Pain in the lumbar region is one of the most common reasons that force a patient to seek help from a neurologist or therapist.Pain in the lumbosacral spine can disrupt the ability to work for a long time, making movement and self-care impossible.Acute lower back pain affects men as often as women.
Occurring more frequently in middle and older age, low back pain can often occur in adolescents and young adults.This is due to rapid growth, weakness in weak lower back muscles, and injuries.So, lumbosacral back pain is an urgent problem that anyone can face.
Lower back pain with lumbar osteochondrosis
Lower back pain accompanied by osteochondrosis can intensify with coughing and sneezing, with any movement, especially when the body is leaned forward.Along with lower back pain, lumbar osteochondrosis can manifest itself as impaired sensitivity in certain areas of the skin or muscles of the lower half of the torso and legs, weakening or disappearance of tendon reflexes in the legs.
- As a rule, with osteochondrosis, curvature of the lumbar spine is observed.Depending on the plane in which the curvature occurs, we distinguish scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (flattening of the lumbar region or even its curvature backwards).If, due to osteochondrosis, the spinal cord is pinched, there is a disorder of urination or defecation, as well as a disorder of sensitivity of the bladder or genitals.
- However, most often lumbar osteochondrosis manifests itself as radicular pain, that is, developing as a result of pinching of the nerve roots extending from the spinal cord at one level or another.Thus, one of the best-known lower back syndromes is lumbago.It occurs during a moment of physical stress or in an uncomfortable body position, and sometimes for no apparent reason.Suddenly, within a few minutes or hours, a stabbing pain (“lumbago”) appears, often burning and bursting (“as if a stake were stuck in the lower back”).
The patient freezes in an uncomfortable position and cannot straighten up if the attack occurs while lifting something heavy.Attempts to get out of bed, cough or bend the leg are accompanied by a sharp increase in pain in the lower back and sacrum.If the patient is asked to stand, a strong immobility of the entire lumbar region is revealed due to muscle tension.
Tests for lumbosacral osteochondrosis
These tests are used to make a preliminary diagnosis and are named after the doctors who suggested them.
| Dejerine's symptom | If you tense your abs and listen to your lower back, the pain will become stronger.In this case, there is a high probability that the patient suffers from osteochondrosis. |
| Neri's symptom | If you tilt your head forward sharply before touching your chest, you feel pain in your lower back, this also indicates spinal problems. |
| Lasègue symptom | this is felt after the following actions: lying on your back, you must lift each leg in turn.If after that the lower back begins to twist and the pain radiates along the sciatic nerve to the leg, this indicates spinal pathology. |
| Lerrey's symptom | if pain appears in a person along the sciatic nerve, after he rises forward, without bending his knees, from a lying position, we are talking about manifestations of chondrosis. |
Intervertebral disc herniation
Intervertebral disc herniation is an equally rare cause, the clinical manifestation of which is pain in the lumbosacral back.The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.
With continued exposure (overweight, injury, progressive osteoporosis), the annulus fibrosus of the disc becomes thinner and defects form in it.Through these weak points in the annulus fibrosus, the nucleus pulposus of the disc can move and even protrude.
Causes of lower back pain
Back pain is a very non-specific symptom that can be caused by many different reasons.Depending on the intensity of back pain in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons that cause it:
Chronic pain:
- Osteomyelitis;
- Ankylosing spondylitis;
- Spondylosis deformans;
- Growing pains – scoliosis;
- Infectious lesions of the intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
- Metabolic bone diseases - osteomalacia, osteoporosis;
- Primary tumors and metastatic tumors of the spinal cord, vertebrae, retroperitoneal space;
- Non-infectious inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
- Renal tumors;
- Atherosclerosis of the abdominal aorta and its branches.
Acute pain:
- Spondyloarthritis;
- Hip joint pathologies;
- Spinal epiduritis;
- Protrusion of the intervertebral discs in the lumbar region;
- Osteochondrosis of the spine;
- Acute intervertebral hernia;
- Intestinal obstruction, atypical course of acute appendicitis;
- Urolithiasis;
- Acute sprain, vertebral fractures;
- Lumbago, sciatica;
- Acute circulatory disorders of the spine – stroke;
- Acute pyelonephritis.
Radiating pain in some diseases of internal organs:
- Diseases of the pelvic organs.In women - inflammatory processes of the uterine appendages, endometriosis, uterine cancer, ovarian cancer, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc.) In men - prostatitis, prostate cancer;
- Diseases of the stomach, pancreas, duodenum, gallbladder;
- Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
- Kidney diseases - renal colic, kidney stones;
- Life-changing aortic aneurysm.
Physiological reasons
Lower back pain may occur if you:
- Are you overweight?
- Additional risk for women;
- You are pregnant or have recently given birth;
- Spend a lot of time driving a car or using a computer;
- Lead a predominantly sedentary life (office workers) or standing (salespeople, waiters, advertisers, surgeons);
- Perform dynamic physical work with sharp changes in body position (especially if your specialty involves intense physical activity);
- You overload yourself at the gym or fitness club.Use extreme caution if you have recently started working out;
- Are you interested in gardening work?
