There are many diseases that manifest as painful sensations in the lumbar region. They can indicate problems with the spine, joints, muscles, internal organs - kidneys, intestines, liver. This is a very insidious symptom, and it is impossible to determine the true cause of pain in the lower back without consulting a doctor. Correct treatment is possible only after diagnosis in a medical institution.
Types of pain
During the initial examination, the doctor should ask the patient about the nature of the pain. In term they can be:
- sharp- occurs suddenly, paroxysmally, differs in intensity, lasts less than 1 month;
- semi-sharp- the last 2-3 months, in most cases they are repeated: they become active for 2-5 days, then decrease and return again after a while;
- chronic- Lasts more than 1 year, the course is repeated most often.
Doctors have found that most chronic pain in this area is associated with the occurrence of local muscle spasms, compressions with specific pain points (the so-called myofascial syndrome). The process also involves the muscles that straighten the spine, the hip muscles, the pelvic ligaments, and the sacroiliac joint.
The nature of the pain is sharp, painful, dull. By intensity - strong, medium, weak. Depending on the location of the pain, the following types are distinguished:
- lumbodynia- pain in the back or lumbosacral region;
- sciatica- radiation to the lower back, legs;
- sacral- in the sacrum region;
- coccydynia- in the tailbone.
5 facts about back pain
- About 25% of all visits to clinics with complaints of back pain are related to sensations in the lower back.
- According to research, 84% of people have experienced back pain at least once in their life.
- 44-78% of patients (depending on age and region of residence) repeat attacks of lumbodynia.
- Up to 37% of people are periodically disabled due to back pain.
- In 85% of patients who consult a doctor about pain in the lower back, diseases of the musculoskeletal system that cause pain are determined.
- According to statistics, about 90% of patients with acute pain in the lumbosacral region recover within 2 weeks.
Causes of back pain
Diseases of the musculoskeletal system
In 2006, the European Federation of Neurological Societies officially adopted the following classification of the causes of pain in the lumbar region. They are divided into 3 main groups:
- Compression of the spinal cord, peripheral nerve in the lumbar region. It occurs due to the protrusion of the intervertebral discs (degenerative changes). Less often, due to dysplasia (disruptions in the formation process) of the upper articular processes of the sacrum.
- Diseases of the spine caused by tumors, joint damage, infection, compression fractures, allergic reactions, autoimmune inflammatory processes.
- Disorders of the musculoskeletal system due to subluxation, contraction of spinal ligaments, muscle tension, dysfunction of intervertebral joints.
Pathologies of internal organs
- Disorders of the genitourinary system.
Diseases of the urinary system - urolithiasis, cystitis, pyelonephritis - often cause discomfort in the lower back.
Back pain in women can indicate dysfunction of the genital organs. Most often, the main sensations are concentrated in the lower abdomen and spread to the sacrolumbar region. They can appear during menstruation or after sex.
One of the possible causes of back pain in women is ovarian tumors located in the back of the uterus. Often discomfort in the lumbar region becomes a symptom of uterine fibroids. As it grows, the pain can manifest itself strongly and sharply and indicates serious disturbances in blood supply, stretching of the peritoneum and compression of nerve plexuses in the pelvic region.
Another cause of back pain in women is pelvic organ prolapse. In this case, feelings are drawn. Their intensity increases during walking and physical work.
- Disorders of the gastrointestinal tract.
Most often, pain in the lower back is felt due to stomach and duodenal ulcers and acute pancreatitis. Patients complain of back pain. Usually, the lower back begins to hurt at the same time as the right/left hypochondrium, where the most intense feelings are concentrated. In a number of clinical cases, back pain is accompanied by an attack of acute appendicitis, although they are not the main symptoms of this disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.
10 Risk Factors for Back Pain
- Congenital pathologies of the lumbar-sacral spine.
- Heavy physical labor involving stress on the lower back, frequent bending and vibration.
- Acute and chronic stress causing muscle spasms.
- Sedentary lifestyle and staying in an unnatural position for a long time with a load in the lumbar region.
- Poor muscle corset resulting in incorrect posture, stooping, scoliosis and kyphoscoliosis.
