Low back pain is one of the most common reasons that make a patient 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 affects both men and women equally often.
Occurring more frequently in middle and old age, low back pain can often occur in teenagers and young adults.This is due to rapid growth, weakness in weak back muscles and injuries.Thus, lumbosacral spine pain is a pressing problem that anyone can face.
Low back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can intensify with coughing and sneezing, with any movements, especially when bending the body forward.Along with pain in the lower back, lumbar osteochondrosis can manifest itself with reduced 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.
- As a rule, with osteochondrosis, curvature of the lumbar spine is observed.Depending on the level at which the curvature appears, 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 the spinal cord is pinched due to osteochondrosis, 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 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 sciatica.It appears at a moment of physical stress or in an uncomfortable position of the body, and sometimes for no apparent reason.Suddenly, within minutes or hours, there is a sharp pain ("lumbago"), often burning and bursting ("as if a stake had been stuck in the lower back").
The patient freezes in an uncomfortable position and cannot straighten up if the attack occurs while lifting something heavy.Attempts to get out of bed, cough or bend your leg are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand on his feet, an abrupt immobility of the entire lumbar region due to muscle tension is revealed.
Examinations 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 symptom | If you tighten your abs 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 tilt your head sharply forward before touching your chest, feel pain in the lower back, this also indicates problems with the spine. |
| Lasègue 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 occurs in a person along the sciatic nerve, after standing forward, without bending his knees, from a lying position, we are talking about manifestations of chondrosis. |
Intervertebral disc herniation
Herniated intervertebral disc is an equally rare cause, the clinical manifestation of which is pain in the lumbosacral spine.The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With constant exposure (excess weight, injury, progressive osteoporosis), the annulus fibrosus of the disc becomes thinner and defects are formed in it.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can be displaced and even protrude.
Causes of lower back pain
Back pain is such a non-specific symptom that it 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:
- Ankylosing spondylitis?
- Pathologies of the hip joint?
- Spondylolisthesis?
- Protrusion of the 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 circulatory disorders of the spine - 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, 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, tumors of the intestine.
- Kidney diseases - renal colic, kidney stones.
- Disturbing aortic aneurysm.
Physiological reasons
Low 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 predominantly sedentary lifestyle (office workers) or standing (salespeople, waiters, street vendors, surgeons).
- Do dynamic physical work with sudden changes in body position (especially if your specialty involves vigorous physical activity).
- Overworking yourself at the gym or gym.Be extremely careful if you have recently started training.
- Are you interested in gardening?
- They have reached postmenopause, which predisposes them to develop osteoporosis.
Back pain and pregnancy
Pregnancy aggravates the manifestations of diseases present 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 lower back pain in a pregnant woman can be:
- herniated disc;
- radiculitis?
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my back hurt below my waist?
When the back hurts under the lower back, in addition to obvious diseases of the spine (sciatica, lumbar spine, intervertebral hernia, ankylosing spondylitis, etc. intestines, appendix inflammation (extension of the cecum, in men - diseases of the prostate, bladder.
Pain over the lower back
If the back hurts right above the lower back, pain can be radiated to the liver, with any pathological changes in the liver - hepatitis, liver failure, taking toxic drugs.The pain is most often located 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 diseases of the kidneys, such as polycystic disease, malignant tumors of the kidneys, chronic pyelonephritis, are accompanied by minor symptoms, since the renal 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, bouts 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 of bowel movements and urination.
- The legs become weak, the buttocks and genitals become numb.
Diagnostics
In order to determine which disease caused the pain in the lower back, 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 deal with back pain in the lumbar region?
How to properly treat your lower back?The approach to the treatment of the back depends entirely on the symptoms of the disease, the diagnosis made by the doctor and the stage of the disease.Usually, 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:
- combination drugs (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 pain relievers).
- chondroprotectors (one of the active ingredients of such drugs is the substance chondroitin sulfate, which is used in pathological processes in the cartilage tissue, promoting the active restoration of the cartilage 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, make the muscles strong, 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 to mutilate, it is necessary to follow all the recommendations of the attending physician.
- Movements are slow and smooth without sharp turns.
- The room must be ventilated before training.
- The patient should wear clothing that does not restrict movement.
- The exercises are done when the patient inhales and during exhalation he needs to return to his original position.
- The load is gradually increased.At first the number of approaches is about 10, and then they increase.
- During exercise, you should monitor your well-being.If sharp pain begins, you must stop your activities.
In addition, massage is excellent in relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- improving blood supply to the diseased part of the body.
- kneading of the muscles, which makes them and the ligaments more flexible and elastic.
- relief from acute pain;
- getting rid of toxins that accumulate in the muscles and subcutaneous tissue.
- pleasant sensations due to stimulation of the nerve endings of the skin.
- positive emotions.
It can be assigned to a specialist in a clinic or carried out at home.in any case, the benefits of this 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 identify the disease based on the set 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 qualified specialist.
Self-medication is allowed only if the exact cause of the pain is known.