Pain in the lower back (pain in the lower back, lumbago, a feeling of pain or pulling in the lumbar region) is a frequent complaint of patients when visiting a doctor.According to medical statistics, at least 70% of the population experiences such symptoms at least once in their life.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 disappear within a few weeks;
- 10-15% - spinal stenosis, radiculopathy, which causes nerve root compression;
- 1-2% - specific syndrome caused by oncopathology and diseases of internal organs.
Pain in the lumbar region ranks second in terms of duration and third in frequency of issuance of temporary disability certificates among all diseases.In order not to repeat the pathology, it is necessary to consult a doctor in a timely manner.
Types of lower back pain
According to the duration of the pain syndrome:
- Acute pain.It occurs suddenly, as a reaction to new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks - this is the period of normal healing of damaged tissues;
- Recurring pain.The syndrome occurs at least six months after the previous exacerbation.Between relapses, symptoms disappear completely;
- Worsening of chronic lower back pain.Difference from relapse: the interval between attacks is shorter than 6 months, symptoms may disappear, but they do not disappear completely.
According to etiopathogenesis, lower back pain is:
- Primary.The symptom is caused by functional and/or dystrophic changes in intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.The cause of frequent pain in the lower back is congenital abnormalities of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pains due to pathologies of the intestines, stomach, abdominal aorta and organs of the genitourinary system.
What does lower back pain look like?
Most 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 the person remains in a bent position and cannot stand up.With every movement, the sharp pain in the lower back intensifies ("shoots" in the back).The main cause of this condition is chronic diseases of the lumbar spine.An acute attack can last from a few minutes to a few weeks.In some cases, the pain recedes so much that the person gets used to it.Complete recovery without recurrent attacks is also possible.
Excruciating pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but cause 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 in the back.
Symptoms you should not ignore
If acute or dull pain in the lower back is accompanied by one or more symptoms from the list below, consult a doctor immediately.
Warning signs:
- numbness of arms or legs, tingling, cotton-like limbs;
- pain in the hip joints and knees;
- leg cramps;
- menstrual irregularities in women;
- sexual impotence in men;
- increased pain when sitting;
- inability to stand for a long time;
- rapid weight loss;
- elevated temperature, fever;
- critical deviations in blood tests;
- age over 50 years;
- lack of dynamics during "routine" treatment during 4 weeks.
The doctor at the clinic will determine the cause of the pain and help alleviate the aggravation.After that, an examination and comprehensive treatment under medical supervision will be required.
What pathologies can cause acute pain in the lumbar region
Diseases of the musculoskeletal system
Pinched sciatic nerve.Severe, shooting pain occurs in the lower back, caused by compression of the nerve roots by closely spaced adjacent vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes on the discs.The tissues are gradually destroyed, the gap between the vertebrae decreases, and with each sudden movement they can squeeze the nerve.Pain is often accompanied by pulsation of compressed blood vessels.
Sciatica (lumbosacral radiculitis).As a result of the pinching, the nerve roots become 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 leg on the affected side.
Osteochondrosis (spondylosis).The vertebrae become denser, deformed and covered with osteophytes - bone growths that look like sharp spines.For a long time, it was believed that osteochondrosis is a consequence 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 already at the age of 25-30.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A fragment of joint tissue protrudes into the spinal canal.A hernia can appear after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spinal column.Pathology can develop for several years without showing itself in any way.The disease begins at an early age and gradually leads to disability.The reason for such a disappointing prognosis is that patients suffer constant night pains that disturb sleep and do not attach importance to morning stiffness in the back.Several years pass from the appearance of the first symptoms to going to the doctor.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, a hump appears, etc.
Spondyloarthritis.Pathologies such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lumbar region.The main symptom is accompanied by inflammation of the joints of the knees, feet or hands, pain in the buttocks, blurred vision, unstable stool of unusual consistency.
Other diseases.Sharp pain in the lumbar region occurs with myositis - inflammation of the lumbar muscles as a result of tension or hypothermia.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of internal organs
Often the cause of pain in the lower back is pathology of the kidneys, internal genital organs and urinary tract.The condition requires careful diagnosis and medical supervision, as many complications are irreversible.
Pain in the lower back due to kidney pathology differs from the consequences of disorders in the musculoskeletal system by its persistence 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 genital organs
Both women and men can feel severe pain in the lower back due to various pathologies of the reproductive system.This is how sexually transmitted infections and inflammation of tissues and organs manifest.
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 periods are very heavy, accompanied by pressure spikes and poor health, it is better to visit the antenatal clinic and get tested for hormones.Menstruation can be normalized with properly selected drugs.
Lower back pain in men can be a sign of prostate problems.It is necessary to schedule an appointment with a urologist and perform an examination.
Pancreatitis
When the entire pancreas becomes inflamed, the pain surrounds the back in the lumbar region.Possible radiation to the coccyx, left thigh, perineum.The pain in the belt begins to increase after eating and is aggravated by physical activity.Walking, jumping and other exercises cause stretching of the pancreatic capsule and a reaction in the nerve endings.
What to do if you have severe lower back pain
If a sharp attack of pain occurs at home or at work, you need to lie down on a hard hard surface and put a pillow under your bent knees so that your legs are at right angles to the body.Take a nonsteroidal anti-inflammatory drug.You can tie a scarf or a warm scarf on the lower back to warm your back a little.
If these measures do not bring relief, it is necessary to call 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, first make an appointment with a general practitioner - he will comprehensively assess your health condition, make a preliminary diagnosis, create an initial examination plan, 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 plasters.Some of them provide relief, but they should not be used continuously without medical supervision.In some cases, warming gels can only harm.Therefore, if you have lower back pain, you should consult a doctor, even if you have managed to suppress the symptoms.
Diagnosis of lower back pain
At the first examination, the doctor interviews the patient, determines how long the symptoms have been, the dynamics of their development and the presence of accompanying complaints.The doctor will take into account how exactly it hurts - left or right, the pain is dull, aching, sharp or throbbing, the duration of the attack and other details to make a preliminary diagnosis.In many typical cases, standard treatment by a general practitioner is possible.
Most often, if there are specific signs of a serious disease of the spine or internal organs, the patient is referred for additional examinations:
- Blood test.A low level of hemoglobin indicates the probable presence of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends not only a general analysis, but also biochemistry to assess the functioning 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 of the joints, disorders of various structures, and the close proximity of the vertebrae due to degenerative changes.Based on the X-ray, the doctor can assume osteoporosis and see fractures;
- Magnetic resonance imaging (MRI).A method of examining patients without X-rays, 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.
Treatment of back and lower back pain
Uncomplicated forms of pain that are not associated with a serious disease of the spine or internal organs are treated with non-steroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to remove the factor that causes it: lose weight, sit less, walk more, do simple exercises regularly.Regular moderate physical activity is recommended on an individual basis.
Eliminating pain caused by a disease of deeper origin requires a systematic and comprehensive approach.The course of treatment should include medication, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In the case of acute, unbearable pain, the doctor performs a blockade immediately during the examination - injection of anesthetic into the affected area.The injection quickly relieves the discomfort, but provides only temporary relief.The patient should start treatment immediately.
To alleviate the exacerbation, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs that 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 prescribed drugs to treat the underlying pathology.
Auxiliary techniques
After easing the exacerbation, the following treatment methods are effective:
- wearing a special fixation bandage;
- medical massage on the lumbar region;
- shock wave therapy;
- swimming and exercise lessons;
- acupuncture;
- applying tapes;
- 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, operative urologist or abdominal surgeon, taking into account the 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.In the medical center, you can undergo a complete examination, find out why the back discomfort appeared and receive high-quality treatment.