Lower back pain (lower back pain, lumbago, feeling of pain or tightness in the lumbar region) is a common complaint of patients when visiting a doctor.According to medical statistics, at least 70% of the population experiences such symptoms at least once in their lives.Furthermore, in 10% of cases, low back pain attacks become chronic.
The structure of symptoms is as follows:
- 80-85% - non-specific lower back pain.Symptoms subside 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.
Pain in the lumbar region ranks second in duration and third in frequency of issuing a certificate of temporary disability among all diseases.To prevent the pathology from recurring, it is necessary to promptly consult a doctor.
Types of back pain
According to the duration of the pain syndrome:
- Sharp pain.It occurs suddenly, as a reaction to new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks: this is the period of normal healing of damaged tissues;
- Recurring pain.The syndrome occurs no less than six months after the previous flare-up.Between relapses, the symptoms disappear completely;
- Exacerbation of chronic low back pain.Difference from relapse: the interval between attacks is less than 6 months, the symptoms may fade, but do not disappear completely.
According to the etiopathogenesis, low back pain is:
- Primary.The symptom occurs due to functional and/or dystrophic alterations of the intervertebral discs, joints, fascia, tendons and muscles;
- Secondary.The cause of frequent low back pain are congenital anomalies of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pain due to pathologies of the intestine, stomach, abdominal aorta and organs of the genitourinary system.
How is low back pain?
Most often, patients complain of sharp, severe pain in the lower back, also called shooting, throbbing or lumbago.Movement in the back is limited.Sometimes a person remains in a bent position and cannot straighten up.With any movement, sharp pain in the lower back intensifies ("shoots" in the back).The main cause of this condition is chronic diseases of the lumbar spine.An acute attack can last from a few minutes to several weeks.In some cases, the pain decreases so much that the person gets used to it.Full recovery without recurrent attacks is also possible.
Nagging pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but cause discomfort.Aching pain in the lower back may intensify with low bending, physical activity, after an infection, or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort in the back remain.
Symptoms you shouldn't ignore
If sharp or dull lower back pain is accompanied by one or more of the symptoms listed below, you should consult a doctor immediately.
Warning signs:
- numbness in the arms or legs, tingling sensation, “cotton-like” 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 long periods;
- rapid weight loss;
- increased temperature, fever;
- critical deviations in blood tests;
- age over 50;
- lack of dynamics during “routine” treatment for 4 weeks.
The doctor at the clinic will determine the cause of the pain and help relieve the exacerbation.Subsequently, 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 the 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 space between the vertebrae decreases, and with any sudden movement they can pinch the nerve.The pain is often accompanied by pulsation of the 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 disease is called sciatica.With lumbosacral radiculitis, lumbar ischialgia is often observed: severe pain in the lower back and leg of the affected side.
Osteochondrosis (spondylosis).The vertebrae become denser, deformed, and covered in osteophytes, bony growths that look like sharp spines.For a long time it was believed that osteochondrosis is a consequence of age-related degenerative changes, but now the diagnosis is “younger” every year.A sedentary lifestyle and sedentary work contribute to changes in the intervertebral discs already at the age of 25-30 years.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A fragment of joint tissue protrudes into the spinal canal.A hernia can appear after a back injury or develop due to osteochondrosis.
Inflammatory diseases of the spine.The 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 is also that patients constantly suffer from night pain that disturbs sleep and do not attach importance to morning stiffness in the back.Several years pass from the moment the first symptoms appear until the doctor's visit.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, a hump appears, etc.
Spondyloarthritis.Conditions such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lower back.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 lower back occurs with myositis: inflammation of the lower back muscles due to tension or hypothermia.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of the internal organs
Often the cause of low back pain is pathology of the kidneys, internal genital organs and urinary tract.The condition requires careful diagnosis and medical monitoring, as many complications are irreversible.
Low back pain due to renal pathology differs from the consequences of disorders of the musculoskeletal system by its constancy and independence from movement or body position.Special attention should be paid if symptoms such as cloudy urine, frequent or painful urination, etc. appear.
