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Lower back pain

back pain in the lumbar region

80% of people in the world have experienced lumbar spine pain at least once. Their causes can vary from so-called psychosomatic, when aching pains in the lumbar region are provoked by stress, to a diagnosis of cancer that is much more terrible and difficult to treat.

How to understand when discomfort and back pain speak of a sick spine, and when they signal an unhealthy state in other organs? And how not to miss the right time to consult a doctor for pain in the spine in the lumbar region?

Causes of back pain in the lumbar region

In the lumbar region there are several organs and systems at once - these are the digestive, urinary, reproductive and musculoskeletal systems, as well as a number of glands that affect a person's well-being. Fortunately, most of the pathologies that make themselves felt with aching pain in the lumbar and lower back are treatable and not life-threatening. Only one in 20 cases of low back pain requires surgery or complex therapeutic measures.

Consider in more detail the causes of pain in the spine in the lumbar region. These include:

  • overstrain of the back muscles, especially the lumbosacral region;
  • spasms of muscles and internal organs;
  • the presence of inflammation or abscess;
  • hormonal disorders;
  • heart disease;
  • diseases of the stomach or intestines (gastritis, peptic ulcer and others);
  • posture disorders;
  • neuralgia, incl. psychogenic character;
  • osteochondrosis, spinal stenosis, vertebral hernia and other pathologies of the spine;
  • diseases of the kidneys or internal genital organs;
  • obesity;
  • pregnancy;
  • neoplasmic metastases.

The nature of pain in lumbar osteochondrosis

It is necessary to distinguish between primary pain in the lumbar vertebra (associated with degenerative-dystrophic, inflammatory processes and damage to the spine) and secondary "reflective" pain that occurs due to functional disorders of the musclesand internal organs. Primary aching pains in the lumbar region appear as if on their own and are rarely accompanied by additional symptoms (usually already in the later stages, for example, with advanced protrusions of the intervertebral discs). Secondary pains are almost always accompanied by bloating, changes in urination and defecation (they are rare, frequent, painful, or have other unusual features), nausea, vomiting, abdominal pain, and fever. The type of pain in the lower back can also tell a lot about the problem:

  • paroxysmal ("catch inside") - diseases of the kidneys and pelvic organs;
  • increasing every day - an inflammatory process (for example, in the epithelial coccygeal passage), an abscess, a cyst;
  • sharp stab wound (especially after injury) - rupture of an internal organ (liver, spleen, kidney, bladder, etc. ) or vessel, internal bleeding, stomach or intestinal ulcer, blockagefrom the vessel by a detached thrombus (consult a doctor immediately for so much pain! );
  • periodic shooting - characteristic of compression of the roots of the spine (radicular syndrome), may be accompanied by spasms;
  • continuous dull - indicates disease of the liver, kidneys, spleen, some endocrine glands;
  • pulling, aggravated by movement - injuries to the spine and adjacent tissues.

Localization of lower back pain

  1. Pain in the lumbar region and above the sacrum can occur due to trauma, diseases of the gastrointestinal tract and cardiovascular system, as well as injuries, oncology or simple overstrain. Often, this zone manifests itself after unsuccessful sports activities, especially with poorly delivered strikes, an unworked fall and non-compliance with exercise technique.
  2. Below the waist (above the tailbone), it often hurts from overexertion when lifting loads, standing or walking for a long time, with bruising on ice and other hard surfaces. Sometimes the cause of aching pain in the lumbar region can be infection or hypothermia. The most common pain is due to working or resting in an awkward, unphysiological posture - for example, spending time in front of the computer or driving in a half-bent "banana" position. Pain is less common due to disorders of the functioning of the intestines and the genitourinary system (constipation, cystitis, pyelonephritis, prostatitis, dysmenorrhea). A "weak" localization of pain can also indicate problems with the hip joint, especially in the elderly or athletes.
  3. If it hurts on the left side of the spine, this does not exclude problems - for example, scoliosis and / or osteochondrosis, impaired blood circulation and even a spinal canal infection.
  4. Persistent aching pain, which intensifies with the slightest physical exertion, is especially characteristic of infections and osteochondrosis.
  5. If the pain syndrome periodically subsides and still gives the patient a break, it may be a displacement of the intervertebral disc, a pinched nerve root or sciatica. Also, pain in the lumbar region can provoke diabetes or hypothermia.
  6. If the patient often feels like they are "staying awake" and experiencing pain after several hours of sedentary activities, the pain may indicate an incorrect lifestyle that has not yet transformed intopathology, but requires urgent changes - not just pain relief in lumbar osteochondrosis. , but a complex therapy.

