Backache

There are many diseases that manifest as painful sensations in the lumbar region. They can indicate problems with the spine, joints, muscles, internal organs - kidneys, intestines, liver. This is a rather insidious symptom, and without visiting a doctor it is impossible to determine the true cause of pain in the lumbar region. Correct treatment is possible only after diagnosis in a medical facility.

Types of pain

During the initial examination, the doctor should ask the patient about the nature of the pain. In terms of duration, they can be:

• sharp- occur suddenly, paroxysmally, have different intensity, last less than 1 month;
• subacute- last 2-3 months, most often they are recurrent: they are activated for 2-5 days, then subside and after some time return again;
• chronic- last more than 1 year, the course is most often recurrent.

Doctors have found that most often chronic pain in this area is associated with the formation of local muscle spasms, seals that have certain pain points (the so-called myofascial syndrome). The muscles that straighten the spine, the gluteal muscles, the pelvic ligaments and the sacroiliac joint are also involved in the process.

The nature of the pain is sharp, painful, dull. By intensity - strong, medium, weak. Depending on the localization of the pain, the following types are distinguished:

• Lumbodynia- pain in the lumbar or lumbosacral region;
• sciatica- in the lower back, radiating to the leg;
• sacralgia- in the area of the sacrum;
• coccidinia- in the coccyx.

5 facts about lower back pain

• About 25% of all visits to clinics with complaints of back pain are related to sensations in the lumbar region.
• According to research, 84% of people have experienced pain in the lumbar region at least once in their life.
• 44–78% of patients (depending on age and region of residence) experience recurrent attacks of lumbodynia.
• Up to 37% of people periodically lose their ability to work due to low back pain.
• In 85% of patients who consult a doctor for pain in the lumbar region, musculoskeletal disorders are identified as the cause of the pain.
• According to statistics, about 90% of patients with acute pain in the lumbosacral region recover within 2 weeks.

Causes of lower back pain

Musculoskeletal disorders

In 2006, the European Federation of Neurological Societies officially adopted the following classification of the causes of lower back pain. They are divided into 3 main groups:

1. Compression of the spinal root, a peripheral nerve in the lumbar spine. It occurs due to protrusion (degenerative changes) of the intervertebral discs. Less often, it is due to dysplasia (disruptions in the process of formation) of the upper articular processes of the sacrum.
2. Diseases of the spine caused by tumors, joint damage, infections, compression fractures, allergic reactions, autoimmune inflammatory processes.
3. Musculoskeletal disorders resulting from subluxation, dislocation of spinal ligaments, muscle strain, intervertebral joint dysfunction.

Pathologies of internal organs

1. Disorders of the genitourinary system.

   Diseases of the excretory system - urolithiasis, cystitis, pyelonephritis - often cause discomfort in the lumbar region.

   Pain in the lower back in women may indicate dysfunction of the genital organs. Most often, the main sensations are concentrated in the lower abdomen and radiate to the sacrolumbar spine. They can appear during menstruation or after intercourse.

   One possible cause of lower back pain in women is ovarian tumors, which are located behind the uterus. Often discomfort in the lower back becomes a symptom of uterine fibroids. As the pain grows, it can be strong and sharp and indicate serious disturbances in the blood supply, stretching of the peritoneum and compression of the nerve plexuses in the pelvic area.

   Another cause of lower back pain in women is pelvic organ prolapse. In this case, the sensations are of a pulling nature. When walking and physical work, their intensity increases.

2. Disorders of the gastrointestinal tract.

   Most often, pain is felt in the lumbar region due to gastric and duodenal ulcers and acute pancreatitis. Patients complain that there is pain of a dangerous nature. Usually, the lower back begins to hurt at the same time as the right / left hypochondrium, where the most intense sensations are concentrated. In a number of clinical cases, lumbar pain accompanies an attack of acute appendicitis, although they are not the main symptoms of this disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.

