Lower back pain (lower back pain, lumbago, a feeling of pain or tightness in the lumbar region) is a common complaint of patients when they consult a doctor.According to medical statistics, at least 70% of the population experiences such symptoms at least once during their life.Furthermore, in 10% of cases, low back pain attacks become chronic.
The structure of the symptoms is as follows:
- 80-85% - nonspecific lower back pain.Symptoms disappear within a few weeks;
- 10-15% - spinal stenosis, radiculopathy, causing compression of the nerve root;
- 1-2% - a specific syndrome caused by oncopathology and diseases of internal organs.
Among all diseases, pain in the lumbar region ranks second in duration and third in frequency of issuing a certificate of temporary disability.To prevent the pathology from becoming recurrent, it is necessary to consult a doctor in time.
Types of lower back pain
Depending on the duration of the pain syndrome:
- Acute pain.This happens suddenly, in reaction to new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks - this is the normal healing period of damaged tissues;
- Recurring pain.The syndrome occurs at least six months after the previous exacerbation.Between relapses, the symptoms disappear completely;
- Exacerbation of chronic low back pain.Difference with relapse: the interval between attacks is less than 6 months, symptoms may subside, but do not disappear completely.
According to the etiopathogenesis, low back pain is:
- Primary.The symptom is due to functional and/or dystrophic changes in the intervertebral discs, joints, fascia, tendons and muscles;
- Secondary.The causes of frequent lower back pain are congenital anomalies of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pain due to pathologies of the intestines, stomach, abdominal aorta and organs of the genitourinary system.
What does low back pain look like?
Most often, patients complain of sharp, intense pain in the lower back, also called shooting, throbbing or lumbago.Movements in the back are limited.Sometimes a person remains hunched over and cannot straighten up.With each movement, the sharp pain in the lower back intensifies (“pulls” in the back).Chronic diseases of the lumbar spine are the main cause of this disease.An acute attack can last from a few minutes to several weeks.In some cases, the pain subsides so much that the person gets used to it.Full recovery without recurring attacks is also possible.
Shooting pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but they cause discomfort.Aching pain in the lumbar region can intensify with weak bending, physical activity, after infection or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort remain in the back.
Symptoms You Shouldn't Ignore
If sharp or dull lower back pain is accompanied by one or more symptoms from the list below, you should consult a doctor immediately.
Warning signs:
- numbness in arms or legs, tingling sensation, “cottony” limbs;
- pain in hip joints and knees;
- leg cramps;
- menstrual irregularities in women;
- sexual impotence in men;
- increased pain when sitting;
- inability to stand for a long time;
- rapid weight loss;
- increased temperature, fever;
- critical deviations in blood tests;
- age over 50;
- lack of dynamics during “routine” treatment for 4 weeks.
The clinic doctor will determine the cause of the pain and help relieve the exacerbation.After that, a comprehensive examination and treatment under medical supervision will be necessary.
What pathologies can cause acute pain in the lumbar region
Diseases of the musculoskeletal system
Pinched sciatic nerve.Severe, stabbing pain occurs in the lower back, caused by compression of nerve roots by closely spaced adjacent vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes in the discs.The tissues are gradually destroyed, the gap between the vertebrae decreases and any sudden movement can pinch the nerve.The pain is often accompanied by pulsations of compressed vessels.
Sciatica (lumbosacral radiculitis).As a result of pinching, the nerve roots become inflamed and radiculitis develops.If the sciatic nerve is affected, the condition is called sciatica.With lumbosacral radiculitis, lumbar ischialgia is often observed - severe pain in the lower back and leg on the affected side.
Osteochondrosis (spondylosis).The vertebrae become denser, deformed and covered in osteophytes, bony growths that look like sharp thorns.For a long time it was believed that osteochondrosis was a consequence of age-related degenerative changes, but today the diagnosis is “younger” every year.A sedentary lifestyle and sedentary work contribute to changes in the intervertebral discs from the age of 25-30.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A piece of joint tissue protrudes into the spinal canal.A hernia can appear after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spine.Pathology can develop for several years without manifesting itself in any way.The disease begins at a young age and gradually leads to disability.The reason for such a disappointing prognosis also lies in the fact that patients suffer from constant night pain that disrupts sleep and do not attach importance to morning stiffness in the back.Several years pass between the appearance of the first symptoms and consultation with a doctor.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, a bump appears, etc.
Spondyloarthritis.Conditions such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lumbar region.The main symptom is accompanied by inflammation of the joints of the knees, feet or hands, pain in the buttocks, blurred vision, unstable stools of unusual consistency.
