Pain in the lumbar region is one of the most common reasons that force patients to seek help from a neurologist or therapist.Pain in the lumbosacral spine can interfere with the ability to work for a long time, making movement and self-care impossible.Acute low back pain affects men and women equally.
Occurring with higher frequency 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 lower back muscles, and injuries.Therefore, pain in the lumbosacral back is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can worsen with coughing and sneezing, with any movement, especially when bending forward.Along with lower 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, weakness or loss of leg tendon reflexes.
- As a rule, with osteochondrosis, 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 the lumbar region or even its curvature backward) are distinguished.If, due to osteochondrosis, the spinal cord is pinched, there are disturbances in urination or defecation, as well as disturbances in the sensitivity of the bladder or genital organs.
- However, most often, lumbar osteochondrosis manifests itself as radicular pain - that is, it develops as a result of pinching the nerve roots that extend from the spinal cord at one level or another.Therefore, one of the well-known lumbar syndromes is lumbago.It occurs at a moment of physical stress or in an awkward body position, and sometimes for no apparent reason.Suddenly, in a few minutes or hours, a sharp shooting pain ("lumbago") appears, often it burns and bursts ("as if a spike was stuck in the lower back").
The patient freezes in an uncomfortable position and cannot stand upright if the attack occurs while lifting something heavy.Attempts to get out of bed, cough or bend your legs are accompanied by a sudden increase in pain in the lower back and sacrum.If the patient is asked to stand on his feet, the sharp immobility of the entire lumbar region is lowered due to muscle tension.
Tests for lumbosacral osteochondrosis
This test is used as a means of making an early diagnosis and is named after the doctor who suggested it.
| Symptoms of Dejerine | If you tighten your stomach and listen to your lower back, the pain will be stronger.In this case, there is a high probability that the patient has osteochondrosis. |
| Symptoms of Neri | If you suddenly tilt your head forward before touching your chest, you experience pain in the lower back, this 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 after this the lower back begins to twist, and the pain radiates along the sciatic nerve to the legs, this is evidence of spinal pathology. |
| Lerrey symptoms | if pain appears in a person along the sciatic nerve, after he rises forward, without bending his knees, from a lying position, we are talking about the manifestation 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 capacity.
With continuous exposure (overweight, injury, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects form in it.Through these weak spots in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of back pain
Back pain is a non-specific symptom that can be caused by many different causes.Depending on how severe the back pain in the lumbar region is, whether it is continuous or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Increasing pain - scoliosis;
- Infectious lesions of the intervertebral disc 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 pathology;
- Spinal epiduritis;
- Protrusion of the intervertebral disc in the lumbar region;
- Osteochondrosis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis;
- Acute sprain, spinal fracture;
- Lumbago, sciatica;
- Acute spinal circulatory disorders - stroke;
- Acute pyelonephritis.
Radiating pain in certain diseases of internal organs:
- Diseases of the pelvic organs.In women - inflammatory processes in the uterine appendages, 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 - diverticulum inflammation, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Interrupting aortic aneurysm.
Physiological reasons
Lower back pain may occur if you:
- Are you overweight?
- Additional risk for women;
- You are pregnant or have just given birth;
- Spend a lot of time driving a car or using a computer;
- Lead a lifestyle that is mostly inactive (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 strain yourself at the gym or fitness club.Be careful if you have just started training;
- Are you interested in gardening?
- Has reached postmenopause, which is prone to the development of osteoporosis.
Back pain and pregnancy
Pregnancy worsens the manifestation of diseases in the mother's body.Due to changes in hormone levels and increased stress, pathology especially often appears in the second half of pregnancy.In addition to the pain that accompanies the threat of premature birth, the causes of lower back pain in pregnant women can be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my back hurt under my lower back?
When the back hurts under the lower back, in addition to obvious spinal diseases (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc.), the possible cause is periodic pain during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages - oophoritis, salpingoophoritis (perivictonitis), as well as arthritis (perivictonitis).appendix (extension of the cecum, in men - diseases of the prostate gland, bladder.
Pain in upper lower back
If the back hurts on the right side above the lower back, liver pain 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 felt on the right or left side just above the lower back, the most likely cause lies in acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, chronic pyelonephritis, are accompanied by 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, attacks of vomiting and nausea, and shortness of breath.
- 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.
- Legs become weak, back and genitals become numb.
Diagnostics
To determine what disease causes lower 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 found in the blood during tumor formation.
Instrumental research methods:
- X-ray of the spine.
- Endoscopy of the intestine, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance imaging.
How to treat back pain in the lumbar region?
How to treat your lower back properly?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.
Pain reliever.The ointment helps relieve inflammation, sprains, and has a warming effect if the lower back has a 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 heparin and demethyl sulfoxide contained in them);
- anti-inflammatory analgesic (it contains cooling medicinal ingredients that relieve irritation - menthol, lavender, and painkillers);
- chondroprotectors (one of the active components of the drug is the substance chondroitin sulfate, used in pathological processes in cartilage tissue, promoting the active restoration of the joint cartilage surface);
- irritant drugs (the effect is based on vasodilatation and blood flow to the source of pain).
With the help of therapeutic exercises, patients can reduce pain, make muscles stronger, increase 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 be paralyzed, it is necessary to follow all the recommendations of the attending physician.
- Movement is made slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- Patients should wear clothing that does not restrict movement;
- The exercise is performed when the patient inhales, and when exhaling he needs to return to the original position;
- The load increases gradually.At first the number of approaches was about 10, and then they increased;
- During gymnastics, you should monitor your well-being.If a sharp pain begins, you need to stop your activity.
In addition, massage is very good in relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- increase blood supply to the diseased part of the body;
- kneading muscles, which makes them and ligaments more flexible and elastic;
- relieves acute pain;
- get rid of toxins accumulated in the muscles and subcutaneous tissue;
- a pleasant sensation 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 experience back pain for which the cause is unknown, you need to see a doctor first.It will help identify the disease based on the overall symptoms.
If the reason is clear: the pain is preceded by an injury, the pain arises during pregnancy, the menstrual cycle or a chronic disease, it makes sense to immediately contact a more specialized specialist.
Self-medication is only allowed if the cause of the pain is known precisely.