Back pain in the lumbar region

Lower back pain is one of the most common reasons for a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be permanently crippling, making movement and self-care impossible. Acute low back pain affects men as often as women.

With higher frequency in people of middle and older age, lower back pain can often be seen in adolescents and young adults. This is due to rapid growth, weakness of the fragile muscles of the lower back, injuries. So, pain in the lumbosacral spine is the most pressing problem that anyone can face.

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Lower back pain with lumbar osteochondrosis

Lower back pain with osteochondrosis can increase with coughing and sneezing, with any movement, especially when the body leans forward. Along with back pain, lumbar osteochondrosis can be manifested by a violation of the sensitivity of certain areas of the skin or muscles of the lower half of the trunk and legs, weakening or disappearance of tendon reflexes of the legs.

  • As a rule, with osteochondrosis there is a curvature of the lumbar spine. Depending on the plane in which the curvature occurs, we can distinguish scoliosis (curvature to the right or to the left), lordosis (curvature towards the front) and kyphosis (smoothing of the lumbar spine or even its curvature towards the rear). In the event that with osteochondrosis the spinal cord is pinched, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.
  • However, most often lumbar osteochondrosis manifests as radicular pain - that is, developing as a result of the pinching of nerve roots extending from the spinal cord to one level or another. So, one of the well-known lumbar syndromes is lumbago. It occurs during physical stress or in an awkward position of the body, and sometimes for no apparent reason. Suddenly, within minutes or hours, there is a sharp, stabbing pain ("lumbago"), often burning and bursting ("as if a stake had been planted in the lower back").

The patient freezes in an uncomfortable position, cannot straighten up if an attack occurs when lifting the weight. Attempts to get out of bed, cough, or bend a leg are accompanied by a sharp increase in pain in the lower back and sacrum. If the patient is asked to stand, then a strong immobility of the entire lumbar region is revealed due to muscle tension.

Lumbosacral osteochondrosis tests

These tests are used as a means of making preliminary diagnoses, they are named after the doctors who suggested them.

Symptom of Déjerine if you tighten your abs and listen to your lower back, the pain will get worse. In this case, there is a high probability that the patient is suffering from osteochondrosis. Neri's symptom if, when the head is tilted sharply forward before touching the chest, there is pain in the lower back, it also indicates problems with the spine. Symptom of asega this can be felt after the following actions: lying on your back, you need to lift each leg in turn. If after that the lower back is twisted, and pain is felt along the sciatic nerve to the leg, then this is evidence of the pathology of the spine. Larrey's symptom if pain occurs in a person along the sciatic nerve, after rising forward without bending the knees from a lying position, we are talking about manifestations of chondrosis.

Herniated disc

An equally rare cause is a herniated disc, the clinical manifestation of which is pain in the lumbosacral back. The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as well as with age, loses its elastic properties and elastic capacity.

With continuous exposure (overweight, trauma, progressive osteoporosis), the fibrous ring of the disc becomes thinner and defects form in it. Thanks to these weak points of the fibrous ring, the nucleus pulposus of the disc can move and even protrude.

Causes of back pain

Back pain is such a non-specific symptom that it can be caused by many different reasons. From the intensity of back pain in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons that cause it:

Chronic pain:

  • Osteomyelitis;
  • Ankylosing spondylitis;
  • Deforming spondylosis;
  • Growth diseases - scoliosis;
  • Infectious lesions of the intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
  • Metabolic bone diseases - osteomalacia, osteoporosis;
  • Primary tumors and metastatic tumors of the spinal cord, vertebrae, retroperitoneal space;
  • Non-infectious inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
  • Kidney tumors;
  • Atherosclerosis of the abdominal part of the aorta and its branches.

Acute pain:

  • Spondylitis;
  • Pathology of the hip joint;
  • spinal epiduritis;
  • Protrusion of intervertebral discs in the lumbar region;
  • Osteocondritis of the spine;
  • Acute intervertebral hernia;
  • Intestinal obstruction, atypical course of acute appendicitis;
  • urolithiasis disease;
  • Acute sprains, vertebral fractures;
  • Lumbago, sciatica;
  • Acute disorders of spinal circulation - stroke;
  • Acute pyelonephritis.

Radiating pain in some diseases of internal organs:

  • Diseases of the pelvic organs. In women - inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc. ) In men - prostatitis, prostate cancer;
  • Diseases of the stomach, pancreas, duodenum, gallbladder;
  • Intestinal diseases - inflammation of the diverticulum, ulcerative colitis, intestinal tumors;
  • Kidney disease - renal colic, kidney stones;
  • Aortic dissecting aneurysm.
Lower back pain in a man

Physiological causes

Low back pain can occur if you:

  1. are overweight;
  2. Additional risk for women;
  3. You are pregnant or have recently given birth;
  4. Spend a lot of time driving a car or a computer;
  5. Lead a predominantly sedentary life (office workers) or standing (salespeople, waiters, street singers, surgeons);
  6. Do dynamic physical work with a sudden change in body position (especially if your specialty is associated with intense physical activity);
  7. Overload yourself in the gym or fitness club. Be extremely careful if you have started training recently;
  8. Likes summer cottage work;
  9. Have reached postmenopause, which is conducive to the development of osteoporosis.

