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, as the main organ is located here - 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 pathologydoes 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 fever. It can be sharp and dull, constant and intermittent, shooting and bursting. The painit can be intermittent, local, painful or annoying, for some it is associated with the weather, for others with physical activity, for others with staying in an uncomfortable position for a long time.
Why does my back hurt?
The causes of frequent back pain can be diseases of the muscle tissue, injuries to the bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spinal diseases
Common causes of lower back pain are congenital abnormalities and acquired spine diseases. The pain is sometimes related to changes in the weather and sometimes to physical activity.
Lumbago– sharp 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, which radiates to the back of the thigh. The pain occurs against the background of radicular syndrome. Painful sensations are detected with pathologies of the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital disorders: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: spinal cord circulation disorders.
- Other diseases: diseaseForester.
Secondary changes of the nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
The curvature of the spine
Mild aching pain associated with spinal curvature is associated with improper distribution of physical activity, overstretching of ligaments and muscles in the lower back. The pain occurs due to the uncomfortable position while sleeping on a hard or, conversely, a soft mattress.
The symptom is accompanied by:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- flat back syndrome.
Osteoporosis
If your lower back feels tense or painful for a long time, you may have osteoporosis. The pain is aggravated by stress and changes in the weather. Osteoporosis can be:
- postmenopausal;
- youthful;
- idiopathic;
- senile.
The same pain sensations occur in patients suffering from genetic diseases, disorders of the endocrine glands and poisoning when taking drugs. Secondary osteoporosis can be caused by 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.
Spinal injuries
A common injury to the lumbar spine is a contusion, which presents as moderate pain and is accompanied by swelling, bruising and bleeding during movement. In severe cases, neurological disorders are also added.
A compression fracture of the lower back occurs due to forced bending of the spine and is characterized by respiratory arrest and severe pain. The pain intensifies when the body turns, the muscles and tissues swell. The lower back is painful to the touch.
Patients with spondylolisthesis and vertebral dislocation have paroxysmal pain with heaviness in the lower back and numbness in the legs.
Soft tissue and kidney damage
Moderate and debilitating pain with bleeding or swelling from soft tissue contusions. Bruises of the kidney are painful and radiate to the lower abdomen, genitals and lumbar region. Sometimes manifestations of hematoma and hematuria are seen. In case of severe bruising, painful shock, blood in the urine and prolonged severe pain may occur.
Infections of the spine and spinal cord
Osteomyelitisit appears as an increasing pain in the lower back accompanied by chills and fever. It can be hematogenous, post-traumatic, contact, postoperative. The intense pain pulls and bulges so much that it prevents movement and forces you to freeze. In the chronic form of osteomyelitis, a fistulous tract is formed with discharged pus, so the manifestations of pain are smoothed out.
Spinal tuberculosisit develops gradually, starting with periodic pain, which intensifies due to stress, and 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 those patientsspinal epidural abscesssevere pain combined with muscle tension, chills and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
It boils,carbuncles- against the background of purulent processes, purple or bluish skin lumps with a diameter of 1 cm appear, with one or more rods in the middle, accompanied by increasing pain in the lower back. The pain is throbbing, throbbing, and can rob you of sleep. Hyperthermia is observed.
Atparanephritisfirst fever occurs, then local edema, hyperemia, and hyperthermia are noted. The intense pain radiating to the stomach and under the ribs intensifies with movement and even breathing on the third day. Due to the severe pain in the background of paranephritis, the patient is forced into a crooked position so that the lower back muscles are not strained. The condition of the body is serious.
Infectious diseases
AtARVI,fluAndsore throatwith an increase in body temperature and poisoning of the body, myositis is characterized by aching pain in the lower back, which causes a desire to change the position. Sometimes lower back pain is caused by a kidney infection. Infectious diseases of the lower back:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- coronavirus;
- bacterial, fungal, viral infections.
