When a person suffers from pain, the only wish is for the pain to disappear quickly and never appear again. The back is a "functional" and important part of our body, as it houses the main organ – the spine. Frequent back pain is a symptom of several diseases. Almost everyone experiences lower back pain, especially after the age of 40. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Lower back pain indicates damage to the spine, diseases of nerve endings, muscle tissue and internal organs. It is observed during fevers. It can be sharp and dull, constant and periodic, shooting and explosive. The pain can be periodic, local, aching or annoying, for some it is associated with the weather, for others with physical activity, for others with prolonged stay in an uncomfortable position.
Why does my lower back hurt?
The causes of frequent back pain can be diseases of muscle tissue, bone injuries and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spine diseases
Common causes of low back pain are congenital anomalies and acquired spinal diseases. Pain is sometimes associated with weather changes and sometimes with physical activity.
Lumbago– acute pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumboischialgia occurs - aching or sharp pain in the lower back, radiating to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are detected with pathologies in the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbalization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal circulatory disorders.
- Other diseases: diseaseForestry.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Spinal curvature
Mild pain with curvature of the spine is associated with improper distribution of physical activity, excessive tension of the ligaments and muscles of the lower back. Pain occurs due to an uncomfortable sleeping position 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 worsened by stress and climate change. Osteoporosis can be:
- post-menopause;
- juvenile;
- idiopathic;
- senile.
The same pain sensations appear 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.
Increased pain and increased duration are associated with injuries and fractures.
Spine injuries
A common injury to the lumbar spine is hematoma, which manifests itself as moderate pain and, when moving, is accompanied by swelling, bruising and hemorrhages. In severe cases, neurological disorders are also added.
A compression fracture in the lower back occurs due to forced flexion of the spine and is characterized by cessation of breathing and severe pain. The pain intensifies when turning the body, muscles and tissues swell. The lower back is painful on palpation.
Paroxysmal pain with heaviness in the lower back and numbness in the legs are found in patients with spondylolisthesis and vertebral dislocations.
Soft tissue and kidney injuries
Moderate, decreasing pain with hemorrhage or swelling occurs due to soft tissue bruising. Kidney hematomas are painful and radiate to the lower abdomen, genitals, and lower back. Sometimes a hematoma and manifestations of hematuria are visible. With severe bruising, painful shock, blood in the urine, and prolonged severe pain may occur.
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, postoperative. The intense pain pulls and swells so much that it impedes movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistulous tract is formed with pus secretion, so the manifestations of pain are alleviated.
Spinal tuberculosisit develops gradually, starting with periodic pain, which intensifies due to stress, then stiffness of movements occurs. The pain becomes burning and radiates to the legs with paresthesia and numbness due to destruction of the vertebrae and compression of the nerve roots.
In patients withspinal epidural abscessSevere pain is combined with muscle tension, chills and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
Boils,carbuncles- against the background of purulent processes, skin compactions of a purple or bluish hue 1 cm in diameter appear, in the center with one or more rods, and are accompanied by increasing pain in the lumbar region. The pain contracts, pulses and can deprive you of sleep. Hyperthermia is observed.
At theparanephritisFirst, fever occurs, then local edema, hyperemia and hyperthermia are detected. Severe pain, radiating to the stomach and under the ribs, intensifies with movement and even breathing, develops on the third day. In the context of paranephritis, due to severe pain, the patient is forced to assume a crooked position so that the muscles in the lower back do not strain. The condition of the body is serious.
Infectious diseases
At theSARS,the fluANDsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by pain in the lower back, which causes the desire to change position. Sometimes lower back pain is caused by a kidney infection. Infectious diseases with low back pain:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- bacterial, fungal and viral infections.
Lower back pain due to severe infections is seen during a cytokine storm. Epidemiological myalgia is accompanied by attacks of intense pain in the lower back, which last up to 10 minutes at intervals of half an hour to an hour and appear in the limbs, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia decreases at rest, intensifies during movement and may disappear a few days after the muscles warm up.
Other muscle injuries
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 muscles of the lower back. Myositis develops not only against the background of an infection, but also due to hypothermia, intoxication, excessive exertion, metabolic disorders and is accompanied by long-lasting severe pain.
Formsmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
Chronic pain with asthenia, sleep disturbances and neurotic disorders are seen in fibromyalgia.
Other diseases
Low back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord neoplasms.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, renal infarction, renal vein thrombosis, renal cyst, renal cancer.
- Hereditary diseases:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous poisonings: Abuse of adrenomimetic drugs.
- Pathologies of the heart and blood vessels: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: blood transfusion shock.
Pain syndrome radiates to the lower back against the background of pelvic diseases, female diseases, as well as prostate cancer, proctitis, sigmoiditis.
Types of pain
Duration must be taken into account when diagnosing low back pain. The muscle pain lasts for about two weeks and then disappears.
The pain caused by changes in the spine lasts longer and radiates to the leg and perineum, and may be accompanied by a pins and needles sensation, numbness and burning.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by intensity and longer duration.
Diagnosis
Medical history is of great importance for diagnosis, as low back pain can be caused by several diseases.
The primary diagnosis is carried out by a traumatologist-orthopedist. When diagnosing, the doctor takes into account the following symptoms: difficulty with defecation and urination, orthopedic defects, weakness and numbness in the legs. An examination is performed to identify pain points and muscle spasms.
It also matters when the pain appears, its connection with stress, the presence of cramps, cough, fever and bladder or bowel dysfunction.
If there are neurological symptoms, the patient is seen by a neurologist. The doctor interviews the patient and performs a visual examination, then the patient is sent for a hardware and instrumental examination. According to the doctor's instructions, consultations with a surgeon, rheumatologist, urologist and other specialized specialists are prescribed.
Diagnosis may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, sensitivity and muscle strength, as well as coordination of movements.
- X-ray.Radiography is the initial examination method that allows you to determine changes in bone tissue. Images of the lumbar region show fractures, degenerative changes in intervertebral discs, signs of inflammatory processes and spondylolisthesis.
- Computed tomography.Computed tomography examines the detailed structure of solid structures.
- MRI– an informative method that allows you to diagnose morphological changes in the state of intervertebral ligaments and discs. To exclude stenosis, myelography is prescribed.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests evaluate muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine conduction disturbances along nerve fibers.
- Laboratory tests.To determine the causative agent of the infection, urine and blood tests are performed for microbiological examination. To detect neuroinfections - using serological tests.
Low back pain treatment
First aid
For spinal injuries, the patient is placed on a flat, hard surface and taken to the clinic. To reduce pain, it is necessary to optimize the body position during work and rest to reduce the load on the back. Before being examined by a doctor, you can take painkillers. For degenerative diseases of the spine, low back pain and lumbar pain, the use of creams, ointments and gels with a warming and analgesic effect is allowed. In case of infectious processes, its use is prohibited.
The basis of treatment is physiotherapy and drug therapy. The following methods are used:
- Inesin the form of tablets and topical agents, used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B Vitamins, enhancing the effect of medicinal analgesics.
- Local anesthetics.They perform therapeutic blockades for acute pain with anesthetics, as well as analgesics in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetotherapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
Surgery
Depending on the pathological characteristics, there are surgical interventions:
- For 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 disc decompression.
Prevention
Massage is effective in the presence of muscle blockages and joint subluxations, reducing muscle spasms and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective in strengthening the muscular corset and improving the biomechanics of the spine. Exercises are selected with a doctor. Systematic implementation allows you to maintain functionality and reduce pain in the lower back.
"Forewarned is forearmed! " But only a doctor can make an accurate diagnosis.