Lower back pain is a symptom that is rarely noticed. Most people associate it with sedentary work, weight lifting, or osteochondrosis and are in no rush to see a doctor. In fact, this condition can indicate kidney, liver, or intestinal disease, and musculoskeletal problems will not go away on their own. Only a timely examination by a specialist and a full examination will help identify the cause of the pain and choose the right treatment.
The lower back is an area that is subject to significant stress due to its sincerity. The spine is represented by five large vertebrae that are additionally reinforced by the muscle frame. 9 out of 10 cases of pain in this area are caused precisely by the pathology of the musculoskeletal system: osteochondrosis, muscle cramps, herniated discs, pinching of the nerve roots.
The remaining 10% of cases are associated with diseases of the internal organs, which are located in the projection of the lower back: kidneys, genitourinary system, intestines, liver. Even a doctor cannot always precisely determine the cause of the pain during the examination, which is why this condition requires careful laboratory and instrument diagnostics.
Types of pain
The first thing the doctor asks about is the nature of the sensations. Depending on the underlying cause, back pain can be:
- acute: usually abrupt, high intensity; The duration of the sensations is no more than 1, 5 months.
- subacute: lasts 6-12 weeks;
- chronic: sensations of any intensity lasting 12 weeks or more;
- temporary (variable): appears periodically;
- strong, medium intensity, weak.
This subdivision is arbitrary. Depending on the situation and circumstances, the type and duration of the sensations can vary. It is important to describe them to your doctor as fully as possible.
There are many reasons why the back starts to hurt in the lumbar region. The most common provoking factors are:
- uneven load distribution (against the background of pregnancy, postural disorders, pathology of the musculoskeletal system);
- infectious lesion;
- diseases of the musculoskeletal system;
- inflammatory processes, including autoimmune diseases;
- being in an uncomfortable position for a long time;
- Changes in the composition of bone tissue (osteoporosis);
- volumetric processes: benign and malignant tumors, abscesses;
- hormonal changes (menstruation, pregnancy, menopause);
- kidney disease (urolithiasis, pyelonephritis, glomerulonephritis, abscesses);
- pathology of the gastrointestinal tract;
- Diseases of the uterus and limbs in women, prostate in men, etc.
Pain in the lower back can be a symptom of various diseases of the musculoskeletal system and internal organs. The main task of the doctor is to find out what exactly caused the worsening of the condition and take the necessary measures.
These are the most common pathologies.
This is a systemic inflammatory disease in which individual vertebrae are fused into a single conglomerate. At the same time, calcium is deposited in the ligaments that stabilize the spine, as a result of which the affected area loses its mobility almost completely.
The distinguishing features of back pain in ankylosing spondylitis include:
- increased intensity at rest, especially in a longer horizontal position;
- stiffness of movement in the lumbar spine;
Osteochondrosis of the lumbar spine
This is a very common condition in which there is a thinning of the intervertebral discs that act as shock absorbers. The result is irritation of the nerve roots and spasms of the surrounding muscles, causing severe pain. At a late stage of the disease, a herniated disc forms that can press on the spinal cord and make the pain worse.
With osteochondrosis, the pain increases:
- when lifting from a sitting or horizontal position;
- when trying to lie on your stomach;
- when leaning.
If the disease has resulted in a massive hernia, lower back pain is often associated with numbness and / or weakness in one or both legs.
Curvature of the spine in the lumbar region (kyphosis, scoliosis)
Pain in this pathology occurs in the middle and late stages of the development of the disease. Symptoms usually appear towards the end of the day and are often associated with back muscle fatigue. The pain is often caused by spasms of the muscles of the spine, and muscle spasms at some distance (glutes, periarticular muscles of the upper and lower extremities) are also possible.
This is a degenerative-dystrophic disease of the cartilage tissue that covers the intervertebral discs. It gradually thins and destroys, bone growths (osteophytes) appear around the affected area. By reducing the distance between the vertebrae, the spinal canal narrows and irritation of the nerve roots and spinal cord occurs.
Pain with this pathology:
- increases after exertion (prolonged standing, walking) and disappears after rest;
- is accompanied by stiffness of movements, first in the morning, then constant;
- can radiate into the thigh and hip area.
The muscles in the affected area cramp and are constantly under tension, which also increases the pain.
An attack of urolithiasis is characterized by severe lumbar pain in the affected kidney. At the same time, the sensations do not change depending on the posture, the person cannot find a position in which he is at least a little weakened. The attack is often accompanied by a decrease in the amount of urine and a reddish change in color.
