When a person suffers from pain, the only wish is for the pain to go away quickly and never to appear again. The back is a "working" and important part of our body, because 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. Pain in the lower back indicates damage to the spine, disease of nerve endings, muscle tissue and internal organs. It is observed during fever. It can be sharp and dull, constant and intermittent, bursting and bursting. The pain can be periodic, local, painful or excruciating, for some it is related to the weather, for others with physical activity, for others with a long stay in an uncomfortable position.
Why does my lower back hurt?
The causes of frequent pain in the lower back can be diseases of muscle tissue, injuries to bones and intervertebral discs. They arise in 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 diseases of the spine. Pain is sometimes associated with weather changes and sometimes with physical activity.
Lumbago- sharp pain that limits movement and is caused by muscle spasm. Along with pathological processes in the spine, lumboischialgia occurs - aching or shooting pain in the lower back, radiating to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are revealed with pathologies in the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: circulation disorders in the spine.
- Other diseases: diseaseForestier.
Secondary lesions of nerve structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Curvature of the spine
Minor aching 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 aggravated by stress and weather changes. Osteoporosis can be:
- postmenopause;
- juvenile;
- idiopathic;
- senile.
The same pain sensations occur in patients with genetic diseases, disorders of the endocrine glands and intoxications when taking drugs. Secondary osteoporosis can be a consequence of the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
An increase in pain and a prolongation of its duration are associated with injuries and fractures.
Spinal injuries
A frequent injury to the lumbar part of the spine is a bruise that is manifested by moderate pain, and when moving, it is accompanied by swelling, hematomas 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. 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 of the legs is found in patients with spondylolisthesis and vertebral dislocation.
Soft tissue and kidney injuries
Moderate and subsiding pain with bleeding or swelling occurs due to soft tissue bruising. Bruises on the kidneys are painful and spread to the lower abdomen, genitals and lumbar region. Hematoma and manifestations of hematuria are sometimes visible. In case of severe bruising, there may be painful shock, blood in the urine and long-lasting severe pain.
Infections of the spine and spinal cord
Osteomyelitisit is manifested by increased pain in the lower back in combination with shivering and temperature. 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 discharged pus, so the manifestations of pain are smoothed out.
Tuberculosis of the spineit develops gradually, starting with periodic pain, which intensifies due to stress, then stiffness of movement appears. 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 appear.
Local inflammation
Boiling,carbuncles- on the background of purulent processes, compactions of the skin of a purple or bluish hue with a diameter of 1 cm appear, with one or more rods in the middle, and are accompanied by increased pain in the lower back. The pain is throbbing, throbbing and can keep you from sleeping. Hyperthermia is observed.
Atparanephritisfirst fever appears, then local edema, hyperemia and hyperthermia are detected. Intense pain, which spreads to the abdomen and under the ribs, intensifies when moving and even when breathing, develops on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a wrong position so that the muscles of the lower back are not strained. The condition of the body is serious.
Infectious diseases
AtARVI,the fluISore throatwith an increase in body temperature and body intoxication, myositis is characterized by aching 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 encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- bacterial, fungal, viral infections.
Lower back pain due to severe infections is seen during a cytokine storm. Epidemiological myalgia is followed by attacks of intense pain in the lower back, which last up to 10 minutes with an interval of half an hour to an hour and occur in the limbs, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and stiffness. Myalgia subsides at rest, increases during movement and may disappear a few days after warming up the muscles.
Other muscle lesions
Painful pain in the lower back occurs after intense physical activity, strength exercises for the back muscles or prolonged 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 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 causes concern in pathological conditions:
- Tumorsspine 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 intoxications: Abuse of adrenomimetics.
- Pathologies of the heart and blood vessels: Loeffler's endocarditis, abdominal aortic aneurysm.
- Emergency conditions: blood transfusion shock.
The pain syndrome radiates to the lower back against the background of pelvic diseases, women's diseases, as well as prostate cancer, proctitis, sigmoiditis.
Types of pain
Duration must 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, groin, and can be accompanied by a feeling of pins and needles, numbness and burning.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by intensity and longer duration.
Diagnostics
Anamnesis is of great importance for establishing a diagnosis, because pain in the lower back can be caused by various diseases.
The primary diagnosis is carried out by a traumatologist-orthopedic. When making a diagnosis, the doctor takes into account the following symptoms: disorder of defecation and urination, orthopedic defects, weakness and numbness in the leg. An examination is conducted to determine pain points and muscle spasms.
It is also important at what time the pain appears, its connection with stress, the presence of cramps, cough, fever and bladder or bowel dysfunction.
If there are neurological symptoms, the patient is examined by a neurologist. The doctor interviews the patient and performs a visual examination, then the patient is sent for a hardware and instrumental examination. According to the doctor's indications, consultations with a surgeon, rheumatologist, urologist and other specialists are prescribed.
Diagnostics may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, muscle sensitivity and strength, and movement coordination.
- x-ray.X-ray is an initial examination method that allows you to determine changes in bone tissue. Fractures, degenerative changes on the intervertebral discs, signs of inflammatory processes and spondylolisthesis are visible on the images of the lumbar region.
- CT scanner.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 ligaments and intervertebral discs. To rule out stenosis, a 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 conduction disturbances along nerve fibers.
- Laboratory tests.To determine the cause of the infection, urine and blood tests are taken for microbiological examination. For the detection of neuroinfections - serological tests.
Treatment of lower back pain
First aid
In the case of spinal injuries, the patient is placed on a hard, flat surface and taken to the ambulance. To reduce pain, it is necessary to optimize the position of the body during work and rest to reduce the load on the back. You can take analgesics before the doctor's examination. In the case of degenerative diseases of the spine, lumbago and lumboischialgia, the use of creams, ointments and gels with warming and analgesic effects is allowed. In case of 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 topical agents, which are used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B vitamins, enhancing the effect of medical painkillers.
- Local anesthetics.They perform therapeutic blockades for acute pain with anesthetics, as well as painkillers in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetotherapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
Operation
Depending on the pathological characteristics, there are surgical interventions:
- For instability: interbody 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, disc puncture.
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 for strengthening the muscular corset and improving the biomechanics of the spine. Exercises are chosen with the doctor. Systematic application allows you to maintain functionality and reduce pain in the lower back.
"Warned is armed! "But only a doctor can make an accurate diagnosis.