Other diseases.Acute pain in the lumbar region occurs with myositis - inflammation of the lumbar muscles resulting from tension or hypothermia.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of internal organs
The cause of lower back pain is often pathology of the kidneys, internal genital organs and urinary tract.This pathology requires careful diagnosis and medical monitoring, because many complications are irreversible.
Low back pain due to kidney pathology differs from the consequences of disorders of the musculoskeletal system by its constancy and independence from movement or body position.You should especially be wary if there are symptoms such as cloudy urine, frequent or painful urination, etc.
Genital diseases
Both women and men can experience severe lower back pain due to various pathologies of the reproductive system.This is how sexually transmitted infections and inflammation of tissues and organs manifest themselves.
Lower back pain in women often occurs during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered a variation of the norm.If your periods are very heavy, accompanied by water hammer and poor health, it is better to visit an antenatal clinic and take hormonal tests.Menstruation can be normalized with correctly selected medications.
Lower back pain in men can be a sign of problems with the prostate.It is necessary to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas becomes inflamed, pain surrounds the back in the lumbar region.Possible irradiation of the coccyx, left thigh, perineum.Pain in the girdles begins to increase after eating and intensifies with physical activity.Walking, jumping and other exercises cause the pancreatic capsule to stretch and the nerve endings to react.
What to do if you have severe lower back pain
If a strong attack of pain occurs at home or at work, you should lie down on a hard, hard surface and place a cushion under your bent knees so that your legs are perpendicular to your body.Take a nonsteroidal anti-inflammatory drug.You can tie a warm shawl or scarf at your lower back to warm your back a little.
If these measures do not provide relief, you should call a doctor or emergency medical help at home.If you feel better, do not wait for a new attack of pain and find time to go to a medical center, first make an appointment with a general practitioner: he will comprehensively assess your state of health, make a preliminary diagnosis, draw up a plan for the first examination, prescribe adequate symptomatic treatment and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many "quick" solutions to back pain: a variety of gels, ointments and patches.Some of them provide relief, but they should not be used continuously without medical supervision.In some cases, warming gels can only harm.Therefore, if you suffer from lower back pain, you should consult a doctor, even if you have managed to suppress the symptoms.
Diagnosis of lower back pain
At the first appointment, the doctor interviews the patient, finds out how long the symptoms have been, the dynamics of their development and the presence of accompanying complaints.The doctor will take into account exactly how it hurts - on the left or right, the pain is dull, aching, sharp or shooting, the duration of the attacks and other details to establish a preliminary diagnosis.In many typical cases, standard treatment by a general practitioner is possible.
Most often, if there are specific signs of a serious disease of the spine or internal organs, the patient is referred for additional examinations:
- Blood test.Low hemoglobin indicates the likely presence of a tumor, increased ESR indicates inflammation or infection, etc.The doctor recommends doing not only a general analysis, but also biochemistry to assess the functioning of internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the analysis results are a direct indication for an ultrasound examination of the urinary system and further examination by a urologist;
- X-ray of the lumbar spine.The photographs show some signs of inflammation of the joints, disruptions of various structures and close proximity of the vertebrae due to degenerative changes.Based on the x-ray, the doctor can assume osteoporosis and note fractures;
- Magnetic resonance imaging (MRI).A method of examining patients without X-rays, which allows you to obtain numerous images (slices) of the area of interest and its three-dimensional image.Unlike X-ray and CT scan, MRI provides information about the condition of not only bones, but also muscles, blood vessels and soft tissues.
Treatment of back and lower back pain
Simple forms of pain that are not associated with serious disease of the spine or internal organs are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to remove the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Moderate, individual and continuous physical activity is recommended.
Getting rid of pain caused by illness with deeper roots requires a systematic and comprehensive approach.Treatment should include medications, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In case of sharp and unbearable pain, the doctor immediately proceeds to the appointment of a blockade - an injection of an anesthetic into the affected area.The injection quickly relieves discomfort, but only provides temporary relief.The patient should start treatment immediately.
To relieve an exacerbation, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasming muscles;
- B vitamins to improve the regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of the internal organs, the patient is prescribed medications to treat the underlying pathology.
Auxiliary techniques
After the exacerbation is relieved, the following treatment methods are effective:
- wear a special fixing bandage;
- medical massage of the lumbar region;
- shock wave therapy;
- swimming and exercise classes;
- acupuncture;
- apply strips;
- manual therapy;
- other physiotherapeutic techniques.
Surgery
Surgery is a last resort.Surgical treatment is indicated in cases of serious disorders in the structure of the spinal cord or internal organs.There are many techniques.The specific type of intervention is ultimately planned by a neurosurgeon, operative urologist or abdominal surgeon, taking into account the established diagnosis and individual characteristics of the patient's condition.
Do not tolerate lower back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center, you can undergo a complete examination, find out the reason for your back pain and receive quality treatment.