When a person is suffering from pain, the only wish is that the pain goes away quickly and never occurs again. The back is a "working" and important part of our body, as it houses the main organ - the spine. Frequent back pain is a symptom of various diseases. Almost everyone has pain in the lumbar spine, especially after 40 years. The most common cause is osteochondrosis, However, 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 with fever. It can be sharp and dull, be constant and periodic, shooting and bursting. The pain may be periodic, local, aching or excruciating, in some it is related to the weather, in others to physical activity, in others to remaining in an uncomfortable position for a long period of time.
Why does my lower back hurt?
The causes of frequent lower back pain can be diseases of muscle tissue, injuries to bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spinal diseases
Common causes of back pain include congenital anomalies and acquired spinal diseases. The pain is sometimes associated with weather changes and sometimes with physical activity.
lumbago– stabbing pain that restricts movement and occurs due to muscle spasms. When pathological processes occur in the spine, lumbosciatica occurs - an aching or stabbing pain in the lower back that radiates to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are noted in diseases of the spine:
- Degenerative pathologies: Osteochondrosis, disc herniation, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: Spondylolysis, spondylolisthesis.
- Vascular diseases: Circulatory disorders in the spine.
- Other diseases: illnessForestier.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Curvature of the spine
Mild aching pain with a curvature of the spine is associated with incorrect distribution of physical activity, overload of the ligaments and muscles in the lower back. Pain occurs due to an uncomfortable position when sleeping on a hard or, conversely, soft mattress.
The symptom is accompanied by:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- Flat Back Syndrome.
osteoporosis
If your lower back feels tight or painful for a long time, it could be osteoporosis. The pain is increased by stress and weather changes. Osteoporosis can be:
- postmenopausal;
- youthful;
- idiopathic;
- senile.
The same pain sensations occur in patients with genetic diseases, disorders of the endocrine glands and intoxication when taking medications. Secondary osteoporosis may be due to the syndromeMalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
Increasing pain and prolonged duration are associated with injuries and fractures.
Injuries to the vertebral acid
A common injury to the lumbar spine is a bruise that presents with moderate pain and is accompanied by swelling, bruising, and bleeding with movement. In severe cases, neurological disorders also occur.
A compression fracture in the lower back occurs due to forced flexion of the spine and is characterized by respiratory failure and severe pain. When the body turns, the pain increases and muscles and tissues swell. The lower back hurts when palpated.
Patients with spondylolisthesis and vertebral dislocations experience paroxysmal pain with heaviness in the lower back and numbness in the legs.
Soft tissue and kidney injuries
Soft tissue bruises cause moderate and decreasing pain with bleeding or swelling. Kidney bruises are painful and radiate to the lower abdomen, genitals and lumbar area. Sometimes a hematoma and manifestations of hematuria are visible. Severe bruises may result in painful shock, blood in the urine, and persistent severe pain.
Infections of the spine and spinal cord
Osteomyelitismanifests itself as increasing pain in the lower back in combination with chills and fever. It can be hematogenous, post-traumatic, contact or postoperative. The intense pain pulls and arches so much that it prevents movement and forces you to freeze. In the chronic form of osteomyelitis, a fistula tract forms with pus escaping, which smooths out the pain.
Spinal tuberculosisdevelops gradually, starting with periodic pain, aggravated by stress, then stiffness of movement occurs. The pain becomes burning and radiates to the legs, with paresthesia and numbness due to destruction of the vertebrae and compression of nerve roots.
In patients withspinal epidural abscessSevere pain is accompanied by muscle tension, chills and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
boil,carbuncle– Against the background of purulent processes, purple or bluish skin compactions with a diameter of 1 cm in the center with one or more rods appear, which are accompanied by increasing pain in the lower back. The pain is twitching, pulsating and can prevent you from sleeping. Hyperthermia is detected.
AtParanephritisFever first appears, then local edema, hyperemia and hyperthermia are noted. On the third day, severe pain develops, radiating to the stomach and under the ribs and increasing with movement and even breathing. Against the background of paranephritis, due to severe pain, the patient is forced to adopt an oblique posture so that there is no strain on the lower back muscles. The condition of the body is serious.
Infectious diseases
AtARVI,fluAndSore throatWith an increase in body temperature and intoxication of the body, myositis is characterized by aching pain in the lower back, causing a desire to change position. Sometimes lower back pain is caused by an infection in the kidneys. Infectious diseases causing lower back pain:
- hemorrhagic fever;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- Coronavirus;
- Bacterial, fungal and viral infections.
