Lower back pain (low back pain, lumbago, aching or pulling feeling in the lumbar area) is a common complaint from patients when visiting the doctor.According to medical statistics, at least 70% of the population suffers from such symptoms at least once in their life.In addition, chronic lower back pain occurs in 10% of cases.
The structure of the symptoms is as follows:
- 80-85% – non-specific lower back pain.Symptoms subside within a few weeks;
- 10-15% – spinal stenosis, radiculopathy, leading to compression of the nerve root;
- 1-2% - a specific syndrome caused by oncopathology and diseases of internal organs.
Pain in the lumbar region ranks second among all diseases in duration and third in frequency of issuing a temporary certificate of incapacity for work.In order to prevent the pathology from recurring, it is necessary to consult a doctor in a timely manner.
Types of lower back pain
Depending on the duration of the pain syndrome:
- Acute pain.It occurs suddenly in response to new damage.Lasts up to 6 weeks;
- Subacute pain.Lasts more than 12 weeks – this is the period of normal healing of damaged tissue;
- Recurring pain.The syndrome occurs no earlier than six months after the previous exacerbation.Zwischen den Schüben verschwinden die Symptome vollständig;
- Worsening of chronic lower back pain.Difference from relapse: The interval between attacks is less than 6 months, the symptoms may subside but do not disappear completely.
According to etiopathogenesis, lower back pain is:
- Primary.The symptom arises from functional and/or dystrophic changes in the intervertebral discs, joints, fascia, tendons, muscles;
- Secondary.The cause of frequent lower back pain is congenital anomalies of the spine (scoliosis, lumbalization, etc.), back injuries, arthritis, projection pain due to diseases of the intestines, stomach, abdominal aorta and organs of the genitourinary system.
How is back pain?
Most often, patients complain of stabbing and severe pain in the lower back, also known as stabbing, throbbing or lumbago.Movement in the back is restricted.Sometimes a person remains in a hunched position and cannot straighten up.With every movement, the stabbing pain in the lower back increases (“shoots” in the back).The main cause of this disease is chronic diseases of the lumbar spine.Ein akuter Anfall kann einige Minuten bis mehrere Wochen dauern.In some cases, the pain decreases enough for the person to get used to it.A complete recovery without new attacks is also possible.
Stabbing pain in the lower back is a common symptom of chronic diseases of the internal organs and spine.The sensations are not pronounced, but cause discomfort.Aching pain in the lumbar region can increase with slight flexion, physical activity, after an infection or hypothermia.Even if the symptoms disappear completely, stiffness and discomfort in the back remain.
Symptoms you shouldn't ignore
If acute or dull lower back pain is accompanied by one or more of the symptoms listed below, you should seek medical attention immediately.
Warning signs:
- numbness of the arms or legs, tingling, “cotton-like” limbs;
- pain in the hip joints and knees;
- leg cramps;
- menstrual disorders in women;
- sexual impotence in men;
- increased pain when sitting;
- inability to stand for long periods of time;
- rapid weight loss;
- increased temperature, fever;
- critical abnormalities in blood tests;
- age over 50 years;
- Lack of dynamism during “routine” treatment over 4 weeks.
The doctor in the clinic will determine the cause of the pain and help relieve the aggravation.After that, an examination and comprehensive treatment under medical supervision are required.
What pathologies can cause acute pain in the lumbar region?
Diseases of the musculoskeletal system
Pinched sciatic nerve.Severe, stabbing pain occurs in the lower back caused by compression of nerve roots by closely spaced vertebrae.The cause of this phenomenon is osteochondrosis - these are degenerative changes in the intervertebral discs.The tissue is gradually destroyed, the distance between the vertebrae decreases and with any sudden movement they can pinch the nerve.The pain is often accompanied by a pulsation of compressed vessels.
Sciatica (lumbosacral radiculitis).The pinching causes the nerve roots to become inflamed and radiculitis develops.If the sciatic nerve is affected, it is called sciatica.With lumbosacral radiculitis, lumbar sciatica is often observed - severe pain in the lower back and leg on the affected side.
Osteochondrosis (spondylosis).The vertebrae become denser, deformed and covered with osteophytes - bone outgrowths that look like sharp spines.For a long time it was believed that osteochondrosis was a consequence of age-related degenerative changes, but now the diagnosis is becoming “younger” every year.A sedentary lifestyle and sedentary work contribute to changes in the intervertebral discs as early as the age of 25-30.Osteophytes irritate and compress the roots and cause pain.
Herniated disc.A fragment of the joint tissue protrudes into the spinal canal.A hernia can occur after a back injury or develop as a result of osteochondrosis.
Inflammatory diseases of the spine.The pathology can develop over several years without showing 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 suffer from constant nighttime pain that disrupts sleep and do not attach importance to morning stiffness in the back.It takes several years from the first symptoms to appear until you see a doctor.Chronic inflammation already leads to 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 lumbar region.The main symptom is associated with inflammation of the knees, feet or wrists, pain in the buttocks, blurred vision and unstable stools with an unusual consistency.
Other diseases.With myositis - inflammation of the lumbar muscles as a result of tension or hypothermia - severe pain occurs in the lumbar region.The symptom is also characteristic of osteoporosis, multiple sclerosis, degenerative sacroiliitis and other pathologies.
Diseases of the internal organs
Often the cause of lower back pain is pathology of the kidneys, internal genital organs and urinary tract.The condition requires careful diagnosis and medical monitoring as many complications are irreversible.
