There is practically no person who has not had back pain in the lumbar region at least once in his life. This is how we pay for walking upright and for our everyday habits.
In addition to damage that can affect the spine, its muscles, nerves and ligaments, it should be borne in mind that the back sometimes hurts in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Back pain symptoms can range from dull to sharp. The pain may go away on its own or become chronic (the symptom has been present for more than three months).
Dangerous! You should see a doctor right away if:
- 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;
- there is involuntary emptying of the intestines and bladder;
- there is numbness in the groin area;
- there was weakness of the lower extremities, their paresis or paralysis, impaired sensitivity;
- pain enters the stomach and sharply increases when coughing or sneezing;
- Symptoms appeared against the background of sharp weight loss, prolonged use of steroids, immunodeficiency;
- in the family history there were cases of cancer, inflammatory or degenerative diseases of bone and cartilage tissue.
Why does the back hurt in the lumbar region?
Myofascial pain
A muscle strain or spasm can develop gradually or come on suddenly. High loads not only damage muscle fibers, but also ligaments and fascia.
Lower back muscle pain occurs after:
- lifting heavy weights or straining at work or playing sports;
- do sports from time to time. Muscles are especially vulnerable when you're inactive during the work week and then spend hours in the gym at the weekend;
- a sharp increase in your own body weight, behind which the muscles do not have time to grow;
- prolonged sitting or standing in an uncomfortable position;
- daily carrying of a bag in one hand or over the shoulder;
- postural disordersThe spine is at its best for support and protection when you are not bending. The muscles of the lower back are least strained when you sit with good support under your lower back and when standing, 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, myositis (inflammation) of the muscles of the lower back can be suspected. Due to inflammation of muscle fibers, there is constant severe pain, "nodules" are felt in the muscles - spasms. Inflammation can be acute or take a chronic form. With a long course of the disease, the pain is unstable, aggravated by prolonged lying or sitting, onlate afternoon or when the weather changes Touching the muscles causes a feeling of pain and discomfort, the muscles of the lower back are in constant tension, inflammatory edema is formed, the temperature rises locally and at the level of the whole body.
With muscle spasms, the roots of the spinal nerves are injured, so seizures often resemble a picture of sciatica or sciatica - there are burning severe pains in the back of the thigh and lower leg, the limbs become numb, they lose sensitivity. The pronounced muscle tone in myositis makes the patient adopt a forced posture, he walks and lies bent, moves on bent legs.
How to treat spinal muscle painNonsteroidal anti-inflammatory drugs and analgesics are used to eliminate inflammation and pain. Drugs can be taken in the form of tablets, ointments, injections, transdermal patches with a gradual release of active substances. Irritating and warming ointments are also used, which reflexively increase blood flow to the muscles of the lower back. A larger volume of inflowing blood helps wash out the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictive drugs.
If the cause of myositis is infection or poisoning of the body with worm poisons, antibiotics or anthelmintics are used first. In this case, warming 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 aging.
Normally, the disc is a gelatinous nucleus pulposus surrounded by a denser layer of annulus fibrosus. The elasticity of the core is due to its ability to bind and retain water: as the load increases it collects water and elasticity increases, as the pressure decreases the core sheds water and flattens out.
Osteochondrosis in the vertebral area develops with undersupply of the intervertebral discs (their "drying out") or with excessive local loads. 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 sitting and lifting weights in front of them. At the same timecracks are formed, displacements in the intervertebral discs, the vertebral ligaments are damaged, there is a constant aching pain, pulsation.
Pain in the spine has several mechanisms of development:
- Violation of microcirculation in the tissues surrounding the spine, and especially in the spinal canal, the formation of congestion and edema. Such states develop against the background of hypothermia, overheating and inflammatory processes.
- degenerative processes in the fixation ligaments of the spine. An increase in the mobility of the vertebrae leads to their slight displacement and unphysiological compression, which leads to damage to nerves, blood vessels and the formation of hernias.
- axial compression of the vertebrae when lifting weights or their damage with excessive twisting (rotation).
- aseptic inflammation. The destruction of the cell nucleus leads to the release of sensitizing factors into the spinal canal. There is irritation of the nerve endings, which causes a muscle spasm that injures the adjacent vertebrae - above and below the hernia. Gradually, the reaction takes hold of the entire lumbar region, causing every movement to cause a sensation of pain.
A weakened disc can rupture, leading to a bulging, bulging, or herniating of the nucleus and eventually a herniated disc. The occurrence of a hernia puts pressure on the spinal cord and the roots of the spinal nerves. In such conditions, a throbbing pain in the lower back appears sharply, diverging along the pinched nerve. The most famous cases of compression of the sciatic nerve (sciatica), which are manifested by severe pain along the back of the thigh and lower leg, numbness of the limb from the side of the hernia, muscle weakness, involuntary retraction of the legs.
