The lower back is called the back - from the area where the ribs end to the coccyx (the lowest protruding vertebra).Most often, when a person has "back pain", we are talking about the lower back.And if 20 years ago pain in the lower back mainly bothered the elderly, now even quite young patients turn to specialists for help with their backs.
Why does the lower back suffer so often?The fact is that the center of gravity of the human body is located exactly at the level of the lumbar spine and takes almost all the load when walking.This is one of the disadvantages of upright walking - vertebrates that move on 4 limbs do not have such ailments.
Causes of lower back pain - what you need to know
Statistical studies tell us the following about the frequency of causative factors for lower back pain:
- 91% of calls are problems with the spine and muscular framework of the back.
- 5% of complaints are related to diseases of the excretory system.
- 4% - pathologies of other organs (reproductive system, gastrointestinal tract).
Types of lower back pain
Often back problems arise unexpectedly – like a bolt from the blue.Such sharp pain in the lower back is called "lumbago", and before you could hear the term "lumbago".The name itself speaks of the sharp, darting nature of the sensations.During an attack of lumbago, any movement only increases the torment, and the patient involuntarily finds himself in a limited position, freezing in one position.The lumbago lasts for a few minutes and then subsides.
If the pain is prolonged and painful in nature, then we are talking about lumbodynia.These are weakly intense, but constant painful sensations in the lumbar region, which intensify during physical activity or during hypothermia.
And there is a condition when there is no back pain itself, but a person feels stiffness and discomfort.In this case, additional diagnostics by specialists is also necessary.Depending on how lower back pain manifests itself, approaches to its treatment vary.
Low back pain as a symptom of disease?
Back pain itself can signal many different pathological conditions, and often understanding the real cause is not so easy.
For example, there is such a thing as displaced pain.It means a situation where the back hurts on the right, left or lower back - and a person thinks that the cause of his suffering is in the spine.However, after examination, it turns out that one of the internal organs (kidneys, intestines or organs of the reproductive system) is to blame.The human body is very complex and confusing.Let's look at some possible root causes of lumbar back discomfort.
Musculoskeletal disorders causing lower back pain
The relationship between spinal disorders and low back pain is direct and unequivocal.It was mentioned earlier that spinal pathologies are the most common cause of back pain and account for more than 90% of all visits.
Protrusions and herniations of the intervertebral discs are rightfully in the first place in terms of prevalence.In such destructive pathologies, the intervertebral disc initially shifts slightly outward, prolapses (disc protrusion), and as the disease progresses, the integrity of the disc is disrupted in such a way that the inner part (nucleus pulposus) protrudes from the surrounding fibrous ring.
Most often, protrusions occur due to traumatic disc damage or osteochondrosis.
Another painful consequence of osteochondrosis is the compression and pinching of the sciatic nerve.The pain is sharp and shooting - lumbago.
As a result of this compression, the nerve can become inflamed.The general name of such a disease is radiculitis, and if the inflammation affects the sciatic nerve, it is indicated by the more specific term "sciatica".Sciatica pain is concentrated in the lumbar region and spreads to the buttock and thigh along the sciatic nerve.
Now about the disease that leads to the development of all of the above - osteochondrosis.Pain in the lower back with osteochondrosis is a sharp shooting or dull pain.With the development of the disease (2nd and 3rd degree), neurological symptoms appear - numbness, a feeling of pins and needles in the lower limbs.In the morning, a person is bothered by a feeling of stiffness.The functioning of the gastrointestinal tract, kidneys and reproductive system is impaired.
The main goal in the treatment of osteochondrosis is to relieve pain and stop the destruction of the vertebrae and intervertebral discs.It is important to understand that the earlier treatment begins, the better the prognosis.
Pain in the kidneys, urinary tract and lower back
You may have heard.that the pains in the lower back are due to diseased kidneys.In some cases, this is indeed true.We recommend consulting a urologist if you are concerned about the following symptoms:
- Frequent painful urination, change in urine color.
- Deterioration of health, indifference to life.
- Hyperthermia is an elevated temperature.
- Decreased appetite, feeling nauseous.
- Arterial hypertension.
Pain varies.For example, with an exacerbation of chronic pyelonephritis, the pain seems to pull and cover the lower back, and renal colic is acute and short-lived.
It is characteristic that the pain in kidney pathology is concentrated on one side - since one kidney is involved in the inflammatory process.This is how a kidney stone (stone) appears in the kidney or ureter.
Another important diagnostic criterion is that, in nephropathies, the intensity of pain does not change with changes in body position.However, as you understand, it is better to leave the right to make an accurate diagnosis to a specialist.
