When a person suffers from pain, the only wish is for the pain to disappear quickly and never appear again. The back is a "functioning" and important part of our body, as 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 the age of 40. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Low back pain indicates damage to the spine, diseases of the nerve endings, muscle tissue and internal organs. It is observed during fevers. It can be sharp and dull, constant and periodic, stabbing and bursting. The pain can be periodic, local, painful or annoying, for some it is associated with the climate, for others with physical activity, for others with prolonged stay in an uncomfortable position.
Why does my lower back hurt?
The causes of frequent back pain can be diseases of the muscle tissue, injuries of the bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spinal diseases
The most common causes of low back pain are congenital anomalies and acquired spinal diseases. Pain is sometimes associated with climate change and sometimes with physical activity.
Lumbago– acute 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 diseases: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal circulatory disorders.
- Other diseases: diseaseMore forestry.
Secondary lesions of the nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathies of various origins.
Spinal curvature
Mild aching pain with curvature of the spine is associated with improper distribution of physical activity, overstrain of the 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 hurts for a long time, it could be osteoporosis. The pain is aggravated by stress and climate change. Osteoporosis can be:
- postmenopause;
- youth;
- 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 disease, 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 as moderate pain and, during movement, is accompanied by swelling, hematomas, and hemorrhages. In more serious cases, neurological disorders are also added.
A compression fracture in the lower back occurs due to forced bending of the spine and is characterized by cessation of breathing and severe pain. The pain intensifies when turning the body, the muscles and tissues swell. The lower back is painful on palpation.
Paroxysmal pain with a feeling of heaviness in the lower back and numbness in the legs is found in patients with spondylolisthesis and vertebral dislocations.
Soft tissue and kidney damage
Moderate, dull pain with hemorrhage or swelling occurs due to soft tissue contusions. Kidney bruising is painful and radiates to the lower abdomen, genitals, and lower back. Sometimes a hematoma and manifestations of hematuria are visible. With severe bruising, painful shock, blood in the urine, and intense, prolonged pain may occur.
Infections of the spine and spinal cord
Osteomyelitismanifests itself with increased pain in the lower back in combination with chills and fever and can be hematogenous, post-traumatic, contact, postoperative. The intense pain tugs and swells so much that it impedes movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistulous tract with discharged pus is formed, so the pain manifestations are dulled.
Spinal tuberculosisdevelops gradually, 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 the destruction of the vertebrae and compression of the nerve roots.
In patients withspinal epidural abscesssevere pain is combined with muscle tension, chills, and hyperthermia. Radicular syndrome and paresis occur as the disease progresses.
Local inflammation
Bubbles,carbuncles– against the background of purulent processes, skin compactions of purple or bluish color with a diameter of 1 cm appear, in the center with one or more sticks, and are accompanied by increasing pain in the lower back. The pain twitches, throbs, and can deprive you of sleep. Hyperthermia is noted.
TOparanephritisfirst fever occurs, then local edema, hyperemia and hyperthermia are detected. On the third day, intense pain develops, radiating to the stomach and under the ribs, intensifies with movements and even with breathing. Against the background of paranephritis, due to severe pain, the patient is forced to take a crooked position so that the muscles of the lower back do not strain. The condition of the body is serious.
Infectious diseases
TOARVI,influenceANDsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by aching pain in the lower back, which causes the desire to change position. Sometimes lower back pain is caused by a kidney infection. Infectious diseases with pain in the lower back:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- corona virus;
- 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, lasting up to 10 minutes with an interval of half an hour to an hour and appearing in the limbs, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia disappears at rest, intensifies during movements and may disappear a few days after warming up the muscles.
Other muscle injuries
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 long-term aching pain.
Shapesmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
In fibromyalgia, chronic pain with asthenia, sleep disorders and neurotic disorders is observed.
Other diseases
Low back pain is a concern in pathological conditions:
- Tumorsvertebral column and spinal cord: sarcomas, hemangiomas, metastases, spinal cord tumors.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, renal infarction, renal vein thrombosis, renal cyst, kidney cancer.
- Hereditary diseases:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous intoxications: Abuse of adrenomimetic drugs.
- Pathologies of the heart and blood vessels: Loeffler 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 consideration when diagnosing low back pain. The muscle pain lasts about two weeks and then goes away.
Pain caused by changes in the spine lasts longer and radiates to the leg, perineum and may be accompanied by a sensation of tingling, 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
The medical history is of great importance in making a diagnosis, since low back pain can be caused by several diseases.
The primary diagnosis is carried out by a traumatologist-orthopedist. During the diagnosis, the doctor takes into account the following symptoms: disorders of defecation and urination, orthopedic defects, weakness and numbness of the leg. An examination is performed to identify tender points and muscle spasms.
The time when the pain appears, its connection with stress, the presence of cramps, cough, fever and bladder or bowel dysfunction is also important.
If neurological symptoms are present, the patient is seen by a neurologist. The doctor interviews the patient and performs a visual examination, then the patient is sent for a hardware and instrumental examination. According to the doctor'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, 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 of the intervertebral discs, signs of inflammatory processes and spondylolisthesis.
- CT scan.CT scans examine the detailed structure of solid structures.
- magnetic resonance imaging– an informative method that allows you to diagnose morphological changes in the condition of the 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 test.To determine the causative agent of the infection, urine and blood tests are performed for microbiological examination. To detect neuroinfections - using serological tests.
Treatment of back pain
First aid
For spinal injuries, the patient is placed on a hard, flat surface and brought to the clinic. To reduce pain it is necessary to optimize the position of the body during work and rest to reduce the load on the back. Before being examined by a doctor, you can take painkillers. For degenerative diseases of the spine, lumbago and lumboischialgia, the use of creams, ointments and gels with a warming and analgesic effect is allowed. 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 anaesthetics.They perform therapeutic blocks for acute pain with anesthetics and 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: sequestration, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdiscectomy, nucleoplasty.
- For narrowing of the spinal canal: laminectomy, facetectomy, disc decompression puncture.
Prevention
The massage is effective in the presence of muscle blocks and joint subluxations, it reduces muscle spasms and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Physical therapy: Physical exercises are effective for strengthening the muscle 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.