There is practically no person who at least once in his life would not experience back pain in the lower back. This is how we pay for the upright walk and our everyday habits.
In addition to the damage that can affect the spine, its muscles, nerves and ligaments, it should be borne in mind that sometimes the back hurts in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Symptoms of low back pain can range from dull to acute. The pain may go away on its own or become chronic (the symptom has been present for more than three months).
Dangerous! You should immediately see a doctor if:
- pain in the lower back came on abruptly after an obvious back injury;
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, difficulty breathing;
- involuntary emptying of the intestines and bladder;
- there is numbness in the groin area;
- there was weakness of the lower extremities, their paresis or paralysis, impaired sensitivity;
- pains are given in the stomach and sharply increase when coughing or sneezing;
- symptoms appeared against the background of marked weight loss, prolonged use of steroids, immunodeficiency;
- in the family history there were cases of cancer, inflammatory or degenerative diseases of bone and cartilaginous tissue.
Why does the back hurt in the lumbar region?
myofascial pain
A muscle tension or spasm can develop gradually or happen suddenly. With a high load, the damage affects not only the muscle fibers, but also the ligament apparatus and fascia.
Muscle pain in the lower back appears after:
- lifting heavy weights or pushing yourself too hard at work or playing sports;
- play sports from time to time. Muscles are especially vulnerable if you're inactive during the work week and then spend hours at the gym on the weekends;
- a sharp increase in the weight of the body itself, after which the muscles do not have time to grow;
- prolonged sitting or standing in an uncomfortable position;
- daily carry a bag in one hand or on the shoulder;
- postural disorders. The spine performs its best supporting and protective role when you are not hunched over. The muscles in your lower back are under less stress when you sit with good support under your lower back, and when you stand, you evenly distribute the weight on both legs.
If the back hurts after a bruise, fracture, sprain, hypothermia, an infectious disease, or an established helminthic invasion, myositis (inflammation) of the muscles of the lower back can be suspected. Intense pain is constantly present due to inflammation of muscle fibers, "lumps" are felt in the muscles - places of spasm. Inflammation can be acute or have a chronic form. With a long course of the disease, the pain is unstable, made worse by lying or sitting for a long time, in the late afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the muscles of the lower back are in constant tension, inflammatory edema forms, the temperature rises locally and at the level of the whole organism.
With muscle spasm, the roots of the spinal nerves are infringed, so the attacks often resemble an image of sciatica or sciatica - there are sharp, burning pains along the back of the thigh and leg, the limbs go numb , they lose sensitivity. Pronounced muscle tone in myositis makes the patient take a forced position, walk and lie down bent over, move with bent legs.
How to treat spinal muscle pain? Non-steroidal anti-inflammatory drugs and pain relievers are used to eliminate inflammation and pain. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of active substances. Hot, irritating ointments are also used, which reflexively increase blood flow to the muscles of the lower back. A greater volume of influencing blood contributes to washing out the products of inflammation and tissue degradation.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictor drugs.
If the cause of myositis is an infection or poisoning the body with worm toxins, antibiotics or anthelmintic drugs are initially used. In this case, ointments or heating compresses cannot be used.
Spinal disorders involving nerve endings
In the lower back, the vertebrae are separated by elastic cartilaginous discs, which protect the spine from injury but are subject to wear and tear and aging.
Typically, the disc is a gelatinous nucleus pulposus surrounded by a denser layer of the annulus fibrosus. The elasticity of the core is due to its ability to bind and retain water: when the load increases, it accumulates water and the elasticity increases, when the pressure decreases, the core releases water and becomes flatter.
Osteochondrosis in the vertebral region develops when the intervertebral discs are malnourished (their "drying out") or under excessive local load. Most of the time, lower back pain is due to the lower poles of your intervertebral discs taking the most load when sitting, when lifting weights in front of them. At the same time, tears, dislocations form in the discs, vertebral ligaments are damaged, there is constant pain, pulsation.
Back pain has several mechanisms of development:
- violation of microcirculation in the tissues around the spine and, in particular, in the spinal canal, the formation of congestion and edema. Such conditions develop against the background of hypothermia, overheating, inflammatory processes.
- degenerative processes in the spinal attachment ligaments. An increase in the mobility of the vertebrae leads to their slight displacement and non-physiological compression, which causes violation of nerves, blood vessels and the formation of hernias.
- axial compression of the vertebrae when lifting weights or damaging them during excessive rotation (turning).
- aseptic inflammation. Destruction of the nucleus leads to the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes a spasm of the muscles that infringe on the neighboring vertebrae - above and below the hernia. Gradually, the reaction covers the entire lower back and leads to the fact that any movement causes a sensation of pain.