Excessive physical exertion and pain in the lower back
Our spine is adapted to physical activity.Therefore, the appearance of back pain after a visit to the gym should alert you.Usually, pain in the back muscles due to the accumulation of lactic acid disappears within 1-2 hours, and if this does not happen, pathology should be suspected.
The cause of pain in the spine after sports can be old injuries or hidden problems with the intervertebral discs - for example, a disc protrusion.In this case, the removal of physical exercises will not lead to healing, but will only hide the course of a destructive spinal disease.
In addition, back pain after exercise is characteristic of myofascial syndrome.It is not a threat to life, but it significantly reduces its quality.
At the same time, physical activity can also contribute to the disappearance of back pain - for example, an overweight patient is more likely to get rid of back pain as a result of weight loss.
Remember that constant and periodic pain in the lower back after physical activity should be a reason to consult a doctor.
Hypothermia and lower back pain
Prolonged exposure to cold air and wind can lead to hypothermia.If the lower back is not protected from harmful environmental factors, an unpleasant condition such as myositis may occur.This is the name of the inflammation of the skeletal muscles.The pain is aching in nature, and on palpation (palpation) there is tightening of the back muscles.
Characteristics of lower back pain in women and the mechanism of their occurrence
It's no secret that women's well-being is closely related to their hormonal levels, which undergo dramatic changes not only throughout life, but also every month.That is why every month in a certain phase of the menstrual cycle, women can experience unpleasant pain in the lower back.Alas, this is a variant of the physiological norm.
And during pregnancy, discomfort in the lower back is considered normal - if it disappears after rest.After all, during this period, significant hormonal changes occur in a woman's body, the uterus expands - which changes the deformation in the lower back and shifts the center of gravity.In addition, the weight of a pregnant woman naturally increases, which also puts a strain on the spine.
If we talk about other causes of pain in the lumbar region in women, back pain can mean approaching menopause.This is due to a decrease in estrogen levels and changes in a number of other sex hormones.
Therefore, the diagnosis of the causes of pain in the lower back in women should be carried out especially carefully, so as not to miss important symptoms of serious diseases and not to write off the pathological causes of pain in the lower back in women.In fact, among such terrible diseases there can be a cyst, apoplexy or inflammation of the ovaries and even tumors of the cervix.Neglect and untimely diagnosis of such conditions can lead to infertility and critical complications.
What diseases can cause lower back pain?
Symptoms, nature of pain |
Presumptive diagnosis by MRI |
| Pain in the lower back when coughing, sneezing, bending over. | Protrusion (bulging) of the intervertebral disc of L1/L2 (L2/L3, L3/L4, L4/L5) vertebra |
| Tingling, tingling, not only in the back, but also in the buttocks and lower limbs. | Symmetrical dorsal (posterior) disc protrusion of L1/L2 (L2/L3, L3/L4, L4/L5) vertebra |
| Weakness in the muscles of the legs, motor reflexes worsen. | Dorsal (posterior) median disc protrusion of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, shooting pains;the patient cannot even stand up during an attack. | Round bumps on L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Staying in one position for a long time causes excruciating pain. | Diffuse protrusions of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Symptoms can be absent for a long time and be discovered accidentally. | Median disc protrusion of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pain in the lower back - also called "lumbago". | Disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Leg pain extending below the knee, "pins and needles" sensation in the leg. | Dorsal disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| It is often asymptomatic, with patients reporting only mild discomfort. | Schmorl's herniation of L1, L2, L3, L4, L5 vertebrae |
| The functioning of the intestines, bladder and reproductive system is impaired. | Paramedian disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| In the early stages, the course is asymptomatic.Pain occurs when the tumor spreads beyond the disc. | Hemangiolipoma and hemangioma in the L1 vertebral body (L2, L3, L4, L5) |
| The pain depends on the degree of displacement of the vertebra.If changes occur in the joints, movement disorders are noted. | Retrolisthesis and antilisthesis of L1 vertebra (L2, L3, L4, L5) |
| The pain is intermittent at first, then becomes constant.It is increased by physical activity. | Ventral sphenoid deformity of the L1 vertebral body (L2, L3, L4, L5) |
| Pain in the lower back, left or right, along the spine.Tingling, "pins and needles" sensation.Muscle tension. | MRI picture, signs of degenerative-dystrophic changes (osteochondrosis) of the lumbar spine |
| Rsharp pain from exertion or careless movement.Changes in gait, dysfunction of the genitourinary system. | Osteochondrosis of the lumbar spine 1st degree (2nd degree, 3rd degree) |
| Buttock and leg pain, discomfort from prolonged sitting in a chair and prolonged walking. | Spondyloarthrosis of the lumbar spine 1st degree (2nd degree, 3rd degree) |
What to do if you have lower back pain?
