There is practically no person who at least once in his life would not have back pain in the lumbar region. This is how we pay for walking upright and our daily habits.
In addition to the damage that can affect the spine, its muscles, nerves and ligaments, it should be taken into account that sometimes the back hurts in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and womengenitals.
Low back pain symptoms can range from dull to sharp. The pain may go away on its own or become chronic (the symptom is present for more than three months).
Dangerous! You should consult a doctor immediately if:
- the pain in the lumbar region came on suddenly after an apparent back injury.
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, difficulty breathing.
- involuntary bowel and bladder emptying occurs.
- there is numbness in the groin.
- there was weakness of the lower limbs, paresis or paralysis of them, reduced sensitivity.
- pains are given in the stomach and increase sharply when you cough or sneeze.
- symptoms appeared in the context of a sharp weight loss, prolonged use of steroids, immunodeficiency.
- in the family history there were cases of cancer, inflammatory or degenerative diseases of bones and cartilage tissue.
Why does the back hurt in the lumbar region?
Myofascial pain
A muscle strain or spasm can develop gradually or occur suddenly. With a high load, the damage affects not only muscle fibers, but also the ligamentous apparatus and fascia.
Muscle pain in the lower back occurs after:
- lifting heavy weights or overexertion at work or sports.
- playing sports from time to time. Muscles are especially vulnerable if you are inactive during the work week and then spend hours in the gym on the weekends.
- a sharp increase in the weight of the body itself, behind which the muscles do not have time to develop.
- prolonged sitting or standing in an uncomfortable position.
- daily carrying of a bag in one of the arms or over the shoulder.
- postural disorders. The spine performs its best supportive and protective function when you are not bending over. The muscles in the lower back experience the least stress when you sit with good support under your waist and when standing, you distribute the weight evenly on both legs.
If the back hurts after a bruise, fracture, sprain, hypothermia, an infectious disease or an established helminthic invasion, then you may suspect myositis (inflammation) of the back muscles. Severe pain is constantly present due to inflammation of the muscle fibers, "knots" are felt in the muscles - spasm points. Inflammation can be acute or take a chronic form. With a long course of the disease, the pain is unstable, worsens with prolonged lying or sitting, in the late afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the back muscles are in constant tension, inflammatory swelling is created, the temperature rises locally and at the level of the whole organism.
With a muscle spasm, the roots of the spinal nerves are violated, so the attacks often resemble a picture of sciatica or sciatica - there are severe pains in the back of the thigh and lower leg, the extremities become numb, they lose sensitivity. Intense muscle tone in myositis makes the patient take a forced position, walks and lies hunched over, moves on bent legs.
How to treat spinal muscle pain? To eliminate inflammation and pain, non-steroidal anti-inflammatory drugs and analgesics are used. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of active substances. Stimulating and warming ointments are also used, which reflexively increase blood flow to the back muscles. A larger volume of incoming blood helps flush out the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictor drugs.
If the cause of myositis is infection or poisoning of the body with worm toxins, then initially antibiotics or anthelmintic drugs are used. 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 cartilaginous discs, which protect the spine from injury, but are themselves subject to wear and aging.
Normally, the disc is a jelly-like pulpy core surrounded by a denser layer of the annulus fibrosus. The elasticity of the core is due to its ability to bind and retain water: when the load increases, water accumulates and elasticity increases, when the pressure decreases, the core releases water and becomes flatter.
Osteochondrosis in the area of the vertebrae develops when the intervertebral discs are malnourished (their "drying") or with excessive local load. Most often, pain in the lower back is due to the fact that the lower poles of the intervertebral discs bear the greatest load when you sit, when you lift weights in front of them. At the same time, tears are formed, displacements in the discs, spinal ligaments are damaged, there is constant pain, throbbing.
Pain in the spine has several mechanisms of development:
- violation of microcirculation in the tissues surrounding the spine and, in particular, in the spinal canal, the formation of congestion and edema. Such conditions develop against the background of hypothermia, overheating, inflammatory processes.
- degenerative processes in the ligaments of fixation of the spine. The increased mobility of the vertebrae leads to a slight displacement and abnormal compression of them, which causes damage to nerves, blood vessels and the formation of hernias.
- axial compression of the vertebrae when lifting weights or damage to them during excessive rotation (turning).
- aseptic inflammation. Damage to the nucleus leads to the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes a spasm of the muscles affecting the neighboring vertebrae - above and below the hernia. Gradually, the reaction covers the entire lumbar region and leads to the fact that any movement causes a feeling of pain.
A weakened disc can rupture, resulting in bulging, protrusion or prolapse of the nucleus and eventually herniation. A herniated disc puts pressure on the spinal cord and spinal nerve roots. In such situations, a throbbing pain in the lower back strongly occurs, which deviates along the strangled nerve. The most well-known cases of compression of the sciatic nerve (sciatica), manifested by sharp pain in the back of the thigh and lower leg, numbness of the limb on the side of the hernia, muscle weakness, involuntary wrapping of the hernia. legs.