Please note that pain can be given to the lower back in case of serious pathologies of the heart and digestive organs. If it hurts simultaneously under the left shoulder blade and on the side, it is important to urgently exclude a heart attack. If, however, attacks of sharp pain are tormented - "as if cut alive" - an ulcer in the stomach or intestines.

Low back pain - diagnoses

Doctors identify more than 120 causes that can cause acute and chronic back pain. The most common of them are.

  1. Diseases resulting from degenerative-dystrophic and other lesions of the vertebral and hip joints. For example, osteochondrosis, osteoarthritis, spondylosis, vertebral hernia, spinal stenosis, kyphosis, scoliosis, protrusion, facet syndrome, sciatica, lumbago, neurogenic lameness, hormonal spondylopathy.
  2. Autoimmune diseases. Rheumatoid arthritis, Bechterew's disease.
  3. Inflammatory diseases. Spondyloarthropathies, incl. psoriatic and reactive arthritis.
  4. Traumatic defeat. Spondylolisthesis, muscle and ligament injuries, bruises, dislocations, subluxations and vertebral fractures.

Less commonly, spinal neoplasms and metastases, osteomyelitis, angina pectoris, cholecystitis, abdominal aortic aneurysm, myocardial infarction, duodenal ulcer and other diseasescan cause lower back pain.

Pain in the lumbar spine in women

In women, acute and subacute (periodic or lasting up to 12 weeks) back pain may indicate minor hormonal disturbances or natural physiological processes - during menstruation, pregnancy or menopause. But more often than not, it goes like this:

  • lumbar osteochondrosis - women who stay on their heels for a long time, regularly carry loads of more than 5 kg, are forced to stay in a reclined position for a long time when performing professional or household work;
  • Arthritis is an inflammatory disease to which young women are vulnerable. It can be caused by injury to the lower back, genitourinary infection, hypothermia due to insufficiently warm but fashionable clothing, as well as heredity (for example, the presence of rheumatoid arthritis in relatives);
  • osteoarthritis is a mainly age-related disease that often occurs after the age of 40 as a reaction to hormonal changes in the body;
  • inflammation of the appendages (adnexitis);
  • cervical or ovarian cancer;
  • torsion of an ovarian cyst;
  • endometriosis.

Seek immediate medical attention if symptoms of low back pain:

  • appeared after an injury;
  • occur in the patient's medical history with oncological and precancerous conditions (eg, cervical dysplasia);
  • accompanied by an increase in temperature;
  • accompanied by unexplained weight loss;
  • cause difficulty urinating and defecating;
  • accompany scouting;
  • associated with a feeling of numbness or stiffness in the legs, a change in gait.

Pain in the lumbar spine in men

Men suffer from lower back pain less frequently than women. Most often, as in women, their cause lies in osteochondrosis or kidney disease. Some of the gender-specific diseases that cause pain in the spine in the lumbar region include:

  • epididymitis (inflammation of the seminal appendix);
  • prostatitis;
  • orchitis (swelling of the testicles);
  • testicles and other oncological diseases of the genital organs;
  • Prostate cancer.

Often, lower back pain in the strong half occurs due to vertebral or inguinal hernia. These diseases are especially prone to men over 40 who are actively engaged in physical labor or work in an uncomfortable position. In women, this pathology is less common.

Back pain treatment

The treatment of back (lumbar) pain requires a therapeutic effect on the vertebrae and intervertebral discs, nerve fibers and muscles. In addition to relieving pain in the lumbar spine, it is necessary to slow down degenerative processes in the spine, if any, to relieve inflammation, to restore blood microcirculation and nerve impulse conduction. Treatment is prescribed exclusively by a doctor or immediately by a group of specialists - neurologist, traumatologist, gynecologist, orthopedist, rheumatologist and other doctors, depending on the main and concomitant diagnoses.

