lower back pain

There are many diseases that manifest as lower back pain. They may indicate problems with the spine, joints, muscles, internal organs (kidneys, intestines, liver). This is a fairly insidious symptom, and it's impossible to determine the real cause of lower back pain without seeing a doctor. Correct treatment can only be given after diagnosis at a medical institution.

type of pain

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

• sharp- Sudden, paroxysmal, varying intensity, lasting less than 1 month;
• subacute- Lasts 2-3 months, most often relapses: active for 2-5 days, then subsides, reappears some time later;
• chronic- Duration longer than one year, the course is usually recurring.

Doctors find that chronic pain in this area is often associated with the development of local muscle spasms, compressions with certain painful points (so-called myofascial syndromes). The process also involves the muscles that straighten the spine, gluteal muscles, pelvic ligaments, and sacroiliac joints.The nature of the pain is sharp, aching, or dull. Press intensity - strong, medium, weak. According to the location of pain, it can be divided into the following types:

• low back pain- Pain in the lower back or lumbosacral region;
• sciatica- Located in the lower back, radiating to the legs;
• Sacroarthritis- In the sacral region;
• tailbone pain- At the tailbone.

5 facts about lower back pain

• Approximately 25% of all back pain presenting complaints are related to low back sensation.
• According to research, 84% of people experience lower back pain at least once in their lives.
• Recurrent episodes of low back pain occur in 44-78% of patients (depending on age and region of residence).
• Up to 37% of people are regularly disabled from work due to low back pain.
• Eighty-five percent of patients who consult a doctor with lower back pain are diagnosed with musculoskeletal disorders that are causing the pain.
• According to statistics, about 90% of patients with acute lumbosacral pain recover within 2 weeks.

Causes of low back pain

Musculoskeletal disorders

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

1. Compression of the spinal roots and peripheral nerves of the lumbar spine. It occurs due to a herniated disc (degenerative change). Less commonly, it is due to hypoplasia (a disorder in the formation process) of the superior facet process of the sacrum.
2. Spinal disorders caused by tumors, joint injuries, infections, compression fractures, allergic reactions, autoimmune inflammatory processes.
3. Musculoskeletal disorders due to subluxations, spinal ligament sprains, muscle strains, intervertebral joint dysfunction.

internal organ pathology

1. Genitourinary diseases.Urinary tract diseases - urolithiasis, cystitis, pyelonephritis - often cause lower back discomfort.Low back pain in women may indicate reproductive organ dysfunction. In most cases, the primary sensation is concentrated in the lower abdomen and radiates to the sacrolumbar spine. They may appear during menstruation or after sexual intercourse.One possible cause of low back pain in women is ovarian tumors located on the back of the uterus. Often, lower back discomfort is a symptom of uterine fibroids. As it grows, the pain becomes intense and severe, indicating a severe disturbance in the blood supply, stretching of the peritoneum, and compression of the nerve plexus in the pelvic area. Another cause of low back pain in women is pelvic organ prolapse. In this case, the feeling has a pulling quality. Their intensity increases during walking and manual labor.
2. Gastrointestinal disorders.Most commonly, pain is felt in the lower back due to gastric and duodenal ulcers and acute pancreatitis. The patient complained of pain of a surrounding nature. Typically, pain begins in the lower back and right/left ribs at the same time, where the strongest sensation is concentrated. In many clinical cases, lumbar pain accompanies the onset of acute appendicitis, although they are not the main symptom of the disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.

10 risk factors for low back pain

1. Congenital lesions of the lumbosacral spine.
2. Heavy physical labor associated with lower back pressure, frequent bending, and vibration.
3. Acute and chronic stress leading to muscle spasms.
4. A sedentary lifestyle and being in unnatural postures for long periods of time can put a strain on the lower back.
5. Weak muscles can lead to poor posture, stooping, scoliosis and kyphosis.
6. Metabolic disorders and excess weight increase the load on the lower spine.
7. Increased physical activity and participation in sports can increase the risk of injury.
8. Age over 50 years - due to the development of degenerative processes of the spine.
9. Often stressed and depressed.
10. Malnutrition and lack of B vitamins.

