Pain in the lower back (pain in the lower back, lumbago, pain or pulling in the lumbar region) is a common complaint of patients when visiting the doctor.According to medical statistics, at least 70% of the population experiences such symptoms at least once during their lives.Moreover, in 10% of cases, lower back pain attacks become chronic.
The structure of symptoms is as follows:
- 80-85% - non-specific lower back pain.Symptoms subside within a few weeks;
- 10-15% - spinal stenosis, radiculopathy, causing nerve root compression;
- 1-2% - specific syndrome caused by oncopathology and diseases of internal organs.
Pain in the lumbar region ranks second in duration and third in frequency of issuing temporary disability certificates among all diseases.To prevent pathology from recurring, it is necessary to consult a doctor in time.
Types of lower back pain
According to the duration of the pain syndrome:
- Acute pain.It happens suddenly, in response to a new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks - this is the normal healing period of damaged tissue;
- Recurring pain.This syndrome occurs no less than six months after the previous exacerbation.Between relapses, symptoms disappear completely;
- Worsening chronic back pain.Differences from relapse: the interval between attacks is less than 6 months, symptoms may disappear, but not disappear completely.
According to etiopathogenesis, lower back pain is:
- main.Symptoms occur due to functional and/or dystrophic changes in intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.Frequent causes of back pain are congenital abnormalities of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pain due to pathologies of the intestines, stomach, abdominal aorta, and organs of the genitourinary system.
What kind of back pain?
Often, patients complain of sharp and severe pain in the lower back, which is also called shooting, throbbing or lumbago.Movement in the back is limited.Sometimes a person remains bent over and cannot stand up.With any movement, the sharp pain in the lower back gets stronger ("shoot" in the back).The main cause of this condition is chronic disease of the lumbar spine.Acute attacks can last from a few minutes to several weeks.In some cases, the pain lessens until the person gets used to it.Full recovery without recurrent attacks is also possible.
Disturbing pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensation is not pronounced, but it causes discomfort.Painful pain in the lumbar region can increase with low bending, physical activity, after infection, or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort remain behind.
Symptoms You Shouldn't Ignore
If acute or dull back pain is accompanied by one or more symptoms from the list below, you should see a doctor immediately.
Warning signs:
- numbness in arms or legs, tingling, "cotton-like" limbs;
- pain in the hip and knee joints;
- leg cramps;
- menstrual irregularities in women;
- sexual impotence in men;
- increased pain while sitting;
- inability to stand for a long time;
- rapid weight loss;
- increased temperature, fever;
- critical deviations in blood tests;
- age over 50 years;
- lack of dynamics during "routine" treatment for 4 weeks.
The doctor at the clinic will determine the cause of the pain and help relieve the severity.After this, comprehensive examination and treatment under medical supervision will be required.
What pathology can cause acute pain in the lumbar region
Diseases of the musculoskeletal system
The sciatic nerve is pinched.Severe, shooting pain occurs in the lower back, caused by compression of the nerve roots by adjacent vertebrae that are closely spaced.The cause of this phenomenon is osteochondrosis - this is a degenerative change in the disc.The tissue is gradually destroyed, the gap between the vertebrae decreases, and with any sudden movement they can pinch the nerves.Pain is often accompanied by pulsation of compressed vessels.
Sciatica (lumbosacral radiculitis).As a result of pinching, the nerve root becomes inflamed and radiculitis develops.If the sciatic nerve is affected, the disease is called sciatica.With lumbosacral radiculitis, lumbar ischialgia is often observed - severe pain in the lower back and legs on the affected side.
Osteochondrosis (spondylosis).The spine becomes denser, deformed, and covered with osteophytes - bony growths that look like sharp spines.For a long time it was believed that osteochondrosis was the result of age-related degenerative changes, but now the diagnosis is "younger" every year.A sedentary lifestyle and sedentary work contribute to changes in the intervertebral discs that are already 25-30 years old.Osteophytes irritate and compress the root, causing pain.
Intervertebral disc herniation.Fragments of articular tissue protrude into the spinal canal.Hernias can appear after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spine.Pathology can develop for several years without showing itself in any way.The disease begins at a young age and gradually leads to disability.The reason for the disappointing prognosis is also that the patient has constant night pain that disturbs sleep and does not care about morning stiffness in the back.Several years pass from the time the first symptoms appear until you see a doctor.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, humps appear, etc.
Spondyloarthritis.Pathologies such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lumbar region.The main symptoms are accompanied by inflammation of the joints of the knees, feet or hands, pain in the back, blurred vision, unstable stools with unusual consistency.
Other diseases.Sharp pain in the lumbar region occurs with myositis - inflammation of the lumbar muscles due to tension or hypothermia.These symptoms are also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of internal organs
Often the cause of back pain is pathology of the kidneys, internal genital organs, and urinary tract.This condition requires careful diagnosis and medical monitoring, as many complications are irreversible.