Pain in the lumbar spine is aggravated when sitting and standing, twisting and tilting. Often there is a protective muscular reaction - a painful contraction of the muscles (rolling) on either side of the spine, isolating the department from unnecessary movements. Osteochondrosis subsequently leads to the appearance of sciatica (inflammation of the roots of the spinal nerves).
The radicular syndrome becomes dangerous when the nerves in the lower back, which are responsible for the innervation of the internal organs (cauda equina horns), are pinched. At the same time, pain in the stomach appears, the functioning of the bladder and intestines is disturbed, problems with potency appear in men and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, take analgesic postures - they distract the body to the left, if the right side hurts, they lie on the right side. If the hernia is on the left. Also characteristic is the occurrence of severe pain when pressing on a fracture in the intervertebral space (ringing symptom).
How to treat if your back hurts with osteochondrosis:
- During an attack of pain, you can take an anesthetic pose - lie on your back and put a roller under your knees. It is also recommended to sleep on a hard surface;
- of analgesics, NSAIDs can be taken orally or as injections on both sides of the spine in the lumbar spine hotel;
- use local irritants as distraction therapy - mustard plasters, iodine grids, pepper plasters and ointments;
- eliminate myotic spasms using manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- during the attenuation of the acute phase, mud treatment, ozokerite and warming up can be used.
Treatment for pain in radicular syndrome includes:
- Provision of bed rest, lumbar traction (dry or submerged);
- the use of novocaine blockades at the site of the violation, the use of NSAIDs or weak opiates;
- Physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for the operation are constant acute pain, as well as dysfunction of internal organs, development of paralysis of the limbs, sequestration of a hernia in the spinal canal.
Degenerative inflammatory lesions
Spondylarthrosis (inflammation of the facet joints of the vertebrae) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Lower back pain is caused by overstretching of the capsule and increasing pressure on the surface of the intervertebral joints. Pain causes the patient to bend more in the lower back, increasing the overload on the intervertebral joints. Lower back discomfort in particular is caused by wearing heeled shoes, long walks, dismounting from elephants, positions in which the body deviates backwards, e. g. B. looking at something above the head, aggravated.
In patients with this diagnosis, stiffness in the lower back is noted in the morning, pain increases during the day or after exercise. It has a diffuse character and it is difficult to clearly show the boundaries: discomfort is noted in the gluteal muscles, in the groin, in the lower abdomen, and in the man - in the scrotum. This spondyloarthrosis differs from radicular syndrome if you can localize the source of pain.
What to do to relieve painIt usually helps to lie on your back and bend your legs at the hip and knee joints.
Their drugs 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 depressive state.
In contrast to osteochondrosis, spondylosis affects the fibrous ring of the intervertebral disc and the front longitudinal ligaments more severely. With this disease there is a calcification of connective tissue structures with the formation of growths on 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 mobility of this department is also reduced.
Vertebral osteophytes are abnormal growths that damage nerves and blood vessels.
Treatment is usually conservative with anti-inflammatory drugs, analgesics, and vitamins. A good effect is achieved by electrophoresis with novocaine, lidase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compacted elements and increase spinal mobility).
Note! In the advanced stage, osteophytes do not dissolve. Although small, treatment aims to eliminate inflammation and pain and improve metabolism. If the back does not hurt very much, nothing is done with the growths. If osteophytes cause persistent pain or are large, they can be removed during surgery.
Diseases with tumor character
Low back pain can arise as a result of compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, starting from the cerebrospinal substance itself).
Cells of different tissues can grow pathologically:
- greasy - a lipoma is formed;
- nerve roots - neuroma;
- Spinal vessels - hemangioma;
- auxiliary tissues - 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), a general deterioration in the patient's condition and exhaustion.
If the pathology affects the area of \u200b\u200bthe I-IV lumbar vertebrae, then there is a burning pain in front and on the sides of the thigh, incomplete paralysis of this area.
With a lesion in the area of \u200b\u200bthe 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 are noted.
A pronounced dysfunction of the pelvic organs occurs with a neoplasm in the region of the V-III sacral vertebrae. The patient suffers from sexual impotence or menstrual disorders, constipation or fecal and urinary incontinence.
The treatment of tumors is specific, painkillers and cancer drugs are prescription drugs.
As you can see, back pain is usually caused by musculoskeletal disorders. They can be diagnosed using 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 suffer from back pain, we recommend that you always seek the advice of a neurologist or orthopedist.