The lumbar area is called the lower back, from the area where the ribs end to the tailbone (the lowest protruding vertebra).Very often, when a person has "back pain", we are talking about the lower back.And if 20 years ago low back pain bothered mainly older people, now even younger patients turn to specialists for back help.
Why does the lower back suffer so often?The fact is that the center of gravity of the human body is located precisely at the level of the lumbar spine and bears almost the entire load when walking.This is one of the disadvantages of walking upright: vertebrates that move on 4 limbs do not suffer from such ailments.
Causes of low back pain: what you need to know
Statistical studies tell us the following about the frequency of factors causing low back pain:
- 91% of calls are problems with the spine and the muscular structure of the back.
- 5% of complaints are related to diseases of the urinary system.
- 4% - pathologies of other organs (reproductive system, gastrointestinal tract).
Types of low back pain
Often, back problems arise unexpectedly, like a bolt from the blue.Such acute pain in the lower back is called “lumbago”, and before you could hear the term “lumbago”.The name itself speaks of the sharp and stinging nature of the sensations.During an attack of lumbago, any movement only intensifies the torment and the patient involuntarily finds himself in a constrained position, frozen in one position.The lumbago lasts several minutes and then subsides.
If the pain is prolonged and painful, then we are talking about lumbodynia.These are low-intensity but constant painful sensations in the lumbar region, which intensify during physical activity or during hypothermia.
And there is a condition where there is no back pain per se, but the person feels stiffness and discomfort.In this case, additional diagnostics by specialists are also required.Depending on how low back pain manifests, approaches to treating it vary.
Low back pain as a symptom of illness?
Back pain itself can indicate very different pathological conditions and often understanding the true cause is not so easy.
For example, there is displaced pain.It denotes a situation in which the right, left or lumbar back hurts, and the person thinks that the cause of his torment is in the spine.However, after investigation, it turns out that one of the internal organs (kidneys, intestines, or organs of the reproductive system) is the culprit.The human body is very complex and confusing.Let's look at some possible root causes of lower back discomfort.
Musculoskeletal disorders causing low back pain.
The connection between spinal diseases and low back pain is direct and unequivocal.It was previously mentioned that spinal pathologies are the most common cause of back pain and account for more than 90% of all visits.
Intervertebral disc bulges and herniations rightfully take first place in terms of prevalence.In such destructive pathologies, the intervertebral disc initially moves slightly outward, prolapses (disc protrusion), and as the disease progresses, the integrity of the disc is disturbed in such a way that the inner part (nucleus pulposus) comes out of the surrounding annulus fibrosus.
Bulges most often occur due to traumatic damage to the disc or osteochondrosis.
Another painful consequence of osteochondrosis is compression and pinching of the sciatic nerve.The pain is sharp and stabbing: lumbago.
As a result of this compression, the nerve can become inflamed.The general name for this condition is radiculitis, and if the inflammation affects the sciatic nerve, it is designated by the more specific term "sciatica."Sciatica pain is concentrated in the lower back and spreads to the buttocks 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 stabbing or dull in nature.With the development of the disease (second and third degrees), neurological symptoms appear: numbness, tingling sensations in the lower extremities.In the morning, the person is bothered by a feeling of stiffness.The functioning of the gastrointestinal tract, kidneys and reproductive system is disturbed.
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 sooner treatment is started, the better the prognosis.
Kidney, urinary tract and lower back pain.
You may have heard it.that lower back pain is due to diseased kidneys.In some cases this is actually true.We recommend consulting a urologist if you are concerned about the following symptoms:
- Pain during frequent urination, change in urine color.
- Deterioration of health, indifference to life.
- Hyperthermia is an elevated temperature.
- Decreased appetite, feeling of nausea.
- Arterial hypertension.
The pain varies.For example, with an exacerbation of chronic pyelonephritis, the pain seems to pull and surround the lower back, and renal colic is acute and short-lived.
It is characteristic that 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 exercise and lower back pain.
