There is practically no person who does not experience back pain in the lumbar region at least once in his life. This is how we pay for walking upright and our daily habits.
In addition to damage that can affect the spine, its muscles, nerves and ligaments, we must remember that sometimes your back hurts in the lower back due to internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Low back pain symptoms can range from dull to severe. The pain may disappear on its own or become chronic (the symptom has been present for more than three months).
Dangerous! You should immediately consult a doctor if:
- Pain in the lower back suddenly appeared after an obvious injury to the back;
- The temperature has increased sharply, there are vegetative disorders, loss of consciousness, sweating, difficulty breathing;
- there is involuntary emptying of bowels and bladder;
- There is numbness in the groin;
- Weakness of the lower limbs, their paresis or paralysis, decreased sensitivity were noted;
- pains fall to the stomach and increase sharply when coughing or sneezing;
- Symptoms appeared against the background of sharp weight loss, long-term use of steroids, immunodeficiency;
- Cases of cancer, inflammatory or degenerative diseases of bone and cartilage tissue were recorded in the family history.
Why does my back hurt in the lumbar region?
Myofascial pain
Muscle tension or spasm can develop gradually or suddenly. With high loads, damage affects not only muscle fibers, but also the ligamentous apparatus and fascia.
Muscular pain in the lower back appears after:
- lifting heavy weights or excessive exertion at work or in sports;
- Playing sports from time to time. Muscles are especially vulnerable if you are inactive during the work week and then spend hours at the gym on the weekend;
- A sharp increase in own body weight, behind which the muscles do not have time to grow;
- sitting or standing in an uncomfortable position for a long time;
- daily carrying of the bag in one hand or on the shoulder;
- posture disorders. The spine performs its best supportive and protective function when you are not slouching. The muscles in the lower back experience the least stress when you sit with good back support and stand with your weight evenly distributed on both legs.
If your back hurts after a bruise, fracture, sprain, hypothermia, infectious disease or an established helminthic infestation, then you may suspect myositis (inflammation) of the muscles of the lower back. Severe pain is constantly due to inflammation of the muscle fibers, "knots" are felt in the muscles - in places of spasm. Inflammation can be acute or chronic. During the long course of the disease, the pain is unstable, it is aggravated by lying or sitting for a long time, in the late afternoon or when the weather changes. Touching the muscles causes pain and discomfort, the muscles of the lower back are in constant tension, inflammatory swelling occurs, the temperature rises locally and at the level of the whole body.
During muscle spasm, the roots of the spinal nerves are broken, so the attacks often resemble a picture of sciatica or sciatica - there are strong burning pains along the back of the thigh and lower leg, the limbs are numb, they lose sensitivity. Pronounced muscle tone during myositis forces the patient to take a forced position, he walks and lies bent, moves on bent legs.
How to treat spinal muscular pain? Nonsteroidal anti-inflammatory drugs and analgesics are used to eliminate inflammation and pain. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of active substances. Irritating and warming ointments are also used, which reflexively increase the blood flow in the lower back muscles. A larger volume of incoming blood helps flush out the products of inflammation and tissue breakdown.
Injections of corticosteroids and vasoconstrictor drugs help reduce inflammatory swelling.
If the cause of myositis is infection or poisoning of the body with worm toxins, then antibiotics or anthelmintics are used initially. In this case, heating ointments or compresses cannot be used.
Diseases of the spine involving nerve endings
In the lumbar region, the vertebrae are separated by elastic cartilage discs that protect the spine from injury, but are themselves subject to wear and tear and aging.
Normally, the disc is a jelly-like core surrounded by a denser layer of annulus fibrosus. The elasticity of the core is due to the ability to bind and retain water: when the load increases, it collects water, and elasticity increases, when the pressure decreases, the core releases water and becomes flatter.
In the spine, osteochondrosis develops due to insufficient nutrition of the intervertebral discs ("drying out") or excessive local load. Most often, lower back pain is caused by the fact that the lower poles of its intervertebral discs bear the greatest load when sitting, when lifting weights in front of them. At the same time, tears, displacements occur in the discs. , the ligaments of the spine are damaged, there is constant aching pain, pulsation.
Spinal pain has several mechanisms of development:
- Disturbance of microcirculation in the tissues surrounding the spine and, in particular, in the spinal canal, the formation of swelling and edema. Such conditions develop against the background of hypothermia, overheating, and inflammatory processes.
- Degenerative processes in spinal fixation ligaments. Increased mobility of the vertebrae leads to their slight displacement and non-physiological compression, which leads to disruption of nerves, blood vessels and the formation of hernias.
- Axial compression of the spine during weight lifting or their damage during excessive rotation (rotation).
- Aseptic inflammation. Destruction of the nucleus causes the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes muscle spasm, which disrupts the neighboring vertebrae - above and below the hernia. Gradually, the reaction covers the entire lumbar region and leads to the point where any movement causes pain.
A weakened disc can rupture, causing a bulging, protrusion or prolapse of the nucleus and eventually a herniation. The appearance of a hernia puts pressure on the spinal cord and spinal nerve roots. In such conditions, a throbbing pain in the lower back, which varies along the pinched nerve, appears sharply. The most famous cases of compression of the sciatic nerve (sciatica), which is manifested by sharp pain along the back of the thigh and lower leg, numbness of the limb from the side of the hernia, muscle weakness, involuntary sticking. legs.