Pain in the lower back due to severe infections can be observed during a cytokine storm. Epidemiological muscle pain is accompanied by intense pain attacks in the lower back, lasting 10 minutes, with an interval of half an hour, and appearing in the limbs, chest and abdominal wall. Can be combined with rhinitis, conjunctivitis and numbness. Myalgia subsides at rest, intensifies during movement, and may disappear after a few days after warming up the muscles.
Other muscle changes
The aching pain in the lower back occurs during intense physical activity, strengthening exercises for the back muscles, or a long-lasting position with tension in the lower back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, poisoning, overload, metabolic disorders, and is accompanied by long-lasting painful pain.
Formsmyositis:
- in case of syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- connective tissue diseases.
Chronic pain, asthenia, sleep disorders and neurotic disorders are observed in fibromyalgia.
Other diseases
Low back pain is a cause for concern in the presence of pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord tumors.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:Pierre-Marie's Hereditary Cerebellar Ataxia.
- Exogenous poisonings: Adrenomimetic drug abuse.
- Pathologies of the heart and blood vessels: Loeffler's endocarditis, abdominal aortic aneurysm.
- Emergencies: 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, and sigmoiditis.
Types of pain
The duration should be taken into account when diagnosing low back pain. The muscle pain lasts for about two weeks and then goes away.
Pain caused by spinal changes lasts longer and radiates to the leg, perineum, and can be accompanied by stabbing, numbness, and burning sensations.
Pain caused by diseases of the cardiovascular system and abdominal organs is characterized by intensity and longer duration.
Diagnostics
The medical history is of great importance for establishing a diagnosis, since lower back pain can be caused by various diseases.
The primary diagnosis is made by a traumatologist-orthopedic. When making a diagnosis, the doctor takes into account the following symptoms: defecation and urination disorders, orthopedic defects, weakness and numbness in the legs. An examination is performed to identify pain points and muscle spasms.
It also matters when the pain occurs, how it is related to stress, convulsions, cough, fever, and bladder or bowel dysfunction.
If neurological symptoms occur, the patient is treated by a neurologist. The doctor questions the patient and performs a visual examination, then sends the patient for a hardware and instrument examination. Consultations with surgeons, rheumatologists, urologists and other specialists are prescribed according to the doctor's indications.
Diagnostics may include:
- Neurological examination.The neurologist evaluates the patient's reflexes, sensitivity and muscle strength, as well as movement coordination.
- X-ray.X-ray is the initial examination method that allows to determine the changes in the 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.
- MRI– an informative method that enables the diagnosis of morphological changes in the condition of ligaments and intervertebral discs. Myelography is prescribed to rule out stenosis.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests evaluate muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)is used to determine conduction disturbances occurring along nerve fibers.
- Laboratory tests.To determine the causative agent of the infection, urine and blood samples are taken for microbiological examination. To detect neuroinfections - using serological tests.
Treatment of lower back pain
First aid
In the case of spinal injuries, the patient is placed on a hard, flat surface and taken to the clinic. To reduce pain, you need to optimize your posture during work and rest to reduce the strain on your back. Before the doctor examines you, you may take painkillers. In the case of degenerative diseases of the spine, lumbago and lumboischialgia, the use of warming and pain-relieving creams, ointments and gels is permitted. Their use is prohibited in case of infectious processes.
The treatment is based on physiotherapy and drug therapy. The following methods are used:
- NSAIDsin the form of tablets and topical agents, it is used for chronic and acute pain in the muscles of the lumbar spine.
- Neurotropic B vitamins, enhances the effect of medicinal pain relievers.
- Local anesthetics.Therapeutic blockades are performed for acute pain with anesthetics, as well as analgesics combined 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:
- In case of instability: interbody fusion, transpedicular fixation, plate fixation.
- In case of tuberculosis, tumor, osteoporosis, osteomyelitis: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdiscectomy, nucleoplasty.
- To narrow the spinal canal: laminectomy, facetectomy, disc puncture decompression.
Prevention
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 and improves blood circulation.
Exercise therapy - physical exercises effectively strengthen the ligaments and improve 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 forewarned! "But only a doctor can make an accurate diagnosis.