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 compromise your ability to work for a long time, making movement and self-care impossible.Acute low back pain affects both men and women equally frequently.
Low back pain, which occurs more frequently in middle and old age, can often occur in adolescents and young adults.This is due to rapid growth, weakness of weak lower back muscles and injuries.Therefore, lumbosacral back pain is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain with osteochondrosis can intensify with coughing and sneezing, with any movement, especially when bending the body forward.Along with lower back pain, lumbar osteochondrosis can be manifested by reduced sensitivity of some areas of the skin or muscles of the lower half of the torso and legs, weakening or disappearance of tendon reflexes in the legs.
- As a rule, with osteochondrosis, curvature of the lumbar spine is observed.Depending on the plane in which the curvature occurs, we distinguish scoliosis (curvature to the right or left), lordosis (forward curvature) and kyphosis (flattening of the lumbar region or even its backward curvature).If, due to osteochondrosis, the spinal cord is pinched, a disorder in urination or defecation occurs, as well as a disorder in the sensitivity of the bladder or genital organs.
- However, very often lumbar osteochondrosis manifests itself as radicular pain, i.e.developing due to pinching of the nerve roots extending from the spinal cord at one level or another.Therefore, one of the best-known lumbar syndromes is low back pain.It occurs in a moment of physical stress or in an uncomfortable position of the body, and sometimes for no apparent reason.Suddenly, within a few minutes or hours, a sharp, stabbing pain (“low back pain”) appears, often burning and bursting (“as if a stake was driven into my lower back”).
The patient gets stuck in an awkward position and is unable to right himself if the attack occurs while lifting something heavy.Attempts to get out of bed, cough or bend the leg are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand, a strong immobility of the entire lumbar region is revealed due to muscle tension.
Test for lumbosacral osteochondrosis
These tests are used as a way to make a preliminary diagnosis and are named after the doctors who recommended them.
| Dejerine's symptom | If you tense your abs 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 feel pain in your 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 raise 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 a spinal pathology. |
| Lerrey's symptom | if pain appears in a person along the sciatic nerve, after he stood forward, without bending his knees, from a lying position, we are talking about manifestations of chondrosis. |
Intervertebral disc herniation
An equally rare cause is intervertebral disc herniation, the clinical manifestation of which is pain in the lumbosacral region.The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With continued exposure (excess weight, injury, progressive osteoporosis), the fibrous ring of the disc thins and defects form.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.
Causes of back pain
Back pain is a nonspecific symptom that can be caused by many different reasons.Depending on the intensity of back pain in the lumbar region, whether it is constant or periodic, primary or secondary, there may be reasons causing it:
Chronic pain:
- osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Growing pains - scoliosis;
- Infectious lesions of the 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;
- Hip joint disorders;
- Spinal epiduritis;
- Protrusion of the 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;
- Low back pain, sciatica;
- Acute spinal circulatory disorders - stroke;
- Acute pyelonephritis.
Radiating pain in some diseases of internal organs:
- Pelvic organ diseases.In women - inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, sexually transmitted diseases (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc.) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Shocking aortic aneurysm.
Physiological reasons
Low back pain can occur if:
- Are you overweight?
- Additional risk for women;
- You are pregnant or have recently given birth;
- You spend a lot of time driving a car or using a computer;
- Lead a predominantly sedentary lifestyle (office workers) or standing (sellers, waiters, street advertising workers, surgeons);
- Do dynamic physical work with sudden changes in body position (especially if your specialty involves heavy physical activity);
- You overwork yourself in the gym or fitness club.Be very careful if you have recently started training;
- Are you interested in gardening work?
- They have reached postmenopause, which predisposes 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 hormone levels and increased stress, pathologies appear especially in the second half of pregnancy.In addition to the pain that accompanies the threat of premature birth, the cause of back pain in a pregnant woman can be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my lower back hurt?
When the back hurts under 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, intestine, inflammation of the appendix(an extension of the cecum, in men - diseases of the prostate, bladder.
Pain above the lower back
If the back hurts right above the lower back, pain in the liver may radiate, with possible pathological changes in the liver: hepatitis, liver failure, taking toxic drugs.The pain is most often localized in the right hypochondrium.
If you feel pain on the right or left just above your lower back, the cause is most likely acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant renal tumors, chronic pyelonephritis, are accompanied by minor symptoms, as the renal capsule gradually stretches.
When should you see a doctor?
- If your back pain radiates to the lower back and is located a little higher (in the chest area).The pain is accompanied by sweating, bouts of vomiting and nausea, and shortness of breath.
- The pain radiates to 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.
- The legs become weak, the buttocks and genitals become numb.
Diagnostics
To determine which disease caused your lower back pain, you need 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 intestine, 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 the 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.An integrated approach that includes several treatment methods is typically used.
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:
- combined drugs (used for sprains and injuries, along with anti-inflammatory and analgesic effects, have a healing effect due to the heparin and demethyl sulfoxide they contain);
- anti-inflammatory analgesics (contain refreshing 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 cartilaginous tissue, promoting the active restoration of the cartilaginous surfaces of the joints);
- irritating drugs (the effect is based on vasodilation and blood flow to the source of the pain).
With the help of therapeutic exercises, the patient can reduce pain, strengthen muscles, increase the distance between the vertebrae.They will help to release compressed nerve roots, normalize blood flow to the affected area and improve metabolic processes.
In order for such gymnastics to heal and not paralyze, it is necessary to follow all the recommendations of the attending physician.
- Movements are performed slowly and smoothly, without sharp turns;
- The room must be ventilated before training;
- The patient must wear clothing that does not restrict movement;
- The exercises are performed when the patient inhales and when he exhales he must return to the original position;
- The load increases gradually.Initially the number of approaches is around 10, then they are increased;
- During gymnastics, you should monitor your well-being.If sharp pain begins, you need to stop your activities.
Additionally, massage is great for relieving pain in the lumbar spine.The positive therapeutic effects of massage include the following:
- improve blood supply to the diseased part of the body;
- knead the muscles, making them and the ligaments more flexible and elastic;
- relieve acute pain;
- eliminate toxins accumulated in the muscles and subcutaneous tissue;
- pleasant sensations due to the 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 resulting from it will be invaluable.
Which doctor should I contact?
If you suffer from back pain, the cause of which is not known, you should first consult a doctor.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 allowed only if the cause of the pain is precisely known.