The pain in the lower back increases when sitting and standing, turning, bending. Often there is a protective reaction of the muscles - a painful contraction of the muscles (formation of rollers) on both sides of the spine, which isolates the section from unnecessary movement. Osteochondrosis subsequently leads to sciatica (inflammation of spinal nerve roots).
Radicular syndrome is dangerous when the nerves of the lower back, which are responsible for the innervation of the internal organs (caudal horseshoes), are pinched. At the same time, the stomach hurts, the functioning of the bladder and intestines is disturbed, men have problems with potency, and women have gynecological diseases.
Many patients, because their back hurts so much, take pain-relieving positions - turn their body to the left, if the right side hurts, lie on the right side. If the hernia is on the left. The appearance of severe pain in the intervertebral space when pressing the hernia (bell symptom) is also characteristic.
What to do if your back hurts with osteochondrosis:
- During a pain attack, you can take an anesthetic position - lie on your back and put the roller under your knees. It is also recommended to sleep on a hard surface;
- From pain relievers, non-steroidal anti-inflammatory drugs can be taken orally or as injections on both sides of the spine in the lumbar region;
- use local irritants as a means of distraction - mustard plasters, iodine mesh, pepper spots and ointments;
- elimination of myotic spasm through manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- During the weakening of the acute period, treatment with mud, ozocerite, warming can be used.
Treatment of pain in radicular syndrome includes:
- providing bed rest, lumbar traction (dry or underwater);
- the use of novocaine blockades at the site of the violation, the use of non-steroidal anti-inflammatory drugs or weak opiates;
- Physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant acute pain, as well as dysfunction of internal organs, development of limb paralysis, separation of a hernia in the spinal canal.
Degenerative inflammatory lesions
Spondylarthrosis (inflammation of the joints of the spine) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back occurs due to excessive stretching of the capsule and increased pressure on the surface of the intervertebral joints. The pain causes the patient to bend more in the lower back, thus increasing the load on the intervertebral joints. Wearing high-heeled shoes, walking for long periods of time, descending from elephants, positions when the body is tilted back, for example, when looking at something above the head, aggravates the discomfort in the lower back.
Patients with this diagnosis have back stiffness in the morning, the pain increases during the day or after exercise. It has a diffuse character and it is difficult to clearly show the boundaries: discomfort appears in the buttock muscles, groin area, lower abdomen and in men, the scrotum. This spondyloarthrosis differs from radicular syndrome when you can pinpoint the source of the pain.
What should we do to relieve the pain? As a rule, it helps to take a lying position, bending the legs at the hip and knee joints.
Their medications are preferred over non-steroidal anti-inflammatory drugs and non-narcotic analgesics.
Muscle relaxants are also added because they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect, since chronic pain puts the patient in a depressed state.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. With this disease, the connective tissue structures are calcified with the formation of growths on the edge of the spine - osteophytes. These formations cause microcirculation disturbances near the nerve roots and lead to back pain in the lower back, as well as limited mobility of this section.
Spinal osteophytes are pathological formations that damage nerves and blood vessels.
Treatment is usually conservative, using anti-inflammatory drugs, analgesics, vitamins. Electrophoresis with novocaine, lidase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compacted elements and increase mobility of the spine) gives a good effect.
Notice! In the advanced stage, osteophytes do not resolve. Although their size is small, the treatment aims to eliminate inflammation, pain, and improve metabolism. If your back doesn't hurt too much, then nothing is done with the growths. If osteophytes cause persistent pain or are large, they can be removed during surgery.
Cancerous diseases
Lumbar pain can occur as a result of compression of the spinal cord by the tumor from the outside (extramedullary formations) and from the inside (intramedullary, arising from the cerebrospinal substance itself).
Cells of various tissues can grow abnormally:
- fatty - a lipoma is formed;
- nerve roots - neuroma;
- Blood vessels of the spinal cord - hemangioma;
- supporting tissue - glioma;
- bone tissue - osteosarcoma;
- Cartilage - chondrosarcoma.
The tumor process, especially malignant, is characterized by a pain syndrome similar to sciatica (can be unilateral or bilateral), general deterioration of the patient's condition and fatigue.
If the pathology affects the area of the I-IV lumbar spine, then there is a burning pain on the sides of the front and upper thighs, incomplete paralysis of this area.
With the damage of the IV lumbar - II sacral segments, there is numbness of the paragenital region, violation of motor and sensory innervation of the gluteal muscles, back of the thigh, calf, fecal and urinary incontinence.
A marked disturbance in the functioning of the pelvic organs occurs with a neoplasm in the region of the V-III pelvic spine. The patient suffers from sexual impotence or menstrual cycle disorder, constipation or faecal and urinary incontinence.
Cancer treatments are specific, pain relievers and anti-cancer drugs are prescription drugs.
As you can see, lower back pain is usually caused by musculoskeletal disorders. They can be diagnosed by clinical signs and research data, the main task of which is to correctly determine the nature of the disease and not confuse it with oncological causes, diseases of internal organs or trauma. If you have back pain, we recommend that you always seek the advice of a neurologist or orthopedist.