Our spine is adapted to physical activity.Therefore, the appearance of back pain after going to the gym should alert you.Normally, 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 playing sports can be old injuries or hidden problems in the intervertebral discs, for example, disc bulges.In this case, eliminating physical exercise will not lead to a cure, but will only hide the course of a destructive disease of the spine.
Additionally, back pain after exercise is characteristic of myofascial syndrome.It is not a threat to life, but 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 cause hypothermia.If the lower back is not protected from harmful environmental factors, an uncomfortable condition such as myositis may occur.This is the name for inflammation of the skeletal muscles.The pain is painful in nature, and upon palpation (palpation), tension of the back muscles occurs.
Characteristics of low back pain in women and the mechanism of its occurrence.
It is no secret that a woman's well-being is closely related to her hormonal levels, which undergo dramatic changes not only throughout her life, but also every month.Therefore, every month, at a certain phase of the menstrual cycle, women may experience persistent pain in the lower back.Unfortunately, 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 deviation in the lower back and changes the center of gravity.Additionally, a pregnant woman's weight naturally increases, which also increases stress on the spine.
If we talk about other causes of pain in the lower back in women, back pain can indicate that menopause is approaching.This is due to a decrease in estrogen levels and changes in other sex hormones.
Therefore, the diagnosis of the causes of low back pain in women should be carried out with special care so as not to miss important symptoms of serious diseases and not to rule out pathological causes of low back pain in women.In fact, among such formidable diseases there can be cysts, stroke or inflammation of the ovary and even tumors of the cervix.Ignoring and misdiagnosing such conditions can lead to infertility and critical complications.
What diseases can cause low back pain?
Symptoms, nature of pain. |
Presumptive diagnosis by MRI |
| Lower back pain when coughing, sneezing, bending. | Protrusion (bulging) of the intervertebral disc of the L1/L2 vertebra (L2/L3, L3/L4, L4/L5) |
| Numbness, tingling not only in the back, but also in the buttocks and lower extremities. | Symmetric dorsal (posterior) protrusion of the discs of the L1/L2 vertebrae (L2/L3, L3/L4, L4/L5) |
| Weakness in the leg muscles, motor reflexes worsen. | Dorsal (posterior) median protrusion of the discs of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pains;the patient cannot even straighten up during an attack. | Circular protuberances of the vertebrae L1/L2, L2/L3, L3/L4, L4/L5 |
| Staying in one position for a long time causes pain. | Diffuse protrusions of the vertebrae L1/L2, L2/L3, L3/L4, L4/L5 |
| Symptoms may be absent for a long time and are discovered by chance. | Median disc protrusion of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pain in the lower back, also called "lumbago." | Herniated discs of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Pain in the leg extending below the knee, “tingling” sensation in the leg. | Dorsal disc herniation of the vertebrae L1/L2, L2/L3, L3/L4, L4/L5 |
| It is often asymptomatic and patients report only mild discomfort. | Schmorl's hernia of the vertebrae L1, L2, L3, L4, L5 |
| The functioning of the intestines, bladder and reproductive system is disturbed. | Paramedian disc herniation of the vertebrae L1/L2, L2/L3, L3/L4, L4/L5 |
| 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 observed. | Retrolisthesis and antelisthesis of the L1 vertebra (L2, L3, L4, L5) |
| The pain is periodic at first and then becomes constant.Increases with physical activity. | Ventral wedge-shaped deformity of the L1 vertebral body (L2, L3, L4, L5) |
| Aching pain in the lower back, left or right, along the spine.Numbness, "tingling" sensation.Muscle tension. | Magnetic resonance imaging, signs of degenerative-dystrophic changes (osteochondrosis) of the lumbar spine |
| RAcute pain due to effort or careless movement.Changes in gait, dysfunction of the genitourinary system. | Osteochondrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
| Pain in the buttocks and legs, discomfort from sitting in a chair for a long time and walking for a long time. | Spondylarthrosis 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 visiting a doctor?
What can you do yourself for lower back pain?
If the cause of the pain is unknown:
- Take your temperature to check for inflammation in the body.
