Low back pain (pain in the lower back, pain or pulling sensation in the lower back) is a common complaint when patients visit the doctor.According to medical statistics, at least 70% of the population experiences such symptoms at least once in their lifetime.Moreover, in 10% of cases, back pain attacks become chronic.
The structure of the symptoms is as follows:
- 80-85% - non-specific back pain.Symptoms disappear within a few weeks;
- 10-15% - spinal stenosis causing nerve root compression, radiculopathy;
- 1-2% - a specific syndrome caused by oncopathology and diseases of internal organs.
Pain in the lower back takes the second place among all diseases in terms of duration, and the third place in terms of the frequency of issuing a certificate of temporary disability.In order to prevent recurrence of the pathology, it is necessary to consult a doctor in time.
Types of back pain
According to the duration of the pain syndrome:
- Sharp pain.It occurs suddenly in response to new injuries.lasts up to 6 weeks;
- Subacute pain.lasts more than 12 weeks - this is the period of normal healing of damaged tissues;
- Recurring pain.The syndrome occurs no less than six months after the previous flare-up.Between relapses, symptoms disappear completely;
- Exacerbation of chronic back pain.Difference from relapse: the interval between attacks is less than 6 months, symptoms may pass, but not completely.
According to etiopathogenesis, back pain is as follows:
- Primary.The symptom occurs due to functional and / or dystrophic changes in intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.Often, the cause of back pain is projection pain due to congenital anomalies of the spine (scoliosis, lumbarization, etc.), back injuries, arthritis, pathologies of the intestines, stomach, abdominal aorta, and organs of the genitourinary system.
How is lower back pain?
Often, patients complain of sharp and severe pain in the lower back, which is called shooting, throbbing or lumbago.Rear movement is limited.Sometimes a person is stuck in a bent position and cannot straighten.With any movement, sharp pain in the lumbar region intensifies ("shoots" in the back).The main cause of this condition is chronic diseases of the spine.An acute attack can last from a few minutes to several weeks.In some cases, the pain decreases so much that a person gets used to it.Complete recovery is also possible without repeated attacks.
Nagging pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.Feelings are not pronounced, but cause anxiety.Painful pain in the lumbar region may intensify after bending down, physical activity, infection or hypothermia.Even if the symptoms completely disappear, stiffness and discomfort remain behind.
Symptoms you should not ignore
If sharp or dull back pain is accompanied by one or more symptoms from the list below, you should see a doctor immediately.
Warning signs:
- numbness of arms or legs, tingling sensation, "cotton-like" limbs;
- pain in the hip joints and knees;
- leg cramps;
- menstrual disorders in women;
- sexual weakness in men;
- increased pain when sitting;
- inability to stand for a long time;
- rapid weight loss;
- increased temperature, fever;
- critical deviations in blood tests;
- Age over 50 years;
- Lack of dynamics during "regular" treatment for 4 weeks.
In the clinic, the doctor will determine the cause of the pain and help to eliminate the exacerbation.After that, an examination and comprehensive treatment will be required under the supervision of a doctor.
What pathologies can cause acute pain in the lower back
Diseases of the musculoskeletal system
A pinched sciatic nerve.Severe, shooting pain occurs in the lower back, caused by compression of nerve roots by closely adjacent vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes in the discs.The tissues are gradually destroyed, the space between the vertebrae decreases, and they can squeeze the nerve with any sudden movement.Pain is often accompanied by pulsation of compressed veins.
Sciatica (lumbosacral radiculitis).As a result of pinching, nerve roots become inflamed and radiculitis develops.If the sciatic nerve is affected, the disease is called sciatica.With lumbosacral radiculitis, lumbar ischialgia is often observed - severe pain in the lower back and leg on the affected side.
Osteochondrosis (spondylosis).Vertebrae become dense, deformed and covered with osteophytes - bony protrusions that look like sharp thorns.For a long time, osteochondrosis was believed to be the result of age-related degenerative changes, but now the diagnosis is "younger" every year.A sedentary lifestyle and sedentary work already contribute to changes in the intervertebral discs at the age of 25-30.Osteophytes irritate and compress the roots, causing pain.
Intervertebral disc herniation.A piece of articular tissue protrudes into the spinal canal.A hernia may appear after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spine.Pathology can develop for several years without manifesting itself in any way.The disease begins at a young age and gradually leads to disability.The reason for such a disappointing prognosis is also that patients endure constant night pains that disrupt sleep and ignore morning stiffness in the back.Several years pass from the time the first symptoms appear until you see a doctor.Chronic inflammation already causes irreversible changes in the spine, its motor activity decreases, a hump appears, etc.
Spondyloarthritis.Pathologies such as Crohn's disease and seronegative spondyloarthritis can cause pain in the lower back.The main symptom is accompanied by inflammation of the joints of the knees, feet or hands, pain in the hips, blurred vision, irregular stools with an unusual consistency.
