Lower back pain (low back pain, lumbago, aching or pulling sensation in the lower back) is a common complaint of patients when consulting the doctor.According to medical statistics, at least 70% of the population experiences these symptoms at least once in their lives.Furthermore, in 10% of cases, low back pain attacks become chronic.
The structure of the symptoms is as follows:
- 80-85% - nonspecific low back pain.Symptoms subside within a few weeks;
- 10-15% - spinal stenosis, radiculopathy, causing compression of the nerve root;
- 1-2% - a specific syndrome caused by oncopathology and diseases of internal organs.
Pain in the lower back ranks second in duration and third in frequency of issuing a certificate of temporary disability among all diseases.To prevent the pathology from recurring, it is necessary to consult a doctor in a timely manner.
Types of low back pain
According to the duration of the pain syndrome:
- Sharp pain.It occurs suddenly, as a reaction to new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks - this is the normal healing period for damaged tissues;
- Recurrent pain.The syndrome occurs at least six months after the previous exacerbation.Between relapses, symptoms disappear completely;
- Exacerbation of chronic low back pain.Difference from relapse: the interval between attacks is less than 6 months, the symptoms may pass, but do not disappear completely.
According to the etiopathogenesis, low back pain is:
- Primary.The symptom occurs due to functional and/or dystrophic changes in intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.The cause of frequent lower back pain is congenital anomalies of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, projection pain due to pathologies of the intestines, stomach, abdominal aorta and organs of the genitourinary system.
What does low back pain feel like?
Most of the time, patients complain of sharp and intense pain in the lower back, also called stabbing, throbbing or low back pain.Movement in the back is restricted.Sometimes a person remains hunched over and cannot straighten up.With any movement, the sharp pain in the lower back intensifies (“shooting” in the back).The main cause of this condition is chronic diseases of the lumbar spine.An acute attack can last from a few minutes to several weeks.In some cases, the pain lessens so much that the person gets used to it.Full recovery without recurring attacks is also possible.
Dull pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but they cause discomfort.Lower back pain may intensify with low bending, physical activity, after an infection or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort remain in the back.
Symptoms you shouldn't ignore
If acute or dull back pain is accompanied by one or more symptoms from the list below, you should see a doctor immediately.
Warning signs:
- numbness in arms or legs, tingling sensation, “cotton-like” limbs;
- pain in the hip and knee joints;
- leg cramps;
- menstrual irregularities in women;
- sexual impotence in men;
- increased pain when sitting;
- inability to stand for a long time;
- rapid weight loss;
- increase in temperature, fever;
- critical deviations in blood tests;
- age over 50 years;
- lack of dynamics during “routine” treatment for 4 weeks.
The clinic's doctor will determine the cause of the pain and help alleviate the exacerbation.After that, examinations and comprehensive treatment under medical supervision will be required.
What pathologies can cause acute pain in the lower back?
Diseases of the musculoskeletal system
Pinched sciatic nerve.Severe, sharp pain occurs in the lower back, caused by compression of the nerve roots by closely spaced adjacent vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes in the discs.The tissues are gradually destroyed, the space between the vertebrae decreases and, with any sudden movement, they can compress the nerve.The pain is often accompanied by pulsation of compressed vessels.
Sciatica (lumbosacral radiculitis).As a result of pinching, the nerve roots become inflamed and radiculitis occurs.If the sciatic nerve is affected, the disease is called sciatica.With lumbosacral radiculitis, lumbar ischialgia is often observed - severe pain in the lower back and leg on the affected side.
Osteochondrosis (spondylosis).The vertebrae become denser, deformed and covered in osteophytes - bony growths that look like sharp spines.For a long time it was believed that osteochondrosis was a consequence of age-related degenerative changes, but now the diagnosis is “younger” every year.A sedentary lifestyle and sedentary work contribute to changes in intervertebral discs already at the age of 25-30 years.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A fragment of articular tissue protrudes into the spinal canal.A hernia can appear after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spine.Pathology can develop for several years without manifesting itself in any way.The disease begins at a young age and gradually leads to disability.The reason for such a disappointing prognosis is also that patients suffer from constant nighttime pain that disturbs sleep and do not attach importance to morning stiffness in the back.Several years pass from the appearance of the first symptoms until you see a doctor.Chronic inflammation already leads to irreversible changes in the spine, its motor activity decreases, a bulge appears, etc.
Spondyloarthritis.Pathologies such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lower back.The main symptom is accompanied by inflammation of the joints of the knees, feet or hands, pain in the buttocks, blurred vision, unstable stools of an unusual consistency.
