When a person is in pain, the only wish is for the pain to go away quickly and never come 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 nerve endings, muscle tissue and internal organs. It is observed during fevers. It can be sharp and dull, steady and periodic, shooting and bursting. The pain can be periodic, local, aching or nagging, for some it is related to the weather, for others to physical activity, for others to staying in an uncomfortable position for a long time.
Why does my back hurt?
The causes of frequent pain in the lower back 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.
Diseases of the spine
Common causes of back pain are congenital anomalies and acquired diseases of the spine. The pain is sometimes related to weather changes and sometimes to physical activity.
Lumbago– sharp pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumbar lumbago occurs - pain or pain in the lower back, radiating to the back of the thigh. Pain appears against the background of the root syndrome. Painful sensations are detected with pathologies in the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondylarthrosis.
- Congenital anomalies: sacralization, backache.
- Multi-etiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal circulatory disorders.
- Other diseases: diseaseForester.
Secondary damage to nerve structures: lumbosacral radiculitis, lumbosacral plexus, myelopathy of various origins.
Spinal curvature
Small pain with curvature of the spine is associated with improper distribution of physical activity, excessive strain on ligaments and muscles in the lower back. Pain occurs due to an uncomfortable position when 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 changes in the weather. Osteoporosis can be:
- postmenopausal;
- juvenile;
- idiopathic;
- senile.
The same pain sensations occur in patients with genetic diseases, disorders of the endocrine glands and poisoning when taking drugs. Secondary osteoporosis may be due to the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
An increase in pain and an increase in its duration are associated with injuries and fractures.
Injuries of the spine
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 bleeding. In severe 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 the body turns, the muscles and tissues swell. The lower back is painful to 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 bleeding or swelling occurs from soft tissue contusions. Kidney bruises are painful and radiate to the lower abdomen, genitals, and lumbar region. Sometimes hematoma and manifestations of hematuria are visible. With severe bruising, painful shock, blood in the urine and prolonged severe pain may occur.
Infections of the spine and spinal cord
Osteomyelitismanifests as increasing pain in the lower back combined with chills and fever Can be hematogenous, post-traumatic, contact, postoperative. The intense pain pulls and swells so much that it prevents movement, forcing you to freeze. In the chronic form of osteomyelitis, a fistulous tract is formed with discharged pus, so the manifestations of pain are normalized.
Tuberculosis of the spineit develops gradually, starting with periodic pain, which intensifies due to stress, then stiffness of movements appears. 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 appear.
Local inflammation
It's boiling,carbuncles– against the background of purulent processes, purple or bluish skin solids with a diameter of 1 cm appear in the center with one or more rods and are accompanied by increasing pain in the lower back. The pain is throbbing, throbbing and can deprive you of sleep. Hyperthermia is noted.
In theparanephritisfirst fever appears, and then local edema, hyperemia and hyperthermia are detected. Severe pain, radiating to the stomach and under the ribs, intensifies with movements, even with breathing, develops on the third day. Against the background of paranephritis, due to intense pain, the patient is forced to take a crooked position so as not to strain the lower back muscles. The condition of the body is serious.
Infectious diseases
In theARVI,fluAndsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by pain in the lower back, causing the desire to change position. Sometimes lower back pain is caused by a kidney infection. Infectious diseases with lower back pain:
- hemorrhagic fevers?
- Japanese mosquito encephalitis?
- Ebola fever?
- foot and mouth disease?
- coronavirus?
- bacterial, fungal, viral infections.
Lower back pain due to severe infections is seen during a cytokine storm. Epidemiologic myalgia is accompanied by attacks of severe pain in the lower back, lasting up to 10 minutes with an interval of half to an hour and appearing in the extremities, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia subsides at rest, intensifies during movement, and may disappear a few days after warming up the muscles.
Other muscle damage
Lower back pain occurs after vigorous physical activity, strengthening exercises for the back muscles, or a long stay in a position with tension on the back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, poisoning, overexertion, metabolic disorders and is accompanied by long-term pain.
Printed mattermyositis:
- for syphilis and tuberculosis.
- idiopathic, juvenile?
- for oncology;
- for connective tissue diseases.
Fibromyalgia is characterized by chronic debilitating pain, sleep disturbances and neurotic disorders.
Other diseases
Low back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, neoplasms of the spinal cord.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:Pierre-Marie hereditary cerebellar ataxia.
- Exogenous poisonings: Abuse of adrenergic drugs.
- Pathologies of the heart and blood vessels: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergency conditions: blood transfusion shock.
The pain syndrome radiates to the lower back against the background of pelvic diseases, women's diseases, as well as prostate cancer, proctitis, sigmoiditis.
Types of pain
Duration should be considered when diagnosing low back pain. 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 pins and needles sensation, 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 for the diagnosis, as low back pain can be caused by various diseases.
The primary diagnosis is made by a traumatologist-orthopedic. 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 performed to identify signs of pain and muscle spasms.
Also important is the time of onset of pain, its connection to stress, the presence of cramps, cough, fever, and bladder or bowel dysfunction.
If there are neurological symptoms, the patient sees a neurologist. The doctor interviews the patient and conducts a visual examination, then the patient is sent for examination of material and instruments. 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 assesses the patient's reflexes, sensitivity and muscle strength and coordination of movements.
- X-ray.X-ray is the initial method of examination 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.
- The 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 rule out stenosis, myelography is prescribed.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests assess muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine conduction disturbances along nerve fibers.
- Laboratory Tests.To determine the causative agent of the infection, urine and blood tests are taken for microbiological examination. For the detection of 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 painkillers. For degenerative diseases of the spine, lumbar spine and lumbar lumbago, 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 pharmaceutical painkillers.
- Local anesthetics.They carry out therapeutic blocks 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 features, there are surgical interventions:
- For instability: intrabody fusion, interpedic fixation, plate fixation.
- For tuberculosis, tumor, osteoporosis, osteomyelitis: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdiscectomy, nucleoplasty.
- For spinal canal stenosis: laminectomy, facetectomy, disc decompression puncture.
Prevention
Massage is effective in the presence of muscle blocks and joint subluxations, reduces muscle spasm and lower back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective in strengthening the muscular corset and improving the biomechanics of the spine. Exercises are selected with a doctor. Systematic application allows you to maintain functionality and reduce lower back pain.
"Warned means prepared! "But only a doctor can make an accurate diagnosis.