A weakened disc can rupture, resulting in a bulge, protrusion, or prolapse of the core, and eventually a hernia. The appearance of a hernia puts pressure on the spinal cord and spinal nerve roots. In such conditions, a throbbing pain in the lower back appears sharply, which diverges along the strangulated nerve. The best known cases of compression of the sciatic nerve (sciatica), which are manifested by sharp pain along the back of the thigh and leg, numbness of the limb on the side of the hernia, muscle weakness, involuntary bending of the legs.
Pain in the lumbar spine is aggravated in the sitting and standing position, when turning, stooping. Often there is a protective muscle reaction - a painful contraction of muscles (rolling) on both sides of the spine, which isolates the department from unnecessary movement. Osteochondrosis later leads to the appearance of sciatica (inflammation of the spinal nerve roots).
Root syndrome is dangerous when the nerves in the lower back, responsible for innervating the internal organs (the horns of the cauda equina), are compressed. At the same time, pain is given to the stomach, the function of the bladder and intestines is disturbed, there are potency problems in men and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, adopt analgesic postures - they shift the body to the left, if the right side hurts, lie on the right side. If the hernia is on the left. Also characteristic is the appearance of intense pain when pressing a hernia in the intervertebral space (symptom of touch).
How to treat if your back hurts with osteochondrosis:
- during an attack of pain, you can do an anesthetic pose - lie on your back and put a roller under your knees. It is also recommended to sleep on a hard surface;
- of analgesic drugs, NSAIDs can be taken orally or as injections into both sides of the spine in the lumbar hotel;
- use local irritants as distraction therapy - mustard plasters, iodine mesh, pepper patch and ointments;
- eliminate myotic spasm through manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- During the attenuation of the acute period, mud treatment, ozokerite, heating can be used.
Pain management in radicular syndrome includes:
- provide bed rest, lumbar traction (dry or underwater);
- the use of novocaine blocks at the site of offence, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant sharp pain, as well as impaired function of internal organs, development of limb paralysis, sequestration of a hernia in the spinal canal.
degenerative inflammatory lesions
Spondylarthrosis (inflammation of the facet joints of the vertebrae) occurs with degeneration, decreased height and volume of the intervertebral discs. Pain in the lower back appears due to 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 on the intervertebral joints. Especially discomfort in the lower back is aggravated by wearing high heels, walking for a long time, getting off 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 noticed in the morning, pain increases during the day or after exercise. It has a diffuse character and it is difficult to clearly show the limits: the discomfort is determined in the gluteal muscles, inguinal region, lower abdomen and in the scrotum in men. This spondyloarthrosis differs from radicular syndrome in that you can identify the source of the pain.
What to do to relieve the pain? It usually helps to lie on your back, bending your legs at the hip and knee joints.
Their medications are the preferred non-steroidal anti-inflammatory drugs and non-narcotic pain relievers.
Muscle relaxants are also added as they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect as chronic pain introduces the patient into a state of depression.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. With this disease, calcification of connective tissue structures occurs with the formation of growths along the edge of the vertebrae - osteophytes. These formations cause a violation of the microcirculation near the nerve roots and lead to the fact that the back hurts in the lumbar region, and the mobility of this department is also limited.
Vertebral osteophytes are pathological growths that damage nerves and blood vessels.
Treatment is usually conservative, with the use of anti-inflammatories, analgesics, vitamins. A good effect is given by electrophoresis with novocaine, lydase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compacted elements and increase spinal mobility).
Observation! In the advanced stage, osteophytes do not resolve. Although its size is small, the treatment is aimed at eliminating inflammation, pain, improving metabolism. If the back doesn't hurt too much, nothing is done with the growths. If the osteophytes cause persistent pain or are large, they can be removed during surgery.
Tumor diseases
Low back pain can occur from compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, originating from the cerebrospinal substance itself).
Cells from various tissues can grow pathologically:
- fatty - a 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 a painful syndrome resembling sciatica (can be unilateral and bilateral), general deterioration of the patient's condition and exhaustion.
If the pathology affects the area of the I-IV lumbar vertebrae, then there will be a burning pain in the front and sides of the upper thigh, incomplete paralysis of this area.
With lesions in the region of the IV lumbar - II sacral segments, there is numbness of the paragenital region, impairment of the motor and sensory innervation of the gluteal, posterior thigh, calf muscles, fecal and urinary incontinence.
A pronounced disturbance in the functioning of Organs pelvic organs occurs with a neoplasm in the region of the V-III sacral vertebrae. The patient suffers from impotence or menstrual disorders, constipation or fecal and urinary incontinence.
Tumor treatment is specific, painkillers and anticancer drugs are prescription drugs.
As you can see, low back pain is usually caused by musculoskeletal pathologies. They can be diagnosed by clinical signs and research data, the main task of which is to correctly determine the nature of the disease and not confuse it with oncological causes, diseases of internal organs or trauma. If you experience lower back pain, we recommend that you always seek the advice of a neurologist or orthopedist.