Pain in the lumbar region is one of the most common reasons that force a patient to seek the help of a neurologist or therapist.Pain in the lumbosacral spine can disrupt work ability for a long time, making movement and self-help impossible.Acute lower back pain affects men and women equally often.
Lower back pain is more common in middle-aged and elderly people, and often occurs in adolescents and young adults.This is due to rapid growth, weakness of weak lower back muscles and injuries.So, lumbosacral back pain is a burning problem that everyone can face.
Pain in the lower back with lumbar osteochondrosis
Pain in the lower back in osteochondrosis can increase when coughing and sneezing, during any movement, especially when bending the body forward.Along with pain in the lower back, lumbar osteochondrosis can be manifested by impaired sensitivity of certain parts of the skin or muscles of the lower half of the trunk 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 curvature backward) are distinguished.If the spinal cord is pinched due to osteochondrosis, urination or defecation disorders occur, as well as bladder or genital sensitivity disorders.
- However, most often, lumbar osteochondrosis manifests itself as radicular pain - that is, it develops as a result of pinching of the nerve roots that extend from the spinal cord at one level or another.So, one of the known lumbar syndromes is lumbago.It occurs at the moment of physical stress or in an awkward position of the body, and sometimes for no apparent reason.Suddenly, within minutes or hours, there is a sharp shooting pain ("lumbago"), often burning and shooting ("as if a stake had been driven into 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 the leg are accompanied by a sudden increase in pain in the lower back and sacrum.If the patient is asked to stand on his feet, 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.
| Dejerin's symptom | If you tighten your abdominal muscles and listen to your lower back, the pain will get worse.In this case, there is a high probability that the patient has osteochondrosis. |
| Neri's symptom | If you suddenly tilt your head forward before touching your chest, you will feel pain in the lower back, this also indicates problems with the spine. |
| Lasègue's symptom | it can be felt after the following actions: lying on your back, you need to raise each leg in turn.If after that the lower back begins to twist, and the pain spreads along the sciatic nerve to the leg, this is evidence of spinal pathology. |
| Lerrey's symptom | if a person experiences pain 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
An equally rare cause is intervertebral disc herniation, the clinical manifestation of which is pain in the lumbosacral back.The intervertebral disc (internal nucleus pulposus) loses its elastic properties and elastic capacity during prolonged traumatic exposure, as well as with age.
With continuous exposure (excess weight, injuries, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects appear on it.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can move and even bulge.
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 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;
- Pathologies of the hip joint;
- Spinal epiduritis;
- Protrusions of 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 disorders of spinal circulation - stroke;
- Acute pyelonephritis.
Radiates 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, gallbladder;
- Intestinal diseases - diverticulitis, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Disturbing aortic aneurysm.
Physiological reasons
Lower 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 (office workers) or standing (salesmen, waiters, street advertising employees, surgeons) lifestyle;
- Do dynamic physical work with sudden changes in body position (especially if your specialty involves heavy physical activity);
- You are overexerting yourself at the gym or fitness club.Be extremely careful if you have recently started training;
- Are you interested in gardening?
- They have reached postmenopause, which predisposes them to the development of osteoporosis.
Lower 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 occur especially often in the second half of pregnancy.In addition to the pain that accompanies the risk of premature birth, the cause of lower back pain in a pregnant woman can be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stone).
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.), possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages - inflammation of the uterus - oophoritis, as well as diseases of oophoritis, etc.peritoneum, intestines, appendicitis (extension of the cecum, in men - diseases of the prostate, bladder.
Pain above lower back
If the back hurts to the right above the lower back, it can radiate pain in the liver, along 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 just above the lower back, it is very possible that the cause lies in acute kidney disease.Many chronic kidney diseases, such as polycystic diseases, 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 radiates to 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 spreads to the peritoneum, chest, neck, jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Spinal injury, followed by loss of bowel control 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.
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.An integrated approach is usually 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 fats are distinguished:
- combined drugs (used for sprains and injuries, with anti-inflammatory and analgesic effects, 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 painkillers);
- chondroprotectors (one of the active components of such drugs is the substance chondroitin sulfate, which is used in pathological processes in the cartilage tissue, promoting the active renewal of the cartilage surfaces of the 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 reduce pain, strengthen 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 doctor.
- 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 movement;
- Exercises are done when the patient inhales, and when exhaling, he should return to the original position;
- The load is gradually increased.At first, the number of accesses is about 10, and then they increase;
- During gymnastics, you should monitor your well-being.If a sharp pain starts, you must stop your activities.
In addition, massage is excellent for relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- improvement of blood supply to the affected part of the body;
- crushing of muscles, which makes them and ligaments more flexible and elastic;
- acute pain relief;
- getting rid of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant feelings 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 will be incalculable.
Which doctor should I contact?
If you have back pain, the cause of which is not known, first consult a doctor.It will help identify the disease based on the total number of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain occurred during pregnancy, the menstrual cycle or a chronic illness, it makes sense to immediately contact a more specialized specialist.
Self-medication is allowed only if the exact cause of the pain is known.