80% of people worldwide have experienced lower back pain at least once. Their causes can range from so-called psychosomatic, when aching pain in the lower back is caused by stress, to a much more terrible and difficult-to-treat cancer diagnosis.
How to understand when discomfort and back pain speak of a diseased spine and when they signal an unhealthy condition in other organs? And how not to miss the right time to see a doctor for pain in the spine in the lumbar region?
Causes of back pain in the lumbar region
In the lumbar region there are several organs and systems at once - these are the digestive, urinary, reproductive and musculoskeletal systems and a number of glands that affect a person's well-being. Fortunately, most conditions that manifest as aching pain in the lower back and lower back are treatable and not life-threatening. Only every 20 cases of pain in the lumbar region require surgery or complex therapeutic measures.
Consider the causes of pain in the spine in the lumbar region in more detail. These include:
- overload of the back muscles, especially the lumbosacral region;
- spasms of muscles and internal organs;
- the presence of inflammation or abscess;
- hormonal disorders;
- heart disease;
- diseases of the stomach or intestines (gastritis, peptic ulcer and others);
- posture disorders;
- neuralgia, incl. psychogenic character;
- osteochondrosis, stenosis of the spinal canal, spinal hernia and other pathologies of the spine;
- diseases of the kidneys or internal genital organs;
- obesity;
- pregnancy;
- neoplastic metastases.
The nature of pain in lumbar osteochondrosis
It is necessary to distinguish between primary pain in the lumbar vertebra (associated with degenerative-dystrophic, inflammatory processes and spinal injuries) and secondary "reflex" pain that occurs due to functional disorders in the muscles and internal organs. Primary aching pains in the lumbar region appear as on their own and are rarely accompanied by additional symptoms (usually already in the later stages, for example, with advanced protrusions of the intervertebral discs). Secondary pains are almost always accompanied by swelling, changes in urination and defecation (they are rare, frequent, painful or have other unusual characteristics), nausea, vomiting, abdominal pain and fever. The type of lower back pain can also tell a lot about the problem:
- paroxysmal ("grabs the inside") - diseases of the kidneys and pelvic organs;
- increasing every day - an inflammatory process (for example, in the epithelial passage of the coccyx), abscess, cyst;
- acute stabbing (especially after an injury) - rupture of an internal organ (liver, spleen, kidney, bladder, etc. ) or vessel, internal bleeding, stomach or intestinal ulcer, blockage of the vessel by a detached thrombus (consult immediately a doctor for such pain! );
- periodic shooting - characteristic of squeezing of the spinal roots (radicular syndrome), may be accompanied by spasms;
- continuous opaque - indicates a disease of the liver, kidneys, spleen, some endocrine glands;
- pulling, aggravated by movement - injuries of the spine and adjacent tissues.
Localization of lower back pain
- Pain in the lumbar region and above the sacrum can occur due to trauma, diseases of the gastrointestinal tract and cardiovascular system, as well as injuries, oncology or simple overexertion. Often this area manifests itself after unsuccessful sports activities, especially with poorly executed shots, unworked fall and failure to observe the exercise technique.
- Below the waist (above the tailbone) often hurts from overexertion when lifting loads, standing or walking for a long time, with bruises on ice and other hard surfaces. Sometimes the cause of aching pain in the lower back can be an infection or hypothermia. The most common pain is due to working or resting in an uncomfortable and non-physiological posture, for example due to time spent at the computer or driving in a half-folded "banana" position. Pain is less common due to disturbances in the functioning of the intestine and the genitourinary system (constipation, cystitis, pyelonephritis, prostatitis, dysmenorrhea). The "low" localization of pain can also indicate problems with the hip joint, especially in older people or athletes.
- If it hurts to the left of the spine, this does not rule out problems with it, for example, scoliosis and / or osteochondrosis, impaired blood circulation and even infection of the spinal canal.
- Particularly characteristic of infections and osteochondrosis is persistent aching pain, which intensifies with minimal physical exertion.