Low back pain is a symptom of many diseases

Lumbar osteochondrosis

One of the most common diseases, the symptom of which is lower back pain. In osteochondrosis, the discs that act as shock absorbers between the vertebrae become thinner. Nerve roots are compressed, muscles spasm, and severe acute pain occurs. Its intensity increases when bending over, lifting heavy objects, or when the patient attempts to sit up from a lying or sitting position.In advanced cases, hernias can form between the vertebrae, which only increases the pain. Osteochondrosis most commonly affects the lumbar spine because it bears the greatest load while sitting and walking.A serious complication of osteochondrosis is spondylosis. It is characterized by the almost complete destruction of the intervertebral discs and the formation of sharp bony protrusions - osteophytes. They can damage nearby tissue, causing severe pain that radiates to one or both legs.

Symptoms of intervertebral hernia

• The patient can only rise from a seated position with the support of a chair/table or knees.
• Any load on the lower back can cause acute pain.
• The patient lies prone with only a pillow under him.
• A person can only pick up an object from the floor by squatting slowly.

ankylosing spondylitis

The disease is the result of an inflammatory process in the spine. The disease most commonly affects men aged 20-35 years. The patient experienced stiffness in the waist and discomfort in the sacrum in the morning and at rest. This feeling will gradually disappear during the day and the person will "pace". Many people do not notice this worrying symptom. At the same time, ankylosing spondylitis can cause the vertebrae to gradually fuse, reduce the mobility of the spine, and even become disabled. Therefore, as soon as the first signs of the disease appear - morning stiffness in the spine, you need to see a doctor.

spondyloarthropathy

This disease affects the cartilage tissue that covers the spinal discs. As we age, cartilage becomes thinner, broken down, and bone growth forms where the cartilage breaks down. As the discs rub against each other, the nerve roots become irritated—a process that can be accompanied by severe low back pain. The muscles in the problem area of the back are constantly tensing and spasming.

Signs of Spondyloarthropathy

• The pain worsens with exercise and disappears with rest.
• Pain occurs after standing or walking for long periods of time.
• Along with pain in the waist, the patient felt discomfort in one hip and hip joint.

urolithiasis disease

The pain of this pathology is episodic and very severe. Often, the pain is caused by inflamed kidneys. The patient had difficulty finding a position that made him feel better. After the attack, the color of the urine becomes red and the volume decreases.

Superficial tissue and fibrous inflammation

The cause of the pain may be a carbuncle or boil. These are dense, purulent formations on the skin that are more than 1 cm in diameter, are purple in color and are easily noticed. The pain is sharp, intense, and pulsating.Paranephritis, an inflammation of the tissue surrounding the kidneys caused by infection, can also cause pain. As you inhale and move, the sensation becomes stronger. The patient tries to lie down with his legs together - in this position, the pain is less noticeable. The skin in the affected area swells and becomes red.

Inflammation of spine and spinal cord

Osteomyelitis is an inflammatory process in the bone marrow that affects all bone tissue. The acute form is characterized by increasing pulling, popping pain. It is accompanied by symptoms of intoxication and fever.Spinal tuberculosis occurs due to infection with the bacterium Koch. The first signs of the disease may appear years after infection. It all starts with deep pain after exercise. The infection affects the vertebrae, impeding the patient's movement and creating a characteristic gait.

other illnesses

Low back pain can be a symptom of a variety of conditions, including some very exotic ones. These diseases include, for example, foot-and-mouth disease, Ebola fever, hemorrhagic fever, and Japanese mosquito encephalitis.

• Cardiovascular disease - abdominal aortic aneurysm, Loeffler endocarditis.
• Myositis is inflammation and muscle pain in the lower back that can be caused by infectious diseases like the flu, sore throat, and even the common ARVI.
• Benign and malignant tumors of the spine and spinal cord.
• Renal pathology - glomerulonephritis, renal vein thrombosis, pyelonephritis, cysts.
• Lower back pain in men is linked to prostate cancer.