10 risk factors for low back pain

1. Congenital pathologies of the lumbosacral spine.
2. Heavy physical work associated with loading the waist, frequent bending and vibration.
3. Acute and chronic stress that causes muscle spasms.
4. Sedentary lifestyle and prolonged stay in an unnatural posture with load on the lumbar region.
5. Weak muscle corset, which leads to incorrect posture, stooping, scoliosis and kyphoscoliosis.
6. Metabolic disorders and excess body weight, which increases the load on the lower part of the spine.
7. Increased physical activity and participation in sports increase the risk of injury.
8. Age over 50 years - due to the development of degenerative processes in the spine.
9. Frequent stress, depression.
10. Poor nutrition with a lack of B vitamins.

Pain in the lower back as a symptom of various diseases

Osteochondrosis of the lumbar spine

One of the most common diseases, the symptom of which is pain in the lumbar region. In osteochondrosis, the intervertebral discs, which play a shock-absorbing role between the vertebrae, become thinner. Nerve roots are pressed, muscles spasm and severe sharp pain occurs. Its intensity increases when bending over, lifting heavy objects, or when the patient tries to sit up from a lying position or stand up from a sitting position.

In advanced cases, a hernia is formed between the vertebrae, which only increases the pain. Osteochondrosis most often affects the lumbar spine, as it bears the maximum load when sitting and walking.

A severe complication of osteochondrosis is spondylosis. It is characterized by almost complete destruction of the intervertebral discs and formation of sharp bony protrusions - osteophytes. They injure nearby tissues, causing sharp, severe pain that radiates down one or both legs.

Signs of intervertebral hernia

• The patient can stand up from a sitting position only with support from a chair/table or a knee.
• Any load on the lower back causes an attack of sharp pain.
• The patient lies on his stomach, placing only a pillow under him.
• A person can only pick up an object from the floor by slowly crouching.

Ankylosing spondylitis

The disease occurs as a consequence of inflammatory processes in the spine. It is most often diagnosed in men aged 20-35 years. The patient feels stiffness in the lower back and discomfort in the sacrum in the morning and at rest. Gradually during the day this sensation passes, the person "walks". Many people do not pay attention to this alarming symptom, and ankylosing spondylitis leads to gradual fusion of the vertebrae, reduced mobility of the spine and damage. That is why you should visit a doctor at the first signs ofdisease - morning stiffness of the spine.

Spondyloarthrosis

This disease affects the cartilage tissue that covers the intervertebral discs. With age, it thins, breaks down, and in places where the cartilage breaks, bone growths form. Due to the fact that the intervertebral discs rub against each other, the nerve roots are irritated - this process is accompanied by severe pain in the lower back. The muscles in the problem area of the back are constantly tense and spasm.

Signs of spondyloarthrosis

• The pain becomes more intense after exercise and disappears after rest.
• The pain occurs after prolonged standing or walking.
• Simultaneously with the lumbar pain, the patient feels discomfort in one of the thighs and the hip joint.

Urolithiasis disease

The pain in this pathology is paroxysmal and very intense. Usually, the painful sensations arise from the inflamed kidney. It is difficult for the patient to find a position in which he feels better. After the attacks, the urine acquires a reddish color and its volume decreases.

Inflammation of superficial tissues and fibers

The cause of the pain may be a carbuncle or boil. These are purulent solid formations on the skin with a diameter of more than 1 cm. They are easily noticed by their purple color. Pain sensations are sharp, intense, pulsating.

Paranephritis, inflammation of the perinephric tissue caused by infection, is also painful. Sensations intensify with inhalation and movement. The patient tries to lie down with his legs together - in this position the pain is less pronounced. The skin in the affected area becomes swollen and reddened.

Inflammation of the spine, spinal cord

Osteomyelitis is an inflammatory process in the bone marrow that affects all bone tissue. The acute form is characterized by increasing pain of a pulling, bursting nature. It is combined with signs of intoxication and fever.

Tuberculosis of the spine occurs due to infection with the Koch bacillus. The first signs of the disease may appear many years after infection. It all starts with a deep pain that appears after a workout. The infection affects the vertebrae, makes the patient's movements difficult and a characteristic gait is formed.

Other diseases

Lumbar pain can be a symptom of many pathologies, including quite exotic ones. These include, for example, foot-and-mouth disease, Ebola, hemorrhagic fevers and Japanese mosquito-borne encephalitis.

