Pain in the lower back (pain in the lower back, lumbago, a feeling of aching 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 such symptoms at least once during their lives.Moreover, in 10% of cases, attacks of lower back pain become chronic.
The structure of symptoms is as follows:
- 80-85% - nonspecific lower 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.
Pain in the lumbar region ranks second in duration and third in frequency of issuing a temporary disability certificate among all diseases.To prevent the pathology from becoming recurrent, 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;
- Recurrent 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 wear off, but do not go away completely.
According to etiopathogenesis, lower back pain 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 lower back pain is congenital abnormalities of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pain due to pathologies of the intestines, stomach, abdominal aorta, and genitourinary system organs.
What is low back pain 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 constrained.Sometimes a person remains in a bent position and cannot straighten up.With any 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 the person gets used to it.Full recovery without recurrent attacks is also possible.
Nagging pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but they cause discomfort.Aching pain in the lumbar region can intensify with low bending, physical activity, after an infection, or hypothermia.Even if the symptoms go away completely, stiffness and discomfort remain in the back.
Symptoms You Shouldn't Ignore
If acute or dull lower back pain is accompanied by one or more symptoms from the list below, you should immediately consult a doctor.
Warning signs:
- numbness of the arms or legs, tingling sensation, “cotton-like” limbs;
- pain in the hip joints and knees;
- 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 exacerbation.After this, 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 in the discs.The tissues are gradually destroyed, the gap between the vertebrae decreases, and with any sudden movement they can pinch the nerve.The 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 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 outgrowths that look like sharp spines.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.
Intervertebral disc herniation.A fragment of articular 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 showing itself in any way.The disease begins at a young 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 time the first symptoms appear until you see a 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 stools with an 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 lower back pain is pathology of the kidneys, internal genital organs, and urinary tract.The condition requires careful diagnosis and medical monitoring, since many complications are irreversible.
Low back pain due to renal pathology differs from the consequences of disorders in the musculoskeletal system in its constancy and independence from movement or body position.It is especially necessary to be wary 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 lower back pain due to various pathologies of the reproductive system.This is how sexually transmitted 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 as a variant of the norm.If your periods are very heavy, accompanied by pressure surges and poor health, it is better to visit an antenatal clinic and get tested for hormones.Menstruation can be normalized with properly selected medications.
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 becomes inflamed, pain surrounds the back in the lumbar region.Possible irradiation to the tailbone, left thigh, perineum.The girdle pain begins to increase after eating and intensifies with 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 place a cushion under your bent knees so that your legs are at right angles to your body.Take a non-steroidal anti-inflammatory drug.You can tie a shawl or a warm scarf on your lower back to warm your back a little.
If these measures do not bring relief, you need 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, establish a preliminary diagnosis, draw up 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 to 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 do harm.Therefore, if you have lower back pain, you should consult a doctor, even if you managed to suppress the symptoms.
Diagnosis of lower back pain
At the first appointment, the doctor interviews 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 exactly how it hurts - on the left or right, the pain is dull, aching, sharp or throbbing, the duration of the 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 hemoglobin level 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 study determine the health of the kidneys and urinary tract.Deviations in the results of the analysis are a direct indication for 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, 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 fractures;
- Magnetic resonance imaging (MRI).A non-X-ray method of examining patients, which allows you to obtain 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 nonsteroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to remove the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Moderate physical activity on an individual basis on an ongoing basis is recommended.
Getting rid of pain caused by a disease that has 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 injection of an anesthetic into the affected area.The injection quickly relieves discomfort, but provides only temporary relief.The patient should begin treatment immediately.
To relieve an exacerbation, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasmodic muscles;
- B vitamins to improve regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of the internal organs, the patient is prescribed medications to treat the underlying pathology.
Auxiliary techniques
After the exacerbation is relieved, the following treatment methods are effective:
- wearing a special fixing bandage;
- medical massage on the lumbar region;
- shock wave therapy;
- swimming and exercise classes;
- 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, operating urologist, or abdominal surgeon, taking into account the established diagnosis and the individual characteristics of the patient’s condition.
Don't 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 why your back discomfort occurred, and receive high-quality treatment.