Pain in the lumbar region is one of the most common reasons that force a patient to seek help from a neurologist or therapist.Pain in the lumbosacral spine can impair work capacity for a long time, making movement and self-care impossible.Acute low back pain affects both men and women with the same frequency.
Low back pain, which occurs most frequently in middle and old age, can often occur in adolescents and young adults.This is due to rapid growth, weakness in weak lower back muscles, and injuries.Therefore, lumbosacral back pain is a pressing problem that anyone can face.
Low back pain with lumbar osteochondrosis.
Lower back pain with osteochondrosis can intensify when coughing and sneezing, with any movement, especially when leaning the body forward.Along with lower back pain, lumbar osteochondrosis can be manifested by altered sensitivity of certain areas of the skin or muscles of the lower half of the torso and legs, weakening or disappearance of tendon reflexes in the legs.
- As a rule, with osteochondrosis, a 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, due to osteochondrosis, the spinal cord is pinched, a disturbance occurs when urinating or defecating, as well as a disturbance 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 of the nerve roots extending from the spinal cord at one level or another.Thus, one of the best-known lumbar syndromes is lumbago.It occurs at a time of physical stress or in an uncomfortable body position and sometimes for no apparent reason.Suddenly, after a few minutes or hours, a 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 straighten up if the attack occurs while lifting something heavy.Attempts to get out of bed, cough or bend the leg are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand up, a strong 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.
| Dejerine's symptom | If you tighten your abs and listen to your lower back, the pain will be stronger.In this case, there is a high probability that the patient has osteochondrosis. |
| Neri's symptom. | If you sharply tilt your head forward before touching your chest, you experience pain in your lower back, this also indicates problems with your spine. |
| Lasègue's symptom | This can be felt after the following actions: lying on your back, you need to raise 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 symptom | 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 manifestations of chondrosis. |
intervertebral disc herniation
Herniated intervertebral disc 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 continued exposure (excess weight, injuries, progressive osteoporosis), the annulus fibrosus of the disc becomes thinner and defects form on it.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of low back pain.
Back pain is such a non-specific symptom that it can be caused by many different reasons.Depending on the intensity of the back pain in the lumbar region, whether it is constant or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondyloarthritis;
- 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;
- Protrusion 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 spinal circulatory disorders: cerebrovascular accident;
- 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 diseases: renal colic, kidney stones;
- Troublesome 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;
- Leading a predominantly sedentary (office workers) or standing lifestyle (salespeople, waiters, street advertising employees, surgeons);
- Performing dynamic physical work with sudden changes in body position (especially if your specialty involves intense physical activity);
- You overload yourself at the gym or fitness club.Be very careful if you have recently started training;
- Are you interested in gardening work?
- Having reached postmenopause, which predisposes to the development of osteoporosis.
Low back pain and pregnancy.
Pregnancy aggravates the manifestations of existing diseases in the mother's body.Due to changes in hormonal levels and increased stress, pathologies appear especially 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:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- Urolithiasis (kidney stones).
Why does my back hurt below my lower back?
When the back hurts below the lower back, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc.), the possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages: oophoritis, salpingoophoritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammationof the appendix (an extension of the cecum, in men: diseases of the prostate, bladder.
Pain above the lower back
If your back hurts on the right side above the lower back, the liver pain can radiate, with any pathological changes in the liver: hepatitis, liver failure, taking toxic medications.The pain is most often located in the right hypochondrium.
If you experience pain on the right or left side, just above your lower back, the cause is most likely due to acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, and chronic pyelonephritis, are accompanied by minor symptoms as the kidney capsule gradually stretches.
When should you see a doctor?
- If the back pain irrigates in the lumbar area, and is located a little higher (in the chest area).The pain is accompanied by sweating, attacks of vomiting and nausea, and difficulty breathing.
- 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 lower back pain, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical tests of urine and blood.
- Testing for tumor markers present in the blood during tumor formation.
Instrumental research methods:
- Spine x-ray.
- Endoscopy of 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 the lower back area?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 that includes several treatment methods.
Painkillers.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:
- combined drugs (used for sprains and injuries, in addition to anti-inflammatory and analgesic effects, they have a healing effect due to the heparin and demethyl sulfoxide they contain);
- anti-inflammatory analgesics (they contain cooling medicinal substances that relieve irritation: menthol, lavender and pain relievers);
- chondroprotectors (one of the active components of such drugs is the substance chondroitin sulfate, used in pathological processes in cartilaginous tissue and promoting the active restoration of cartilaginous surfaces of the joints);
- Irritant medications (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 and 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 paralyze, it is necessary to follow all the recommendations of the treating 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;
- The exercises are 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 is about 10, and then they increase;
- During gymnastics, you should monitor your well-being.If acute pain begins, you should stop your activities.
Additionally, massage is excellent for relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- improve blood supply to the diseased part of the body;
- knead the muscles, which makes them and ligaments more flexible and elastic;
- relieve acute pain;
- get rid of toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensations due to the stimulation of the nerve endings in the skin;
- positive emotions.
It can be entrusted to a specialist in a clinic or done at home;In any case, the benefits will be invaluable.
Which doctor should I contact?
If you have back pain whose cause is unknown, you should first consult a doctor.It will help identify the disease based on the totality of the 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 specialized specialist.
Self-medication is only allowed if the cause of the pain is precisely known.