Lower back pain is a symptom that is rarely noticed. Most people associate it with working in a sitting position, lifting weights or osteochondrosis and are in no hurry to see a doctor. In fact, this condition can signal diseases of the kidneys, liver or intestines, and problems with the musculoskeletal system will not go away by themselves. 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 being upright. The vertebral column is represented by five large vertebrae, which are additionally strengthened by the muscular frame. 9 out of 10 cases of pain in this area are provoked precisely by the pathology of the musculoskeletal system: osteochondrosis, muscle spasm, herniated disc, pinching of the nerve root.
The remaining 10% of cases are associated with diseases of internal organs located in the projection of the lower back: kidneys, genitourinary system, intestines, liver. Even a doctor, upon examination, cannot always accurately determine the cause of the pain, which is why this condition requires careful laboratory and instrumental diagnostics.
Types of pain
The first thing the doctor asks about is the nature of the sensations. Depending on the underlying cause, lower back pain can be:
- acute: usually abrupt, high intensity; the duration of sensations is no more than 1. 5 months;
- subacute: lasts 6-12 weeks;
- chronic: sensations of any intensity, lasting 12 weeks or more;
- transitory (variable): appears periodically;
- strong, medium intensity, weak.
This division is arbitrary. Depending on the situation and circumstances, the nature and duration of the sensations may vary. It is important to describe them to your doctor as fully as possible.
There are many reasons why the back begins to hurt in the lumbar region. The most common provoking factors are:
- weight lifting;
- uneven load distribution (against the background of pregnancy, posture disorders, pathology of the musculoskeletal system);
- infectious lesion;
- diseases of the musculoskeletal system;
- inflammatory processes, including autoimmune;
- 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 appendages in women, prostate in men, etc.
Low back pain 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 deterioration 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, with the result that the affected area almost completely loses its mobility.
Distinguishing features of low back pain in ankylosing spondylitis include:
- increase in intensity at rest, especially with prolonged horizontal position;
- stiffness of movement in the lumbar region;
Osteochondrosis of the lumbar spine
This is a very common disease in which thinning of the intervertebral discs, which act as shock absorbers, occurs. 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, which can press on the spinal cord, increasing pain.
With osteochondrosis, the pain intensifies:
- when lifting from a sitting or horizontal position;
- when trying to lie on your stomach;
- when leaning.
If the disease has caused the formation of a massive hernia, pain in the lower back is often accompanied by numbness and or weakness in one or both legs.
Curvature of the spine in the lumbar region (kyphosis, scoliosis)
Pain in this pathology occurs at the middle and late stages of the development of the disease. Discomfort usually occurs towards the end of the day and is often accompanied by fatigue of the back muscles. The pain is often caused by a spasm of the muscles of the spine, and muscle spasm at a distance (gluteal, periarticular muscles of the upper and lower extremities) is also possible.
This is a degenerative-dystrophic disease of the cartilaginous tissue covering the intervertebral discs. It gradually becomes thinner and destroyed, bone growths (osteophytes) appear around the affected area. As a result of shortening 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 to the thigh and hip area.
The muscles in the affected area spasm and are constantly in tension, which also increases pain.
An attack of urolithiasis is characterized by severe lumbar pain from the affected kidney. At the same time, sensations do not change depending on the posture, a person cannot find a position in which they weaken at least a little. The attack is often accompanied by a reduction in the amount of urine and a reddish color change.
Low back pain can also result from:
- algomenorrhea (painful periods);
- inflammation of the pancreas;
- intestinal obstruction;
- appendicitis, etc.
Pain in various parts of the back
Localization of pain can tell a lot about its cause. Pain in the upper lumbar region may result from:
- diseases of the spine;
- muscle spasm against the background of their overstrain;
- cardiovascular diseases;
- diseases of the gastrointestinal tract.
If the epicenter is in the lower part of the lower back, the list of probable causes includes, in addition to spinal diseases:
- kidney pathology (pyelonephritis, urolithiasis);
- disruption of the intestines (constipation, flatulence);
- spasms or inflammation in the pelvic organs (salpingo-oophoritis, endometritis);
- physiological reasons, in particular pregnancy;
- entrapment of the sciatic nerve.
Displacement of pain to the right or left may indicate damage to the corresponding root of the spinal cord, kidney.
Diagnosing low back pain requires a comprehensive examination. The first step in finding the cause is a survey. The doctor specifies:
- pain localization;
- its character and duration;
- reasons causing an attack or intensifying pain;
- circumstances under which the condition improves (a certain posture, immobility, taking medications, etc. ).
Data on injuries and diseases, already identified chronic pathologies are collected without fail. Further possible diagnostic search at the discretion of the doctor includes:
- general analysis of blood and urine: helps to 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 small pelvis, in men - ultrasound of the prostate gland;
- kidney ultrasound;
- x-ray, CT or MRI of the lumbar spine;
- chest x-ray.
If any pathology is suspected, after a general diagnosis and examination, more targeted analyzes, examinations and consultations of narrow specialists are prescribed. They allow you to clarify or refute the diagnosis.
Treatment for low back pain depends on the cause. Neurologist, urologist, gynecologist and surgeon can deal with pathology. When it comes to diseases of the musculoskeletal system, doctors use medication, non-medication and surgical methods to improve the patient's condition.
The most common remedies for lumbar pain are non-steroidal 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 decides on the dosage of the drug, as well as the duration of the course, since uncontrolled use of these drugs can cause unpleasant side effects.
If NSAIDs are ineffective, doctors prescribe hormones (corticosteroids). They also stop inflammation and reduce pain.
The third group of drugs that improve the patient's condition are antispasmodics. They relieve muscle spasms in the lumbar region.
Additionally can be assigned:
- decongestants to reduce swelling of the pinched root;
- B vitamins to improve nerve conduction;
Drug-free treatment complements drug regimens. Depending on the clinical situation, it may include:
- physiotherapeutic procedures (magnetotherapy, laser exposure, electrophoresis, etc. );
- physiotherapy exercises: the course of exercises is developed individually in accordance with the underlying and concomitant diseases; gymnastics should be performed regularly, not only in the clinic's office, but also at home, only in this case it has an effect;
- fortifying and therapeutic massage (carried out without exacerbations);
- manual therapy and osteopathic assistance.
The help of surgeons is necessary if the attending physician, based on the general picture, identifies one of the indications for surgical treatment. In itself, the presence of a herniated disc is not an indication for surgical treatment, regardless of its size. Depending on the indications, doctors can remove a herniated disc, remove compression of the spinal cord root, remove a tumor, etc. The decision to carry out a particular operation is made on an individual basis.
The most effective way to prevent low back pain is to adjust your lifestyle in order to spare the kidneys, the spine, and the pelvic organs, but if pain still occurs, then this should be the reason for an extraordinary visit to a specialist:
- avoid hypothermia;
- avoid hypodynamia;
- go in for sports at an amateur level (swimming has a particularly beneficial effect on the condition of the spine and back muscles);
- eat properly and in a balanced way: avoid overeating, minimize fatty, spicy, overly salty foods;
- eliminate alcohol and nicotine;
- drink at least 1. 5 liters of pure water daily, excluding tea, coffee or juices;
- keep body mass index at a normal level: being overweight has a negative effect on the condition of the spine, and a lack of it can cause kidney prolapse.
If a person has already been diagnosed with a pathology of the musculoskeletal system, it is advisable to take preventive courses at least twice a year, according to the European guidelines for the rehabilitation of spinal pathology, in accordance with the doctor's prescription.