Pain in the lower back can also have the following causes:
- algomenorrhea (painful periods);
- inflammation of the pancreas;
- intestinal obstruction;
- Appendicitis etc.
Pain in different parts of the back
The location of pain can reveal a lot about its cause. Pain in the upper lumbar region can be caused by:
- diseases of the spine;
- muscle spasm against the background of their overload;
- cardiovascular diseases;
- Diseases of the gastrointestinal tract.
If the epicenter is in the lower part of the lower back, in addition to diseases of the spine, the list of likely causes includes the following:
- kidney pathology (pyelonephritis, urolithiasis);
- Disturbance of the intestines (constipation, flatulence);
- cramps or inflammation in the pelvic organs (salpingo-oophoritis, endometritis);
- physiological reasons, especially pregnancy;
- Entrapment of the sciatic nerve.
A shift in the pain to the right or left can indicate damage to the corresponding root of the spinal cord, the kidney.
Diagnosing lower back pain requires a thorough evaluation. The first step in finding the cause is taking a survey. The doctor states:
- Pain localization;
- its character and its duration;
- reasons that cause a seizure or make the pain worse;
- Circumstances in which the condition improves (certain posture, immobility, taking medication, etc. ).
Data on injuries and diseases, already identified chronic pathologies, are necessarily collected. Another possible diagnostic search at the doctor's discretion includes:
- general analysis of blood and urine: helps identify the inflammatory process in the body, kidney pathology;
- biochemical blood test to detect signs of damage to the kidneys, pancreas, liver and gallbladder, etc. ;
- Ultrasound of the abdominal cavity and pelvis in men - ultrasound of the prostate;
- kidney ultrasound;
- X-ray, CT or MRI of the lumbar spine;
- Chest x-ray.
If a pathology is suspected, after a general diagnosis and examination, more targeted analyzes, examinations and consultations by narrow specialists are prescribed. They allow you to clarify or refute the diagnosis.
Treatment for back pain depends on the cause. Neurologist, urologist, gynecologist and surgeon can deal with pathology. When it comes to musculoskeletal disorders, doctors use drugs, non-drugs, and surgical methods to improve the patient's condition.
The most common remedies for lower back pain are nonsteroidal anti-inflammatory drugs (NSAIDs). They are prescribed in the form of tablets, intravenous and intramuscular injections, rectal suppositories, as well as topical creams, ointments, and patches. The doctor will decide the dosage of the drug, as well as the duration of the course, since the uncontrolled use of these drugs can cause unpleasant side effects.
When NSAIDs are ineffective, doctors prescribe hormones (corticosteroids). They also stop inflammation and relieve pain.
The third group of drugs that improve the patient's condition are anticonvulsants. They relieve muscle spasms in the lumbar spine.
The following can also be assigned:
- decongestants to reduce the swelling of the pinched root;
- B vitamins to improve nerve conduction; Sedatives
The drug-free treatment supplements the drug scheme. Depending on the clinical situation, this can include:
- physiotherapeutic procedures (magnetotherapy, laser exposure, electrophoresis, etc. );
- Physiotherapy exercises: The course of the exercise is developed individually according to the underlying illnesses and accompanying illnesses; Gymnastics should be carried out regularly, not only in the clinic office, but also at home, only in this case it will have an effect;
- general strengthening and therapeutic massage (performed without exacerbations);
- manual therapy and osteopathic support.
The help of surgeons is required when the attending physician identifies one of the indications for surgical treatment based on the general picture. In and of itself, the presence of a herniated disc, regardless of its size, is not an indication of surgical treatment. Depending on the indications, doctors may remove a herniated disc, remove compression from the root of the spinal cord, remove a tumor, etc. The decision to perform a particular operation is made on an individual basis.
The most effective way to prevent back pain is to adapt your lifestyle to be easy on the kidneys, spine and pelvic organs. However, if pain persists, this should be the reason for an exceptional visit to a specialist:
- Avoid hypothermia;
- avoid hypodynamia;
- Do sports at an amateur level (swimming has a particularly positive effect on the condition of the spine and back muscles);
- eat right and balanced: avoid overeating, minimize fatty, spicy and excessively salty foods;
- eliminates alcohol and nicotine;
- drink at least 1. 5 liters of pure water a day, excluding tea, coffee or juices;
- Keep body mass index at normal levels: being overweight has a negative impact on the condition of the spine, and a lack of it can lead to kidney prolapse.
If a person has already been diagnosed with a pathology of the musculoskeletal system, it is advisable to attend prevention courses at least twice a year in accordance with the European recommendations for rehabilitation of spinal pathology according to the doctor's prescription.