When one suffers from pain, the only wish is for the pain to go away quickly and never appear again. The back is a "working" and important part of our body, as the main organ is located there - the spine. Frequent back pain is a symptom of various diseases. Almost everyone experiences pain in the lower back, especially after 40 years. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Pain in the lower back indicates damage to the spine, diseases of nerve endings, muscle tissue and internal organs. It is observed during fever. It can be sharp and dull, constant and periodic, shot and burst. The pain can be periodic, local, aching or annoying, for some it is associated with the weather, for others with physical activity, for others with a long stay in an uncomfortable position.
Why does my lower back hurt?
Causes of frequent back pain can be diseases of muscle tissue, injuries of bones and intervertebral discs. They arise against the background of pathologies of the organs of the abdomen, pelvis and chest.
Diseases of the spine
Common causes of low back pain are congenital anomalies and acquired diseases of the spine. Pain is sometimes associated with weather changes and sometimes with physical activity.
Lumbago– sharp pain that limits movement and occurs due to muscle spasm. With pathological processes in the spine, lumboischialgia occurs - pain or 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 pathology in the back:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: Spinal circulation disorders.
- Other diseases: diseasesFORESTRY.
Secondary lesions of nervous structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Curvature of the spine
Small back pain with curvature of the spine is associated with improper distribution of physical activity, excessive straining of ligaments and muscles in the lower back. The 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 weather changes. Osteoporosis can be:
- after menopause;
- minors;
- idiopathic;
- senile.
The same pain sensations appear in patients with genetic diseases, disorders of the endocrine glands and intoxication while taking medications. Secondary osteoporosis may be due to the syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
Increased pain and increased duration are associated with injuries and fractures.
Spinal cord injuries
A common injury to the lumbar spine is a bruise, which appears as moderate pain and when moving, is accompanied by swelling, hematoma and hemorrhage. 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 on palpation.
Paroxysmal pain with 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, quiet pain with hemorrhage or swelling occurs from soft tissue bruising. Kidney bruises are painful and radiate to the lower abdomen, genitals, and lumbar region. Sometimes a hematoma and manifestations of hematuria are visible. With severe bruising, painful shock, blood in the urine and severe prolonged pain may occur.
Infections of the spine and spinal cord
Osteomyelitismanifests as increasing pain in the lower back in combination with chills and fever, can be hematogenous, posttraumatic, contact, postoperative. The intense pain pulls and swells so much that it impedes movement, forcing you to get up. In the chronic form of osteomyelitis, a fistulous tract is formed with discharged pus, so the manifestations of pain are alleviated.
Spinal tuberculosisit gradually develops, 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 the destruction of the vertebrae and compression of the nerve roots.
In patients withepidural abscess of the spinesevere pains are combined with muscle tension, chills and hyperthermia. As the disease progresses, radicular syndromes and paresis appear.
Local inflammation
seethe,carbuncles- against the background of purulent processes, skin compressions with a purple or bluish tint appear with a diameter of 1 cm, in the center with one or several rods and are accompanied by increasing pain in the lower back. The pain is throbbing, throbbing and can deprive you of sleep. Hyperthermia is observed.
INparanephritisfirst fever appears, then local edema, hyperemia and hyperthermia are detected. Strong pains, radiating to the stomach and under the ribs, intensifying with movement, even with breathing, develop on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a crooked position so that the back muscles are not strained. The body condition is serious.
Infectious diseases
INARVI,fluANDsore throatwith an increase in body temperature and intoxication of the body, myositis is characterized by pain in the lower back, which causes the desire to change position. Sometimes back pain is caused by a kidney infection. Infectious diseases with pain in the lower back:
- hemorrhagic fever;
- Japanese mosquito-borne encephalitis;
- Ebola fever;
- foot and mouth diseases;
- coronavirus;
- 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, which last up to 10 minutes with an interval of half an hour to an hour and appear in the limbs, chest and abdominal walls. It can be combined with rheumatism, conjunctivitis and numbness. Myalgia decreases at rest, intensifies during movement and may disappear a few days after warming up the muscles.
Other muscle lesions
Pain in the lower back occurs after intense physical activity, strength exercises for the back muscles or long standing in a position with tension in the muscles of the lower back. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overload, metabolic disorders and is accompanied by long-term pain.
formmyositis:
- for syphilis and tuberculosis;
- idiopathic, juvenile;
- for oncology;
- for connective tissue diseases.
Chronic pain with asthenia, sleep disturbances and neurotic disorders are seen in fibromyalgia.
Other diseases
Back pain is a concern in pathological conditions:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord neoplasms.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:Pierre-Marie's hereditary cerebellar ataxia.
- Exogenous intoxications: Adrenomimetic drug abuse.
- 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, female 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 legs, perineum and can be accompanied by a sensation of pins and needles, numbness and burning.
Pains caused by diseases of the cardiovascular system and diseases of the abdominal organs are characterized by intensity and longer duration.
Diagnosing
A medical history is of great importance for establishing the diagnosis, as low back pain can be caused by various diseases.
The primary diagnosis is carried out by a traumatologist-orthopedic. During the diagnosis, the doctor takes into account the following symptoms: impaired defecation and urination, orthopedic defects, weakness and numbness in the legs. An examination is performed to identify pain points and muscle spasms.
It is also important what time the pain appears, its connection with stress, the presence of cramps, cough, temperature and bladder or bowel dysfunction.
If there are neurological symptoms, the patient is seen by a neurologist. The doctor interviews the patient and performs a visual examination, then the patient is sent for hardware and instrumental examination. According to the doctor's indications, consultations with a surgeon, rheumatologist, urologist and other specialized specialists are prescribed.
Diagnosis may include:
- Neurological examination.The neurologist assesses the patient's reflexes, sensitivity and muscle strength, as well as coordination of movements.
- X-Ray.X-rays are the initial examination method 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.
- 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 disorders along nerve fibers.
- Laboratory tests.To determine the cause of the infection, urine and blood samples are taken for microbiological examination. To detect neuroinfections - using serological tests.
Back pain treatment
First aid
For spinal injuries, the patient is placed on a hard, flat surface and sent to the clinic. To reduce pain, you should 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, lumbago and lumboischialgia, it is allowed to use creams, ointments and gels with a warming and analgesic effect. 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, increasing the effect of medicinal sedatives.
- Local anesthetics.They perform therapeutic blockades for acute pain with anesthetics, as well as pain relievers in combination with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetic therapy,
- 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: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdisectomy, nucleoplasty.
- For narrowing of the spinal canal: laminectomy, facetectomy, disc puncture decompression.
Preventing
Massage is effective in the presence of muscle blocks and joint subluxations, reduces muscle spasms and back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy – physical exercises are effective for strengthening the muscular corset and improving the biomechanics of the spine. Exercises are chosen with a doctor. Systematic application allows you to maintain functionality and reduce pain in the lower back.
"Forewarned is armed! "But only a doctor can make an accurate diagnosis.