Diseases of the genital organs
Both women and men can experience severe pain in the lower back 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 variant of the norm.If your menstruation is very heavy, accompanied by changes in blood pressure and poor health, it is better to visit a antenatal clinic and take a hormonal test.Menstruation can be normalized with properly selected drugs.
Back pain in men can be a sign of prostate problems.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 to the coccyx, left thigh, perineum.Belt pain begins to increase after eating and intensifies with physical activity.Walking, jumping and other exercises cause stretching of the pancreatic capsule and a reaction in the nerve endings.
What to do if you suffer from severe back pain
If you experience a severe attack of pain at home or at work, you need to lie down on a hard surface and place a pillow under your bent knees so that your legs are at right angles to the body.Take a nonsteroidal anti-inflammatory drug.You can tie a warm shawl or scarf over your lower back to warm it up a bit.
If these measures do not bring relief, you need to 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 health condition, establish a preliminary diagnosis, draw up a plan for an initial 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 plasters.Some of them provide relief, but they should not be used continuously without medical supervision.In some cases, heating gels can only cause harm.Therefore, if you suffer from back pain, you should consult a doctor, even if you have managed to suppress the symptoms.
Diagnosis of low back pain
At the first appointment, the doctor interviews the patient, finds out how long the symptoms last, the dynamics of their development and the presence of associated disorders.The doctor will take into account exactly the type of pain: on the left or right, is the pain dull, aching, sharp or throbbing, the duration of the attacks and other details to make a preliminary diagnosis.In many typical cases, standard treatment by a general practitioner is possible.
Very often, if there are specific signs of a serious disease of the spine or internal organs, the patient undergoes additional examinations:
- Blood tests.A low hemoglobin level indicates the probable presence of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends doing not only a general analysis, but also a biochemistry to evaluate the functioning of the internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the results of the analysis are a direct indication for ultrasound of the urinary system and further examination by a urologist;
- Radiography of the lumbar spine.The photographs show some signs of inflammation of the joints, disorders of various structures and proximity of the vertebrae due to degenerative changes.Based on the x-ray, the doctor can hypothesize osteoporosis and see fractures;
- Magnetic resonance imaging (MRI).A non-radiographic method of examining patients, which allows you to obtain numerous images (slices) of the area of interest and its three-dimensional image.Unlike radiography and computed tomography, magnetic resonance imaging provides information about the condition of not only bones, but also muscles, blood vessels and soft tissues.
Treatment of back and lumbar pain
Uncomplicated forms of pain that are not associated with a serious disease of the spine or internal organs are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).To eliminate discomfort, it is enough to remove the provoking factor: lose weight, sit less, walk more, regularly do simple exercises.Moderate physical activity on an individual and continuous basis is recommended.
Getting rid of the pain caused by an illness that has deeper origins requires a systematic and comprehensive approach.The course of treatment should include medications, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In case of acute, unbearable pain, the doctor immediately at the appointment makes a blockade - an injection of anesthetic into the affected area.The injection quickly relieves discomfort, but provides only temporary relief.The patient must start treatment immediately.
To relieve a flare-up, your doctor prescribes:
- nonsteroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasmodic 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 drugs to treat the underlying pathology.
Auxiliary techniques
After the exacerbation has been relieved, the following treatment methods are effective:
- wear a special fixing bandage;
- medical massage on the lumbar region;
- shock wave therapy;
- swimming and gymnastics lessons;
- acupuncture;
- application of tapes;
- manual therapy;
- other physiotherapeutic techniques.
Surgery
Surgery is the last resort.Surgical treatment is indicated for serious disorders in the structure of the spinal cord or internal organs.There are many techniques.The specific type of operation is finally planned by a neurosurgeon, an operating urologist or an abdominal surgeon, taking into account the established diagnosis and the individual characteristics of the patient's condition.
Don't tolerate back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center you can undergo a comprehensive examination, find out why your back pain occurred and receive high-quality treatment.