Lumbar pain is one of the most common reasons that compel a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be persistent, making movement and self-care impossible. Acute low back pain affects men and women equally frequently.
With a greater frequency in middle and old age, low back pain can often be observed in adolescents and young adults. This is due to rapid growth, weakness in the delicate muscles of the lower back, and injury. Hence, lumbar spine pain is the most pressing problem that anyone can face.
Back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis may increase with any movement from coughing and sneezing, especially when the body leans 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 the tendon reflexes of the legs.
- With osteochondrosis, there is usually a curvature of the lumbar spine. Depending on the level in which the curvature occurs, a distinction is made between scoliosis (curvature to the right or left), lordosis (curvature forwards) and kyphosis (smoothing of the lumbar spine or even its curvature backwards). In the event that the spinal cord is pinched with osteochondrosis, there is a violation of urination or bowel movements, as well as a violation of the sensitivity of the bladder or genitals.
- But most often, lumbar osteochondrosis is manifested by radicular pain - i. H. develops as a result of entrapment of the nerve roots that extend out of 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 exertion or in an awkward posture, sometimes for no apparent reason. Suddenly, within a few minutes or hours, there is a sharp, stabbing pain ("lumbago"), it often burns and bursts ("as if a stake was stuck in the lower back").
The patient freezes in an uncomfortable position, cannot straighten up 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 lower back and sacrum pain. When the patient is asked to stand on their feet, there is great immobility of the entire lumbar region due to muscle tension.
Lumbar sacral osteochondrosis tests
These tests are used for preliminary diagnosis and are named after the doctors who suggested them.
| Dejerine's symptom | As you tense your abs and listen to your lower back, the pain increases. In this case, there is a high possibility that the patient has osteochondrosis. |
| Neri's symptom | If the head is tilted sharply forward before touching the chest and 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 one by one. If after that the lower back is twisted and the pain is directed to the leg along the sciatic nerve, it is evidence of the pathology of the spine. |
| Larrey's symptom | If a person experiences pain along the sciatic nerve after rising forward without bending the knees from a lying position, we speak of manifestations of chondrosis. |
disc prolapse
An equally rare cause is a herniated disc, the clinical manifestation of which is pain in the lumbosacral back. The intervertebral disc (inner nucleus pulposus) loses its elastic properties and elasticity with prolonged traumatic exposure and with increasing age.
With prolonged exposure (obesity, trauma, progressive osteoporosis), the annulus fibrosus of the intervertebral disc becomes thinner and defects form in it. Through these weak points in the annulus fibrosus, the nucleus pulposus of the intervertebral disc can shift and even protrude.
Causes of Back Pain
Back pain is such a non-specific symptom that it can have many different causes. Depending on how much the back hurts in the lumbar area, whether constantly or periodically, primary or secondary, there can be causes:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Growth diseases - scoliosis;
- Infectious lesions of intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Bone Metabolic Diseases - Osteomalacia, Osteoporosis;
- Primary 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 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 circulatory disorders of the spine - stroke;
- Acute pyelonephritis.
Radiant 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, venereal 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;
- Aortic dissection aneurysm.
Physiological causes
Lower 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 worker) or upright lifestyle (vendor, waiters, street signs, surgeons)
- Perform dynamic physical work with a sharp change in body position (especially if your specialty is vigorous physical activity);
- Overload yourself in the gym or health club. Be extremely careful if you have recently started exercising;
- They love working in the summer house;
- Have reached post menopause, which is conducive to the development of osteoporosis.
Back pain and pregnancy
Pregnancy aggravates the manifestations of diseases that exist in the mother's body. Due to changes in the level of hormones and increased loads, pathologies are manifested especially often in the second half of pregnancy. In addition to pain associated with the threat of premature birth, the cause of back pain in a pregnant woman can be:
- Disc prolapse;
- Radiculitis;
- Pancreatitis;
- Pyelonephritis;
- Urolithiasis (kidney stones) disease.
Why does the back hurt below the lower back?
If the back hurts below the lumbar spine, in addition to obvious diseases of the spine (sciatica, lumbago, herniated disc, ankylosing spondylitis, etc. ), 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), in men - diseases of the prostate, bladder.
Lower back pain
If the back hurts on the right above the lower back - this is how liver pain can radiate, with pathological changes in the liver - hepatitis, liver failure, use of toxic drugs. The pain in this case is most often 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 kidney disease, malignant neoplasms of the kidneys, chronic pyelonephritis are accompanied by mild symptoms as the kidney capsule is gradually stretched.
When should you see a doctor?
- When back pain radiates to the lower back and is a little higher (in the chest area). The pain is accompanied by sweating, 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 become weaker, buttocks, genitals become numb.
diagnosis
In order to determine which disease caused lower back pain, a full diagnostic examination is required.
Laboratory methods:
- General and biochemical analyzes of urine and blood.
- Tests for tumor markers that are 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 do you treat low back pain?
How do you properly treat your lower back? The procedure for treating the back depends entirely on the symptoms of the disease, the medical diagnosis and the stage of the disease. Usually an integrated approach that includes multiple treatment modalities is used.
Painkiller. . .The ointment helps with inflammation, stretching and has a warming effect on colds of the lower back.
A distinction is made between the following groups of ointments:
- combined drugs (for sprains and injuries, in addition to anti-inflammatory and analgesic effects, due to their ingredients, they have a healing effect);
- anti-inflammatory analgesics (they contain drugs with a cooling effect that relieve irritation - menthol, lavender and pain relievers);
- Chondroprotectors (one of the active ingredients of such drugs is a substance that is used in pathological processes in cartilage tissue and contributes to the active restoration of the cartilage 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 relieve pain, strengthen muscles and increase the distance between the vertebrae. They help loosen compressed nerve roots, normalize blood flow in the affected area and improve metabolic processes.
In order for such gymnastics to cure and not cripple, 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 should wear clothing that does not restrict movement;
- Exercise is performed when the patient inhales, and when exhaling, he must return to the original position.
- The load increases gradually. First the number of approaches is about 10, then they are increased;
- While doing gymnastics, you should monitor your well-being. When a sharp pain begins, you need to stop your studies.
In addition, the massage is great for relieving pain in the lumbar spine. The beneficial therapeutic effects of massage include:
- Improving blood supply to the diseased part of the body;
- knead the muscles, which makes them and ligaments more flexible and elastic;
- Acute pain relief;
- get rid of toxins accumulated in muscles and subcutaneous tissues;
- pleasant sensations due to stimulation of the nerve endings of the skin;
- positive feelings.
It can be entrusted to a specialist in the clinic or carried out at home, in any case, the benefits will be invaluable.
Which doctor should I go to?
For back pain whose cause is unknown, the first step is to see a therapist. It will help diagnose the disease through a combination of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose against the background of pregnancy, the menstrual cycle or a chronic illness, it makes sense to consult a close specialist immediately.
Self-medication is only permitted if the cause of the pain is precisely known.