- Have reached postmenopause, which predisposes to the development of osteoporosis.
Low back pain and pregnancy
Pregnancy aggravates the manifestations of diseases existing in the mother's body.Due to changes in hormonal levels and increased stress, pathologies especially often appear in the second half of pregnancy.In addition to the pain that accompanies the threat of premature birth, the cause of lower back pain in a pregnant woman may be:
- intervertebral disc herniation;
- radiculitis;
- pancreatitis;
- pyelonephritis;
- urolithiasis (kidney stones).
Why does my back hurt below my lower back?
When the back hurts below the lower back, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernia, ankylosing spondylitis, etc.), possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as inflammation of the uterine appendages - oophoritis, salpingoophoritis (adnexitis), as well as diseases of the peritoneumpelvic, intestines, inflammation.appendix (an extension of the cecum, in men - diseases of the prostate, bladder.
Pain above the lower back
If the back hurts right above the lower back, liver pain can radiate, accompanied by pathological changes in the liver - hepatitis, liver failure, taking toxic medications.The pain is most often localized in the right hypochondrium.
If the pain is felt on the right or left just above the lower back, it is very possible that the cause lies in acute kidney disease.Many chronic kidney diseases, such as polycystic disease, malignant kidney tumors, chronic pyelonephritis, are accompanied by minor symptoms, as the kidney capsule gradually stretches.
When should you consult a doctor?
- If the back pain irrigates in the lower back, and is located a little higher (at chest level).The pain is accompanied by sweating, attacks of vomiting and nausea, as well as shortness of breath.
- The pain radiates into the peritoneum, chest, neck and jaw.
- The patient feels dizzy and confused.
- Tachycardia begins
- Spinal injury, accompanied by loss of control over bowel movements and urination.
- The legs become weak, the buttocks and genitals become numb.
Diagnosis
In order to determine which disease caused the pain in the lower back, it is necessary to undergo a comprehensive diagnostic examination.
Laboratory methods:
- General and biochemical tests of urine and blood.
- Tests for tumor markers present in the blood when tumors form.
Instrumental research methods:
- Spinal x-ray.
- Endoscopy of the intestines, stomach and uterus.
- Ultrasound examination of the abdominal cavity.
- Magnetic resonance imaging.
How to treat back pain in the lumbar region?
How to properly care for your lower back?The approach to back treatment depends entirely on the symptoms of the disease, the diagnosis made by the doctor and the stage of the disease.Typically, an integrated approach is used, including several treatment methods.
Painkillers.The ointment helps relieve inflammation, sprains and has a warming effect if the lower back has a cold.
The following groups of ointments are distinguished:
- combined drugs (used for sprains and injuries, as well as their anti-inflammatory and analgesic effects, they have a healing effect thanks to the heparin and desmethyl sulfoxide contained in them);
- anti-inflammatory painkillers (they contain cooling medicinal substances that relieve irritation - menthol, lavender and pain relievers);
- chondroprotectors (one of the active components of these drugs is the substance chondroitin sulfate, used in pathological processes of cartilaginous tissue, promoting the active restoration of the cartilaginous surfaces of the joints);
- irritant drugs (the effect is based on vasodilation and blood flow to the source of pain).
With the help of therapeutic exercises, the patient can reduce pain, strengthen muscles and increase the distance between the vertebrae.They will help release compressed nerve roots, normalize blood flow in the affected area and improve metabolic processes.
In order for such gymnastics to heal and not paralyze, it is necessary to follow all the recommendations of the attending physician.
- Movements are performed slowly and smoothly, without sharp turns;
- The room must be ventilated before training;
- The patient should wear clothing that does not restrict movement;
- The exercises are performed when the patient breathes in, and when he exhales, he must return to the original position;
- The load increases gradually.At first, the number of approaches is about 10, then they increase;
- During gymnastics you need to monitor your well-being.If sharp pain appears, you should stop your activities.
In addition, massage is excellent for relieving pain in the lumbar spine.The positive therapeutic effects of massage include:
- improve blood supply to the diseased part of the body;
- knead the muscles, making them and the ligaments more flexible and elastic;
- relieve acute pain;
- get rid of toxins accumulated in muscles and subcutaneous tissues;
- pleasant sensations due to stimulation of nerve endings in the skin;
- positive emotions.
It can be entrusted to a specialist in a clinic or carried out at home;in any case, the benefits will be inestimable.
Which doctor should I contact?
If you are suffering from back pain of unknown cause, you should first consult a doctor.This will help identify the disease based on the set of symptoms.
If the reason is obvious: the pain was preceded by an injury, the pain arose during pregnancy, the menstrual cycle or a chronic illness, it makes sense to immediately contact a more specialized specialist.
Self-medication is only allowed if the cause of the pain is precisely known.