When a person suffers from pain, his only desire is for the pain to go away quickly and never to appear again. The back is an "active" and important part of our body, as it houses the main organ – the spine. Frequent back pain is a symptom of various diseases. Almost everyone experiences pain in the lumbar spine, especially after the age of 40. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Lower back pain indicates damage to the spine, disease of nerve endings, muscle tissues and internal organs. It is observed during fevers. It can be sharp and dull, constant and periodic, pulling and bursting. The pain can be periodic, local, aching or throbbing, for some it is associated with the weather, for others with physical activity, for still others with staying in an uncomfortable position for a long time.
Why does my lower back hurt?
The causes of frequent lower back pain can be diseases of muscle tissue, injuries to bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spinal diseases
Common causes of low back pain are congenital anomalies and acquired diseases of the spine. Pain is sometimes associated with climatic changes and sometimes with physical activity.
Lumbago– sharp pain that limits movement and occurs due to muscle spasms. With pathological processes in the spine, lumboischialgia occurs - aching or shooting pain in the lower back, radiating to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are detected with spinal pathologies:
- Degenerative pathologies: osteochondrosis, protrusion of the intervertebral disc, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbalization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: circulatory disorders of the spine.
- Other illnesses: illnessForest.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Spinal curvature
Minor pain with curvature of the spine is associated with improper distribution of physical activity, overload of the ligaments and muscles of the lower back. Pain occurs due to an uncomfortable position when sleeping on a hard or, conversely, soft mattress.
The symptom is accompanied by:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- flat back syndrome.
Osteoporosis
If your lower back is tight or painful for a long time, it could be osteoporosis. The pain is made worse by stress and climate changes. Osteoporosis can be:
- postmenopausal;
- juvenile;
- idiopathic;
- senile.
The same painful sensations appear in patients with genetic diseases, disorders of the endocrine glands and poisoning when taking medications. Secondary osteoporosis may be due to the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
Increased pain and increased duration are associated with injuries and fractures.
Spinal Injuries
A common injury to the lumbar spine is a bruise that manifests itself as moderate pain and, when moving, is accompanied by swelling, hematomas and hemorrhages. In severe cases, neurological disorders are also added.
A compression fracture in the lower back occurs due to forced flexion of the spine and is characterized by cessation of breathing and severe pain. The pain intensifies when rotating the body, muscles and tissues swell. The lower back is painful on palpation.
Paroxysmal pain with a feeling of heaviness in the lower back and numbness of the legs are found in patients with spondylolisthesis and vertebral dislocations.
Soft tissue and kidney injuries
Moderate, dull pain with hemorrhage or swelling results from soft tissue bruising. Kidney bruises are painful and radiate to the lower abdomen, genitals, and lumbar region. Sometimes hematoma and manifestations of hematuria are visible. In case of severe bruising, painful shock, blood in the urine and prolonged severe pain may occur.
Spine and spinal cord infections
Osteomyelitismanifests as increasing pain in the lower back associated with chills and fever. It can be hematogenous, post-traumatic, contact, postoperative. Severe pain pulls and swells so much that it prevents movement, causing you to freeze. In the chronic form of osteomyelitis, a fistulous tract with discharged pus is formed, so pain manifestations are alleviated.
Spinal tuberculosisdevelops gradually, starting with periodic pain, which intensifies due to stress, then stiffness of movements appears. The pain becomes burning and radiates to the legs with paresthesia and numbness due to the destruction of the vertebrae and compression of the nerve roots.
In patients withspinal epidural abscesssevere pain is associated with muscle tension, shivering and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
Boils,anthrax– against the background of purulent processes, skin compactions of a purple or bluish tint with a diameter of 1 cm appear, in the center with one or more rods, and are accompanied by increasing pain in the lower back. The pain twitches, throbs and can deprive you of sleep. Hyperthermia is noted.
HASparanephritisfirst, fever appears, then local edema, hyperemia and hyperthermia are detected. Severe pain, radiating to the stomach and under the ribs, intensifies with movements, and even with breathing, develops on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a twisted position so that the muscles of the lower back do not contract. The condition of the body is serious.
Infectious diseases
HASARVI,fluAndsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by aching pain in the lower back, which causes a desire to change position. Sometimes lower back pain is caused by a kidney infection. Infectious diseases with lower back pain:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot-and-mouth disease;
- corona virus;
- bacterial, fungal and viral infections.