If the symptoms of back pain in the lumbar region do not disappear or decrease within 3 days, you should consult a doctor.What to do before seeing a doctor?
What you can do yourself for lower back pain
If the cause of the pain is unknown:
- take your temperature to detect inflammation in the body.
- determination of accompanying symptoms (vomiting, diarrhea or others)
- call a doctor at home or go to the emergency room.
If the cause of the pain is known (bruise, sprain or low back injury):
- take a non-steroidal anti-inflammatory drug (NSAID) - diclofenac, ibuprofen or another.
- applying cold topically will help reduce swelling and dull the pain.
- tightly tighten the lumbar area with a towel or orthopedic belt to fix the damaged area in one position.
- Consult a doctor for a complete diagnosis and determination of further treatment tactics.
What not to do for lower back pain
- In no case should you heat a painful area of the back!Heat will increase blood flow and, if there is inflammation, it will worsen the situation: it will increase the pain and lead to the spread of the infectious process.For the same reason, you should avoid visiting baths and saunas.
- You cannot relieve the pain for a long time if you have persistent and unexplained back problems.Ignoring the main cause can only worsen the course of the disease and lead to serious complications.
- You can not try to straighten the vertebrae yourself or massage your back roughly.Without a diagnosis, such actions can cause the vertebrae to shift and cause unnecessary additional injury.
Which doctor should I see for lower back pain?
It happens that a person is happy to go to a specialist, but does not know which doctor to turn to with a complaint of pain in the lower back.Let's shed some light on this matter.
First of all, you need to make an appointment with a general practitioner.He will conduct a differential diagnosis and determine which doctor you should continue treatment with.It could be:
- Neurologist – for neurological symptoms and nerve involvement in the process.
- Urologist - in case of suspected diseases of the excretory system (kidneys).
- Gynecologist - for the treatment of diseases of the female reproductive system.
According to the indications, a complete blood count (CBC) and general urinalysis (UCA), X-ray examination of the spine (especially MRI), ultrasound of the pelvic organs, kidneys and other examinations may be prescribed.
It is important to remember that self-medication and other home remedies for low back pain are a waste of money and time.In addition, by postponing the visit to a specialist, you risk acquiring an advanced form of the disease, thus dooming yourself to long-term, expensive and often less successful (than in the early stages) treatment.
How to treat lower back pain: basic treatment methods
Naturally, you may have a question: if self-medication is not effective, then how to cure lower back pain?A competent specialist has many techniques in his arsenal, including both conservative and surgical treatment.
Conservative treatment consists of the following points:
- Taking anti-inflammatory (NSAIDs) and painkillers orally and topically.
- Physiotherapy (shock wave therapy, acupuncture).
- Kinesitherapy.
- Therapeutic massage.
- Therapeutic physical education and gymnastics.
Physiotherapy procedures and massage should be performed after the acute phase of the disease, when the pain syndrome is relieved.
Surgical treatment is indicated for advanced diseases of the spine, when conservative methods do not give a significant result.However, with timely diagnosis and correctly prescribed treatment, the need for surgical interventions can be postponed or completely avoided.
Prevention of back pain
As a rule, painful sensations in the back and lower back arise due to a careless attitude to one's own health.After all, a sedentary lifestyle, burdened by sedentary work and forced prolonged stay in one position, is typical for many of us.No less harmful are excessive physical exertion without preparation (stretching) and lifting weights with incorrect back position.It's no wonder that the majority of the world's population experiences lower back pain.
Doctors' advice to prevent back pain:
- Watch your posture, keep your back straight.
- Avoid awkward positions in the workplace.You can place a small pillow under your back to support your back.Try it!
- When sitting at a desk for a long time, it is advisable to get up from time to time (every hour), ideally doing a joint warm-up or you can just walk.
- It is recommended to sleep on an orthopedic mattress;it is quite hard and at the same time elastic.
- Start the day with exercises to strengthen the back and core muscles.
How to lift weights correctly?
If you need to pick up and carry something heavy, you should do it by bending your knees, not your back.That is, first you need to sit down, take the load, and then straighten your knees, leaving the back straight.
Lower back pain: what to do?
After reading the most common causes of lower back pain, you know what you need to know and what to do, the question arises - where to turn?Definitely, when choosing a clinic, preference should be given to a medical center where you can be consistently examined by different specialists.That is, it will not be necessary to go to the other end of the city for additional diagnostics, and in one place a complete comprehensive plan for the treatment of back pain in the lumbar region will be prepared.
An equally important role is played by the qualifications of doctors and the availability of appropriate equipment.Ultimately, pain in the lower back due to osteochondrosis and myositis requires different approaches to therapy.