Low back pain is a rare symptom. Most people associate it with working in a sitting position, lifting weights or osteochondrosis and not rushing to see a doctor. In fact, this condition can indicate kidney, liver or intestinal disease, and problems with the musculoskeletal system will not go away on their own. Only a timely examination by a specialist and a full examination will help identify the cause of the pain and choose the right treatment.
The lower back is the area that experiences significant stress due to uprightness. The vertebral column is represented by five large vertebrae, which are also strengthened by the skeletal muscle. 9 out of 10 cases of pain in this area are accurately provoked by pathology of the musculoskeletal system: osteochondrosis, muscle spasms, herniated discs, pinching of nerve roots.
The remaining 10% of cases are related to diseases of internal organs located in the projection of the lower back: kidneys, genitourinary system, intestines, liver. Even a doctor, during an examination, is unable to determine the cause of the pain accurately, which is why this condition requires careful laboratory and instrumental diagnostics.
Type of pain
The first thing a doctor asks is the nature of the sensation. Depending on the underlying cause, lower back pain may be:
- acute: usually sudden, high intensity; sensation period not exceeding 1. 5 months;
- subacute: lasts 6-12 weeks;
- chronic: sensation of any intensity, lasting for 12 weeks or more;
- temporary (variable): appears periodically;
- strong, medium intensity, weak.
This section is arbitrary. Depending on the circumstances and circumstances, the nature and duration of the sensation may vary. It is important to explain it to your doctor as completely as possible.
There are many reasons why the back starts to hurt in the lumbar region. The most common provoking factors are:
- lifting weights;
- uneven load distribution (with pregnancy background, posture disorders, pathology of the musculoskeletal system);
- infectious wounds;
- diseases of the musculoskeletal system;
- inflammatory processes, including autoimmune;
- has been in an uncomfortable position for a long time;
- changes in bone tissue composition (osteoporosis);
- volumetric processes: benign and malignant tumors, abscesses;
- hormonal changes (menstruation, pregnancy, menopause);
- kidney disease (urolithiasis, pielonefritis, glomerulonephritis, abscess);
- pathology of the gastrointestinal tract;
- diseases of the uterus and complement in women, prostate in men, etc.
Low back pain can be a symptom of various diseases of the musculoskeletal system and internal organs. The main task of the doctor is to find out what exactly is causing the deterioration of the condition and take the necessary steps.
This is the most common pathology.
This is a systemic inflammatory disease in which the individual vertebrae merge into a single conglomerate. At the same time, calcium is stored in the ligaments that stabilize the spine, as a result of which the affected area almost loses its movement.
Features of low back pain in ankylosing spondylitis include:
- increased intensity during rest, especially with prolonged horizontal positioning;
- stiffness of movement in the lumbar region;
Osteochondrosis of the lumbar spine
This is a very common disease in which thinning of the intervertebral disc, which acts as a shock absorber, occurs. The result is nerve root irritation and surrounding muscle spasms, causing severe pain. In the final stages of the disease, a herniated disc is formed, which can press on the spinal cord, increasing pain.
With osteochondrosis, the pain increases:
- while lifting from a sitting or horizontal position;
- when trying to lie on your stomach;
- while leaning.
If the disease causes the formation of large hernias, pain in the lower back is often accompanied by numbness and or weakness in one or both legs.
Curvature of the spine in the lumbar region (kyphosis, scoliosis)
Pain in this pathology occurs in the middle and late stages of the development of the disease. Discomfort usually occurs at the end of the day and is often accompanied by back muscle fatigue. Pain is often caused by spasm of the spinal muscles, and long-term muscle spasms (gluteal, periarticular muscles in the upper and lower extremities) may also occur.
This is a degenerative-dystrophic disease of the cartilage tissue covering the intervertebral disc. Gradually becoming thinner and sharper, bone growth (osteophytes) appear around the affected area. As a result of shortening the distance between the vertebrae, the spinal canal narrows, and there is irritation of the nerve roots and spinal cord.
Pain with this pathology:
- increases after exercise (long standing, walking) and disappears after rest;
- is accompanied by stiffness of movement, first in the morning, then continuous;
- can radiate to the thighs and hips.
Muscles in areas affected by cramps and constantly in tension, which also increases pain.
Urolithiasis attacks are characterized by severe back pain from the affected kidney. At the same time, the sensation does not change depending on the posture of the body, one can not find a position where they weaken at least a little. The attacks are often accompanied by a decrease in the amount of urine and a reddish discoloration.
