Pain in the lower back is one of the most common reasons that force patients to seek help from a neurologist or therapist.Pain in the lumbosacral spine can hinder the ability to work for a long time, making movement and self-care impossible.Acute low back pain affects men and women equally often.
Occurring most frequently in middle age and old age, low back pain can frequently occur in teenagers and young adults.This is due to rapid growth, weakness in the weak muscles of the lower back, and injuries.Thus, lumbosacral back pain is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can intensify with coughing and sneezing, with any movement, especially when tilting the body forward.Along with lower back pain, lumbar osteochondrosis can be manifested by impaired sensitivity of certain areas of the skin or muscles of the lower half of the trunk and legs, weakening or disappearance of tendon reflexes in the legs.
- As a rule, with osteochondrosis, curvature of the lumbar spine is observed.Depending on the plane in which the curvature occurs, scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (flattening of the lumbar region or even its curvature backwards) are distinguished.If, due to osteochondrosis, the spinal cord is pinched, there is a disturbance in urination or defecation, as well as a disturbance in the sensitivity of the bladder or genitals.
- However, most often lumbar osteochondrosis manifests itself as radicular pain - that is, developing as a result of compression of the nerve roots extending from the spinal cord at one level or another.Thus, one of the best-known lumbar syndromes is low back pain.It occurs in a moment of physical stress or in an uncomfortable body position and, sometimes, for no apparent reason.Suddenly, within a few minutes or hours, a sharp pain (“lumbago”) appears, often burning and bursting (“as if a stake were driven into the lower back”).
The patient freezes in an uncomfortable position and cannot straighten up if the attack occurs when lifting something heavy.Attempts to get out of bed, cough or bend the leg are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand, there is marked immobility of the entire lumbar region due to muscle tension.
Tests for lumbosacral osteochondrosis
These tests are used as a way to make a preliminary diagnosis and are named after the doctors who suggested them.
| Dejerine's symptom | If you tense your abdominals and listen to your lower back, the pain will become more severe.In this case, there is a high probability that the patient has osteochondrosis. |
| Neri's symptom | If you sharply tilt your head forward before touching your chest, you will feel pain in your lower back, which also indicates problems with your spine. |
| Lasègue's symptom | this can be felt after the following actions: lying on your back, you need to lift each leg in turn.If after this the lower back begins to twist and the pain radiates along the sciatic nerve to the leg, this is evidence of spinal pathology. |
| Lerrey's symptom | if pain appears in a person along the sciatic nerve, after he rises forward, without bending his knees, in a lying position, we are talking about manifestations of chondrosis. |
Intervertebral disc herniation
Intervertebral disc herniation is an equally rare cause, the clinical manifestation of which is lumbosacral back pain.The intervertebral disc (inner nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With continued exposure (overweight, injuries, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects form.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of low back pain
Back pain is a non-specific symptom that can be caused by a number of different reasons.Depending on the intensity of back pain in the lower back, whether it is constant or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Growing pains – 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.
Sharp pain:
- Spondyloarthritis;
- Hip joint pathologies;
- Spinal epiduritis;
- Protrusion of intervertebral discs in the lumbar region;
- Osteochondrosis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis;
- Acute sprain, vertebral fractures;
- Lumbago, sciatica;
- Acute spinal circulatory disorders - stroke;
- Acute pyelonephritis.
Radiating pain in certain diseases of 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;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Disturbing aortic aneurysm.
Physiological reasons
Lower back pain may occur if you:
- Are you overweight?
- Additional risk for women;
- You are pregnant or have recently given birth;
- Spend a lot of time driving a car or using a computer;
- Lead a predominantly sedentary lifestyle (office workers) or standing (salespeople, waiters, street advertisers, surgeons);
- Do dynamic physical work with sudden changes in body position (especially if your specialty involves intense physical activity);
- You overwork yourself in the gym or at the gym.Be very careful if you have recently started training;
- Are you interested in gardening jobs?
- They have reached post-menopause, which predisposes them to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy aggravates the manifestations of existing diseases in the mother's body.Due to changes in hormonal levels and increased stress, pathologies appear more frequently 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 a pregnant woman may be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my back hurt below my lower back?
When the back hurts below the lumbar region, 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, salpingoophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix(an extension of the cecum, in men - diseases of the prostate, bladder.
Pain above the lower back
If the back hurts on the right, above the lower back, pain in the liver can radiate, with any pathological changes in the liver - hepatitis, liver failure, taking toxic medications.The pain is usually localized in the right hypochondrium.
If the pain is felt on the right or left, just above the lower back, it is very possible that the cause is acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, chronic pyelonephritis, are accompanied by minor symptoms, as the kidney capsule gradually stretches.
When should you see a doctor?
- If the back pain irrigates the lower back and is located a little higher (in the chest region).The pain is accompanied by sweating, bouts of vomiting and nausea, and shortness of breath.
- Pain radiates to the peritoneum, chest, neck, jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Injury to the spine, accompanied by loss of control over bowel movements and urination.
- The legs become weak, the buttocks and genitals become numb.
Diagnosis
To determine which disease caused lower back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical urine and blood tests.
- Tests for tumor markers present in the blood during tumor formation.
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 back pain in the lower back?
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.Typically, an integrated approach is used, including several treatment methods.
Painkillers.The ointment helps relieve inflammation, sprains 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, in addition to anti-inflammatory and analgesic effects, they have a curative effect due to the heparin and demethyl sulfoxide they contain);
- anti-inflammatory analgesics (contain refreshing medicinal substances that relieve irritation - menthol, lavender and painkillers);
- chondroprotectors (one of the active components of these drugs is the substance chondroitin sulfate, used in pathological processes in cartilaginous tissue, promoting 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 can reduce pain, strengthen muscles, 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 this gymnastics to heal and not hurt, it is necessary to follow all the recommendations of the attending physician.
- Movements are made slowly and smoothly, without sharp turns;
- The room must be ventilated before training;
- The patient must wear clothing that does not restrict movement;
- The exercises are done when the patient inhales and when exhaling he needs to return to the original position;
- The load gradually increases.At first, the number of approaches is about 10 and then increases;
- During gymnastics, you must monitor your well-being.If sharp pain begins, you will need to stop your activities.
Furthermore, 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;
- massaging the muscles, which makes them and the ligaments more flexible and elastic;
- relieve acute pain;
- get rid of toxins accumulated in muscles and subcutaneous tissue;
- pleasant sensations due to the stimulation of nerve endings in the skin;
- positive emotions.
It can be entrusted to a specialist in a clinic or carried out at home;in any case, the benefits will be invaluable.
Which doctor should I contact?
If you have back pain whose cause is unknown, consult a doctor first.It will help identify the disease based on the totality of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose during pregnancy, the menstrual cycle or a chronic illness, it makes sense to immediately contact a more specialized specialist.
Self-medication is only permitted if the cause of the pain is precisely known.