There is practically no person who has not experienced lower back pain at least once in his life. This is how we pay for our upright gait and daily habits.
In addition to injuries that can affect the spine, its muscles, nerves and ligaments, it is necessary to take into account that sometimes pain in the lower back is caused by internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Back pain symptoms can range from dull to severe. The pain may go away on its own or it may become chronic (the symptom lasts for more than three months).
Dangerous! You should see a doctor immediately if:
- pain in the lumbar region appeared sharply after an open back injury;
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, difficulty breathing;
- forced emptying of bowels and bladder occurs;
- there is numbness in the groin area;
- there was weakness of the lower limbs, paresis or paralysis of them, impaired sensitivity;
- pains are transmitted to the stomach and increase sharply during coughing or sneezing;
- symptoms appeared against the background of acute weight loss, long-term use of steroids, immunodeficiency;
- there is a family history of cancer, inflammatory or degenerative diseases of bone and cartilage tissue.
Why does the lower back hurt?
Myofascial pain
Muscle tension or spasm may develop gradually or occur suddenly. High-load injury affects not only muscle fibers, but also ligamentous apparatus and fascia.
Lower back muscle pain appears after:
- lifting heavy weights or engaging in work or sports;
- exercise from time to time. If you are inactive during the work week and spend hours in the gym on the weekends, the muscles are especially vulnerable;
- a sharp increase in the weight of one's own body, behind which the muscles do not have time to grow;
- sitting for a long time or standing in an uncomfortable position;
- carrying the bag in one hand or on the shoulder every day;
- posture disorders. The spine does its best supporting and protective function when you are not bending over. The muscles in the lower back experience the least amount of stress when you sit with good support under your lower back and when you are standing, with your weight evenly distributed on both legs.
If the back hurts after a bruise, fracture, sprain, hypothermia, infectious disease or a certain helminthic invasion, one can suspect myositis (inflammation) of the lower back muscles. Due to the inflammation of the muscle fibers, there is constant severe pain, "knots" are felt in the muscles - in the places of spasm. Inflammation can be acute or chronic. With a long course of the disease, the pain is unstable, sleeping or sitting for a long time, intensifies in the afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the lower back muscles are under constant tension, inflammatory edema is formed, the temperature rises locally and at the level of the whole body.
With muscle spasm, the roots of the spinal nerves are disturbed, so the attacks often look like sciatica or sciatica - there are severe burning pains along the back of the thigh and the lower leg, the limbs become numb, they lose sensitivity. The muscle tone expressed in myositis forces the patient to take a forced position, walk and bend, move on bent legs.
How to treat spinal muscle pain? Non-steroidal anti-inflammatory drugs and analgesics are used to relieve inflammation and pain. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of active substances. Irritant and warming ointments are also used, which reflexively increase blood flow to the back muscles. A larger volume of blood helps wash away the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictive drugs.
If the cause of myositis is infection or poisoning of the body with worm toxins, antibiotics or anthelmintic drugs are used first. In this case, warming ointments or compresses cannot be used.
Spinal diseases involving nerve endings
In the lumbar region, the vertebrae are separated by discs of elastic cartilage that protect the spine from injury, but are themselves subject to wear and tear and aging.
Normally, the disc is a jelly-like nucleus pulposus surrounded by a denser layer of annulus fibrosus. The elasticity of the core is related to its ability to bind and retain water: when the load increases, water accumulates and increases elasticity, when the pressure decreases, the core releases water and becomes flatter.
Osteochondrosis in the spinal region develops when the intervertebral discs are not nourished (they "dry out") or with excessive local load. Most often, back pain is due to the fact that the lower pillars of its intervertebral discs bear the greatest load when sitting and lifting weights in front of them. At the same time, disc herniations and displacements occur, vertebral ligaments are damaged, there is constant aching pain, pulsation.
Pain in the spine has several mechanisms of development:
- disruption of microcirculation, congestion and edema formation in the tissues surrounding the spine and especially in the spinal canal. Such conditions develop against the background of hypothermia, overheating, and inflammatory processes.
- degenerative processes in the fixation ligaments of the spine. The increased mobility of the vertebrae causes them to be slightly displaced and unphysiologically compressed, which leads to disruption of nerves, blood vessels and the formation of hernias.
- damage to the vertebrae during axial compression or excessive rotation (rotation) when lifting weights.
- aseptic inflammation. Destruction of the nucleus causes the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes a spasm of the muscles that disturb the neighboring vertebrae - above and below the hernia. Gradually, the reaction covers the entire lumbar region and any movement causes a feeling of pain.
A weakened disc can rupture, resulting in bulging, bulging, or protrusion of the nucleus, resulting in a herniated disc. The appearance of a hernia puts pressure on the spinal cord and spinal nerve roots. In such conditions, severe pain appears in the lower back, which is separated from each other along the strangled nerve. The most common cases of compression of the sciatic nerve (sciatica) are manifested by sharp pain along the back of the thigh and the lower part of the leg, numbness of the limb on the side of the tear, muscle weakness, voluntary twisting. legs.
