When a person suffers from pain, the only wish is for the pain to go away quickly and never appear again. The back is the "working" and important part of our body, because it is where the main organ - the spine - is located. Back pain is often a symptom of various diseases. Almost everyone experiences back pain, especially after 40 years. The most common cause is osteochondrosis, but this pathology does not explain the nature, severity and duration of back pain. Lower back pain indicates damage to the spine, disease of nerve endings, muscle tissue and internal organs. It is observed during fever. It can be sharp and dull, constant and periodic, fire and burst. Pain can be periodic, local, aching or aching, for some it is associated with the weather, for others physical activity, for others it is associated with prolonged restlessness.
Why does my lower back hurt?
Common causes of back pain can be diseases of muscle tissue, damage to bones and intervertebral discs. They arise against the background of pathologies of the abdominal organs, pelvis and chest.
Spine diseases
Common causes of back pain are congenital anomalies and acquired spinal diseases. Pain is sometimes associated with weather changes, and sometimes with physical activity.
Lumbago– sharp pain that restricts movement and is caused by muscle spasm. With pathological processes in the spine, lumboischialgia occurs - aching or burning pain in the lower back radiating to the back of the thigh. Pain occurs against the background of radicular syndrome. Painful sensations are detected by pathologies in the spine:
- Degenerative pathologies: osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyloarthrosis.
- Congenital anomalies: sacralization, lumbarization.
- Polyetiological conditions: spondylolysis, spondylolisthesis.
- Vascular diseases: disorders of spinal circulation.
- Other diseases: diseaseForestier.
Secondary lesions of nerve structures: lumbosacral radiculitis, lumbosacral plexitis, myelopathy of various origins.
Curvature of the spine
Small aching pain with curvature of the spine is associated with improper distribution of physical activity, overloading of ligaments and muscles in the lumbar region. The pain occurs due to an uncomfortable position when sleeping on a hard or, conversely, a soft mattress.
It is accompanied by symptoms:
- lordosis;
- kyphosis;
- scoliosis;
- kyphoscoliosis;
- flat back syndrome.
Osteoporosis
If your back is tight or painful for a long time, it could be osteoporosis. The pain is aggravated by stress and weather changes. Osteoporosis can be:
- postmenopausal;
- minor;
- idiopathic;
- old man
The same pain sensations appear in patients with genetic diseases, disorders in the work of the endocrine glands, and intoxication when taking drugs. It may be due to secondary osteoporosis syndromemalabsorption, kidney and liver diseases, rheumatoid arthritis, lupus erythematosus.
The increase and duration of pain is associated with injuries and fractures.
Spinal injuries
A common injury to the back is bruising, which manifests itself as moderate pain and is accompanied by swelling, hematomas and bleeding when moving. In severe cases, neurological disorders are also added.
A compression fracture in the lower back occurs due to forced bending of the spine and is characterized by cessation of breathing and severe pain. When turning the body, pain intensifies, muscles and tissues swell. The lower back is painful during palpation.
Patients with spondylolisthesis and vertebral dislocation experience paroxysmal pains accompanied by a feeling of heaviness in the lower back and numbness of the legs.
Soft tissue and kidney injuries
Moderate to dull pain with bleeding or swelling is caused by soft tissue bruises. Kidney bruises are painful and spread to the lower abdomen, genitals, and lower back. Sometimes manifestations of hematoma and hematuria appear. With severe bruising, painful shock, blood in the urine, and long-lasting severe pain may occur.
Infections of the spine and spinal cord
Osteomyelitismanifests itself as increased pain in the lower back along with chills and fever. It can be hematogenous, post-traumatic, contact, postoperative. The intense pain is so tight and bulging that it prevents movement, forcing you to freeze. In the chronic form of osteomyelitis, a pus-filled fistulous path is formed, so pain manifestations are smoothed.
Spinal tuberculosisit develops gradually, starting with periodic pain that increases due to stress, then stiffness of movements occurs. The pain is burning and spreads to the legs with paresthesia and numbness due to the destruction of the vertebra and compression of the nerve roots.
in patients withspinal epidural abscesssevere pain is combined with muscle tension, shivering and hyperthermia. As the disease progresses, radicular syndrome and paresis occur.
Local inflammation
it's hot,carbuncles- against the background of purulent processes, purple or blue skin pressures with one or more sticks in the center with a diameter of 1 cm appear and are accompanied by increasing pain in the lumbar region. The pain is throbbing, throbbing, and can keep you awake. Hyperthermia is noted.
Horseparanephritisfirst fever occurs, then local edema, hyperemia and hyperthermia are detected. Severe pain spreading to the stomach and under the ribs, aggravated by movements and even breathing, develops on the third day. Against the background of paranephritis, due to severe pain, the patient is forced to take a crooked position so as not to strain the muscles of the lower back. The condition of the body is serious.
Infectious diseases
HorseARVI,fluAndsore throatmyositis with an increase in body temperature and intoxication of the body is characterized by aching pain in the lower back, which causes a desire to change the position. Sometimes back pain is caused by an infection in the kidneys. Infectious diseases accompanied by pain in the lumbar region:
- hemorrhagic fevers;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- corona virus;
- bacterial, fungal, viral infections.
During a cytokine storm, pain in the lower back is observed due to severe infections. Epidemiological myalgia is accompanied by severe pain attacks in the lumbar region, lasting up to 10 minutes with an interval of half an hour to an hour and appearing in the limbs, chest and abdominal wall. It can be combined with rhinitis, conjunctivitis and numbness. Myalgia decreases at rest, increases during movement, and may disappear after a few days of warming up the muscles.