• Cardiovascular diseases - aneurysm of the abdominal aorta, Loeffler's endocarditis.
• Myositis is inflammation and muscle pain in the lower back, which can be caused by infectious diseases such as flu, sore throat and even common ARVI.
• Benign and malignant neoplasms of the spine and spinal cord.
• Kidney pathologies - glomerulonephritis, renal vein thrombosis, pyelonephritis, cyst.
• Lower back pain in men occurs with prostate cancer.

Why does my lower back hurt when I cough?

Coughing provokes muscle tension in the affected area, which leads to pain. Often, patients first learn about a developing disease when they notice pain when coughing. Most often, such sensations are a sign of:

• intervertebral hernia,
• osteochondrosis,
• neuralgia,
• facet arthropathy,
• kidney diseases.

Diagnosis

As noted above, pain in the sacrolumbar area can be a symptom of many diseases. Therefore, to identify objective causes, you should consult a doctor at the first signs. You can make an appointment with an orthopedist, neurologist or surgeon. In the future, you may need to consult a rheumatologist, urologist or gastroenterologist.

• Initial review.The doctor assesses tissue sensitivity, muscle function and reflexes in the affected area.
• Radiography.The examination shows changes in the structure of the bones, cartilages and joints.
• Blood and urine tests.With their help, you can determine the presence of infection and inflammatory processes.
• Functional diagnostics.Includes methods for assessing nerve conduction and muscle function - electroneurography, electromyography.
• CT and MRI.Allows detailed examination of the state of bone, muscle, nerve and vascular structures.
• Ultrasoundperformed in case of suspected pathology of the pelvic organs, prostate or kidneys.

It is important to exclude (or confirm the presence of) a tumor, to distinguish between spinal root compression and musculoskeletal pain syndrome. Based on the diagnostic data, the doctor will determine the true cause of the pain and prescribe an effective treatment program.

Is bed rest necessary?

None of the recommendations for the treatment of lower back pain in diseases of the musculoskeletal system contain instructions for strict bed rest. On the contrary, patients are advised to return to normal activity as soon as possible to prevent the formation of a chronic pain syndrome. Strict immobilization is recommended for 1-3 days in severe cases, i. e. severe pain. In case of acute pain in the lower back, you can use a fixing belt. However, long-term lumbar fixation is not recommended unless there is trauma or spondylolisthesis. You should gradually include special exercises to strengthen the spine and muscles.

Treatment of lower back pain

Most often, a combination of medicinal and non-medicinal means is needed to solve the problem.

medicines

The basis of drug therapy is non-steroidal anti-inflammatory drugs (NSAIDs). They affect the peripheral mechanisms of pain formation and are prescribed for exacerbation of the pain syndrome. In most clinical cases, treatment is carried out in courses - no more than 12 weeks.

In most cases, patients are prescribed B vitamins to improve nerve conduction, decongestants and sedatives. In the chronic course of the disease, it is possible to take antidepressants. For strong muscle spasms and pain - muscle relaxants, weak opioids.

Non-medicinal

In addition, the patient may be prescribed manual therapy, acupuncture (acupuncture). The procedures are aimed at activating metabolism and blood circulation in the affected area. This allows for improved tissue nutrition.

According to doctors, physical therapy, lumbar muscle strengthening exercises, traction therapy and transcutaneous electrical neurostimulation have little effect. Most often, these procedures are prescribed in the absence of a pronounced effect of taking drugs for 4-6 weeks. There is no scientific evidence for the effectiveness of massage, physical therapy or wearing different belts.

What to do for prevention

• In the morning, do exercises with simple exercises to stretch the spine and muscles.
• Eat rationally, excluding fatty, fried, smoked, salty, spicy and alcohol.
• Monitor your own weight.
• Drink at least 1. 5 liters of fluid (preferably water) per day.
• Once every 6 months, take a course of classic massage.
• Avoid standing in one position for a long time.

Conclusion

Painful sensations in the lumbar region can be a symptom not only of pathologies of the musculoskeletal system, but also of internal organs. Many patients self-diagnose and treat, for example, a muscle strain, although the problem may actually be inflammation of the kidneys. Such treatment only worsens the situation - a person concentrates on a non-existent disease and causes serious pathology. That is why it is important to seek qualified help and identify the real cause of the pain. It is strictly not recommended to self-prescribe drugs.