Lower back pain is one of the most common reasons for a visit to a neurologist among people of working age.According to statistics, 9 out of 10 people at least once in their life had discomfort in the lower back, and about 9% of cases lead to disability.The first episode is most often recorded before the age of 30.From 30 to 60 years, the risk of morbidity increases.
Unfortunately, young people don't always pay attention to the warning signs.Many people believe that lower back pain is caused by overwork, physical activity or sitting for a long time in front of the computer.But in fact, it can be a symptom of a serious illness.Pain in the lower back can be caused by various pathologies: from spine 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 occurs due to the fusion of the vertebrae into a large conglomerate.The back loses mobility in the lower part.In ankylosing spondylitis, calcium deposits are also seen in the ligaments that hold the spine together, which also causes pain when trying to turn over, stand up, or perform any other action.
Distinctive symptoms of the pathology:
- stiffness of body movements in the lumbar region;
- increased pain after prolonged immobility, especially after a night's sleep.
Osteochondrosis
The disease manifests itself as thinning of the intervertebral discs.As a result, the cushioning function of the spine is reduced, the nerve roots are compressed and the muscles around the affected area spasm.A person experiences severe pain.Without treatment, osteochondrosis progresses, leading to protrusions and disc herniations.The protrusion of the cartilage tissue compresses the spinal cord.A person not only has severe pain in the lower back, but also the innervation of the lower limbs is disturbed.
Distinctive signs of osteochondrosis:
- the pain intensifies when trying to roll over from the back to the stomach, when standing up from a horizontal or sitting position, when bending over;
- Patients often report weakness and numbness in one or both legs.
Spondyloarthrosis
The lower back can hurt due to degenerative changes in the cartilage tissue that covers the intervertebral discs.The elastic layers thin out and osteophytes appear in their place - hard bone formations.The distance between the vertebrae decreases with simultaneous compression of the spinal canal.
The nature of pain in spondyloarthrosis:
- accompanied by limited mobility of the spine in the lower back, to constant stiffness;
- worsens after walking, prolonged sitting, standing and other stress;
- radiates to the pelvic region and thighs.
Urolithiasis
An attack of pathology 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 the position of the body.The patient cannot find a position in which it would be even slightly easier.
An attack of urolithiasis is accompanied by additional specific symptoms:
- back pain in the lower back;
- the volume of urine decreases, its color changes and blood impurities appear;
- pain occurs when urinating;
- There may be an increase in temperature due to inflammation.
Other causes of lower back pain and spasms
Lumbar pain syndrome is observed in the following conditions:
- pregnancy, including early pregnancy;
- algomenorrhea in women;
- osteomyelitis;
- appendicitis;
- inflammation of the pancreas;
- intestinal pathologies;
- back injury;
- a 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 appears as a result of a fall or impact.Try to take the most comfortable position.If the pain is sharp and does not subside with a change of position, call an ambulance - it is probably renal colic that requires hospitalization.In other cases, you can use ointments and tablets to relieve the condition.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 perform a block to relieve acute pain.When the patient feels better, the doctor conducts a more thorough examination and collects anamnesis.It is important to clarify the location, nature, duration of pain, factors that cause exacerbation or, conversely, improve well-being.The doctor will ask about past injuries and illnesses starting in early childhood.Anamnesis helps to guess why the back hurts and what diagnostic procedures will provide more complete information.
The doctor may prescribe:
- General analysis of urine and blood.Based on the results, they diagnose inflammatory processes, determine signs of pathology of the kidneys and digestive organs;
- Ultrasound of the kidneys and excretory system.If urolithiasis is suspected, an examination is necessary.With the help of ultrasound, the doctor determines the localization and degree of spread of the inflammatory process, evaluates the size of the stones in order to correctly build the treatment tactics;
- X-ray of the lumbar vertebrae.The images help to determine the pathology of the vertebrae and adjacent tissues.To clarify the X-ray image, CT or MRI are additionally prescribed - these are more informative research methods;
- Ultrasound of the pelvic organs.When a woman has pain in the lower back, it can mean endometritis or salpingo-oophoritis.Pregnant women should be examined to determine uterine tone;
- Ultrasound of the prostate gland.If a person has pain in the lower back, this may be a sign of inflammation or a prostate tumor.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor can prescribe more targeted procedures.In some cases, a consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Treatment of lower back pain
Therapy is strictly individual.The doctor begins to treat the patient when he receives the most complete information about his condition, or at least has data to suggest a diagnosis.Therapy for renal colic and osteochondrosis is fundamentally different.
Drug treatment
To reduce pain, non-steroidal anti-inflammatory drugs are most often prescribed in the form of injections, ointments and tablets.Medicines help to 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 the treatment of pain in the lower back does not bring results within 2-3 days, the doctor chooses hormonal drugs.Medicines are only needed to relieve an acute condition.Antispasmodics, decongestants, and B vitamins are prescribed as auxiliary agents. If the patient has lower back pain and pain during urination, antibiotics may be selected.The doctor will tell you why this or that medicine is needed and how to take it correctly.
Non-drug treatment
Procedures are carried out in courses after easing the exacerbation.In the complex treatment of pain, the following is used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetotherapy;
- physiotherapy: a set of daily exercises selected by a doctor, exercises in the pool;
- massage: healing in the lower back and buttocks and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is performed strictly according to the indications.If the patient has pain in the lower back and the temperature does not decrease during medication, it will be necessary to remove the inflammatory focus.Tumors and metastases require radical intervention.
In the case of pathology of the female genital organs, when the lower abdomen hurts, diagnostic curettage and laparoscopic operations are performed.If urolithiasis cannot be removed with the help of drugs, the patient is also indicated for surgical treatment.
You cannot tolerate pain and discomfort in the lower back.Your body is giving you a signal that you need to pay attention to this area.