Pain in the lumbar spine worsens when sitting and standing, when turning, leaning. Often there is a protective muscle reaction - a painful contraction of the muscles (formation of cylinders) on both sides of the spine, which isolates the segment from unnecessary movements. Osteochondrosis then leads to sciatica (inflammation of the spinal nerve roots).
Radical syndrome is dangerous when the nerves of the back, which are responsible for the innervation of the internal organs (horns of the cauda equina), are pressed. At the same time, there is pain in the stomach, the functioning of the bladder and intestines is disturbed, there are problems with potency in men and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, take analgesic positions - they deviate the body to the left, if the right side hurts, they lie on the right side. If the hernia is on the left. The appearance of severe pain when pressing on a hernia in the intervertebral space (ringing symptom) is also characteristic.
How to treat if your back hurts with osteochondrosis:
- during a pain attack, you can take an anesthetic position - lie on your back and put a cylinder under your knees. It is also recommended to sleep on a hard surface.
- Of analgesic drugs, NSAIDs can be taken orally or as injections on both sides of the spine at the lumbar hotel.
- use topical irritants as a distraction treatment - mustard, iodine mesh, pepper patch and ointments.
- Elimination of muscle spasm through manual therapy, acupuncture, vacuum massage, reflexology, gymnastics.
- during the weakening of the acute period, mud treatment, ozokerite, heating can be used.
Treatment of pain in radicular syndrome includes:
- providing bed rest, lumbar traction (dry or underwater).
- the use of blockades from novocaine at the site of the offense, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant sharp pain, as well as the disruption of the functioning of internal organs, the development of paralysis of the limbs, the binding of a hernia in the spinal canal.
Degenerative inflammatory lesions
Spondyloarthropathy (inflammation of the facet joints of the vertebrae) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back occurs from 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 overload of the intervertebral joints. Discomfort in the lower back is especially aggravated when wearing shoes with heels, walking for a long time, getting off elephants, positions when the body deviates backwards, for example, when looking at something above the head.
In patients with this diagnosis, stiffness in the lower back is noted in the morning, the pain increases during the day or after exercise. It has a diffuse character and it is difficult to clearly see the boundaries: discomfort is determined in the gluteal muscles, in the groin, in the lower abdomen and in the scrotum in men. This spondylitis differs from radicular syndrome when you can locate the source of the pain.
What to do to relieve the pain? It usually helps to take a supine position, bending the legs at the hip and knee joints.
Their medications are preferred non-steroidal anti-inflammatory drugs and non-narcotic analgesics.
Muscle relaxants are also added as they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect, since chronic pain puts the patient in a state of depression.
Spondylosis, unlike osteochondrosis, mostly affects the annulus fibrosus of the intervertebral disc and the anterior longitudinal ligaments. With this disease, calcification of connective tissue structures occurs with the formation of growths along the edge of the vertebrae - osteophytes. These formations cause a violation of microcirculation near the nerve roots and lead to the fact that the back hurts in the lower back, and the mobility of this part is also limited.
Vertebral osteophytes are pathological growths that damage nerves and blood vessels.
Treatment is usually conservative, using anti-inflammatory drugs, analgesics, vitamins. A good result is given by electrophoresis with novocaine, lidase, manual therapy, physical therapy (amplifier, laser installation, shock wave therapy to destroy solid elements and increase the mobility of the spine).
Note! At an advanced stage, osteophytes do not regress. While their size is small, the treatment aims to eliminate inflammation, pain, improve metabolism. If the back does not hurt much, then nothing is done with the increases. If the osteophytes cause persistent pain or are large, they can be removed during surgery.
Tumor diseases
Low back pain can occur from compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, originating from the cerebrospinal substance itself).
Cells of various tissues can grow abnormally:
- fatty - a lipoma is formed.
- nerve roots - neuroma.
- spinal cord vessels - hemangioma;
- accessory tissue - glioma;
- bone tissue - osteosarcoma;
- cartilage - chondrosarcoma.
The tumor process, especially malignant, is characterized by a pain syndrome resembling sciatica (it can be unilateral and bilateral), general deterioration of the patient's condition and exhaustion.
If the pathology affects the region of lumbar vertebrae I-IV, then there is a burning pain in front and on the sides of the upper thigh, incomplete paralysis of this region.
With a lesion in the region of the IV lumbar - II sacral segments, numbness of the paragenital region, impaired motor and sensory innervation of the gluteal muscles, posterior thigh, calf, fecal and urinary incontinence is observed.
A pronounced disorder in the function of the pelvic organs occurs with a neoplasm in the area of the V-III sacral vertebrae. The patient suffers from sexual impotence or menstrual disorders, constipation or faecal and urinary incontinence.
Tumor treatment is specialty, painkillers and cancer drugs are prescription drugs.
As you can see, lower back pain is usually caused by musculoskeletal pathologies. 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 to confuse it with oncological causes, diseases of internal organs or trauma. If you experience lower back pain, we recommend that you always seek the advice of a neurologist or orthopedist.