In more than 98% of cases associated with diseases of the spine, treatment is carried out conservatively - surgery can be removed even in case of hernia.

Medical approach

With the help of drugs, the pain can be completely eliminated within a few months (for example, pain in the spine in the lumbar region is treated for 3-4 months with compression of the roots, hernias). Then, depending on the diagnosis, therapy is supplemented or carried out periodically, ongoing - to maintain remission.

In the treatment of back pain (lumbar) help:

  1. Nonsteroidal anti-inflammatory drugs in the form of tablets, ointments, injections.
  2. Hormonal preparations (in the form of blockages and droppers).
  3. Analgesics to relieve pain.
  4. Chondroprotectors.
  5. Warming preparations, for example, ointments based on bee and snake venom, mustard plasters.
  6. Venotonics and angioprotectors.
  7. Anticonvulsants, anxiolytics and antidepressants.

Physiotherapy for back pain

Used to treat lower back pain:

  • massage (classic, cupping, hydromassage);
  • phonophoresis;
  • electrophoresis;
  • magnetic therapy;
  • laser therapy;
  • diadynamic therapy;
  • electrical neuromyostimulation;
  • manual therapy;
  • acupuncture;
  • balneological procedures and mud therapy;
  • physiotherapy.

Exercise therapy for lower back pain

A set of exercises for pain in the lumbar region is performed daily and only after achieving remission! With an exacerbation of the disease, any load can only aggravate the situation. Before doing the exercises, you should consult with an exercise therapy instructor.

  1. Get on your knees and bring your right leg forward (foot on the ground, knee bent at a right angle). Maintaining balance, pull your left foot towards your buttock with your left hand and feel the tension in the muscles. 10 times on each side.
  2. Get on all fours, look straight ahead. Bend and arch your back - do the "cat" exercise.
  3. Lie on your back and, keeping your legs under your knees, pull your knees towards your chest and lock this position for a few seconds. 10 times.
  4. The starting position is the same. Cross the legs (over the weight) and stretch the muscles well, supporting the lower leg below the knee with both hands.
  5. Standing on all fours, raise your left arm and right leg perpendicular to the floor. Repeat for the other side. 10 times.

A set of exercises for pain in the lumbar region with a massage roller is also recommended. For example: place the roller under the sacrum and pull the knee towards the chest while the other leg is on the ground. Repeat 10 times for each leg. If the tension isn't enough, place your hand behind your head and/or move your bent knee slightly to the side.

How to take care of your back - recommendations of doctors

We recommend 10 simple tips to protect your lower back.

  1. To keep your back healthy, it's important to avoid severe physical (as well as mental and emotional) overstrain and hypothermia. If you are forced to work for a long time in the cold or in rooms with sharp temperature changes, get high-quality thermal underwear.
  2. Perform prompt treatment for pain in the spine in the lumbar region.
  3. If you have already been diagnosed with the initial stage of osteochondrosis, have congenital or acquired malformations of the musculoskeletal system, use orthoses - special bandages and corsets that help relieve your back. If you carry a heavy backpack, get one designed to protect your back from low back pain symptoms.
  4. Also, do not forget to take chondroprotectors for therapeutic and prophylactic purposes for at least 3-6 months a year.
  5. Balance your diet so that your body gets enough vitamins and minerals, as well as protein.
  6. Properly equip a place to sleep. The mattress should be neither too soft nor too hard, the length of the bed should be slightly longer than your height. The height of the pillow is also important for relieving pain from lumbar osteochondrosis - it is better to buy an orthopedic one. If pets are forcing you into an awkward sleeping position, don't let them on the bed.
  7. During seated work, make sure your elbows are on top of the table, at a comfortable height, and the seat of the chair allows you to keep your shins perpendicular to the floor.
  8. If you have ever been diagnosed with a disease of the spine, take care of a rational job, which will reduce work stress on the lower back.
  9. Try not to abuse alcohol, coffee and cigarettes.
  10. Maintain a normal level of physical activity (at least in the form of 15 minute exercises for lower back pain 3-4 times a day).

Health to your back!