Lower back pain due to kidney disease differs from the consequences of musculoskeletal system diseases in its constancy and independence from movement or posture.Particular caution should be taken if symptoms such as cloudy urine, frequent or painful urination, etc. occur.
Diseases of the sexual organs
Both women and men can suffer from severe lower back pain due to various pathologies of the reproductive system.This is how sexually transmitted infections and inflammation of tissues and organs manifest themselves.
Lower back pain in women often occurs during menstruation and is accompanied by discomfort in the lower abdomen.This can be considered a variant of the norm.If your period is very heavy, accompanied by pressure surges and your health deteriorates, it is better to visit an antenatal clinic and get tested for hormones.With properly selected drugs, menstruation can be normalized.
Lower back pain in men can be a sign of prostate problems.It is necessary to make an appointment with a urologist and undergo an examination.
Pancreatitis
When the entire pancreas becomes inflamed, pain occurs in the lumbar region.Possible irradiation of the coccyx, left thigh and perineum.Belt pain begins to increase after eating and increases with physical activity.Walking, jumping and other exercises cause the pancreatic capsule to stretch and the nerve endings to respond.
What to do if you have severe lower back pain?
Wenn zu Hause oder am Arbeitsplatz ein starker Schmerzanfall auftritt, müssen Sie sich auf eine harte, harte Oberfläche legen und ein Kissen unter Ihre gebeugten Knie legen, sodass Ihre Beine im rechten Winkel zum Körper stehen.Take a nonsteroidal anti-inflammatory drug.You can tie a scarf or warm scarf around your lower back to warm your back a little.
If these measures do not bring relief, you need to call a doctor or an emergency doctor at home.When you feel better, do not wait for a new attack of pain and take the time to go to a medical center.First, make an appointment with a general practitioner.He will comprehensively assess your health condition, make a preliminary diagnosis, draw up a plan for an initial examination, prescribe appropriate symptomatic treatment and, if necessary, refer you to a specialist.
Competent advice
Modern advertising offers many “quick” solutions to back pain: various gels, ointments and plasters.Although some of them provide relief, they should not be used long-term without medical supervision.In some cases, warming gels can only do harm.That's why you should see a doctor if you have lower back pain, even if you've managed to suppress the symptoms.
Diagnosis of lower back pain
At the first appointment, the doctor questions the patient and finds out how long the symptoms have existed, how dynamically they develop and whether there are any accompanying symptoms.The doctor takes into account exactly how it hurts - left or right, the pain is dull, aching, stabbing or throbbing, the duration of the attacks and other details to make a preliminary diagnosis.In many typical cases, standard treatment by a family doctor is possible.
If there are specific signs of a serious disease of the spine or internal organs, in most cases the patient is referred for further examinations:
- Blood test.A low hemoglobin level indicates the likely presence of a tumor, an increase in ESR indicates inflammation or infection, etc.The doctor recommends carrying out not only a general analysis, but also biochemistry to assess the functioning of the internal organs;
- Urinalysis.The results of the study determine the health of the kidneys and urinary tract.Deviations in the analysis results are a direct indication for an ultrasound examination of the urinary system and further examination by a urologist;
- X-ray of the lumbar spine.The photos show certain signs of joint inflammation, disruption of various structures and close proximity of the vertebrae due to degenerative changes.The doctor can use the x-ray to assume osteoporosis and detect fractures;
- Magnetic resonance imaging (MRI).An X-ray-free method of examining patients, which allows you to obtain many images (sectional images) of the area of interest and its three-dimensional image.In contrast to radiography and computed tomography, MRI provides information not only about the condition of the bones, but also the muscles, blood vessels and soft tissues.
Treatment of back and lower back pain
Uncomplicated forms of pain that are not associated with a serious disease of the spine or internal organs are treated with nonsteroidal anti-inflammatory drugs (NSAIDs).To get rid of discomfort, it is enough to eliminate the provoking factor: lose weight, sit less, walk more, regularly do simple exercises.It is recommended to engage in long-term, individual physical activity.
To eliminate pain caused by an underlying disease, a systematic and comprehensive approach is required.The course of treatment should include medication, physiotherapy, therapeutic exercises and massage.
Conservative therapy
In case of acute, unbearable pain, the doctor immediately performs a blockage at the appointment - an injection of an anesthetic into the affected area.The injection relieves the symptoms quickly, but only provides temporary relief.The patient should start treatment immediately.
To relieve an exacerbation, the doctor prescribes:
- nonsteroidal anti-inflammatory drugs that relieve pain and swelling;
- muscle relaxants to relax tense muscles;
- B vitamins to improve regeneration and nutrition of nerve fibers.
If the cause of back pain is a disease of the internal organs, the patient is prescribed medications to treat the underlying pathology.
Assistive techniques
After the exacerbation is relieved, the following treatment methods are effective:
- wearing a special fixation bandage;
- medical massage in the lumbar area;
- shock wave therapy;
- swimming and fitness classes;
- Acupuncture;
- applying adhesive tapes;
- manual therapy;
- other physiotherapeutic techniques.
Surgical intervention
Surgery is the last resort.In case of severe disorders of the structure of the spinal cord or internal organs, surgical treatment is indicated.There are many techniques.The specific type of intervention is ultimately planned by a neurosurgeon, operating urologist or abdominal surgeon, taking into account the confirmed diagnosis and the individual characteristics of the patient's condition.
Do not tolerate lower back pain.Make an appointment with a therapist, neurologist or urologist at the clinic.In the medical center you can undergo a comprehensive examination, find out the cause of your back problems and receive high-quality treatment.