Low back pain is one of the most common reasons forcing patients to seek help from a neurologist or therapist.Pain in the lumbosacral spine can disrupt the ability to work for a long time, leaving the patient unable to move and care for themselves.Acute back pain affects both men and women equally often.
Occurring with greater frequency in middle age and the elderly, low back pain can often occur in adolescents and young adults.This is due to rapid growth, lower back muscle weakness, and injury.Therefore, lumbosacral back pain is an urgent problem that anyone can encounter.
Lower back pain due to lumbar spondylosis
Lower back pain due to osteoarthritis can increase with coughing and sneezing, with any movement, especially when bending forward.Along with lower back pain, lumbar osteoarthritis can be manifested by a decrease in the sensitivity of certain areas of the skin or muscles in the lower half of the trunk and legs, weakening or disappearing tendon reflexes of the legs.
- As a rule, with osteoarthritis, curvature of the lumbar spine is observed.Depending on the plane in which the curvature occurs, one distinguishes scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (flattening of the lumbar region or even curvature to the back).If due to osteoarthritis, the spinal cord is compressed, there will be urinary or defecation disorders as well as disorders of the sensitivity of the bladder or genital organs.
- However, lumbar cartilage degeneration often manifests itself in the form of radicular pain - that is, it develops due to compression of nerve roots extending from the spinal cord at one level or another.Therefore, one of the well-known low back syndromes is low back pain.It occurs at times when the body is stressed or in an awkward position and sometimes for no apparent reason.Suddenly, within minutes or hours, a sharp pain (“low back pain”) appears, often burning and explosive (“as if a stake was stuck in the lower back”).
The patient freezes in an uncomfortable position and is unable to stand upright if the pain occurs while lifting heavy objects.Attempts to get out of bed, cough or bend the legs are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand on his feet, the entire lumbar region will become visibly immobile due to muscle tension.
Tests for lumbosacral bone degeneration
These tests are used as a way to make a preliminary diagnosis and are named after the doctors who recommended them.
| Symptoms of Dejerine | If you tense your abdominal muscles and listen to your lower back, the pain will become stronger.In this case, there is a high possibility that the patient has osteoarthritis. |
| Neri's symptoms | If you strongly tilt your head forward before touching your chest, you will feel pain in the lower back, which also indicates a problem with the spine. |
| Lasègue symptoms | This can be felt after the following actions: lying on your back, you need to lift each leg in turn.If then the lower back begins to twist and pain spreads along the sciatic nerve to the leg, this is evidence of spinal pathology. |
| Lerrey's symptoms | If pain appears in a person along the sciatic nerve, after the person stands forward without bending the knees, from a lying position, we are talking about manifestations of cartilage disease. |
Disc herniation
Disc herniation is an equally rare cause, clinically manifesting as lumbosacral pain.The intervertebral disc (inner nucleus pulposus) when subjected to prolonged injury as well as with age, will lose its elastic properties and resilience.
With constant exposure (overweight, trauma, progressive osteoporosis), the fibrous ring of the intervertebral disc becomes thinner and defects form in it.Through these weak spots in the annulus fibrosus, the nucleus pulposus of the intervertebral disc can shift and even protrude.
Causes of lower back pain
Back pain is a non-specific symptom and can have many different causes.Depending on the level of back pain in the lumbar region, whether it is continuous or periodic, primary or secondary, there may be the following causes:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Degenerative spinal deformity;
- Increasing pain - scoliosis;
- Infectious lesions of the intervertebral disc and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Metabolic bone diseases - osteomalacia, osteoporosis;
- Primary and metastatic tumors of the spinal cord, vertebrae, and retroperitoneal space;
- Non-infectious inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
- Kidney tumor;
- Atherosclerosis of the abdominal aorta and its branches.
Acute pain:
- Spondylitis;
- Hip joint pathology;
- Spinal laminitis;
- Protrusion of the intervertebral disc in the lumbar region;
- Spinal degeneration;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical acute appendicitis;
- urinary stones;
- Acute sprains, vertebral fractures;
- Low back pain, sciatica;
- Acute spinal circulatory disorders - stroke;
- Acute pyelonephritis.
Diffuse pain in some diseases of internal organs:
- Diseases of the pelvic organs.In women - inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, sexually transmitted diseases (chlamydia, ureaplasmosis, gonorrhea, trichomonas, etc.) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Intestinal diseases - diverticulitis, ulcerative colitis, intestinal tumors;
- Kidney disease - abdominal pain, kidney stones;
- Unpleasant aortic aneurysm.