Other diseases.Acute pain in the lower back occurs with myositis - inflammation of the lumbar muscles as a result of tension or hypothermia.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of internal organs
Often the cause of lower back pain is pathology of the kidneys, internal genital organs and urinary tract.The condition requires careful diagnosis and medical monitoring, as many complications are irreversible.
Low back pain due to kidney pathology differs from the consequences of disorders of the musculoskeletal system in its constancy and independence of movement or body position.It is especially necessary to be careful if there are symptoms such as cloudy urine, frequent or painful urination, etc.
Diseases of the genital organs
Both women and men can experience severe back pain due to various pathologies of the reproductive system.This is how sexually transmitted infections and inflammation of tissues and organs manifest themselves.
Lower back pain in women often occurs during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered a variant of the norm.If your period is very heavy, accompanied by pressure surges and health problems, it is best to visit a prenatal clinic and get tested for hormones.Menstruation can be normalized with properly selected medications.
Lower back pain in men can be a sign of prostate problems.It is necessary to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas becomes inflamed, pain involves the back in the lower back.Possible irradiation to the coccyx, left thigh, perineum.Waist pain begins to increase after eating and intensifies with physical activity.Walking, jumping and other exercises cause stretching of the pancreatic capsule and a reaction in the nerve endings.
What to do if you have severe lower back pain
If a severe attack of pain occurs at home or at work, you need to lie down on a hard surface and place a pillow under your bent knees so that your legs are at right angles to the body.Take a nonsteroidal anti-inflammatory medication.You can tie a shawl or warm scarf around your lower back to warm your back a little.
If these measures do not bring relief, you will need to call a doctor or provide emergency medical care at home.If you feel better, do not wait for a new pain attack and find time to go to the medical center, first make an appointment with a general practitioner - he will assess your health status in detail, establish a preliminary diagnosis, draw up a plan for an initial examination, prescribe adequate symptomatic treatment and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many “quick” solutions for back pain: a variety of gels, ointments and patches.Some of them provide relief, but should not be used continuously without medical supervision.In some cases, heating the gels can only cause harm.Therefore, if you have lower back pain, you should see a doctor, even if you have managed to suppress the symptoms.
Diagnosis of low back pain
At the first consultation, the doctor interviews the patient, finds out how long the symptoms have been present, the dynamics of their development and the presence of concomitant complaints.The doctor will take into account exactly how it hurts - on the left or right, whether the pain is dull, aching, sharp or throbbing, the duration of the attacks and other details to make a preliminary diagnosis.In many typical cases, standard treatment by a general practitioner is possible.
Most often, if there are specific signs of a serious disease of the spine or internal organs, the patient is referred for additional examinations:
- Blood test.A low hemoglobin level indicates the likely presence of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends doing not only a general analysis, but also a biochemical one to assess the functioning of the internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the analysis results are a direct indication of ultrasound of the urinary system and subsequent examination by a urologist;
- X-ray of the lumbar spine.Photographs show certain signs of inflammation of the joints, disorders of various structures and proximity of the vertebrae due to degenerative changes.Based on the x-ray, the doctor may assume osteoporosis and see fractures;
- Magnetic resonance imaging (MRI).Method of examining patients without X-rays, which allows obtaining several images (slices) of the area of interest and its three-dimensional image.Unlike radiography and computed tomography, MRI provides information about the condition of not only bones, but also muscles, blood vessels and soft tissues.
Treatment of back and lower back pain
Uncomplicated forms of pain that are not associated with serious diseases of the spine or internal organs are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to remove the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Moderate, individual and continuous physical activity is recommended.
Getting rid of pain caused by a deeper disease requires a systematic and comprehensive approach.The course of treatment should include medication, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In case of acute and unbearable pain, the doctor immediately performs a blockade at the appointment - an injection of anesthetic into the affected area.The injection quickly relieves discomfort, but only provides temporary relief.The patient must start treatment immediately.
To alleviate an exacerbation, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs, which reduce pain and swelling;
- muscle relaxants to relax spasmodic muscles;
- B vitamins to improve the regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of internal organs, the patient is prescribed medications to treat the underlying pathology.
Auxiliary techniques
After the exacerbation is relieved, the following treatment methods are effective:
- use a special fixing bandage;
- medical massage of the lower back;
- shock wave therapy;
- swimming and gymnastics classes;
- acupuncture;
- application of tapes;
- manual therapy;
- other physiotherapeutic techniques.
Surgical intervention
Surgery is the last resort.Surgical treatment is indicated for serious disorders of the structure of the spinal cord or internal organs.There are many techniques.The specific type of intervention is ultimately planned by a neurosurgeon, operating urologist or abdominal surgeon, taking into account the established diagnosis and individual characteristics of the patient's condition.
Do not tolerate lower back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center you can undergo a complete examination, find out the reason for your back discomfort and receive quality treatment.