Pain in the lumbar region intensifies when sitting and standing, turning, bending. Often there is a protective muscle reaction - a painful contraction of the muscles on both sides of the spine (formation of rollers), isolating the department from unnecessary movements. Osteochondrosis later causes the appearance of sciatica (inflammation of the roots of the spinal nerves).
Radicular syndrome is dangerous when the nerves of the lumbar region responsible for the innervation of internal organs are compressed (horns of the cauda equina). At the same time, pain occurs in the stomach, the function of the bladder and intestines is disturbed, impotence in men, and gynecological diseases in women.
Many patients, the lower back hurts a lot, take analgesic postures - turn the body to the left, if the right side hurts, lie on the right side. If the hernia is on the left side. Also characteristic is the appearance of severe pain when pressing on the hernia in the intervertebral space (bell sign).
How to treat back pain with osteochondrosis:
- during a pain attack, you can take an anesthetic pose - lie on your back and put a roller under your knees. Sleeping on a hard surface is also recommended;
- of the analgesic drugs, NSAIDs can be taken orally or can be taken as an injection on both sides of the spine in the lumbar hotel;
- use local irritants as distraction therapy - mustard plasters, iodine mesh, pepper patch and ointments;
- eliminate miotic spasm through hand therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- mud treatment, ozokerite, warming can be used during the weakening of the acute period.
Treatment of pain in radicular syndrome includes:
- provision of bed rest, lumbar traction (land or underwater);
- the use of novocaine blockades at the site of violation, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant sharp pains, as well as dysfunction of internal organs, development of limb paralysis, sequestration of the hernia in the spinal canal.
Degenerative inflammatory lesions
Spondylarthrosis (inflammation of the facet joints of the vertebra) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back appears as a result of excessive stretching of the capsule and increased pressure on the surface of the intervertebral joints. The pain causes the patient to bend more in the lower back, thus increasing the overload of the intervertebral joints. In particular, the discomfort in the lower back is aggravated by wearing high-heeled shoes, walking for a long time, dismounting from elephants, positions in which the body deviates backwards, for example, when looking at something above the head.
In patients with this diagnosis, stiffness in the lower back is noted in the morning, the pain increases during the day or after exercise. It has a diffuse nature and it is difficult to show the boundaries clearly: in men, discomfort is determined in the gluteal muscles, in the groin area, in the lower abdomen, and in the scrotum. This spondyloarthrosis differs from radicular syndrome when you can determine the source of the pain.
What to do to relieve pain? This usually helps to maintain a supine position by bending the legs at the hip and knee joints.
Their drugs are preferred over non-steroidal anti-inflammatory drugs and non-narcotic analgesics.
Muscle relaxants are also added because they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect, because chronic pain makes the patient depressed.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. With this disease, the calcification of connective tissue structures occurs with the formation of growths on the edge of the vertebra - osteophytes. These formations cause disruption of microcirculation near the nerve roots and cause pain in the lumbar region of the back, and the mobility of this department is also limited.
Vertebral osteophytes are pathological growths that damage nerves and blood vessels.
Treatment is usually conservative, anti-inflammatory drugs, analgesics, vitamins are used. Electrophoresis with novocaine, lidase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compressed elements and increase spinal mobility) has a good effect.
Note! At an advanced stage, osteophytes do not dissolve. Although their size is small, treatment is aimed at relieving inflammation, pain, and improving metabolism. If the back does not hurt much, then nothing is done with the growths. Osteophytes can be removed during surgery if they cause persistent pain or are large.
Tumor diseases
Back pain can occur as a result of compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, arising from the cerebrospinal substance itself).
Cells of various tissues can develop pathologically:
- fatty - lipoma is formed;
- nerve roots - neuroma;
- spinal cord vessels - hemangioma;
- auxiliary tissue - glioma;
- bone tissue - osteosarcoma;
- cartilage - chondrosarcoma.
The tumor process, especially malignant, is characterized by sciatica-like pain syndrome (can be unilateral or bilateral), general deterioration of the patient's condition and exhaustion.
If the pathology affects the area of I-IV lumbar vertebrae, then there is a burning pain in the front and sides of the upper thigh, incomplete paralysis of this area.
Numbness of the paragenital region, violation of motor and sensory innervation of the gluteal muscles, the back of the thigh, calf, stool and urinary incontinence are noted with an injury in the region of the IV lumbar - II sacral segments.
With a neoplasm in the region of the V-III sacral vertebrae, a clear disorder in the work of the pelvic organs occurs. The patient suffers from sexual impotence or menstrual disorder, constipation or faecal and urinary incontinence.
Tumor treatment is specific, pain relievers and anti-cancer drugs are prescription drugs.
As you can see, back pain is usually caused by pathologies of the musculoskeletal system. They can be diagnosed by clinical signs and research data, their main task is to correctly determine the nature of the disease and not confuse it with oncological causes, diseases of internal organs or trauma. If you have back pain, we always recommend consulting a neurologist or orthopedist.