Pain in the back

Low back pain is often referred to as lumbago or lumbodinia. Lumbago or "lumbago" is an attack of severe lumbar pain that is usually associated with hypothermia and strain. Lumbago is found in many people and is often the cause of temporary disability. Lumbago is characterized by pain in the legs without irradiation. Lumbar pain (lumbago) may be severe and gradually progress throughout the day. Caused by muscle spasms, which in turn can be related to other causes, such as overload or stretching, sports injuries, disc herniation, spondylosis (spondylosis), kidney disease (infections or kidney stones), and sometimes the patient can pinpoint the cause of weakness. - Effective connection with exercise, hypothermia, but often the pain occurs for no apparent reason. Sometimes back pain can appear even after falling, bending over or putting on shoes. This will help with deformable diseases of the spine such as scoliosis.

Unlike lumbago, the term lumbodinia means not acute pain but subacute or chronic pain. Typically, pain with lumbodynia manifests itself gradually over several days. Pain can also occur in the morning and can be reduced with physical activity. Lumbodinia is characterized by increased pain during prolonged static loads (sitting, uncomfortable position of the body). It is also characteristic of lumbodin that the pain relieves lying in a certain posture. Patients with lumbodynia find it difficult to perform routine activities such as washing shoes or dressing due to muscle spasm. Due to the disease, the volume of stem movement decreases (tilt forward or, to a lesser extent, tilt or widen to the side). Because of the pain syndrome, the patient often has to change position when it is necessary to sit or stand. Unlike lumbago, muscle spasm is less pronounced and usually does not cover the entire lower back and often shows signs of spasm spreading to one side.

Causes of back pain

Back pain is a symptom. The most common causes of back pain are diseases (injuries) of muscles, bones and intervertebral discs. sometimeBack painIt can be caused by diseases of the abdomen, small pelvis and chest. Such pains are called reflected pains. Abdominal diseases (eg, appendicitis), aortic aneurysm, kidney disease (urolithiasis, kidney infection, bladder infections), pelvic infections, ovaries - all of these diseases can be detectedBack pain. . . Even a normal pregnancy can cause lumbar pain due to stretching in the pelvis, muscle spasm due to stress and nerve irritation.

OftenBack painAssociated with the following diseases:

• Compression of the nerve root that causes the symptoms of sciatica and is most often caused by a disc herniation. Typically, the pain when the nerve root is compressed is severe, has radiation, and has reduced sensitivity in the innervated area of the nerve root. Disc herniation mainly occurs as a result of disc degeneration. There is a protrusion of the gelatinous part of the disc from the central cavity and pressure on the nerve roots. Degenerative processes in the intervertebral discs begin at the age of 30 years and older. But the presence of a hernia does not always affect the nerve structures.
• Spondylosis - Degenerative changes occur in the vertebrae themselves, causing bone formations (osteophytes) that can affect nearby nerves, causing pain.
• Spinal stenosis can occur as a result of degenerative changes in the spine (spondylosis and osteochondrosis). A patient who has a spinal stenosis in the lumbar region may experience lower back pain in both legs. Low back pain can occur as a result of standing or walking.
• Cauda equina syndrome. This is an ambulance. Cauda equina syndrome occurs as a result of compression of the elements of the cauda equina (terminal part of the spinal cord). A patient with tail bladder syndrome may experience pain and impaired bowel and bladder function (urinary incontinence and atony). This syndrome requires urgent surgery.
• Pain syndromes such as myofascial pain syndrome or fibromyalgia. Myofascial pain syndrome is characterized by pain and soreness at certain points (trigger points), a decrease in the volume of muscle movement in painful areas. Pain syndrome is reduced by relaxing the muscles located in the painful areas. With fibromyalgia, aches and pains are common throughout the body. Fibromyalgia is not characterized by stretching and muscle pain.
• Spinal bone infections (osteomyelitis) are rarely the cause of the disease.
• Non-infectious inflammatory diseases of the spine (ankylosing spondylitis) can cause stiffness and pain in the spine (including the lower back), which is especially worse in the morning.
• Tumors, most often cancer metastases, can be a source of lumbar discomfort.
• Inflammation of the nerves and, consequently, manifestations of pain (in the chest or lumbar region) can be caused by damage to the nerves themselves (for example, zoster)
• Given the various causes of symptoms, such as acute or subacute lumbar pain, it is very important to fully evaluate the patient and perform all necessary diagnostic procedures.

Symptoms

Pain in the lumbosacral area is the main symptom of lumbago, lumbodinia, lumboshalgia.

