Pain in the lower back (low back pain, lumbago, a feeling of pain or pulling in the lower back) is a common complaint of patients when they visit the doctor.According to medical statistics, at least 70% of the population experiences these symptoms at least once in their life.Also, in 10% of cases, attacks of low back pain become chronic.
The structure of the symptoms is as follows:
- 80-85% - nonspecific low back pain.Symptoms disappear 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 certificate of temporary disability among all diseases.So that the pathology does not become recurrent, it is necessary to consult a doctor in a timely manner.
Types of low back pain
Depending on 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 normal healing period for damaged tissues;
- Recurrent pain.The syndrome occurs at least six months after the previous exacerbation.Between relapses, symptoms disappear completely;
- Exacerbation of chronic low back pain.Difference from a relapse: the interval between attacks is less than 6 months, symptoms may disappear, but do not disappear completely.
According to the etiopathogenesis, low 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 low back pain is congenital anomalies of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pains due to pathologies of the intestines, stomach, abdominal aorta and organs of the genitourinary system.
What is low back pain like?
Most often, patients complain of sharp, severe pain in the lower back, which is also called stabbing, stabbing or lumbago.Movement in the back is restricted.Sometimes a person remains bent over and cannot straighten up.With any movement, acute pain in the lower back intensifies ("shots" 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 decreases so much that the person gets used to it.A complete recovery without recurrent attacks is also possible.
Persistent pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but cause discomfort.Pain in the lower back may intensify with excessive bending, physical activity, after an infection, or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort remain in the back.
Symptoms that you should not ignore
If sharp 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 arms or legs, tingling sensation, “cotton-like” extremities;
- pain in the hip and knee joints;
- leg cramps;
- menstrual irregularities in women;
- sexual impotence in men;
- increased pain when 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, a comprehensive examination and treatment under medical supervision will be necessary.
What pathologies can cause acute pain in the lumbar region?
Diseases of the musculoskeletal system.
Pinched sciatic nerve.Intense, stabbing 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, which are degenerative changes in the discs.The tissues are gradually destroyed, the space between the vertebrae decreases, and with any sudden movement they can pinch the nerve.The pain is usually accompanied by pulsations of compressed vessels.
Sciatica (lumbosacral radiculitis).As a result of the pinch, 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, bony 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 getting "younger" every year.A sedentary lifestyle and sedentary work contribute to changes in the intervertebral discs already between the ages of 25 and 30.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A fragment of joint 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.The pathology can develop for several years without manifesting 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 suffer from constant night pains that disturb sleep and do not give importance to morning stiffness in the back.Several years pass from the time the first symptoms appear until you go to the doctor.Chronic inflammation already causes 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 lower back.The main symptom is accompanied by inflammation of the joints of the knees, feet or hands, pain in the buttocks, blurred vision, unstable stools of unusual consistency.
Other diseases.Acute pain in the lower back occurs with myositis, an inflammation of the lower back 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 follow-up, as many complications are irreversible.
Low back pain due to kidney pathology differs from the consequences of disorders of the musculoskeletal system by its constancy and independence from movement or position of the body.It is especially necessary to be careful 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.
Low back pain in women usually appears during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered a variant of the norm.If your periods are very heavy, accompanied by pressure surges and poor health, it is better to visit a prenatal clinic and take a hormonal test.Menstruation can be normalized with appropriately selected medications.
Low back pain in men can be a sign of problems with the prostate.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.Waist pain begins to increase after eating and intensifies with physical activity.Walking, jumping and other exercises cause a stretching of the pancreatic capsule and a reaction in the nerve endings.
What to do if you have severe lower back pain
If an acute attack of pain occurs at home or at work, you should lie down on a hard, hard surface and place a cushion under your bent knees so that your legs form right angles to the body.Take a nonsteroidal anti-inflammatory medication.You can tie a shawl or warm scarf around your lower back to warm your back a little.
If these measures do not provide relief, you should call a doctor or receive 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 facility, first make an appointment with a general practitioner: he will comprehensively assess your state of health, establish a preliminary diagnosis, draw up a plan for an initial examination, prescribe appropriate symptomatic treatment and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many "quick" solutions for 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, hot gels can only cause damage.Therefore, if you have lower back pain, you should see a doctor, even if you managed to suppress the symptoms.
Diagnosis of low back pain.
At the first appointment, the doctor interviews the patient, finds out how long the symptoms last, 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 side, the pain is dull, aching, sharp or stabbing, 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.
In most cases, if there are specific signs of serious disease of the spine or internal organs, the patient is referred for additional examinations:
- Blood test.A low level of hemoglobin indicates the probable presence of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends carrying out not only a general analysis, but also biochemistry to evaluate the functioning of internal organs;
- Urine analysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the analysis results are a direct indication for an ultrasound of the urinary system and additional examination by a urologist;
- X-ray of the lumbar spine.The photographs show certain signs of inflammation of the joints, alterations of various structures and proximity of the vertebrae due to degenerative changes.Based on the x-ray, the doctor may assume osteoporosis and see fractures;
- Magnetic resonance imaging (MRI).A method of examining patients without X-rays, which allows you to obtain many images (slices) of the area of interest and its three-dimensional image.Unlike X-ray and CT scan, MRI provides information about the condition of not only bones, but also muscles, blood vessels and soft tissues.
Treatment of back and lumbar pain.
Uncomplicated forms of pain that are not associated with 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 eliminate the provoking factor: lose weight, sit less, walk more and do simple exercises regularly.It is recommended to carry out moderate physical activity individually and continuously.
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 and unbearable pain, the doctor immediately after the appointment performs a blockade - an injection of an anesthetic into the affected area.The injection quickly relieves discomfort, but only provides temporary relief.The patient should begin treatment immediately.
To relieve an exacerbation, the doctor prescribes:
- non-steroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasmodic muscles;
- Vitamins of group B to improve the 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:
- use a special fixation bandage;
- medical massage in the lumbar region;
- shock wave therapy;
- swimming and exercise classes;
- acupuncture;
- apply tapes;
- manual therapy;
- other physiotherapeutic techniques.
surgical intervention
Surgery is the last resort.Surgical treatment is indicated for serious 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, surgical urologist or abdominal surgeon, taking into account the established diagnosis and the individual characteristics of the patient's condition.
Do not tolerate lower back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center you can undergo a comprehensive examination, find out the reason for your back discomfort and receive high-quality treatment.