Lower back pain is one of the most common reasons for visiting a neurologist among working-age people.According to statistics, 9 out of 10 people have experienced lower back pain at least once during their life, and about 9% of cases result in disability.The first episode is usually recorded before the age of 30.Between the ages of 30 and 60, the risk of morbidity increases.
Unfortunately, young people don't always pay attention to warning signs.Many people believe that back pain is due to overwork, physical activity or sitting at the computer for a long time.In fact, it may be a symptom of a serious illness.Lower back pain can be caused by a variety of pathologies: from spinal problems to kidney failure.Only a timely visit to the doctor will help determine the cause and carry out the correct treatment.
Possible causes of lower back pain: What hurts?
Ankylosing spondylitis
Lumbar pain syndrome arises from the fusion of vertebrae into a large conglomerate.The back loses mobility in the lower part.In ankylosing spondylitis, calcium deposits are also observed in the ligaments that support the spine, which also causes pain when trying to turn over, stand up, or perform any other action.
Distinctive symptoms of pathology:
- Stiffness of body movements in the lumbar region;
- increased pain after prolonged immobility, especially after a night's rest.
Osteochondrosis
The disease manifests itself in a thinning of the intervertebral discs.This reduces the shock-absorbing function of the spine, pinches the nerve roots, and causes the muscles around the affected area to spasm.The person feels acute pain.Without treatment, osteochondrosis progresses and leads to bulging and herniated discs.The protrusion of cartilage tissue compresses the spinal cord.A person not only experiences severe pain in the lower back, but the innervation of the lower extremities is also disrupted.
Distinctive signs of osteochondrosis:
- the pain increases when trying to turn from back to stomach, when getting up from a horizontal or sitting position, or when bending over;
- Patients often report weakness and numbness in one or both legs.
Spondyloarthrosis
The lower back may hurt due to degenerative changes in the cartilage tissue that covers the intervertebral discs.The elastic layers become thinner and osteophytes – hard bone structures – form in their place.The distance between the vertebrae decreases while the spinal canal is compressed.
The nature of pain in spondyloarthrosis:
- accompanied by limited mobility of the spine in the lower back, up to constant stiffness;
- worsens after walking, prolonged sitting, standing and other exertion;
- radiates into the pelvic area and thighs.
Urolithiasis
A pathological attack is manifested by sharp, severe pain in the back on the side of the affected kidney.The severity and nature of the sensation does not change depending on posture.The patient cannot find a position that would make him even a little easier.
An attack of urolithiasis is accompanied by other specific symptoms:
- back pain in the lower back;
- urine volume decreases, its color changes and blood impurities appear;
- Pain occurs when urinating;
- An increase in temperature may occur due to inflammation.
Other causes of lower back pain and spasms
Lumbar pain syndrome is observed in the following diseases:
- pregnancy, including early pregnancy;
- algomenorrhea in women;
- osteomyelitis;
- Appendicitis;
- inflammation of the pancreas;
- intestinal diseases;
- back injury;
- tumor in the lumbar region;
- inflammatory processes in the female genital organs;
- prostatitis in men, etc.
Expert opinion
Lower back pain: what to do?Do not make sudden movements, especially if the pain is caused by a fall or blow.Try to get into the most comfortable position.If the pain is acute and does not subside when changing position, call an ambulance - renal colic is likely, requiring hospitalization.In other cases, ointments and tablets can be used to relieve the symptoms.Contact a specialist as soon as possible.The doctor will help relieve even severe pain and prescribe treatment.
Diagnosis of lower back pain
At the first appointment, the doctor may arrange a block to relieve acute pain.If the patient is feeling better, the doctor will conduct a more thorough examination and take a medical history.It is important to clarify the location, nature and duration of the pain, as well as the factors that cause its exacerbation or, conversely, improve well-being.The doctor will ask about past injuries and illnesses in early childhood.The anamnesis provides information about why the back hurts and which diagnostic procedures provide more comprehensive information.
The doctor may prescribe:
- General analysis of urine and blood.Based on the results, they diagnose inflammatory processes and identify signs of pathology in the kidneys and digestive organs.
- Ultrasound of the kidneys and urinary system.If urolithiasis is suspected, an examination is necessary.Using ultrasound, the doctor determines the location and extent of the spread of the inflammatory process, assesses the size of the stones in order to correctly develop treatment tactics;
- X-ray of the lumbar spine.The images help determine the pathology of the vertebrae and adjacent tissues.X-rays, CT or MRI are also prescribed for clarification - these are more meaningful examination methods;
- Ultrasound of the pelvic organs.If a woman has pain in the lower back, this may indicate endometritis or salpingo-oophoritis.In pregnant women, the tone of the uterus must be examined;
- Ultrasound of the prostate.If a man suffers from back pain, it may be a sign of inflammation or tumor of the prostate.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor can prescribe more targeted measures.In some cases, consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Treating lower back pain
Therapy is strictly individual.The doctor begins treating the patient when he receives the most complete information about his condition or at least has data suggesting a diagnosis.The therapy of renal colic and osteochondrosis is fundamentally different.
Drug treatment
To relieve pain, nonsteroidal anti-inflammatory drugs are usually prescribed in the form of injections, ointments and tablets.The medications help quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dosage and duration of the course for each patient.
If treatment of lower back pain does not bring results within 2-3 days, the doctor selects hormonal drugs.Medication is only needed to relieve an acute illness.Antispasmodics, decongestants and B vitamins are prescribed as excipients.If the patient has pain in the lower back and during urination, antibiotics can be selected.The doctor will tell you why this or that medication is needed and how to take it correctly.
Non-drug treatment
The procedures are carried out in courses after the exacerbation has been relieved.The following is used in complex pain treatment:
- Physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetic field therapy;
- Physiotherapy: a set of daily exercises selected by the doctor, exercises in the pool;
- Massage: therapeutic in the lower back and buttocks as well as for general strengthening;
- Acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to indications.If the patient has pain in the lower back and the temperature does not decrease while taking medication, the focus of inflammation must be removed.In the case of tumors and metastases, radical intervention is required.
In pathologies of the female genital organs, when the lower abdomen hurts, diagnostic curettage and laparoscopic operations are performed.If the urolithiasis cannot be removed with the help of medication, surgical treatment is also indicated for the patient.
You cannot tolerate pain and discomfort in the lower back.The body is giving you a signal that you need to pay attention to this area.