Pain in the lumbar region is one of the most common reasons that force a 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 back pain affects both men and women equally often.
Commonly occurring in middle and old age, low back pain can often appear in teenagers and young adults.This is due to rapid growth, weakness in weak back muscles and injuries.Thus, lumbosacral back pain is an urgent problem that anyone can face.
Pain in the lower back with lumbar osteochondrosis
Lower back pain with osteochondrosis can intensify with coughing and sneezing, with any movement, especially when bending the body forward.Along with back pain, lumbar osteochondrosis can be manifested by impaired sensitivity of certain areas of the skin or muscles of the lower half of the torso and legs, weakening or disappearance of leg tendon reflexes.
- As a rule, with osteochondrosis, the 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 backward curvature) are distinguished.If, due to osteochondrosis, the spinal cord is compressed, there is a disturbance in urination or defecation, as well as a disturbance in the sensitivity of the bladder or genitals.
- However, more often lumbar osteochondrosis manifests as radicular pain - i.e.develops as a result of entrapment 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 it burns and bursts ("as if a pole was stuck in the lower back").
The patient freezes in an uncomfortable position and cannot stand if the attack occurs while 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, a sharp immobility of the entire lumbar region is revealed 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.
| Symptom of fatigue | If you strain your stomach 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 you bend your head strongly forward before touching your chest, experience 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, you need to lift each leg in turn.If after that the lower back begins to twist and the pain radiates along the sciatic nerve in 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 the knees, from 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 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 ability.
With continued exposure (excess weight, injury, progressive osteoporosis), the fibrous annulus of the disc becomes thinner and defects are created in it.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can be displaced and even protrude.
Causes of back pain
Back pain is a non-specific symptom that can be caused by many different reasons.Depending on how intense the back pain in the lumbar region is, 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.
Acute pain:
- Spondyloarthritis;
- Hip joint pathologies;
- Spinal epiduritis;
- Prolongation of the intervertebral discs in the lumbar region;
- Osteochondrosis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis;
- Acute compression, vertebral fracture;
- Lumbago, sciatica;
- Acute disorders of spinal circulation - stroke;
- Acute pyelonephritis.
Radiating pain in certain diseases of 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, gall bladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Disturbing Aortic Aneurysm.
Physiological reasons
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 a car or using a computer;
- Lead a lifestyle that is mainly sitting (office workers) or standing (salesmen, waiters, street advertising workers, surgeons);
- Do dynamic physical work with sudden changes in body position (especially if your specialty involves heavy physical activity);
- You overexert yourself at the gym or fitness club.Be extremely careful if you have recently started exercising;
- Are you interested in gardening jobs?
- They have reached postmenopause, which is predisposed to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy worsens the manifestations of diseases that exist in the mother's body.Due to changes in hormonal levels and increased stress, pathologies appear especially often in the second half of pregnancy.In addition to the pain that accompanies the threat of premature birth, the cause of back pain in a pregnant woman can be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my lower back hurt?
When the back hurts below the lower back, 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 inflammation of the appendages of the uterus - oophoritis, diseases of the salpingophore, intestines, appendix inflammation (an extension of the cecum, in men - diseases ofprostate gland, bladder.
Pain over the lower back
If the back hurts on the right above the lower back, liver pain can radiate, with any pathological changes in the liver - hepatitis, liver failure, taking toxic medications.The pain 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 likely 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 renal capsule gradually expands.
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, attacks of vomiting and nausea and shortness of breath.
- The pain radiates to the peritoneum, chest, neck, jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Spinal cord injury, accompanied by loss of control over bowel movements and urination.
- The legs become weak, the buttocks and genitals become numb.
Diagnosing
To determine which disease caused the back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical tests of urine and blood.
- Tests for tumor markers present in the blood during tumor formation.
Instrumental research methods:
- X-ray of the spine.
- Endoscopy of 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.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 is cold.
The following groups of ointments are distinguished:
- combined medications (used for sprains and injuries, along with anti-inflammatory and analgesic effects, they have a healing effect due to the heparin and demethyl sulfoxide they contain);
- anti-inflammatory analgesics (contain cooling medicinal substances that relieve irritation - menthol, lavender and sedatives);
- chondroprotectors (one of the active ingredients of such drugs is the substance chondroitin sulfate, used in pathological processes in cartilage tissue, promoting active restoration of cartilage surfaces of 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, 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 participating doctor.
- Movements are made slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothes that do not restrict movement;
- Exercises are done when the patient breathes, and during exhalation he must return to the original position;
- The load increases gradually.At first the number of approaches is about 10, and then they increase;
- During gymnastics, you should monitor your well-being.If sharp pain begins, you should stop your activities.
In addition, massage is excellent in relieving lower back pain.The positive therapeutic effects of massage include the following:
- improvement of blood supply to the diseased part of the body;
- boiling of muscles, which makes them and ligaments more flexible and elastic;
- relief of acute pain;
- removal of toxins accumulated in muscles and subcutaneous tissue;
- pleasant sensations due to the stimulation of the nerve endings of the skin;
- positive emotions.
It can be entrusted to a specialist in a clinic or carried out at home;in any case, the benefits from it will be invaluable.
Which doctor should I contact?
If you have back pain, the cause of which is unknown, you should first consult a doctor.It will help to identify the disease based on the totality of symptoms.
If the reason is clear: the pain was preceded by an injury, the pain appeared during pregnancy, the menstrual cycle or a chronic disease, it makes sense to immediately contact a more specialized specialist.
Self-medication is allowed only if the exact cause of the pain is known.