When a person is in pain, the only wish is for the pain to go away quickly and never come again. The back is a "working" 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 40 years. The most commonthe cause is osteochondrosis, but this pathology does not explain the nature, strength and duration of back pain. Pain in the lower back indicates damage to the spine, disease of nerve endings, muscle tissue and internal organs. It is observed during fever. Itit can be sharp and dull, constant and intermittent, shooting and bursting. Pain can be intermittent, local, aching or pressing, for some it is associated with time, for others with physical activity, for others with staying in an uncomfortable position for a long timetime.
Why does my lower back hurt?
The causes of frequent pain in the lower back can be diseases of the muscle tissue, injuries to the bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Diseases of the spine
Common causes of low back pain are congenital anomalies and acquired spinal diseases. Pain is sometimes associated with changes in weather and sometimes with physical activity.
Lumbago– sharp pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumboischialgia occurs - pains or shooting pains in the lower back, radiating to the back of the thigh. The pain appears against the background of radicular syndrome. Painful sensations are detected in pathologies of the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal circulatory disorders.
- Other diseases: diseaseForestier.
Secondary lesions of the 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, overstrain of ligaments and muscles in the lower back. The pain occurs due to an uncomfortable position while sleeping on a hard or, conversely, a soft mattress.
The symptom is accompanied by:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- flat back syndrome.
osteoporosis
If your lower back feels tight or hurts for a long time, it could be osteoporosis. The pain is made worse by stress and changes in the weather. Osteoporosis can be:
- after menopause;
- youthful;
- idiopathic;
- senile.
The same pain sensations appear in patients with genetic diseases, disorders of the endocrine glands and intoxications when taking drugs. Secondary osteoporosis may be due to the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
An increase in pain and an increase in its duration are associated with injuries and fractures.
Spinal injuries
A common injury to the lumbar spine is a contusion that manifests as moderate pain and is accompanied by swelling, hematomas and hemorrhages when moving. In severe cases, neurological disorders are also added.
A compression fracture in the lower back occurs due to forced bending of the spine and is characterized by cessation of breathing and severe pain. The pain intensifies when turning 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 in the legs occur in patients with spondylolisthesis and dislocation of the vertebrae.
Soft tissue and kidney injuries
Moderate and subsiding pain with hemorrhage or swelling occurs from soft tissue contusions. Kidney bruises are painful and spread to the lower abdomen, genitals, and lumbar region. Hematoma and manifestations of hematuria are sometimes observed. With severe bruising, painful shock, blood in the urine and prolonged severe pain may occur.
Infections of the spine and spinal cord
Osteomyelitismanifests itself as increasing pain in the lower back combined with chills and high fever. It can be hematogenous, post-traumatic, contact, postoperative. The intense pain pulls and protrudes so much that it interferes with movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistula tract is formed with the release of pus, so the manifestations of pain are smoothed out.
Spinal tuberculosisit gradually develops, starting with periodic pain, which increases due to stress, then stiffness of movements appears. The pain becomes burning and radiates to the legs with paresthesia and numbness due to destruction of the vertebrae and compression of the nerve roots.
In patients withspinal epidural abscesssevere pain is combined with muscle tension, chills and hyperthermia. As the disease progresses, radicular syndrome and paresis appear.
Local inflammation
Boils,carbuncles- against the background of purulent processes, skin seals with a purple or bluish tint appear with a diameter of 1 cm, in the center with one or several rods and are accompanied by increasing pain in the lower back. The pain is throbbing, throbbing, and can keep you awake. Hyperthermia is noted.
Atparanephritisfirst fever appears, then local edema, hyperemia and hyperthermia are detected. On the third day, severe pain develops, radiating to the stomach and under the ribs, increasing with movement and even with breathing. Against the background of paranephritis, due to severe pain, the patient is forced to take a crooked position so that the muscles of the lower back do not strain. The condition of the body is grave.
Infectious diseases
AtORVI,fluAndsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by 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-borne encephalitis;
- Ebola fever;
- foot and mouth
- coronavirus;
- bacterial, fungal, viral infections.
Lower back pain due to severe infections is seen during a cytokine storm. Epidemiologic myalgia is accompanied by attacks of severe pain in the lower back, lasting up to 10 minutes with an interval of half an hour to an hour and occurring in the limbs, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia subsides at rest, increases during movement, and may disappear several days after warming up the muscles.
Other muscle lesions
Pain in the lower back appears after intense physical activity, strength exercises for the back muscles, or a long stay in a position with tension in the muscles of the lower back. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overexertion, metabolic disorders and is accompanied by painful long-term pain.
Formsmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
Chronic pain with asthenia, sleep disorders and neurotic disorders are observed in fibromyalgia.
Other diseases
Pain in the lower back is alarming in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, neoplasms of the spinal cord.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, renal infarction, renal vein thrombosis, renal cyst, kidney cancer.
- Hereditary diseases:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous intoxications: abuse of adrenomimetic drugs.
- Pathologies of the heart and blood vessels: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: blood transfusion shock.
The pain syndrome spreads in the lower back against the background of pelvic diseases, women's diseases, as well as prostate cancer, proctitis, sigmoiditis.
Types of pain
Duration should be considered when diagnosing low back pain. The muscle pain lasts for about two weeks and then goes away.
Pain caused by changes in the spine lasts longer and radiates to the leg, perineum and can be accompanied by a feeling of pins and needles, tingling and burning.
The pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by intensity and longer duration.
Diagnosis
The anamnesis is of great importance for making the diagnosis, because pain in the lower back can be caused by various diseases.
The primary diagnosis is made by a traumatologist-orthopedic. When diagnosing, the doctor takes into account the following symptoms: impaired defecation and urination, orthopedic defects, weakness and numbness in the leg. An examination is performed to identify pain points and muscle spasms.
It also matters at what time the pain occurs, its relation to stress, the presence of spasms, cough, temperature and bladder or bowel dysfunction.
If there are neurological symptoms, the patient is monitored by a neurologist. The doctor interviews the patient and performs a visual examination, after which the patient is sent for hardware and instrumental examination. Consultations with a surgeon, rheumatologist, urologist and other specialized specialists are scheduled according to the doctor's indications.
Diagnosis may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, sensitivity and muscle strength, coordination of movements.
- Roentgen.X-ray is the initial research method that allows you to determine changes in bone tissue. Photographs of the lumbar region show fractures, degenerative changes in the intervertebral discs, signs of inflammatory processes and spondylolisthesis.
- CT.A CT scan examines the detailed structure of solid structures.
- MRI- an informative method that allows you to diagnose morphological changes in the condition of the ligaments and intervertebral discs. To rule out stenosis, myelography is prescribed.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests assess muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine disturbances in nerve fiber conduction.
- Laboratory researches.To establish the cause of the infection, urine and blood are taken for microbiological examination. To 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 can take analgesics. In degenerative diseases of the spine, lumbago and lumboschialgia, it is allowed to use creams, ointments and gels with a warming and analgesic effect. In 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 means for local application, used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B vitamins, enhancing the effect of medicinal pain relievers.
- Local anesthetics.They perform therapeutic blockades for acute pain with anesthetics, as well as pain relievers in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetic therapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
surgery
Depending on the pathological characteristics, there are surgical interventions:
- For instability: inter-unit 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, puncture decompression of the disc.
Prevention
Massage is effective in the presence of muscle blocks and joint subluxations, reduces muscle spasm and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective in strengthening the muscle corset and improving the biomechanics of the spine. Exercises are chosen with a doctor. Systematic application allows you to maintain functionality and reduce pain in the lower back.
"The forewarned is armed in advance! "But only a doctor can make an accurate diagnosis.