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 disrupt work ability for a long time, making movement and self-care impossible.Acute lower back pain affects both men and women equally often.
Occurring with greater frequency in middle and old age, low back pain can often occur in adolescents and young adults.This is due to rapid growth, weakness in the weak lower back muscles, and injuries.Thus, pain in the lumbosacral back is a pressing problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can intensify with coughing and sneezing, with any movements, especially when bending the body forward.Along with lower back pain, lumbar osteochondrosis can be manifested by impaired sensitivity of certain areas of the skin or muscles of the lower half of the torso and legs, weakening or disappearance of tendon reflexes of the legs.
- As a rule, with osteochondrosis, 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, there is a disturbance in urination or defecation, as well as a disturbance in the sensitivity of the bladder or genital organs.
- However, most often lumbar osteochondrosis manifests itself as radicular pain - i.e.developing as a result of pinching of nerve roots extending from the spinal cord at one level or another.Thus, one of the well-known lumbar syndromes is lumbago.It occurs at a moment of physical stress or in an awkward position of the body, and sometimes for no apparent reason.Suddenly, within a few minutes or hours, a sharp shooting pain (“lumbago”) appears, often it is burning and bursting (“as if a stake was 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 your leg are accompanied by a sharp 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.
| Dejerine's symptom | If you tense your abdominals and listen to your lower back, the pain will become 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 the lower back, this also indicates problems with the spine. |
| Lasègue's symptom | this can be felt after the following actions: lying on your back, you need to lift 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's 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
Intervertebral disc herniation 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 ability.
With continued exposure (excess weight, injury, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects form in it.Through these weak spots in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of lower back pain
Back pain is such a nonspecific symptom that can be caused by a lot of different reasons.Depending on how intensely the 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;
- 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 - stroke;
- 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, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc.) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gall bladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Upsetting aortic aneurysm.
Physiological reasons
Lower back pain may occur if you:
- 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 (salespeople, waiters, street advertising employees, surgeons) lifestyle;
- Do dynamic physical labor with sudden changes in body position (especially if your specialty involves heavy physical activity);
- You overload yourself in the gym or fitness club.Be extremely careful if you have recently started training;
- Are you interested in gardening work?
- Have reached postmenopause, which is predisposing to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy aggravates the manifestations of diseases existing in the mother’s body.Due to changes in hormonal levels and increased stress, pathologies especially often appear 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.), 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, inflammationappendix (an extension of the cecum, in men - diseases of the prostate gland, bladder.
Pain above the lower back
If the back hurts on the right above the lower back, liver pain can radiate, with any pathological changes in the liver - hepatitis, liver failure, taking toxic medications.The pain is most often localized in the right hypochondrium.
If 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 disease, malignant kidney tumors, chronic pyelonephritis, are accompanied by minor symptoms, since the renal capsule gradually stretches.
When should you see a doctor?
- If the back pain irrigates in the lower back, and is located a little higher (in the chest area).The pain is accompanied by sweating, attacks of vomiting and nausea, and shortness of breath.
- The pain radiates into the peritoneum, chest, neck, jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Spinal injury, accompanied by loss of control over bowel movements and urination.
- Legs become weak, buttocks and genitals go numb.
Diagnostics
In order to determine what disease caused the lower back pain, 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 the 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 your 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.Typically, an integrated approach is used, including 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:
- combination medications (used for sprains and injuries, along with 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 painkillers);
- chondroprotectors (one of the active components of such drugs is the substance chondroitin sulfate, used in pathological processes in cartilage tissue, promoting the active restoration of the cartilaginous surfaces of 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, make muscles strong, 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 attending physician.
- Movements are made slowly and smoothly without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothes that do not restrict movement;
- The exercises are done 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 are increased;
- During gymnastics, you should monitor your well-being.If sharp pain begins, you need to stop your activities.
In addition, massage is excellent in relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- improving blood supply to the diseased part of the body;
- kneading the muscles, which makes them and ligaments more flexible and elastic;
- relieving acute pain;
- getting rid of toxins accumulated in muscles and subcutaneous tissue;
- pleasant sensations due to 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 from it will be invaluable.
Which doctor should I contact?
If you have back pain, the cause of which is unknown, you should first consult a physician.It will help identify the disease based on the totality of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose during pregnancy, the menstrual cycle or a chronic disease, it makes sense to immediately contact a more specialized specialist.
Self-medication is only permissible if the cause of the pain is precisely known.