When a person experiences pain, the only wish is for the pain to go away quickly and not reappear. The back is the "working" and important part of our body, because it houses the main organ - the spine. Frequent back pain is a symptom of various diseases. Almost everyone experiences pain in the lumbar spine, especially after 40 years. 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, disease of nerve endings, muscle tissue, and internal organs. It is observed during fever. It can be sharp and dull, continuous and periodic, shooting and bursting. Pain can be periodic, local, aching or nagging, for some it is associated with the weather, for others with physical activity, for others with staying in an uncomfortable position for a long time.
Why does my lower back hurt?
Frequent causes of back pain can be muscle tissue diseases, bone injuries and intervertebral discs. They arise against the background of pathologies of the organs of the abdomen, pelvis and chest.
Spine disease
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– sharp pain that limits movement and occurs due to muscle spasms. With pathological processes in the spine, lumboischialgia occurs - pain or shooting 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 pathology in the spine:
- Degenerative pathology: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular disease: spinal circulation disorder.
- Other diseases: diseasesForester.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Curvature of the spine
Mild pain with curvature of the spine is associated with improper distribution of physical activity, tension of ligaments and muscles in the lower back. Pain occurs due to an uncomfortable position when sleeping on a hard or, on the contrary, soft mattress.
These symptoms are accompanied by:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- flat back syndrome.
Osteoporosis
If your lower back feels tense or painful for a long time, it may be osteoporosis. The pain is aggravated by stress and changes in weather. Osteoporosis can:
- after menopause;
- juvenile;
- idiopathic;
- old age
Similar pain sensations appear in patients with genetic diseases, endocrine gland disorders, and intoxication when taking drugs. Secondary osteoporosis may be caused by the syndromemalabsorption, kidney and liver disease, rheumatoid arthritis, lupus erythematosus.
Increasing pain and increasing its duration are associated with injuries and fractures.
Spinal cord injury
A common injury to the lumbar spine is a bruise, which manifests itself as moderate pain and, when moving, is accompanied by swelling, hematoma and bleeding. In severe cases, neurological disorders are also added.
Compression fractures in the lower back occur as a result of forced flexion of the spine and are characterized by cessation of breathing and severe pain. Pain increases when turning the body, muscles and tissues swell. The lower back feels painful during palpation.
Paroxysmal pain with a feeling of heaviness in the lower back and numbness of the legs is found in patients with spondylolisthesis and vertebral dislocation.
Soft tissue and kidney injury
Mild, reduced pain with bleeding or swelling occurs from soft tissue bruising. Kidney bruises are painful and radiate to the lower abdomen, genitals, and lumbar region. Sometimes hematomas and manifestations of hematuria are visible. With severe bruising, painful shock may occur, blood in the urine and prolonged severe pain.
Infection 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, after trauma, contact, after surgery. Pain lingers and bulges so strongly that it prevents movement, forcing you to freeze. In the form of chronic osteomyelitis, fistulous channels with released pus are formed, so the manifestation of pain is smoothed.
Tuberculosis of the spinegradually develops, starting with periodic pain, which intensifies due to pressure, then stiffness of movement occurs. The pain becomes burning and radiates to the legs with paresthesia and numbness due to the destruction of the vertebrae and compression of the nerve roots.
In patients withspinal epidural abscesssevere pain combined with muscle tension, shivering and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
boils,carbuncle– against the background of the purulent process, a purple or bluish skin compaction with a diameter of 1 cm appears, in the center with one or several stems, and is accompanied by increased pain in the lower back. The pain is throbbing, throbbing, and can keep you from sleeping. Hyperthermia was observed.
Onparanephritisfirst, fever occurs, then local edema, hyperemia and hyperthermia are detected. Severe pain, radiating to the abdomen and under the ribs, increasing with movement, and also with breathing, developed on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a bent position so that the lower back muscles are not strained. Bad body condition.
Contagious disease
OnARVI,common coldAndsore throatwith an increase in body temperature and body intoxication, myositis is characterized by aching pain in the lower back, which causes the desire to change position. Sometimes back pain is caused by a kidney infection. Infectious diseases with pain in the lower back:
- dengue fever;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- bacterial, fungal, viral infections.