- Metabolic disorders and excess body weight, which increases the load on the lower part of the spine.
- Increased physical activity and playing sports increase the risk of injury.
- Age over 50 years - due to the development of degenerative processes in the spine.
- Often stress, depression.
- Malnutrition with a lack of B vitamins.
Back pain as a symptom of various diseases
Osteochondrosis of the lumbar spine
One of the most common diseases, the symptom of which is pain in the lower back. During osteochondrosis, the intervertebral discs, which act as shock absorbers between the vertebrae, become thinner. Nerve roots are compressed, muscles spasm, sharp pains occur. Its intensity increases when bending over, lifting heavy objects, or when the patient tries to sit up from a lying position or get up from a sitting position.
In advanced cases, a hernia develops between the vertebrae, which only increases the pain. Osteochondrosis most often affects the lower back, because it bears the maximum load when sitting and walking.
A serious complication of osteochondrosis is spondylosis. It is characterized by the almost complete destruction of the intervertebral discs and the formation of sharp bone protrusions - osteophytes. They damage nearby tissues, causing sharp, severe pain that radiates down one or both legs.
Symptoms of intervertebral hernia
- Patient can rise from sitting position only with chair/table or knee support.
- Any load on the back causes a sharp pain attack.
- The patient lies on his stomach, only putting a pillow under him.
- A person can only pick up things from the ground by crouching slowly.
Ankylosing spondylitis
The disease occurs as a result of inflammatory processes in the spine. It is diagnosed mostly in men aged 20-35. The patient feels stiffness in the lumbar region and discomfort in the sacrum in the morning and at rest. Gradually during the day this feeling passes, the person takes "steps". Many people do not pay attention to this disturbing symptom, meanwhile, ankylosing spondylitis causes gradual fusion of the vertebrae, reduced spinal mobility and disability. Therefore, it is necessary to consult a doctor at the first signs of the disease - morning stiffness in the spine.
Spondyloarthrosis
This disease affects the cartilage tissue that surrounds the intervertebral discs. With age, it becomes thinner, destroyed, and bone growths form where the cartilage is broken. Due to the friction of the intervertebral discs, the nerve roots are irritated - this process is accompanied by severe pain in the lower back. The muscles in the problem area of the back are constantly tense and spasmodic.
Symptoms of spondyloarthrosis
- The pain worsens after exercise and disappears after rest.
- The pain appears after standing or walking for a long time.
- At the same time as the back pain, the patient feels discomfort in one of the hip and hip joints.
Urolithiasis disease
In this pathology, the pain is paroxysmal and very intense. Typically, painful sensations arise from an inflamed kidney. It is difficult to find a position where the patient feels better. After the attacks, the color of the urine is red and the volume decreases.
Inflammation in superficial tissues and fibers
The cause of the pain may be a carbuncle or boil. These are purulent dense formations on the skin with a diameter of more than 1 cm. They are easily distinguished by their purple color. Pain sensations are sharp, intense, pulsating.
Paranephritis, an inflammation of the perinephric tissue caused by infection, is also painful. Feelings are heightened by breathing and movement. The patient tries to lie down with his legs bent - in this case, the pain is less pronounced. The skin in the affected area becomes swollen and red.
Inflammation of the spine, spinal cord
Osteomyelitis is an inflammatory process that affects all bone tissues in the bone marrow. The acute form is characterized by increased pain of a pulling, bursting nature. It is combined with symptoms of intoxication and fever.
Tuberculosis of the spine is caused by infection with Koch bacillus. The first symptoms of the disease may appear years after infection. It all starts with deep pain that appears after exercise. The infection affects the vertebrae, hinders the patient's movement, and a characteristic gait is formed.
Other diseases
Back pain can be a symptom of numerous pathologies, including quite exotic ones. These include, for example, foot-and-mouth disease, Ebola fever, hemorrhagic fevers, and Japanese mosquito-borne encephalitis.
- Cardiovascular diseases - abdominal aortic aneurysm, Loeffler endocarditis.
- Myositis is inflammation and muscle pain in the lower back, which can be caused by infectious diseases such as flu, sore throat and even common ARVI.