- If the pain syndrome periodically subsides and still gives the patient a break, it could be a displacement of the intervertebral disc, a pinched nerve root, or sciatica. Also, pain in the lower back can cause diabetes or hypothermia.
- If the patient often feels that he has "been up" and feels pain after several hours of sedentary activity, the pain may indicate an improper lifestyle that has not yet developed into a pathology, but requires urgent changes - not just pain relief. in lumbar osteochondrosis, but complex therapy.
Please note that pain can be given to the lower back in case of severe pathologies of the heart and digestive organs. If it hurts under the left shoulder blade and laterally at the same time, it is important to urgently exclude a heart attack. If, however, the acute pain attacks are tormented - "as if cut alive" - a stomach or intestinal ulcer.
Low back pain - diagnosis
Doctors identify more than 120 causes that can cause acute and chronic back pain. The most common of these are.
- Diseases resulting from degenerative-dystrophic and other injuries of the vertebral and hip joints. For example, osteochondrosis, osteoarthritis, spondylosis, vertebral hernia, spinal stenosis, kyphosis, scoliosis, protrusion, facet syndrome, sciatica, low back pain, neurogenic lameness, hormonal spondylopathy.
- Autoimmune Diseases. Rheumatoid arthritis, Bechterew's disease.
- Inflammatory diseases. Spondyloarthropathies, incl. psoriatic and reactive arthritis.
- Traumatic defeat. Spondylolisthesis, damage to muscles and ligaments, bruises, dislocations, subluxations and fractures of the vertebrae.
Less commonly, neoplasms and metastases of the spine, osteomyelitis, angina pectoris, cholecystitis, abdominal aortic aneurysm, myocardial infarction, duodenal ulcer and other diseases can become the cause of lower back pain.
Pain in the lumbar spine in women
In women, acute and subacute (periodic or lasting up to 12 weeks) back pain may indicate minor hormonal disturbances or natural physiological processes - during menstruation, pregnancy or menopause. But most of the time it declares itself like this:
- lumbar osteochondrosis - women who stand on their heels for a long time, regularly carry loads of more than 5 kg, are forced to remain in a bent position for a long time when doing professional or household work;
- arthritis is an inflammatory disease to which young women are vulnerable. It can be provoked by an injury to the lower back, a genitourinary infection, hypothermia due to insufficiently warm but fashionable clothes, as well as heredity (for example, the presence of rheumatoid arthritis in relatives);
- osteoarthritis is a predominantly age-related disease that often manifests itself after 40 years as a reaction to hormonal changes in the body;
- inflammation of the appendages (adnexitis);
- cervical or ovarian cancer;
- torsion of an ovarian cyst;
- endometriosis.
Seek immediate medical attention if symptoms of low back pain:
- appeared after an injury;
- occur in the medical history of a patient with oncologic and precancerous conditions (eg, cervical dysplasia);
- accompanied by an increase in temperature;
- accompanied by unexplained weight loss;
- cause difficulties in urination and defecation;
- accompany the sighting;
- associated with a feeling of numbness or stiffness in the legs, a change in gait.
Pain in the lumbar spine in men
Men suffer from back pain less frequently than women. Most often, as in women, their cause lies in osteochondrosis or kidney disease. Among the gender-specific diseases that cause pain in the spine in the lumbar region, we can name:
- epididymitis (inflammation of the seminal appendix);
- prostatitis;
- orchitis (swelling of the testicles);
- testicular diseases and other oncological diseases of the genital organs;
- prostate cancer.
Often, lower back pain in the strong half occurs due to a vertebral or inguinal hernia. These diseases are especially predisposed to men over the age of 40 who are actively engaged in physical labor or working in an awkward position. In women, this pathology is less common.
Back pain treatment
Treatment of back (lumbar) pain requires a therapeutic effect on the vertebrae and intervertebral discs, nerve fibers and muscles. In addition to relieving pain in the lumbar spine, it is necessary to slow down the degenerative processes of the spine, if any, relieve inflammation, restore blood microcirculation and the conduction of nerve impulses. Treatment is prescribed exclusively by a doctor or immediately by a group of specialists: neurologist, traumatologist, gynecologist, orthopedist, rheumatologist and other doctors, depending on the main and concomitant diagnoses.
