pain that accompanies the threat of premature birth, the cause of low back pain in a pregnant woman can be:
- disc hernia;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why it hurts back down the waist
When the back hurts below the waist, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc. ), the possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as p. sh. inflammation of the appendages of the uterus - oophoritis, salpingo-oophoritis (adnexitis), as well as diseases of the peritoneum of the pelvis, intestines, inflammation of the appendix (appendix of the appendix), in men - diseases of the prostate gland, bladder.
Pain in the lower back
If the back hurts on the right above the lower back - so the liver pain can radiate, with some pathological change in the liver - hepatitis, liver failure, taking toxic medication. The pain in this case is most often localized in the right hypochondrium.
If the pain is felt right or left, just 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 neoplasms of the kidney, chronic pyelonephritis are associated with minor symptoms because the kidney capsule gradually stretches.
When should you see a doctor?
- If the back pain radiates to the lower back, and itself is located slightly above (in the chest area). The pain is accompanied by sweating, periods 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 cord trauma, accompanied by loss of control over bowel movements, urination.
- Legs weaken, buttocks, genitals numb.
Diagnosing
To determine which disease provoked 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 search methods:
- Spine radiography.
- Endoscopy of the 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 treatment of the spine 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, stretch and has a warming effect if the lower back has a cold.
The following groups of oils are distinguished:
- combination medicines (used for contractions and injuries, along with anti-inflammatory and analgesic effects, they have a healing effect due to their constituent substances);
- anti-inflammatory analgesics (they contain medicinal substances with cooling effect that relieve irritation - menthol, lavender and pain relievers);
- chondroprotectors (one of the active ingredients of such drugs is a substance used in pathological processes in cartilage tissues, which contributes to the active restoration of cartilaginous surfaces of joints);
- irritating medications (effect 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, make muscles stronger, increasing 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 be crippled, all the recommendations of the attending physician must be followed.
- The movements are done slowly and smoothly without sharp turns;
- The room should be ventilated before training;
- The patient should wear clothes that do not restrict movement;
- Exercise is done when the patient inhales, and during exhalation he should return to the original position;
- The load gradually increases. First, the number of approaches is about 10, and then they have increased;
- During gymnastics, you should monitor your well-being. If a sharp pain starts, then you should stop studies.
In addition, the massage is excellent for relieving back pain. The positive therapeutic effects of massage include the following:
- improving blood supply to the diseased part of the body;
- muscle kneading, which makes them and ligaments more flexible and elastic;
- acute pain relief;
- removal of toxins accumulated in muscle and subcutaneous tissue;
- pleasant sensations due to stimulation of nerve endings of the skin;
- positive emotions.
It can be entrusted to a specialist in the clinic or performed at home, in any case, the benefits 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 visit a therapist. This will help determine the disease by a combination of symptoms.
If the reason is clear: the pain was preceded by an injury, the pain arose against the background of pregnancy, menstrual cycle or a chronic disease, it makes sense to immediately contact a closer specialist.
Self-medication is permissible only in cases where the exact cause of the pain is known.