When a person is in pain, the only wish is for the pain to disappear quickly and never come back. 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 the age of 40. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Low back pain indicates damage to the spine, disease of nerve endings, muscle tissue and internal organs. It is observed during fevers. It can be sharp and dull, constant and periodic, shot and bursting. Pain can be periodic, local, painful or annoying, for some it is associated with the weather, for others with physical activity, for others with staying in an uncomfortable position for a long time.
Why does my lower back hurt?
The causes of frequent low back pain 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.
Spinal diseases
Common causes of low back pain are congenital anomalies and acquired spinal diseases. Pain is sometimes associated with weather changes and sometimes with physical activity.
Lumbago– acute pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumboischialgia occurs - stabbing or stabbing pain in the lower back, which radiates to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are detected in spinal pathologies:
- Degenerative pathologies: osteochondrosis, protrusion of the intervertebral disc, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal circulatory disorders.
- Other diseases: diseasemore forest.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
spinal curvature
Mild pain with curvature of the spine is associated with improper distribution of physical activity, overstrain of 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 feels tight or hurts for a long time, it could be osteoporosis. The pain is aggravated by stress and changes in weather. Osteoporosis can be:
- postmenopausal;
- youth;
- idiopathic;
- senile.
The same pain sensations appear in patients with genetic diseases, disorders of the endocrine glands and poisoning when taking medications. Secondary osteoporosis may be due to the syndrome.malabsorption, 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 hematoma, which manifests itself as moderate pain and, when moving, is accompanied by swelling, bruising and bleeding. 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 turning the body, the muscles and tissues swell. The lumbar area is painful on palpation.
In patients with spondylolisthesis and vertebral dislocations, paroxysmal pain with a feeling of heaviness in the lower back and numbness in the legs is found.
Soft tissue and kidney injuries.
Moderate pain occurs and decreases with bleeding or swelling due to soft tissue bruising. Hematomas in the kidneys are painful and radiate to the lower abdomen, genitals and lumbar region. Sometimes a hematoma and manifestations of hematuria are visible. In case of severe bruising, painful shock, blood in the urine and severe, prolonged pain may occur.
Infections of the spine and spinal cord.
OsteomyelitisIt manifests itself as increasing pain in the lumbar area in combination with chills and fever, it can be hematogenous, post-traumatic, contact, postoperative. The intense pain pulls and bulges so much that it prevents movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistulous tract is formed with pus secretion, due to which the pain manifestations are softened.
Spinal tuberculosisIt develops gradually, starting with periodic pain, which intensifies due to stress, then stiffness of movements occurs. 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 combined with muscle tension, chills and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
Boil,carbuncles– in the context of purulent processes, skin compactions of a violet or bluish tone 1 cm in diameter appear, in the center with one or more rods, and are accompanied by increased pain in the lumbar area. The pain contracts, pulsates and can deprive you of sleep. Hyperthermia is noted.
InparanephritisFirst, fever appears, then local edema, hyperemia and hyperthermia are detected. Severe pain, radiating to the stomach and under the ribs, intensifying with movements and even 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 lumbar muscles do not tense. The condition of the body is serious.
Infectious diseases
InARVI,fluANDsore throatWith an increase in body temperature and intoxication of the body, myositis is characterized by pain in the lower back, which causes the desire to change positions. Sometimes lower back pain is caused by an infection in the kidneys. Infectious diseases with pain in the lower back:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- Bacterial, fungal and viral infections.
Pain in the lower back due to severe infections is seen during a cytokine storm. Epidemiological 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 appearing in the extremities, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia subsides at rest, intensifies during movement, and may disappear a few days after warming up the muscles.
Other muscle injuries
Pain in the lower back occurs after intense physical activity, strength exercises for the back muscles, or prolonged stay in a position with tension on the lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, excessive exertion, metabolic disorders and is accompanied by prolonged pain.
Formsmyositis:
- 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
Low back pain is a concern in pathological conditions:
- Tumorscolumn 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:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous poisonings: Abuse of adrenomimetic drugs.
- Pathologies of the heart and blood vessels.: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: shock from blood transfusion.
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 should be taken into account when diagnosing low back pain. The muscle pain lasts about two weeks and then goes away.
Pain caused by changes in the spine lasts longer and radiates to the leg, perineum and may be accompanied by tingling, numbness and burning sensations.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by its intensity and longer duration.
Diagnosis
A medical history is of great importance to make a diagnosis, since low back pain can be caused by various diseases.
The primary diagnosis is made by a traumatologist-orthopedist. When diagnosing, the doctor takes into account the following symptoms: problems with 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 when the pain appears, its relationship with stress, the presence of cramps, cough, fever and dysfunction of the bladder or intestines.
If there are neurological symptoms, the patient is seen by a neurologist. The doctor interviews the patient and performs a visual examination, then the patient is sent for an instrumental and hardware examination. According to the doctor's instructions, 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 and muscle strength, and coordination of movements.
- Bone scan.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.
- Computed tomography.CT scans examine the detailed structure of solid structures.
- magnetic resonance– an informative method that allows you to diagnose morphological changes in the state of the intervertebral ligaments and 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)It is used to determine conduction alterations along nerve fibers.
- Lab tests.To determine the causative agent of the infection, urine and blood tests are performed for microbiological examination. To detect neuroinfections through serological tests.
Low back pain treatment
First aid
For spinal injuries, the patient is placed on a hard, flat surface and brought to the clinic. To reduce pain, it is necessary 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 pain relievers. For degenerative diseases of the spine, lumbago and lumboischialgia, the use of creams, ointments and gels with a warming and analgesic effect is allowed. In case of infectious processes, its use is prohibited.
The basis of treatment is physiotherapy and pharmacotherapy. 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 blocks 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:
- For instability: interbody fusion, transpedicular fixation, plate fixation.
- For tuberculosis, tumor, osteoporosis, osteomyelitis: sequestectomy, 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 muscle corset and improving spinal biomechanics. Exercises are selected with a doctor. Systematic implementation allows you to maintain functionality and reduce pain in the lower back.
"Forewarned is forearmed! "But only a doctor can make an accurate diagnosis.