- Benign and malignant neoplasms of the spine and spinal cord.
- Kidney pathologies - glomerulonephritis, thrombosis of renal vessels, pyelonephritis, cyst.
- Back pain in men occurs with prostate cancer.
Why does my back hurt when I cough?
Coughing provokes muscle tension in the affected area, resulting in pain. Often, patients first learn about a developing disease when they feel pain during coughing. Often, such feelings are a sign of:
- intervertebral hernia,
- osteochondrosis,
- neuralgia,
- facet arthropathy,
- kidney diseases.
Diagnostics
As mentioned above, pain in the sacrolumbar region can be a symptom of many diseases. Therefore, you should consult a doctor at the first signs to determine the objective reasons. You can make an appointment with an orthopedist, neurologist or surgeon. In the future, you should consult a rheumatologist, urologist or gastroenterologist.
- Initial examination.The doctor evaluates tissue sensitivity, muscle function and reflexes in the affected area.
- Radiography.The examination shows changes in the structure of bones, cartilage and joints.
- Blood and urine tests.With their help, you can determine the presence of infection and inflammatory processes.
- Functional diagnostics.It includes methods for assessing nerve conduction and muscle performance - electroneurography, electromyography.
- CT and MRI.It allows detailed examination of the condition of bone, muscle, nerve and vascular structures.
- Ultrasoundit is performed in case of suspicion of pathology of the pelvic organs, prostate or kidneys.
It is important to exclude (or confirm the presence of) a tumor, to differentiate spinal cord compression and pain syndrome of the musculoskeletal system. Based on the diagnostic information, the doctor will determine the true cause of the pain and prescribe an effective treatment program.
Need bed rest?
None of the recommendations for the treatment of back pain in musculoskeletal disorders prescribe strict bed rest. On the contrary, patients are advised to return to normal activities as soon as possible to prevent the development of chronic pain syndrome. In severe cases, that is, with severe pain, strict immobilization is recommended for 1-3 days. For acute pain in the lower back, you can use a fixation belt. However, in the absence of trauma or spondylolisthesis, long-term lumbar fixation is not recommended. You should gradually introduce special exercises to strengthen the spine and muscles.
Back pain treatment
Often, a combination of drug and non-drug treatments is required to solve the problem.
Medicine
The basis of drug therapy is non-steroidal anti-inflammatory drugs (NSAIDs). They affect peripheral mechanisms of pain formation and are prescribed for exacerbation of pain syndrome. In most clinical cases, treatment is carried out in courses - no more than 12 weeks.
In most cases, patients are prescribed B vitamins to improve nerve conduction, decongestants and sedatives. In the chronic course of the disease, it is possible to take antidepressants. For severe muscle spasms and pain - muscle relaxants, weak opioids.
Non-narcotic
In addition, manual therapy, acupuncture (acupuncture) can be prescribed to the patient. The procedures are aimed at activating metabolism and blood circulation in the affected area. This allows to improve tissue nutrition.
According to doctors, physical therapy, exercises to strengthen the muscles of the lower back, traction therapy, transcutaneous electrical neurostimulation have little effect. Often, these procedures are prescribed when there is no clear effect from taking the drug for 4-6 weeks. There is no scientific evidence on the effectiveness of massage, physiotherapy, wearing different belts.
What to do for prevention
- In the morning, do exercises with simple stretching movements for the spine and muscles.
- Eat rationally, excluding fatty, fried, smoked, salty, spicy and alcohol.
- Watch your weight.
- Drink at least 1. 5 liters of liquid (preferably water) per day.
- Take a classic massage course once every 6 months.
- Avoid staying in one position for a long time.
The result
Painful sensations in the lumbar region can be a symptom not only of pathologies of the musculoskeletal system, but also of internal organs. Many patients self-diagnose and treat, for example, muscle tension, when in fact the problem may be kidney inflammation. Such treatment only aggravates the situation - a person focuses on a non-existent disease and triggers a serious pathology. Therefore, it is important to seek professional help and determine the real cause of the pain. Self-prescription of drugs is absolutely not recommended.