Lower back pain due to serious infections is seen during a cytokine storm. Epidemiological myalgia is accompanied by attacks of severe pain in the lower back, which last up to 10 minutes with an interval of half an hour to an hour and appear in the limbs, in the chest and in the abdominal wall. May be associated with rhinitis, conjunctivitis and numbness. Myalgia eases at rest, intensifies during movement and may disappear a few days after the muscles warm up.
Other muscle injuries
Aching pain in the lower back occurs after intense physical activity, strength exercises of the back muscles or a long stay in a position with tension in the lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overwork, metabolic disorders and is accompanied by long-term painful pain.
Shapesmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
Chronic pain with asthenia, sleep disturbances and neurotic disorders are observed in fibromyalgia.
Other diseases
Lower back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord neoplasms.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:Hereditary cerebellar ataxia of Pierre-Marie.
- Exogenous poisonings: Adrenomimetic drug abuse.
- Pathologies of the heart and blood vessels: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: transfusion shock.
The pain syndrome radiates to the lower back against the background of pelvic diseases, female diseases, as well as prostate cancer, proctitis and sigmoiditis.
Types of pain
Duration must be taken into account when diagnosing low back pain. Muscle pain lasts about two weeks and then disappears.
Pain caused by changes in the spine lasts longer and radiates to the leg, perineum and may be accompanied by a feeling of tingling, numbness and burning.
Pain caused by diseases of the cardiovascular system and abdominal organs is characterized by greater intensity and duration.
Diagnostic
Medical history is of great importance in making a diagnosis, as lower back pain can be caused by various diseases.
The primary diagnosis is carried out by a traumatologist-orthopedist. When making a diagnosis, the doctor takes into account the following symptoms: disturbances in defecation and urination, orthopedic defects, weakness and numbness of the leg. An examination is performed to identify painful points and muscle spasms.
It is also important to know when the pain appears, its relationship to stress, the presence of cramps, cough, fever and bladder or bowel dysfunction.
In the event of neurological symptoms, the patient is seen by a neurologist. The doctor interviews the patient and conducts a visual examination, then the patient is sent for a hardware and instrumental examination. According to the doctor's indications, consultations with a surgeon, rheumatologist, urologist and other specialized specialists are prescribed.
Diagnoses may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, sensitivity, muscle strength and coordination of movements.
- X-ray.X-ray is the initial examination method that allows you to determine changes in bone tissue. Images of the lumbar region show fractures, degenerative changes in the intervertebral discs, signs of inflammatory processes and spondylolisthesis.
- To scan.CT scans examine the detailed structure of solid structures.
- MRI– an informative method that allows you to diagnose morphological changes in the condition of ligaments and intervertebral discs. To exclude stenosis, myelography is prescribed.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests evaluate muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine conduction disorders along nerve fibers.
- Laboratory tests.To determine the causative agent of infection, urine and blood tests are taken for microbiological examination. Detect neuroinfections – using serological tests.
Treatment of lower back pain
FIRST AID
For spinal injuries, the patient is placed on a hard, flat surface and taken to the clinic. To reduce pain, you need to optimize your body position during work and rest to reduce the load on your back. Before being examined by a doctor, you may take painkillers. For degenerative diseases of the spine, lumbago and lumboischialgia, it is allowed to use creams, ointments and gels with a warming and analgesic effect. In case of infectious processes, their use is prohibited.
The basis of treatment is physiotherapy and drug therapy. The following methods are used:
- NSAIDsin the form of tablets and topical agents, used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B vitamins, enhancing the effect of medicinal analgesics.
- Local anesthetics.They carry out therapeutic blockades for acute pain with anesthetics, as well as analgesics in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetotherapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
Surgery
Depending on the pathological characteristics, there are surgical interventions:
- In case of instability: interbody fusion, transpedicular fixation, plate fixation.
- For tuberculosis, tumor, osteoporosis, osteomyelitis: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdiscectomy, nucleoplasty.
- For narrowing of the spinal canal: laminectomy, facetectomy, disc decompression puncture.
Prevention
Massage is effective in the presence of muscle blockages and joint subluxations, reduces muscle spasms and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective in strengthening the muscular corset and improving the biomechanics of the spine. Exercises are selected with a doctor. Systematic implementation helps maintain functionality and reduce lower back pain.
"He who is warned is warned! »But only a doctor can make an accurate diagnosis.