• The pain may spread to the front, side, or back of the leg (lumbar ischalgia), or it may be localized only to the lumbar region (lumbago, lumbodinia).
• The feeling that the lower back hurts can be intensified after exercise.
• Sometimes the pain may intensify at night or when sitting for long periods of time, such as during long trips.
• There may be numbness and weakness in the part of the leg that is located in the innervation zone of the compressed nerve.

For timely diagnosis and treatment, a number of criteria (symptoms) deserve special attention:

• Recent history of injuries such as falls from heights, traffic accidents or similar incidents.
• Presence of minor injuries in patients older than 50 years (e. g. , falling from a low altitude as a result of slipping and falling on the buttocks).
• History of long-term use of steroids (for example, these are patients with bronchial asthma or rheumatic diseases).
• Any patient with osteoporosis (mostly older women).
• Any patient over the age of 70: At this age there is a high risk of cancer, infections and diseases of the abdominal organs that can cause low back pain.
• History of Oncology
• Presence of infectious diseases in the recent past
• Temperature above 100F (37. 7C)
• Drug use: Drug use increases the risk of infectious diseases.
• Low back pain is exacerbated during rest: this type of pain is usually associated with oncology or infection, and such pain may also be associated with ankylosing spondylitis (ankylosing spondylitis).
• Significant weight loss (for no apparent reason).
• The presence of any acute nerve dysfunction is a signal to the ambulance. For example, it is a gait disorder, leg dysfunction is usually a symptom of severe nerve damage or compression. In certain circumstances, such symptoms may require urgent neurosurgery.
• Intestinal or bladder dysfunction (both incontinence and urinary retention) may be a sign of emergency medical care.
• Failure to recommend treatment or increased pain may also require seeking medical attention.

The presence of any of the above factors (symptoms) is a signal to get medical help within 24 hours.

Diagnosis

Medical history is important to make an accurate diagnosis because different conditions can cause low back pain. Time of onset of pain, connection with physical activity, presence of other symptoms such as cough, fever, bladder or intestinal dysfunction, presence of seizures, etc. Sh. Physical examination is performed: identification of pain points, presence of muscle spasm, study of neurological condition. If there is a suspicion of diseases of the abdomen or pelvic organs, then an examination is carried out (ultrasound of the abdominal organs, ultrasound of the pelvis and pelvic organs, urine blood test).

If the somatic genesis of low back pain is ruled out, then instrumental examination methods such as radiography, CT or MRI may be prescribed.

X-ray is a method of initial examination and allows you to determine the presence of changes in bone tissue and indirect signs of changes in the intervertebral discs.

CT allows you to visually visualize the presence of various changes in both bone tissue and soft stones (especially in contrast).

MRI is the most informative method of research that allows the diagnosis of morphological changes in various tissues.

Densitometry is necessary when osteoporosis is suspected (usually in women older than 50 years)

EMG (ENMG) is used to detect conduction disturbances along nerve fibers.

Laboratory tests are prescribed (blood tests, urine tests, blood biochemistry) mainly to rule out inflammatory processes in the body.

Pain treatment

After diagnosis and confirmation of spinal genesis with lumbago and lumbodin, certain treatments for low back pain are prescribed.

In case of severe pain it is necessary to rest for 1-2 days. Bed rest can reduce muscle tension and muscle spasm. In most cases, when the pain syndrome is caused by muscle spasm, the pain syndrome is reduced in a few days without the use of medication, just because of rest.

Medication. Nonsteroidal anti-inflammatory drugs are used for pain syndrome. COX-2 inhibitors have fewer side effects, but long-term use of these drugs also has some risks. Given that all medications in this group have many side effects, taking medications in this group should be short-lived and under the mandatory supervision of a physician.

Muscle relaxants can be used to relieve spasms. But the use of these drugs is effective only in the presence of spasms.

Steroids can be used to treat pain, especially when there are signs of sciatica. But due to the presence of pronounced side effects, the use of steroids should be selective and short-lived.

Manual therapy. This technique can be very effective in the presence of muscle blockage or subluxation of the phase joints. Mobilization of motor segments can reduce both muscle spasm as well as low back pain.

Physiotherapy. There are many modern physiotherapy procedures that can reduce pain and inflammation, improve microcirculation (e. g. , electrophoresis, cryotherapy, laser therapy, etc. ).

Exercise therapy. Exercise is not recommended during acute lumbar pain. Exercise therapy can be combined after reducing the pain syndrome. In the presence of chronic pain, exercise can be very effective in strengthening the muscular corset and improving the biomechanics of the spine. Exercises should be selected only with an exercise therapy physician, as often independent exercises can lead to increased pain manifestations. Systemic exercise therapy, especially in the presence of degenerative changes in the spine (osteochondrosis, spondylosis), can maintain spinal function and significantly reduce the risk of pain syndrome.