Low back pain can also be caused by:
- algomenorrhea (painful period);
- inflammation of the pancreas;
- intestinal obstruction;
- appendicitis, etc.
Pain in various parts of the back
Localization of pain can tell a lot about the cause. Pain in the upper lumbar region may be caused by:
- spinal disease;
- Muscle spasms with their excessive training background;
- cardiovascular disease;
- gastrointestinal tract disease.
If the epicenter of the earthquake is in the lower back, the list of possible causes includes, in addition to spinal diseases:
- renal pathology (pielonefritis, urolithiasis);
- intestinal dysfunction (constipation, bloating);
- cramps or inflammation of the pelvic organs (salpingo-oophoritis, endometritis);
- physiological reasons, especially pregnancy;
- sciatic nerve trap.
Replacement of pain to the right or to the left may indicate damage to the spinal cord root, suitable kidney.
Diagnosing back pain requires a thorough examination. The first step to finding the cause is a survey. The doctor prescribes:
- localization of pain;
- character and duration;
- the cause of the attack or the growing pain;
- conditions in which conditions improve (certain posture, not moving, taking medication, etc. ).
Data on injuries and illnesses, chronic pathologies that have been identified are collected without fail. Further diagnostic searches at the discretion of the doctor include:
- general analysis of blood and urine: helps identify inflammatory processes in the body, renal pathology;
- biochemical blood tests to detect signs of damage to the kidneys, pancreas, liver and gallbladder, etc . ;
- ultrasound of the abdominal cavity and small pelvis, in men - ultrasound of the prostate gland;
- kidney ultrasound;
- x-ray, CT or MRI of the lumbar spine;
- x-ray chest.
If there is a suspected pathology, after general diagnosis and examination, a more accurate narrow specialist analysis, examination and consultation is prescribed. They allow you to explain or refute the diagnosis.
Treatment for back pain depends on the cause. Neurologists, urologists, gynecologists and surgeons can deal with pathology. Regarding diseases of the musculoskeletal system, doctors use methods of medicine, not drugs and surgery to improve the patient's condition.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common medications for lumbar pain. They are prescribed in the form of tablets, intravenous and intramuscular injections, rectal suppositories, as well as topical creams, ointments and patches. Decisions about the dosage of the drug, as well as the duration of the course, are taken by the doctor, as uncontrolled use of these drugs can cause unpleasant side effects.
When NSAIDs are ineffective, doctors prescribe hormones (corticosteroids). They also stop inflammation and reduce pain.
The third group of drugs that improve the patient's condition is antispasmodics. They relieve muscle spasms in the lumbar region.
In addition it can be provided:
- decongestants to reduce swelling of pinched roots;
- Vitamin B to increase nerve conduction;
Drug-free treatment completes the medication regimen. Depending on the clinical condition, this may include:
- physiotherapeutic procedures (magnetotherapy, laser exposure, electrophoresis, etc. );
- physiotherapy training: training is carried out individually according to the underlying and concomitant diseases; gymnastics should be done periodically, not only in the clinic office, but also at home, only in this case it has an effect;
- consolidation sequence and general therapy (performed without exacerbation);
- manual therapy and osteopathic assistance.
The help of a surgeon is needed if the attending physician, based on an overview, identifies one of the indications for surgical treatment. By itself, the presence of a herniated disc is not an indication for surgical treatment, regardless of its size. Depending on the instructions, the doctor may remove the herniated disc, remove compression of the spinal cord root, remove the tumor, etc. Decisions to carry out certain operations are made individually.
The most effective way to prevent back pain is to adjust your lifestyle to save the kidneys, spine, and pelvic organs, but if the pain still occurs, this should be a reason for an unusual visit to a specialist:
- avoid hypothermia;
- avoid hypodynamia;
- sports at the amateur level (swimming has a very good effect on the condition of the spine and back muscles);
- eat properly and balanced: avoid overeating, reduce fatty, spicy, overly salty foods;
- eliminates alcohol and nicotine;
- drink at least 1. 5 liters of pure water daily, excluding tea, coffee or juice;
- keeps the body mass index at a normal level: being overweight has a negative impact on the condition of the spine, and deficiency can lead to kidney prolapse.
If a person has been diagnosed with pathology of the musculoskeletal system, it is recommended to take a preventive course at least twice a year, according to European recommendations for the rehabilitation of spinal pathology, in accordance with a doctor's prescription.