- determine 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 lower back injury):
- take a nonsteroidal anti-inflammatory drug (NSAID): diclofenac, ibuprofen, or other.
- Local application of cold will help reduce swelling and relieve pain.
- Firmly squeeze the lumbar area with a towel or orthopedic belt to fix the injured area in one position.
- Consult a doctor for a complete diagnosis and to determine other treatment tactics.
What not to do for lower back pain
- Under no circumstances should you heat a painful area of your back!Heat will increase blood flow and, if there is inflammation, it will worsen the situation: it will increase pain and cause the spread of the infectious process.For the same reason, it is advisable to avoid visiting baths and saunas.
- You cannot relieve pain for a long time if you have persistent and unexplained back problems.Ignoring the root cause can only aggravate the course of the disease and lead to serious complications.
- You cannot try to straighten the vertebrae yourself or sharply massage your back.Without diagnosis, such actions can cause vertebral displacement and cause additional unnecessary injuries.
Which doctor should I see if I have pain in the lower back?
It happens that a person would be happy to go to a specialist, but does not know which doctor to go to if he has lower back pain.Let's bring some clarity to this topic.
First of all, it is advisable to make an appointment with a general practitioner.He will perform a differential diagnosis and determine which doctor you should continue treatment with.Could be:
- Neurologist: for neurological symptoms and involvement of nerves in the process.
- Urologist – if diseases of the urinary system (kidneys) are suspected.
- Gynecologist – for the treatment of diseases of the female reproductive system.
Depending on the indications, a complete blood count (CBC) and a general urinalysis (UCA), an X-ray examination of the spine (in particular, an MRI), an ultrasound of the pelvic organs, kidneys and other studies may be prescribed.
It is important to remember that self-medication and other home remedies for lower back pain are a waste of time and money.Furthermore, by delaying visiting a specialist, you run the risk of contracting an advanced form of the disease, thus condemning yourself to prolonged, expensive and often less successful treatment (than in the early stages).
How to cure lower back pain: basic treatment methods
Naturally, you may have a question: if self-medication is not effective, 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:
- Take anti-inflammatories (NSAIDs) and analgesics orally and locally.
- Physiotherapy (shock wave therapy, acupuncture).
- Kinesiotherapy.
- Therapeutic massage.
- Therapeutic exercise and gymnastics.
Physiotherapeutic and massage procedures should be carried out after the acute phase of the disease, when the pain syndrome has been relieved.
Surgical treatment is indicated in advanced cases of spinal diseases, when conservative methods do not achieve any significant results.However, with timely diagnosis and correctly prescribed treatment, the need for surgical interventions can be delayed or avoided altogether.
Prevention of low back pain
As a rule, painful sensations in the back and lower back arise due to a careless attitude towards 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 activity without preparation (stretching) and lifting weights with incorrect back position.It is no wonder that the majority of the world's population experiences lower back pain.
Doctors' Tips to Prevent Back Pain:
- Take care of your posture, keep your back straight.
- Avoid awkward postures in the workplace.You can place a small pillow under your lower back to support it.Try it!
- When sitting for a long time at a desk, it is recommended to get up from time to time (every hour), ideally doing a joint warm-up, or simply walk.
- It is advisable to sleep on an orthopedic mattress;It is quite hard and, at the same time, elastic.
- Start your day with exercises to strengthen your back and core muscles.
How to lift weights correctly?
If you need to lift and carry something heavy, you should do so by bending your knees, not your back.That is, you must first sit down, take the load and then straighten your knees, leaving the line of your back straight.
Low back pain: what to do?
Now that you have read about the most common causes of low back pain, know what you need to know and what to do, the question arises: who to turn to?Definitely, when choosing a clinic, preference should be given to a medical center where you can be constantly 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 comprehensive and complete treatment plan for back pain in the lumbar region will be drawn up.
The qualification of doctors and the availability of suitable equipment play an equally important role.After all, lower back pain due to osteochondrosis and myositis require different therapeutic approaches.