Other diseases.Acute pain in the lumbar region occurs with myositis - inflammation of the lumbar muscles as a result of tension or hypothermia.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of internal organs
Often, the cause of back pain is the pathology of the kidneys, internal genital organs and urinary tract.The condition requires careful diagnosis and medical supervision, as many complications are irreversible.
Back pain due to kidney pathology differs from the results of disorders in the musculoskeletal system by its persistence and independence from movement or body position.Care should be taken especially if there are symptoms such as cloudy urine, frequent or painful urination, etc.
Diseases of the genital organs
Both women and men can experience severe back pain due to various pathologies of the reproductive system.Sexually transmitted infections, inflammation of tissues and organs are also manifested.
Back pain in women often occurs during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered as a variant of the norm.If your periods are very heavy, pressure increases and your health deteriorates, it is better to visit an antenatal clinic and undergo tests for hormones.Menstruation can be normalized with properly selected drugs.
Back pain in men can be a symptom of problems with the prostate gland.It is necessary to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas is inflamed, the pain in the lumbar region covers the back.Possible irradiation of the coccyx, left thigh, perineum.Pelvic pain begins to increase after eating and worsens with physical activity.Walking, jumping and other exercises cause stretching of the pancreatic capsule and a reaction in the nerve endings.
What to do if you have severe back pain
If an acute pain attack occurs at home or at work, you should lie down on a hard hard surface and put a pillow under your bent knees so that your legs are at the right angle to your body.Take non-steroidal anti-inflammatory drugs.You can tie a shawl or a warm scarf around your waist to warm your back a little.
If these measures do not bring relief, you should call a doctor at home or an ambulance.If you feel better, do not wait for a new pain attack and find time to go to the medical center, first make an appointment with a general practitioner - he will thoroughly assess your health condition, make a preliminary diagnosis, make a plan for an initial examination, prescribe adequate symptomatic treatment and, if necessary, refer you to a specialist.
Expert advice
Modern advertising offers many "quick" solutions for back pain: various gels, ointments and patches.Some of them provide relief, but should not be used continuously without medical supervision.In some cases, warming gels can only cause harm.Therefore, if you have back pain, you should consult a doctor, even if you manage to suppress the symptoms.
Diagnosis of low back pain
At the first appointment, the doctor conducts an interview with the patient, learns how long the symptoms last, the dynamics of their development and the presence of accompanying complaints.The doctor will take into account exactly how it hurts - on the left or right, whether the pain is dull, aching, sharp or throbbing, the duration of the attacks and other details to make a preliminary diagnosis.In many typical cases, standard treatment by a general practitioner is possible.
Often, if there are specific symptoms of a serious disease of the spine or internal organs, the patient is sent for additional examinations:
- Blood test.A low hemoglobin level indicates the possibility of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends not only general analysis, but also biochemistry to assess the work of internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the results of the analysis are a direct indication for an ultrasound examination of the urinary system and additional examination by a urologist;
- X-ray of the lumbar spine.The photos show certain signs of inflammation of the joints, disruption of various structures, proximity of the vertebra due to degenerative changes.Based on an X-ray, a doctor can diagnose osteoporosis and see fractures;
- Magnetic resonance imaging (MRI).A non-X-ray method for examining patients that allows obtaining multiple images (slices) of the area of interest and its three-dimensional image.Unlike X-rays and computed tomography, MRI provides information not only about bones, but also about muscles, blood vessels, and soft tissues.
Treatment of back and back pain
Uncomplicated forms of pain that are not related to a serious disease of the spine or internal organs are treated with non-steroidal anti-inflammatory drugs (NSAIDs).To get rid of anxiety, it is enough to eliminate the provoking factor: lose weight, sit less, walk more, do simple exercises regularly.Regular moderate physical activity is recommended individually.
Getting rid of pain caused by a disease of deeper origin requires a systematic and comprehensive approach.The course of treatment should include drugs, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In the case of acute, unbearable pain, the doctor immediately blocks during admission - anesthetic injection into the affected area.The injection quickly relieves the discomfort, but only provides temporary relief.The patient should start treatment immediately.
To eliminate the exacerbation, the doctor prescribes the following:
- non-steroidal anti-inflammatory drugs that reduce pain and swelling;
- muscle relaxants to relax spasmodic muscles;
- B vitamins improve the regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of internal organs, the patient is prescribed drugs to treat the underlying pathology.
Auxiliary techniques
After the exacerbation is eliminated, the following treatment methods are effective:
- wearing a special fixation bandage;
- medical massage in the lumbar region;
- shock wave therapy;
- swimming and sports lessons;
- acupuncture;
- application of tapes;
- manual therapy;
- other physiotherapeutic methods.
Surgical intervention
Surgery is a last resort.Surgical treatment is indicated for serious disorders in the structure of the spinal cord or internal organs.There are many techniques.The specific type of intervention is finally planned by a neurosurgeon, surgical urologist or abdominal surgeon, taking into account the established diagnosis and the individual characteristics of the patient's condition.
Don't put up with back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.At the medical center, you can undergo a complete examination, find out the cause of back pain and receive high-quality treatment.