During a cytokine storm, lower back pain is observed due to severe infections. Epidemiological myalgia is accompanied by attacks of severe pain in the lower back, lasting up to 10 minutes with an interval of half an hour to an hour, occurring in the limbs, chest and abdominal wall. May be combined with rhinitis, conjunctivitis and numbness. Myalgia decreases at rest, increases with movement, and may disappear a few days after the muscles are warmed up.
Other muscle lesions
Aching pain in the lower back occurs after intense physical activity, strength exercises for the back muscles, or a long stay in a position with tension in the lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overexertion, metabolic disorders and is accompanied by aching long-term pain.
to formMyositis:
- against syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- in connective tissue diseases.
In fibromyalgia, chronic pain with asthenia, sleep disorders and neurotic disorders are observed.
Other diseases
Lower back pain is a problem with pathological diseases:
- TumorsSpine and spinal cord: sarcoma, hemangioma, metastases, neoplasms of the spinal cord.
- Kidney disease: Pyelonephritis, glomerulonephritis, urolithiasis, renal infarction, renal vein thrombosis, renal cyst, renal cancer.
- Hereditary diseases:Hereditary cerebellar ataxia by Pierre-Marie.
- Exogenous poisoning: Adrenomimetic drug abuse.
- Pathologies of the heart and blood vessels: Löffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: Blood transfusion shock.
The pain syndrome radiates to the lower back against the background of pelvic diseases, gynecological diseases, as well as prostate cancer, proctitis and sigmoiditis.
Types of pain
Duration must be taken into account when diagnosing back pain. Muscle pain lasts about two weeks and then disappears.
Pain caused by changes in the spine lasts longer and radiates into the leg and perineum and may be accompanied by tingling, numbness and burning.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by intensity and prolonged duration.
diagnosis
The medical history is very important for making the diagnosis, as back pain can be caused by various diseases.
The primary diagnosis is carried out by a traumatologist-orthopedist. When diagnosing, the doctor takes into account the following symptoms: disturbed bowel movements and urination, orthopedic defects, weakness and numbness in the leg. An examination will be performed to identify pain points and muscle spasms.
It also plays a role when the pain occurs, its association 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 conducts a visual examination. The patient is then sent for hardware and instrument examination. Depending on medical indications, consultations with a surgeon, rheumatologist, urologist and other specialists are prescribed.
Diagnosis may include:
- Neurological examination.The neurologist assesses the patient's reflexes, sensitivity and muscle strength as well as movement coordination.
- Roentgen.X-ray is the first examination method that allows you to detect changes in bone tissue. Images of the lumbar region show fractures, degenerative changes in the intervertebral discs, signs of inflammatory processes and spondylolisthesis.
- CT scan.CT scans examine 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, myelography is prescribed.
- Densitometrynecessary for osteoporosis.
- Electromyography,ElectroneurographyThese tests evaluate muscle function and nerve conduction.
- UltrasonicKidneys, prostate, abdominal and pelvic organs.
- USDGAbdominal aorta.
- EMG (ENMG)is used to determine conduction disorders along nerve fibers.
- Laboratory tests.To determine the causative agent of the infection, urine and blood tests are carried out for microbiological examination. To detect neuroinfections - using serological tests.
Treating lower back pain
First aid
In the case of spinal injuries, the patient is placed on a hard, flat surface and taken to the clinic. To relieve pain, you need to optimize your posture while working and resting to reduce strain on your back. You can take painkillers before a medical examination. For degenerative diseases of the spine, lumbago and lumbosciatica, creams, ointments and gels with warming and pain-relieving effects may be used. Their use is prohibited in infectious processes.
The basis of treatment is physiotherapy and drug therapy. The following methods are used:
- NSAIDsin the form of tablets and topical agents, used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B vitamins, which increases the effect of medical painkillers.
- Local anesthetics.They carry out therapeutic blocks for acute pain using anesthetics and painkillers in combination with glucocorticosteroids.
physical therapy
- Ultrasonic,
- magnetic field therapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- Massage,
- manual therapy,
- Acupuncture.
surgery
Depending on the pathological features, there are surgical interventions:
- In case of 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, puncture decompression of the intervertebral disc.
prevention
Massage is effective for muscle blockages and joint subluxations and relieves muscle spasms and lower back pain.
Physiotherapy reduces pain and inflammation and improves blood circulation.
Movement therapy – physical exercises effectively strengthen the muscle corset and improve the biomechanics of the spine. The exercises are selected with a doctor. Systematic implementation allows you to maintain functionality and reduce lower back pain.
"Forewarned is forearmed! "But only a doctor can make an accurate diagnosis.