Lumbar 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 lower back pain affects both men and women equally often.
With a greater frequency in middle and old age, lower back pain can often be observed in adolescents and young adults. This is due to rapid growth, weakness in the fragile muscles of the lower back, injuries. Thus, pain in the lumbosacral spine is the most pressing problem that anyone can face.
Low back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can increase with coughing and sneezing, with any movement, especially when the body bends 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 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 curvature backward) 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 - i. e. developing as a result of pinching of the 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 the moment of physical stress or in an awkward position of the body, and sometimes for no apparent reason. Suddenly, within a few minutes or hours, there is a sharp shooting pain ("lumbago"), often it is burning and bursting ("as if a stake had been stuck in the lower back").
The patient freezes in an uncomfortable position, cannot straighten out 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 on his feet, then a sharp immobility of the entire lumbar region is revealed due to muscle tension.
Lumbosacral osteochondrosis tests
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 tighten your abdominals 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 forward sharply 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 given 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. |
Herniated disc
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 continued exposure (overweight, trauma, progressive osteoporosis), the annulus fibrosus 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 non-specific 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 may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- 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;
- Pathology of the hip joint;
- Spinal epiduritis;
- Protrusion of intervertebral discs in the lumbar region;
- Osteocondritis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis disease;
- Acute sprains, vertebral fractures;
- Lumbago, sciatica;
- Acute disorders of the spinal circulation - stroke;
- Acute pyelonephritis.
Irradiating 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, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc. ) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Bowel diseases - inflammation of the diverticulum, ulcerative colitis, bowel tumors;
- Kidney disease - renal colic, kidney stones;
- Aortic dissecting aneurysm.
Physiological causes
Low back pain can occur if you:
- Are 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 (office workers) or stand-up (vendors, waiters, street signers, surgeons) lifestyle;
- Do dynamic physical labor with a sharp change in body position (especially if your specialty is associated with heavy physical activity);
- Overloading yourself in the gym or fitness club. Be extremely careful if you started training recently;
- Are you fond of 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 are especially often manifested in the second half of pregnancy. In addition to pain accompanying the threat of premature birth, the cause of lower back pain in a pregnant woman can be:
- herniated disc;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones) disease.
Why does the back hurt below the lower back
When the back hurts below the lumbar, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernias, 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-oophoritis(adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (appendix of the blind intestine), in men - diseases of the prostate gland, bladder.
Pain above the lower back
If the back hurts on the 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 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 possible that the cause lies in acute kidney disease. Many chronic kidney diseases such as polycystic kidney disease, 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 back pain radiates to the lower back, and itself is located slightly higher (in the chest area). 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 dizzy and confused.
- Tachycardia begins.
- Spinal trauma, accompanied by loss of control over bowel movements, urination.
- Legs grow weak, buttocks and genitals grow numb.
Diagnostics
In order to determine which disease provoked lower back pain, 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 the formation of tumors.
Instrumental research methods:
- X-ray of the spine.
- 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 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 to 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, they have a healing effect due to their constituent substances);
- anti-inflammatory analgesics (they contain medicinal substances with a cooling effect that relieve irritation - menthol, lavender, and pain relievers);
- chondroprotectors (one of the active components of such drugs is a substance used in pathological processes in cartilaginous tissue, which contributes to the active restoration 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, make muscles strong, increasing the distance between the vertebrae. They will help release compressed nerve roots, normalize blood flow in the affected area, and improve metabolic processes.
In order for such gymnastics to heal, and not cripple, it is necessary to follow all the recommendations of the attending physician.
- Movements are done slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothing that does not restrict movement;
- Exercise is done when the patient inhales, and on exhalation he needs to return to the original position;
- The load increases gradually. First, the number of approaches is about 10, and then they are increased;
- During gymnastics, you should monitor your well-being. If a sharp pain begins, then you need to stop your studies.
In addition, massage is excellent 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 the muscles, which makes them and the ligaments more flexible and elastic;
- relief of acute pain;
- getting rid of toxins accumulated in 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 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 see a therapist. It will help determine the disease by a combination of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose against the background of pregnancy, menstrual cycle or chronic illness, it makes sense to immediately contact a narrower specialist.
Self-medication is permissible only in cases where the cause of the pain is precisely known.