Low back pain due to kidney pathology differs from that due to disorders in the musculoskeletal system in its consistency and independence from movement or body position.It is especially necessary to be careful if there are symptoms such as cloudy urine, frequent or painful urination, etc.
Diseases of the genital organs
Both women and men can experience severe back pain due to various pathologies of the reproductive system.This is how sexual infections and inflammation of tissues and organs manifest themselves.
Lower back pain in women often occurs during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered a variant of the norm.If your period is very heavy, accompanied by stress spikes and poor health, it is better to visit an antenatal clinic and undergo a hormone test.Menstruation can be normalized with properly selected medicines.
Lower back pain in men can be a sign of problems with the prostate gland.It is necessary to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas is inflamed, pain surrounds the back in the lumbar region.Possible irradiation on the tailbone, left thigh, perineum.Girdle pain begins to increase after eating and increases with physical activity.Walking, jumping and other exercises cause stretching of the pancreatic capsule and a reaction on the nerve endings.
What to do if you have severe back pain
If a sharp attack of pain occurs at home or at work, you need to lie on a hard hard surface and place a cushion under the bent knees so that your legs are at right angles to your body.Take non-steroidal anti-inflammatory drugs.You can tie a scarf or a warm scarf around your lower back to warm your back a bit.
If these measures do not bring relief, you need to contact a doctor or emergency medical help at home.If you feel better, do not wait for a new attack of pain and find time to go to a medical center, make an appointment with a general practitioner first - he will comprehensively assess your health condition, establish an initial diagnosis, make a plan for an initial examination, prescribe adequate symptomatic treatment, and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many "quick" solutions for back pain: various gels, ointments and patches.Some of them do provide relief, but they should not be used continuously without medical supervision.In some cases, heating gels can only cause harm.Therefore, if you experience back pain, you should see a doctor, even if you manage to suppress the symptoms.
Diagnosis of lower back pain
At the first appointment, the doctor interviews the patient, finds out how long the symptoms last, the dynamics of their development, and the presence of accompanying complaints.The doctor will take into account exactly how it hurts - on the left or right side, the pain is dull, aching, sharp or throbbing, the duration of the attack and other details to make an initial diagnosis.In most common cases, standard treatment by a general practitioner is possible.
Often, if there are specific signs of a serious disease in the spine or internal organs, the patient is referred for additional examination:
- Blood test.A low level of hemoglobin indicates the possible presence of a tumor, an increase in ESR indicates inflammation or infection, etc.Doctors recommend doing not only a general analysis, but also biochemistry to assess the function of internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the results of the analysis are a direct indication for an ultrasound of the urinary system and further examination by a urologist;
- X-ray of the lumbar spine.The photographs show certain signs of inflammation in the joints, disturbances of various structures, and close proximity of the vertebrae due to degenerative changes.Based on the x-ray, the doctor can assume osteoporosis and see a fracture;
- Magnetic resonance imaging (MRI).A non-X-ray method of examining the patient, which allows you to get many images (slices) of the area of interest and its three-dimensional image.Unlike radiography and computed tomography, MRI provides information about the condition of not only bones, but also muscles, blood vessels, and soft tissues.
Back and waist pain treatment
Uncomplicated forms of pain that are not associated with serious diseases of the spine or internal organs are treated with non-steroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to eliminate the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Regular moderate physical activity is recommended.
Eliminating pain caused by diseases that have deeper origins requires a systematic and comprehensive approach.The course of treatment should include medication, physiotherapy, therapeutic exercises, and massage.
Conservative therapy
In case of acute, unbearable pain, the doctor immediately at the appointment makes a blockade - an anesthetic injection to the affected area.Injections quickly relieve discomfort, but only provide temporary relief.Patients should start treatment immediately.
To relieve the severity, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasmodic muscles;
- B vitamins to improve the regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of internal organs, the patient is given medication to treat the underlying pathology.
Assistive techniques
After exacerbation of relief, the following treatment methods are effective:
- wear a special fixing bandage;
- medical massage in the lumbar region;
- shock wave therapy;
- swimming and exercise classes;
- acupuncture;
- using tape;
- manual therapy;
- other physiotherapeutic techniques.
Surgical intervention
Surgery is a last resort.Surgical treatment is indicated for severe disorders in the structure of the spinal cord or internal organs.There are many techniques.The specific type of intervention is ultimately planned by a neurosurgeon, surgical urologist, or abdominal surgeon, taking into account the established diagnosis and the individual characteristics of the patient's condition.
Do not tolerate lower back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center, you can undergo a full examination, find out the cause of your back discomfort, and receive high-quality treatment.