In over 98% of cases associated with spinal diseases, treatment is carried out conservatively: surgery can be avoided even in the case of a hernia.
Medical approach
With the help of drugs, the pain can be completely eliminated in a few months (for example, pain in the spine in the lumbar region is treated for 3-4 months with compression of the roots, hernias). Then, depending on the diagnosis, therapy is completed or performed periodically, in courses, to maintain remission.
In the treatment of back (lumbar) pain it helps:
- Non-steroidal anti-inflammatory drugs in the form of tablets, ointments, injections.
- Hormonal preparations (in the form of blocks and droppers).
- Analgesics for pain relief.
- Chondroprotectors.
- Preparations for warming, for example, ointments based on venom from bees and snakes, mustard plasters.
- Venotonics and angioprotectors.
- Anticonvulsants, anxiolytics and antidepressants.
Physiotherapy for back pain
Used to treat low back pain:
- massage (classic, cupping, hydromassage);
- phonophoresis;
- electrophoresis;
- magnetotherapy;
- laser therapy;
- diadynamic therapy;
- electrical neuromyostimulation;
- manual therapy;
- acupuncture;
- balneological procedures and mud therapy;
- kinesitherapy.
Physical therapy for lower back pain
A set of exercises for pain in the lumbar region is performed daily and only when remission is achieved! With an exacerbation of the disease, any load can only aggravate the situation. Before performing the exercises, you should consult with a physical therapy instructor.
- Get on your knees and put your right leg forward (foot on the floor, knee bent at a right angle). Keeping your balance, pull your left foot towards your buttock with your left hand and feel the tension in the muscles. 10 times per side.
- Get on all fours, look straight ahead. Bend and arch your back - "cat" exercise.
- Lie on your back and, keeping your legs under your knees, bring your knees to your chest and lock in this position for a couple of seconds. 10 times.
- The starting position is the same. Cross your legs (on the weight) and stretch the muscles well, supporting the lower leg below the knee with both hands.
- Standing on all fours, raise your left arm and right leg perpendicular to the floor. Repeat for the other side. 10 times.
A series of exercises for pain in the lower back with a massage roller is also recommended. For example: put the roller under the sacrum and pull the knee to the chest while the other leg is on the ground. Repeat 10 times for each leg. If there is not enough tension, put your hand behind your head and / or move your bent knee slightly to the side.
How to take care of your back - recommendations of doctors
We recommend 10 simple tips to protect your lower back.
- To keep your back healthy, it is important to avoid physical (as well as mental and emotional) overwork and hypothermia. If you are forced to work for a long time in the cold or in environments with sudden changes in temperature, get high-quality thermal underwear.
- Carry out timely treatment of pain in the spine in the lumbar region.
- If you have already been diagnosed with the initial stage of osteochondrosis, have congenital or acquired deformities of the musculoskeletal system, use orthoses - special bandages and corsets that help relieve the back. If you carry a heavy backpack, get one designed to protect your back from low back pain symptoms.
- Also, do not forget to take chondroprotectors for therapeutic and prophylactic purposes for at least 3-6 months of the year.
- Balance your diet so that your body gets enough vitamins and minerals, as well as protein.
- Properly equip a place to sleep. The mattress should be neither too soft nor too hard, the length of the bed should be slightly greater than your height. The height of the pillow is also important for relieving pain in lumbar osteochondrosis - it is best to purchase an orthopedic one. If pets force you to sleep in an uncomfortable position, don't leave them on the bed.
- While sitting, make sure your elbows are on the table top, at a comfortable height, and the seat of the chair allows you to keep your shins perpendicular to the floor.
- If you have already been diagnosed with a disease of the spine, take care of rational work, which will reduce professional stress on the lower back.
- Try not to abuse alcohol, coffee and cigarettes.
- Maintain a normal level of physical activity (at least in the form of 15-minute exercises for lower back pain 3-4 times a day).
Back health!