Pain in the lower back due to severe infection is observed during a cytokine storm. Epidemiological myalgia is accompanied by attacks of severe pain in the lower back, which lasts up to 10 minutes at intervals of half an hour to an hour and appears in the limbs, in the chest, and on the abdominal wall. Can be combined with rhinitis, conjunctivitis and numbness. Myalgia decreases at rest, increases during movement, and may disappear a few days after warming up the muscles.
Other muscle lesions
Pain in the lower back occurs after intense physical activity, strength exercises for the back muscles, or staying for a long time in a position with tension in the lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, too much energy, metabolic disorders and is accompanied by long-term pain.
Formmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue disease.
Chronic pain with asthenia, sleep disorders, and neurotic disorders are observed in fibromyalgia.
Other diseases
Lower back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastasis, spinal cord neoplasm.
- Kidney disease: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary disease:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous poisoning: Adrenomimetic drug abuse.
- Pathology of the heart and blood vessels: Loeffler's endocarditis, abdominal aortic aneurysm.
- State of emergency: blood transfusion shock.
Pain syndrome radiates to the lower back against the background of pelvic diseases, women's 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 about two weeks and then goes away.
Pain caused by changes in the spine lasts longer and radiates to the legs, perineum, and may be accompanied by a sensation of pins and needles, numbness and burning.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal organs is characterized by a longer intensity and duration.
Diagnostics
Medical history is very important to make a diagnosis, because back pain can be caused by various diseases.
The main diagnosis is carried out by a traumatologist-orthopedic. When diagnosing, doctors take into account the following symptoms: defecation and urination disorders, orthopedic deformities, weakness and numbness in the legs. Examinations are conducted to identify pain points and muscle spasms.
It is also important when the pain appears, its relation to 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 surgeons, rheumatologists, urologists, and other specialists are prescribed.
Diagnostics may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, muscle sensitivity and strength, and movement coordination.
- X-ray.X-rays are an early screening method that allows you to determine changes in bone tissue. Images of the lumbar region show fractures, degenerative changes in the intervertebral disc, signs of inflammatory processes, and spondylolisthesis.
- CT scan.CT scans examine the detailed structure of solid structures.
- MRI– an informative method that allows you to diagnose morphological changes in the condition of ligaments and intervertebral discs. To exclude stenosis, myelography is prescribed.
- Densitometryneeded for osteoporosis.
- Electromyography,electroneurographyThis test evaluates muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, stomach and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine conduction disturbances along nerve fibers.
- Lab test.To determine the causative agent of infection, urine and blood tests are taken for microbiological examination. To detect nerve infection - using serological tests.
Lower back pain treatment
first aid
For spinal injuries, the patient is placed on a hard, flat surface and taken to the clinic. To reduce pain, you need to optimize your body position during work and rest to reduce the load on your back. Before being examined by a doctor, you can take analgesics. For degenerative diseases of the spine, lumbago, and lumboischialgia, it is allowed to use creams, ointments, and gels with warming and analgesic effects. In the case of an infectious process, its use is prohibited.
The basis of treatment is physiotherapy and drug therapy. The following methods are used:
- NSAIDsin the form of tablets and topical agents, used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotrophic B vitamins, increasing the effect of painkillers.
- Local anesthetic.They perform therapeutic blockade for acute pain with anesthetics, as well as painkillers in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetotherapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
Surgery
Depending on the pathological features, there are surgical interventions:
- For instability: interbody fusion, transpedicular fixation, plate fixation.
- For tuberculosis, tumors, osteoporosis, osteomyelitis: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernia: discectomy, microdiscectomy, nucleoplasty.
- For spinal canal narrowing: laminectomy, facetectomy, disc puncture decompression.
Prevention
Massage is effective in the presence of muscle block and joint subluxation, reducing muscle spasms and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercise is effective for strengthening the muscular corset and improving the biomechanics of the spine. Training is selected with the doctor. Systematic implementation allows you to maintain function and reduce pain in the lower back.
"Be warned is armed forward! "But only a doctor can make an accurate diagnosis.