Pain in the lumbar region is one of the most common reasons forcing a patient to see a neurologist or therapist.Pain in the lumbosacral spine can affect the ability to work for a long time and make movement and self-care impossible.Acute lower back pain affects men and women equally often.
Low back pain is more common in middle age and older age and can also often occur in adolescents and young adults.This is due to rapid growth, weakness of weak lower back muscles, and injuries.Therefore, lumbosacral back pain is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Pain in the lower back with osteochondrosis can increase when coughing and sneezing, as well as during any movements, especially when bending the body forward.In addition to pain in the lower back, lumbar osteochondrosis can manifest itself in impaired sensitivity of certain areas of the skin or muscles of the lower half of the trunk and legs, as well as weakening or disappearance of tendon reflexes of the legs.
- With osteochondrosis, a curvature of the lumbar spine is usually observed.Depending on the plane in which the curvature occurs, a distinction is made between scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (flattening of the lumbar spine or even its curvature backwards).If the spinal cord is pinched due to osteochondrosis, there will be 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, i.e.h.as a result of the entrapment of nerve roots emanating from the spinal cord at one level or another.One of the best-known lumbar syndromes is lumbago.It occurs in a moment of physical stress or in an uncomfortable posture, and sometimes for no apparent reason.Suddenly, within a few minutes or hours, a sharp, stabbing pain (“lumbago”) appears, often burning and bursting (“as if there was a stake stuck in the lower back”).
The patient freezes in an uncomfortable position and cannot sit up if the attack occurs while lifting heavy objects.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, the entire lumbar region becomes severely immobile due to muscle tension.
Tests for lumbosacral osteochondrosis
These tests are used to make a preliminary diagnosis and are named after the doctors who suggested them.
| Dejerine's symptom | If you tense your abdominal muscles and listen to your lower back, the pain will increase.In this case, there is a high probability that the patient suffers from osteochondrosis. |
| Neri's symptom | If you tilt your head forward sharply before touching your chest, you will 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 raise each leg one after the other.If after that the lower back begins to twist and the pain radiates down the sciatic nerve to the leg, this is an indication of spinal pathology. |
| Lerrey's symptom | If a person experiences pain along the sciatic nerve after rising forward from a lying position without bending his knees, we are talking about manifestations of chondrosis. |
Herniated disc
An equally rare cause is a herniated disc, the clinical manifestation of which is pain in the lumbosacral back.The intervertebral disc (internal nucleus pulposus) loses its elastic properties and elasticity with prolonged traumatic exposure and with increasing age.
With continued stress (excess weight, injury, progressive osteoporosis), the fibrous ring of the intervertebral disc becomes thinner and defects form in it.These weak points in the anulus fibrosus can cause the nucleus pulposus of the intervertebral disc to shift and even protrude.
Causes of lower back pain
Back pain is a non-specific symptom that can have many different causes.Depending on how severe the back pain is in the lumbar region, whether it occurs constantly or periodically, primary or secondary, there may be reasons for this:
Chronic pain:
- osteomyelitis;
- ankylosing spondylitis;
- spondylosis deformans;
- Growing Pains – Scoliosis;
- Infectious lesions of the 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;
- Arteriosclerosis of the abdominal aorta and its branches.
Acute pain:
- spondyloarthritis;
- pathologies of the hip joint;
- Spinal epiduritis;
- Protrusion of the intervertebral discs in the lumbar region;
- osteochondrosis of the spine;
- Acute intervertebral fracture;
- 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 uterine appendages, endometriosis, uterine cancer, ovarian cancer, sexually transmitted 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;
- Troublesome aortic aneurysm.
Physiological reasons
Lower back pain may occur if you:
- 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 (office workers) or standing (salespeople, waiters, street advertising workers, surgeons) lifestyle;
- Perform dynamic physical work with sudden changes in posture (especially if your specialty involves heavy physical activity);
- You overwork yourself in the gym or fitness club.Be extremely careful if you have recently started exercising.
- Are you interested in gardening?
- You have reached postmenopause, which predisposes you to the development of osteoporosis.
Lower back pain and pregnancy
Pregnancy worsens the manifestations of diseases in the mother's body.Due to changes in hormonal levels and increased stress, pathologies are especially common in the second half of pregnancy.In addition to the pain associated with 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 lower back?
If the back hurts below the lower back, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc.), possible causes include periodic pain during menstruation in women, diseases of the female genital organs, such as:B. Inflammation of the uterine appendages - oophoritis, salpingoophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (an expansion of the appendix, in men - diseases of the prostate, bladder.
Pain above the lower back
If the back hurts on the right above the lower back, liver pain can radiate, with pathological changes in the liver – hepatitis, liver failure, taking toxic drugs.The pain is most often localized in the right hypochondrium.
If pain occurs 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 asB. polycystic diseases, malignant kidney tumors, chronic pyelonephritis, are accompanied by minor symptoms as the kidney capsule gradually expands.
When should you see a doctor?
- If the back pain occurs in the lower back and is localized slightly higher (in the chest area).The pain is accompanied by sweating, vomiting and nausea as well as shortness of breath.
- The pain radiates 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.
- The legs become weak, the buttocks and genitals become numb.
diagnosis
To determine which disease caused the lower back pain, a comprehensive diagnostic examination is required.
Laboratory methods:
- General and biochemical examinations of urine and blood.
- Tests for tumor markers that are present in the blood during tumor development.
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 to treat lumbar back pain?
How to properly treat the lower back?The procedure for 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 that includes multiple treatment methods.
Painkillers.The ointment relieves inflammation and sprains and has a warming effect for colds in the lower back.
The following groups of ointments are distinguished:
- Combination drugs (used for sprains and injuries, have anti-inflammatory and analgesic effects and have a healing effect due to the heparin and demethyl sulfoxide they contain);
- anti-inflammatory analgesics (they contain cooling medicines that relieve irritation – menthol, lavender and painkillers);
- Chondroprotectors (one of the active components of such drugs is the substance chondroitin sulfate, which is used in pathological processes in cartilage tissue and promotes the active restoration of the cartilage surfaces of 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 release compressed nerve roots, normalize blood flow in the affected area and improve metabolic processes.
In order for such gymnastics to heal and not paralyze, all recommendations of the attending physician must be followed.
- Movements are performed slowly and smoothly, without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothing that does not restrict freedom of movement;
- The exercises are performed as the patient inhales, while exhaling he must return to the starting position;
- The load increases gradually.At first the number of approaches is about 10, then they are increased;
- When doing gymnastics, you should pay attention to your well-being.If severe pain occurs, you must stop your activities.
In addition, the massage is ideal for relieving pain in the lumbar spine.The positive therapeutic effects of massage include:
- improving blood supply to the diseased part of the body;
- kneading the muscles, making them and ligaments more flexible and elastic;
- relief of acute pain;
- elimination of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensations due to 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 resulting benefits will be invaluable.
Which doctor should I contact?
If you have back pain for which the cause is unknown, you should first consult a doctor.It helps to identify the disease based on the totality 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 disease, it makes sense to immediately consult a more specialized specialist.
Self-medication is only permitted if the cause of the pain is precisely known.