Other muscle lesions
Painful pain in the lower back occurs after intense physical activity, strength exercises for the back muscles, or a long stay in a position with tension in the back muscles. Myositis develops not only against the background of infection, but also due to hypothermia, intoxication, overload, metabolic disorders and is accompanied by painful long-term pain.
Formsmyositis:
- for syphilis and tuberculosis;
- idiopathic, young;
- for oncology;
- for connective tissue diseases.
Fibromyalgia is characterized by chronic pain accompanied by asthenia, sleep disorders, and neurotic disorders.
Other diseases
Lower back pain is a concern in pathological situations:
- Tumorsspine and spinal cord: sarcoma, hemangioma, metastases, spinal cord neoplasms.
- Kidney diseases: pyelonephritis, glomerulonephritis, urolithiasis, kidney infarction, renal vein thrombosis, kidney cyst, kidney cancer.
- Hereditary diseases:Hereditary cerebellar ataxia of Pierre-Marie.
- Exogenous intoxications: Adrenomimetic drug use.
- Pathologies of the heart and blood vessels: Loeffler endocarditis, abdominal aortic aneurysm.
- Emergencies: transfusion shock.
Pain syndrome spreads to the lower back against the background of pelvic diseases, women's diseases, as well as prostate cancer, proctitis, sigmoiditis.
Types of pain
Duration should be considered when diagnosing back pain. The muscle pain lasts for about two weeks and then goes away.
Pain caused by changes in the spine lasts longer and spreads to the leg, perineum and may be accompanied by pins and needles, numbness and burning.
Pain caused by diseases of the cardiovascular system and diseases of the abdominal cavity is characterized by intensity and longer duration.
Diagnostics
Medical history is of great importance for making a diagnosis, because back pain can be caused by various diseases.
The initial diagnosis is made by a traumatologist-orthopedic. When making a diagnosis, the doctor takes into account the following symptoms: defecation and urination disorders, orthopedic defects, leg weakness and numbness. An examination is performed to identify pain points and muscle spasms.
When the pain appears, its relationship to stress, cramps, cough, fever, and bladder or bowel dysfunction are also important.
If there are neurological symptoms, the patient is referred to a neurologist. The doctor interviews the patient and conducts a visual examination, then the patient is sent for hardware and instrumental examination. Consultations of surgeons, rheumatologists, urologists and other specialized specialists are prescribed based on the doctor's instructions.
Diagnostics may include:
- Neurological examination.The neurologist assesses the patient's reflexes, sensitivity and muscle strength, coordination of movements.
- x-ray.X-ray is an initial examination method that allows identifying changes in bone tissue. Fractures, degenerative changes in intervertebral discs, signs of inflammatory processes and spondylolisthesis are visible in the images of the lumbar region.
- CT scan.CT scans examine the detailed structure of solid structures.
- MRI- an informative method that allows diagnosing morphological changes in the condition of ligaments and intervertebral discs. Myelography is prescribed to rule out stenosis.
- Densitometrynecessary for osteoporosis.
- Electromyography,electroneurographyThese tests evaluate muscle function and nerve conduction.
- Ultrasoundkidneys, prostate, abdominal and pelvic organs.
- USDGabdominal aorta.
- EMG (ENMG)used to determine conduction disturbances along nerve fibers.
- Laboratory tests.Urine and blood tests are taken for microbiological examination to determine the causative agent of the infection. To detect neuroinfections - using serological tests.
Treatment of lower back pain
First aid
For spinal injuries, the patient is placed on a hard, flat surface and taken to the clinic. To reduce pain, you should optimize your body position to reduce the load on your back during work and rest. Before being examined by a doctor, you can take analgesics. It is allowed to use creams, ointments and gels with warming and analgesic effects for degenerative diseases of the spine, lumbago and lumboischialgia. Their use during infectious processes is prohibited.
Physiotherapy and medication are the basis of treatment. The following methods are used:
- NSAIDsin the form of tablets and local agents, it is used for chronic and acute pain in the back muscles.
- Neurotropic B vitamins, strengthens the effect of medicinal painkillers.
- Local anesthetics.They perform therapeutic blockades for acute pain with anesthesia, as well as pain relievers with glucocorticosteroids.
Physiotherapy
- ultrasound,
- magnetic therapy,
- transcutaneous electrical stimulation,
- laser therapy,
- electrophoresis,
- massage,
- manual therapy,
- acupuncture.
Surgery
Depending on the pathological features, there are surgical interventions:
- For instability: interbody fusion, transpedicular fixation, plate fixation.
- For tuberculosis, tumor, osteoporosis, osteomyelitis: sequestrectomy, vertebroplasty, kyphoplasty, corpectomy.
- For intervertebral hernias: discectomy, microdisectomy, nucleoplasty.
- For spinal canal narrowing: laminectomy, facetectomy, disc puncture decompression.
Prevention
Massage is effective in case of muscle blocks and subluxations of joints, reduces muscle spasm and back pain.
Physiotherapy reduces pain and inflammation, improves blood circulation.
Exercise therapy - physical exercises are effective in strengthening the muscle corset and improving the biomechanics of the spine. Exercises are selected by the doctor. Systematic implementation allows maintaining functionality and reducing back pain.
"He is warned in advance, he is armed! "But only a doctor can make an accurate diagnosis.