Physiological causes
Lower back pain can occur if you:
- Are you overweight?
- Additional risks for women;
- You are pregnant or have just given birth;
- Spend a lot of time driving or using the computer;
- Have a lifestyle that is mainly sedentary (office workers) or standing (salesmen, waiters, street advertising workers, surgeons);
- Perform dynamic physical labor with sudden changes in body position (especially if your specialty involves heavy physical activity);
- You overload the gym or fitness club.Be extremely careful if you have recently started working out;
- Are you interested in gardening?
- Having reached menopause, this easily leads to the development of osteoporosis.
Back pain and pregnancy
Pregnancy worsens the symptoms of existing diseases in the mother's body.Due to changes in hormone levels and increased stress, special pathologies often appear in the second half of pregnancy.In addition to the pain that comes with the risk of premature birth, causes of lower back pain in pregnant women can be:
- disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urinary stones (kidney stones).
Why does my lower back hurt?
When the back hurts below the lower back, in addition to obvious pathologies of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc.), the cause can be periodic pain during menstruation in women, diseases of the female genital organs, such as uterine adnexitis - oophoritis, salpingitis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, appendicitis (extension of the cecum, inMen - prostate and bladder diseases.
Pain in the upper lower back
If the back pain is on the right side above the lower back, liver pain can spread with any pathological changes in the liver - hepatitis, liver failure, taking toxic drugs.The pain is most often localized in the right lower quadrant.
If pain is felt on the right or left side just above the lower back, the cause most likely lies in acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, and chronic pyelonephritis, are accompanied by mild symptoms due to gradual dilation of renal cysts.
When should you see a doctor?
- If the pain spreads to the lower back and lies a little higher (in the chest area).The pain is accompanied by sweating, vomiting and nausea and difficulty breathing.
- The pain spreads to the peritoneum, chest, neck, and jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Spinal injury, accompanied by loss of control over bowel movements and urination.
- Legs are weak, buttocks and genitals are numb.
Diagnose
To determine which disease is causing lower back pain, it is necessary to undergo a comprehensive diagnostic examination.
Experimental method:
- General and biochemical tests of urine and blood.
- Testing for tumor markers present in the blood during tumor formation.
Tool 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 your lower back?The approach to back treatment depends entirely on the symptoms of the disease, the doctor's diagnosis and the stage of the disease.Typically, an integrated approach is used, which includes several treatments.
Analgesic.Ointment helps relieve inflammation, sprains and has a warming effect if the lower back is cold.
The following groups of ointments are distinguished:
- combined drugs (used for sprains and injuries, along with anti-inflammatory and analgesic effects, they have a healing effect due to the presence of heparin and demethyl sulfoxide);
- anti-inflammatory painkillers (they contain cooling medicinal substances that help reduce irritation - menthol, lavender and analgesics);
- chondroprotectors (one of the active ingredients of these drugs is the substance chondroitin sulfate, which is used in pathological processes in cartilage tissue, promoting the active restoration of the cartilage surface of the joints);
- irritating drugs (effect based on vasodilation and blood flow to the source of pain).
With the support of therapeutic exercises, patients can reduce pain, strengthen muscles, and increase the distance between vertebrae.They will help release compressed nerve roots, normalize blood flow in the affected area and improve metabolism.
In order for such gymnastics to heal and not paralyze, it is necessary to follow all the recommendations of the attending physician.
- Movements are performed slowly and rhythmically, without sharp turns;
- The room must be ventilated before exercising;
- Patients should wear clothing that does not restrict movement;
- The exercise is performed when the patient inhales, and when exhaling, they need to return to the original position;
- Load gradually increases.At first, the number of approaches was about 10, then increased;
- During exercise, you should monitor your health.If sharp pain begins, you need to stop your activity.
In addition, massage also has a great effect in reducing pain in the lumbar spine.Positive therapeutic effects of massage include:
- improves blood supply to the diseased part of the body;
- kneading the muscles, making them and the ligaments more flexible and elastic;
- acute pain relief;
- eliminates toxins accumulated in muscles and subcutaneous tissue;
- pleasant sensation due to stimulation of the skin's nerve endings;
- positive emotions.
It can be assigned to a specialist in the clinic or performed at home;In any case, the benefits from it will be invaluable.
Which doctor should I contact?
If you have back pain of unknown cause, you should first consult your doctor.It will help identify the disease based on the overall symptoms.
If the reason is clear: the pain preceded an injury, the pain arose during pregnancy, the menstrual cycle or a chronic disease, then you should immediately contact a more specialized specialist.
Self-medication is allowed only if the exact cause of pain is known.