Why does my lower back hurt when I cough?

Coughing can cause muscle tension in the affected area, causing pain. Often, patients first learn about an ongoing illness when they notice pain when coughing. Most often, this feeling is a sign of:

• intervertebral hernia,
• osteochondrosis,
• neuralgia,
• facet joint disease,
• Kidney disease.

diagnosis

As mentioned above, sacrolumbar pain can be a symptom of many conditions. Therefore, in order to find out the objective cause, you should consult a doctor as soon as symptoms appear. You can make an appointment with an orthopedic surgeon, neurologist, or surgeon. In the future, you may need to consult a rheumatologist, urologist, or gastroenterologist.

• Initial inspection.Doctors evaluate tissue sensitivity, muscle function, and reflexes in the affected area.
• Radiography.Examination shows changes in bone, cartilage, and joint structures.
• Blood and urine tests. With their help, you can determine whether there are infections and inflammatory processes.
• Functional diagnostics.It includes methods to assess nerve conduction and muscle performance - electroneurography, electromyography.
• CT and MRI.The condition of bones, muscles, nerves, and blood vessel structures can be examined in detail.
• ultrasoundThis test is done if there is suspicion of disease in the pelvic organs, prostate, or kidneys.

It is important to exclude (or confirm the presence of) neoplasm to differentiate between spinal root compression and pain syndromes of a musculoskeletal nature. Based on the diagnostic data, the doctor will determine the real cause of the pain and develop an effective treatment plan.

Is bed rest necessary?

None of the recommendations for the treatment of low back pain due to disorders of the musculoskeletal system include instructions for strict bed rest. Instead, patients are advised to return to normal activities as early as possible to prevent the development of a chronic pain syndrome. In severe cases, that is, when the pain is severe, strict immobilization is recommended for 1-3 days. For acute pain in the lower back, a strap can be used. However, long-term lumbar immobilization is not recommended unless there is trauma or spondylolisthesis. Gradually, you will need to perform special exercises to strengthen your spine and muscles.

Low back pain treatment

In most cases, a combination of medications and non-drugs are needed to solve the problem.

drug

The basis of pharmacotherapy is nonsteroidal anti-inflammatory drugs (NSAIDs). They influence the peripheral mechanisms of pain development and are used to relieve pain syndromes. In most clinical cases, treatment is given in divided courses - no longer than 12 weeks.In most cases, patients take B vitamins to improve nerve conduction, decongestants, and sedatives. In the chronic course of the disease, antidepressants can be taken. For severe muscle spasms and pain - muscle relaxants, weak opioids.

non-drug

In addition, patients may receive manual therapy, acupuncture (cupuncture). The purpose of these surgeries is to activate metabolism and blood circulation in the affected area. This improves tissue nutrition.According to doctors, physical therapy, exercises to strengthen the lower back muscles, traction therapy and transcutaneous electrical nerve stimulation have had little effect. Most of the time, these surgeries are performed after 4-6 weeks of taking the medication without noticeable effects. There is no scientific evidence for the effectiveness of massage, physical therapy or wearing various belts.

What should be done to prevent

• In the morning, perform simple spine and muscle stretches.
• Eat a reasonable diet and avoid greasy, fried, smoked, salty, spicy and alcoholic foods.
• Watch your own weight.
• Drink at least 1. 5 liters of fluid (preferably water) per day.
• Classic massage sessions every 6 months.
• Avoid staying in one position for long periods of time.

in conclusion

Low back pain is not only a symptom of disease in the musculoskeletal system, but also a symptom of disease in internal organs. Many patients self-diagnose and treat conditions such as muscle strains, even though the problem may actually be kidney inflammation. Such treatment only aggravates the situation - a person focuses on a disease that does not exist and induces serious pathology. That's why it's important to seek qualified help and find out the real cause of your pain. Self-prescription of medications is strictly not recommended.