Low back pain and pregnancy

Pregnancy exacerbates the manifestations of diseases that exist in the mother's body. Due to changes in hormonal levels and increased loads, pathologies are especially often manifested in the second half of pregnancy. In addition to the pain accompanying the threat of premature labor, the cause of lower back pain in a pregnant woman can be:

  • herniated disc;
  • radiculitis;
  • pancreatitis;
  • pyelonephritis;
  • urolithiasis disease (kidney stones).

Why does the back hurt below the lower back

When the back hurts under the lumbar region, in addition to obvious diseases of the spine (sciatica, lumbago, intervertebral hernias, ankylosing spondylitis, etc. ), the possible causes are periodic pain during menstruation in women, diseases of thefemale genitals, inflammation of the uterine appendages - oophoritis, salpingo-ovaritis (adnexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (blind appendix of the intestine), in men - diseases of theprostate, bladder.

Pain above the lower back

If the back hurts on the right above the lower back - therefore liver pain can radiate, with pathological changes in the liver - hepatitis, liver failure, taking toxic drugs. Pain in this case is most often localized in the right hypochondrium.

If the pain is felt on the right or left just above the lower back, it is very possible that the cause is acute kidney failure. Many chronic kidney diseases such as polycystic kidney disease, malignant kidney tumors, chronic pyelonephritis are accompanied by minor symptoms because the kidney capsule is gradually stretched.

When to consult a doctor?

  1. If the back pain radiates to the lower back and is itself slightly higher (in the chest area). The pain is accompanied by sweating, episodes of vomiting and nausea, shortness of breath.
  2. The pain radiates to the peritoneum, chest, neck, jaw.
  3. The patient is dizzy and confused.
  4. Tachycardia begins.
  5. Spinal trauma, accompanied by loss of control of defecation, urination.
  6. The legs weaken, the buttocks, the genitals go numb.
Lower back pain in a woman

Diagnostic

In order to determine which disease caused lower back pain, it is necessary to undergo a comprehensive diagnostic examination.

Laboratory methods:

  • General and biochemical analyzes of urine and blood.
  • Tests for tumor markers present in the blood during tumor formation.

Methods of instrumental research:

  • X-ray of the spine.
  • Endoscopy of the intestines, stomach and uterus.
  • Ultrasound examination of the abdominal cavity.
  • Magnetic resonance imaging.

How to treat low back pain?

How to properly treat the lower back? The approach to treating the back depends entirely on the symptoms of the disease, the diagnosis made by the doctor and the stage of the disease. Usually an integrated approach is used which includes several treatment methods.

Pain medication. . .The ointment helps relieve inflammation, stretching, and has a warming effect if the lower back has a cold.

The following groups of ointments are distinguished:

  • combined drugs (used for sprains and injuries, with anti-inflammatory and analgesic effects, they have a healing effect due to their constituent substances);
  • anti-inflammatory pain relievers (they contain medicinal substances with a cooling effect that relieve irritation - menthol, lavender and pain relievers);
  • chondroprotectors (one of the active components of these drugs is a substance used in pathological processes of cartilage tissue, which contributes to the active restoration of cartilage surfaces of the joints);
  • irritant drugs (the effect is based on vasodilation and blood flow to the source of the pain).

With the help of therapeutic exercises, the patient will be able to reduce pain, strengthen the muscles and increase the distance between the vertebrae. They will help release the compressed nerve roots, normalize blood flow to the affected area and improve metabolic processes.

In order for such gymnastics to heal and not paralyze, all the recommendations of the attending physician should be followed.

  1. Movements are performed slowly and smoothly without sharp turns;
  2. The room must be ventilated before training;
  3. The patient should wear clothes that do not restrict movement;
  4. The exercise is carried out when the patient breathes in, and when exhaling should return to the original position;
  5. The load gradually increases. First, the number of approaches is about 10, then they are increased;
  6. During gymnastics, you need to monitor your well-being. If acute pain begins, you should stop studying.

In addition, massage is excellent for relieving pain in the lumbar spine. The positive therapeutic effects of massage are as follows:

  • improve the blood supply to the diseased part of the body;
  • knead the muscles, which makes them as well as the ligaments more flexible and elastic;
  • relief of acute pain;
  • get rid of toxins accumulated in muscles and subcutaneous tissues;
  • pleasant sensations due to stimulation of nerve endings in the skin;
  • Positive emotions.

It can be entrusted to a specialist in a clinic or performed at home, in any case, the benefits will be invaluable.

Which doctor should I contact?

For back pain, the cause of which is not known, the first step is to see a therapist. This will help to determine the disease by a combination of symptoms.

If the reason is obvious: the pain was preceded by an injury, the pain occurred against the background of pregnancy, menstrual cycle or chronic disease, it makes sense to immediately contact a narrower specialist.

Self-medication is allowed only in cases where the cause of the pain is precisely known.