Pain in the lower back (pain in the lower back, lumbago, a feeling of pain or pulling in the lumbar region) is a common complaint of patients when visiting a doctor.According to medical statistics, at least 70% of the population experiences similar symptoms at least once in their lifetime.In addition, in 10% of cases, lower back pain attacks become chronic.
The structure of the symptoms is as follows:
- 80-85% - non-specific low back pain.Symptoms subside within a few weeks;
- 10-15% - spinal stenosis, radiculopathy, causing compression of the nerve root;
- 1-2% - a specific syndrome caused by oncopathology and diseases of internal organs.
Lumbar pain ranks second in terms of duration and third in terms of frequency of issuance of a certificate of temporary incapacity among all diseases.In order to prevent the re-development of the pathology, it is necessary to consult a doctor in time.
Types of lower back pain
According to the duration of the pain syndrome:
- Sharp pain.Occurs suddenly, as a reaction to a new injury.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 no less than six months after the previous exacerbation.Between relapses, symptoms disappear completely;
- Exacerbation of chronic low back pain.Difference from relapse: the interval between attacks is less than 6 months, symptoms may disappear, but do not disappear completely.
According to etiopathogenesis, pain in the lower back is:
- Primary.The symptom occurs due to functional and/or dystrophic changes in the intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.The cause of frequent pain in the lower back is congenital anomalies 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 is low back pain?
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 a person remains in a prone 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 several weeks.In some cases, the pain subsides so much that a person gets used to it.A full recovery without recurrent attacks is also possible.
Piercing pain in the lower back is a common symptom of chronic diseases of the internal organs and the spine.The sensations are not expressed, but cause discomfort.Pain in the lumbar region may increase with low bending, physical activity, after infection or hypothermia.Even if the symptoms disappear completely, the stiffness and discomfort in the back remain.
Symptoms you shouldn't ignore
If sharp or dull pain in the lower back is accompanied by one or more symptoms from the list below, you should immediately consult a doctor.
Warning signs:
- numbness in the hands or feet, 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;
- fever, 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 alleviate the exacerbation.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.There is a sharp, shooting pain in the lower back caused by compression of the nerve roots from closely spaced adjacent vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes in the discs.The tissues are gradually destroyed, the distance between the vertebrae decreases, and with any sharp movement they can press the nerve.Pain is often accompanied by pulsation of compressed vessels.
Sciatica (lumbosacral radiculitis).As a result of pinching, the nerve roots become inflamed and radiculitis develops.If the sciatic nerve is affected, the condition is called sciatica.With lumbosacral radiculitis, lumbar sciatica 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 spikes.For a long time, it was believed that osteochondrosis was 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 years.Osteophytes irritate and compress the roots, causing pain.
Herniated intervertebral disc.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 spine.Pathology can develop for several years without manifesting itself in any way.The disease begins at an early age and gradually leads to disability.The reason for such a disappointing prognosis is also that patients endure constant night pain that disturbs sleep and do not attach importance to morning stiffness in the back.Several years pass from the appearance of the first symptoms to the visit to the doctor.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, a hump appears, etc.
Spondyloarthrosis.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, legs or hands, pain in the buttocks, blurred vision, unstable stools with an unusual consistency.
Other diseases.Acute 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 monitoring, as many complications are irreversible.
Low back pain due to kidney pathology differs from the consequences of musculoskeletal disorders in its persistence and independence from body movement or position.You should be especially 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 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 menstruation is very abundant, accompanied by pressure spikes and poor health, it is better to visit a prenatal pregnancy clinic and be examined for hormones.Menstruation can be normalized with properly selected drugs.
Lower back pain in men can be a sign of problems with the prostate gland.You need to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas becomes inflamed, the pain covers the back in the lumbar region.Possible radiation to coccyx, left thigh, perineum.The girdle pain 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 an acute attack of pain occurs at home or at work, you should lie down on a firm hard surface and place a pillow under your bent knees so that your legs are at right angles to your body.Take a nonsteroidal anti-inflammatory drug.You can tie a scarf or a warm scarf on your lower back to warm your back a bit.
If these measures do not bring relief, you should 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 assess your overall state of health, make a preliminary diagnosis, draw up a plan for a primary examination, prescribe adequate symptomatic treatment and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many "quick" solutions for back pain: a variety of gels, ointments and patches.Some of them do provide relief, but they should not be used continuously without medical supervision.In some cases, warming gels can only harm.Therefore, if you have pain in the lower back, you should consult a doctor, even if you have managed to suppress the symptoms.
Diagnosis of lower back pain
At the first meeting, the doctor questions the patient, finds out 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 attacks 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 doing not only a general analysis, but also biochemistry to assess the functioning of the internal organs;
- Urinalysis.The results of the test determine the health of the kidneys and urinary tract.Deviations in the analysis results are a direct indication for ultrasound of the excretory system and further examination by a urologist;
- X-ray of the lumbar vertebrae.The photographs show signs of inflammation of the joints, disorders of various structures and 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 non-X-ray method for examining patients, which allows you to get many images (slices) of the area of interest and its three-dimensional image.Unlike X-rays and computed tomography, MRI gives 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 nonsteroidal anti-inflammatory drugs (NSAIDs).To get rid of the discomfort, it is enough to remove the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Moderate physical activity is recommended on an individual, ongoing basis.
Eliminating pain caused by a disease that has a deeper origin requires a systematic and comprehensive approach.The course of treatment should include medication, physiotherapy, therapeutic gymnastics and massage.
Conservative therapy
In the case of acute, unbearable pain, the doctor immediately at the appointment performs a blockade - 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 relieve an 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 the back pain is a disease of the internal organs, the patient is prescribed drugs to treat the underlying pathology.
Auxiliary techniques
After relieving the exacerbation, the following treatment methods are effective:
- wearing a special fixing bandage;
- medical massage of the lumbar region;
- shock wave therapy;
- swimming and exercise lessons;
- acupuncture;
- band placement;
- manual therapy;
- other physiotherapy 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 finally planned by a neurosurgeon, an operating urologist or an 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 discomfort in the back appeared and receive high-quality treatment.