When a person suffers from pain, the only desire is for the pain to go away quickly and never appear again. The back is a "working" and important part of our body, since 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 the nerve endings, muscle tissue, and internal organs. It is observed during fevers. It can be sharp and dull, constant and periodic, shooting and bursting. The 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?
The causes of frequent lower back pain can be diseases of muscle tissue, injuries of bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spinal diseases
Common causes of low back pain are congenital anomalies and acquired spinal diseases. The pain is sometimes associated with weather changes and sometimes with physical activity.
Lumbago– sharp pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumboischialgia occurs - aching 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 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: illnessForestier.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Spinal curvature
Minor aching pain with curvature of the spine is associated with improper distribution of physical activity, overstrain of ligaments and muscles in the lower back. Pain occurs due to an uncomfortable position while sleeping 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 aches for a long time, it could be osteoporosis. The pain is aggravated by stress and changes in weather. Osteoporosis can be:
- postmenopausal;
- juvenile;
- idiopathic;
- senile.
The same pain sensations appear in patients with genetic diseases, disorders of the endocrine glands, and intoxications when taking medications. Secondary osteoporosis may be due to the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
Increasing pain and increasing its duration are associated with injuries and fractures.
Spinal injuries
A common injury to the lumbar spine is a bruise, which manifests itself as moderate pain and, when moving, is accompanied by swelling, hematomas 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 a feeling of heaviness in the lower back and numbness of the legs are found in patients with spondylolisthesis and vertebral dislocations.
Soft tissue and kidney injuries
Moderate and subsiding pain with hemorrhage or swelling occurs from soft tissue bruises. Kidney bruises are painful and radiate to the lower abdomen, genitals, and lumbar region. Sometimes a hematoma and manifestations of hematuria are visible. With severe bruises, painful shock may occur, blood in the urine and prolonged severe pain.
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. Intense pain tugs and bulges so much that it prevents movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistulous tract with discharged pus is formed, so the manifestations of pain are smoothed out.
Spinal tuberculosisgradually develops, 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 with a diameter of 1 cm appear, in the center with one or several rods, and are accompanied by increasing pain in the lower back. The pain twitches, pulsates, and can deprive you of sleep. Hyperthermia is noted.
Atparanephritisfirst, fever occurs, then local edema, hyperemia and hyperthermia are detected. Intense pain, radiating to the stomach and under the ribs, intensifies with movements, and even with breathing, develops on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a crooked position so that the lower back muscles do not strain. The body's condition is serious.
Infectious diseases
AtARVI,fluAndsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by aching pain in the lower back, which causes a desire to change position. Sometimes lower back pain is caused by an infection in the kidneys. Infectious diseases with pain in the lower back:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- bacterial, fungal, viral infections.
Pain in the lower back due to severe infections is observed during a cytokine storm. Epidemiological myalgia is accompanied by attacks of intense pain in the lower back, which last up to 10 minutes with an interval of half an hour to an hour and appear in the limbs, in the chest, and in the abdominal wall. May be combined with rhinitis, conjunctivitis and numbness. Myalgia subsides at rest, intensifies during movements, and may disappear a few days after warming up the muscles.
Other muscle lesions
Aching 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 lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overexertion, metabolic disorders and is accompanied by aching long-term pain.
Formsmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
Chronic pain with asthenia, sleep disturbances, and neurotic disorders are observed in fibromyalgia.
Other diseases
Lower back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord neoplasms.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:hereditary cerebellar ataxia of Pierre-Marie.
- Exogenous intoxications: Adrenomimetic drug abuse.
- Pathologies of the heart and blood vessels: Loeffler's 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. Muscle pain lasts about two weeks and then disappears.
Pain caused by changes in the spine lasts longer and radiates to the leg, 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 intensity and longer duration.
Diagnostics
A medical history is of great importance for making a diagnosis, since low back pain can be caused by various diseases.
Primary diagnosis is carried out by a traumatologist-orthopedist. When diagnosing, the doctor takes into account the following symptoms: impaired defecation and urination, orthopedic defects, weakness and numbness in the leg. An examination is carried out to identify pain points and muscle spasms.
It also matters at what time the pain appears, its connection with stress, the presence of cramps, cough, fever and dysfunction of the bladder or intestines.
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 hardware and instrumental examination. According to the physician’s indications, consultations with a surgeon, rheumatologist, urologist, and other specialized specialists are prescribed.
Diagnostics may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, sensitivity and muscle strength, and coordination of movements.
- X-ray.X-ray is the initial examination method that allows you to determine changes in bone tissue. Images of the lumbar region show fractures, degenerative changes in the intervertebral discs, 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.
- 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.
- Lab tests.To determine the causative agent of the infection, urine and blood tests are taken for microbiological examination. To detect neuroinfections - using serological tests.
Treatment of lower back pain
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 a warming and analgesic effect. In case of infectious processes, their 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.
- Neurotropic B vitamins, enhancing the effect of medicinal painkillers.
- Local anesthetics.They perform therapeutic blockades 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 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 decompression of the disc.
Prevention
Massage is effective in the presence of muscle blocks and subluxations of joints, reduces muscle spasm and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective for 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.