Pain in the lumbar region is one of the most common reasons that force the patient to seek help from a neurologist or therapist.Pain in the lumbosacral spine can disrupt the ability to work for a long time, making movement and self-care impossible.Acute lower back pain often affects both men and women.
Low back pain, which is more common in middle and old age, often occurs in adolescents and young adults.This is due to rapid growth, weak lower back muscles and injuries.Thus, lumbosacral back pain is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Osteochondrosis back pain can be aggravated by coughing and sneezing, by any movement, especially by bending the body forward.In addition to lower back pain, lumbar osteochondrosis can manifest itself in the sensitivity of certain areas of the skin or the muscles of the trunk and lower half of the legs, with the weakening or disappearance of tendon reflexes in the legs.
- Generally, in case of osteochondrosis, the curvature of the lumbar spine is observed.Depending on the plane in which the curvature occurs, we distinguish between scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (flattening or even backward curvature of the lumbar region).If the spinal cord is pinched due to osteochondrosis, it causes disturbance in urination or defecation, as well as sensitivity of the bladder or genitals.
- However, lumbar osteochondrosis most often manifests itself as radicular pain - that is, it develops as a result of pinching of the nerve roots extending from the spinal cord at one level or another.Thus, one of the well-known lumbar syndromes is lumbago.It occurs at a 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 burning and cracking ("like a stake stuck in the lower back").
The patient freezes in an uncomfortable position and cannot straighten up if the attack occurs while lifting a heavy object.Attempts to get out of bed, cough or bend the legs are associated with a sharp 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.
Examination of lumbosacral osteochondrosis
These tests are used to make a preliminary diagnosis and are named after the doctors who recommended them.
| Dejerine's symptom | If you tighten your stomach and listen to your waist, the pain will be stronger.In this case, there is a high probability that the patient has osteochondrosis. |
| Neri's symptom | If you tilt your head sharply forward before touching your chest, feel pain in the lower back, this also indicates problems with the spine. |
| Lasègue's symptom | this can be felt after the following actions: lying on your back, lift each leg.If, after that, 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 occurs in a person along the sciatic nerve after rising forward, without bending the knees, from a lying position, then we are talking about the manifestations of chondrosis. |
Intervertebral disc herniation
An equally rare cause is intervertebral disc herniation, the clinical manifestation of which is lumbosacral back pain.The intervertebral disc (internal nucleus pulposus) loses its elastic properties and flexibility with prolonged traumatic exposure and with age.
In the case of continuous exposure (overweight, injury, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects occur in it.Through these weak points of the annulus fibrosus, the nucleus pulposus of the disc can move and even protrude.
Causes of lower back pain
Back pain is a non-specific symptom that can be caused by many different causes.Depending on how intense the back pain in the lumbar region is, whether it is constant or periodic, primary or secondary, its causes may be:
Chronic pain:
- osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Growing pains - 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 aorta and its branches.
Acute pain:
- Spondyloarthritis;
- Pathologies of the hip joint;
- Spinal epiduritis;
- Protrusion of the intervertebral discs in the lumbar region;
- Osteochondrosis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, an atypical course of acute appendicitis;
- Urolithiasis;
- Acute sprain, vertebral fractures;
- Lumbago, sciatica;
- Acute spinal cord circulatory disorders - stroke;
- Acute pyelonephritis.
Radiating pain in diseases of certain internal organs:
- Diseases of the pelvic organs.In women - inflammatory processes in the appendages of the uterus, endometriosis, uterine cancer, ovarian cancer, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc.) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gall bladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- kidney diseases - renal colic, kidney stones;
- Exciting aortic aneurysm.
Physiological reasons
Lower back pain can occur if:
- Are you overweight?
- Additional risk for women;
- You are pregnant or have recently given birth;
- Spend a lot of time driving or using a computer;
- Lead a predominantly sedentary (office workers) or standing (salesmen, waiters, street advertisers, surgeons) lifestyle;
- Perform dynamic physical work with a sudden change in body position (especially if your specialty involves heavy physical activity);
- You overexert yourself in the gym or fitness club.Be extra careful if you've just started exercising;
- Are you interested in gardening?
- They have reached postmenopause, which predisposes them to osteoporosis.
Back pain and pregnancy
Pregnancy aggravates the manifestations of diseases in the mother's body.Due to changes in hormone levels and increased stress, pathologies appear especially often in the second half of pregnancy.In addition to the pain accompanying the risk of premature birth, lower back pain in pregnant women can be caused by:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stone).
Why does my lower back hurt?
If the back hurts below the lower back, in addition to obvious spinal diseases (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 inflammation of the uterine appendage - oophoritis, and kidney diseases (e.g. peritoneum, intestines, inflammatory appendix (prolongation of the appendix, in men -prostate and bladder diseases.
Pain in the lower back
If the back hurts on the right side above the lower back, the pain in the liver 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 on the right or left side, directly at the lower back, it is very likely that the cause lies in acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, chronic pyelonephritis, have minor symptoms because 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 area).The pain is accompanied by sweating, vomiting and nausea, as well as shortness of breath.
- The pain radiates to the peritoneum, chest, neck, and jaw.
- The patient is dizzy and confused.
- Tachycardia begins
- Spinal injury accompanied by loss of control over defecation and urination.
- The legs become weak, the buttocks and genitals become numb.
Diagnostics
In order to determine what disease caused the back pain, a comprehensive diagnostic examination should be performed.
Laboratory methods:
- General and biochemical examination of urine and blood.
- Examination of 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 lumbar region?
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.They usually use an integrated approach that includes several treatment methods.
Pain relievers.The ointment helps relieve inflammation, sprains, and has a warming effect when the lower back is cold.
We distinguish the following groups of ointments:
- combined medicines (used for sprains and injuries, in addition to their anti-inflammatory and pain-relieving effects, they have a healing effect due to the heparin and demethyl sulfoxide contained in them);
- anti-inflammatory pain relievers (contain cooling medicinal substances that relieve irritation - menthol, lavender and pain relievers);
- chondroprotectors (one of the active ingredients of such drugs is chondroitin sulfate, which is used in pathological processes of cartilage tissue, promoting the active restoration of the cartilaginous surfaces of the joints);
- irritant 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 the muscles, and increase the distance between the vertebrae.They 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 become a cripple, all the recommendations of the attending physician must be followed.
- Movements are slow and smooth, without sharp turns;
- Before training, the room must be ventilated;
- The patient should wear clothing that does not restrict movement;
- Exercises should be performed when the patient inhales, and when exhaling, he must return to the original position;
- The load increases gradually.At first, the number of approaches is about 10, then they increase;
- During the tournament, you need to monitor your well-being.If a sharp pain begins, you should stop your activity.
In addition, massage is excellent for relieving pain in the lumbar spine.The positive therapeutic effects of massage are as follows:
- improves blood supply in the diseased part of the body;
- kneading the muscles, which makes them and ligaments more elastic and flexible;
- relief of acute pain;
- get rid of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensations due to the stimulation of the nerve endings of the skin;
- positive emotions.
It can be performed by a trusted specialist at the clinic or at home;in any case, the benefits from this will be invaluable.
Which doctor should I see?
If you have back pain for which the cause is unknown, you should first see a doctor.It helps to identify the disease based on the set of symptoms.
If the cause is obvious: the pain was preceded by an injury, the pain arose during pregnancy, the menstrual cycle or a chronic illness, it is worth contacting a more specialized specialist immediately.
Self-medication is allowed only if the cause of the pain is precisely known.