There is practically no person who does not experience back pain in the lumbar region at least once in their life. This is how we pay for walking straight and for our daily habits.
In addition to damage to the spine, its muscles, nerves and ligaments, it should be borne in mind that sometimes the back hurts in the lumbar region due to internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Symptoms of low back pain can range from dull to sharp. The pain may go away on its own or become chronic (symptoms persisting for more than three months).
Dangerous! You should see a doctor immediately if:
- pain in the lumbar region after a sudden obvious back injury;
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, breathing difficulties;
- involuntary emptying of the bowels and bladder occurs;
- there is numbness in the groin area;
- there was weakness, paresis or paralysis of the lower limbs, loss of sensitivity;
- pains appear in the stomach and are sharply aggravated by coughing or sneezing;
- symptoms appeared against the background of sharp weight loss, long-term use of steroids, immunodeficiency;
- family history of cancer, inflammatory or degenerative bone and cartilage tissue diseases.
Why does the back hurt in the lumbar region?
Myofascial pain
A muscle strain or spasm can develop gradually or suddenly. In the case of heavy loads, the damage affects not only the muscle fibers, but also the ligament apparatus and the fascia.
Muscle pain in the lower back occurs after:
- lifting heavy weights or overexertion at work or during sports;
- exercise occasionally. Muscles are especially vulnerable if you are inactive during the work week and spend hours at the gym on weekends;
- a sharp increase in the weight of one's own body, behind which the muscles do not have time to grow;
- prolonged sitting or standing in an uncomfortable position;
- carrying a bag everyday in one hand or on the shoulder;
- posture disorders. The spine performs its best supporting and protective function when you are not slouching. The muscles of the lower back are least strained if you sit with good support under the lower back and distribute the weight evenly on both legs when standing.
If the back hurts after a bruise, fracture, sprain, hypothermia, infectious disease or developed helminthic invasion, then myositis (inflammation) of the muscles of the lower back can be suspected. Due to the inflammation of the muscle fibers, there is constant severe pain, "knots" can be felt in the muscles - in spasmodic places. The inflammation can be acute or chronic. In the case of a long course of the disease, the pain is unstable, which is aggravated by prolonged lying or sitting, in the late afternoon or when thethe weather changes. Touching the muscles causes pain and discomfort, the muscles of the waist are under constant tension, inflammatory edema develops, the temperature rises locally and throughout the body.
In the case of a muscle spasm, the roots of the spinal nerves are damaged, so the attacks often resemble the picture of sciatica or sciatica - there are strong burning pains in the back of the thigh and lower leg, the limbs become numb and lose their sensitivity. Pronounced muscle tone in myositis forces the patient into a forced position, he walks and lies hunched over, moves on bent legs.
How to treat spinal muscle pain? Nonsteroidal anti-inflammatory drugs and pain relievers are used to eliminate inflammation and pain. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches, with a gradual release of the active ingredients. They also use irritating and warming ointments that reflexively increase blood flow in the muscles of the lower back. The larger amount of inflowing blood contributes to the washing out of inflammatory and tissue decomposition products.
The reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictor drugs.
If the cause of myositis is infection or poisoning of the body with toxins from worms, antibiotics or anthelmintic drugs are used initially. In this case, warming ointments or poultices cannot be used.
Spinal diseases involving nerve endings
In the lumbar region, the vertebrae are separated by flexible discs that protect the spine from injury, but are themselves subject to wear and tear and aging.
Normally, the disc is a jelly-like nucleus pulposus surrounded by a denser layer of the annulus fibrosus. The flexibility of the core is due to its ability to bind and retain water: as the load increases, it accumulates water, and the flexibility increases, as the pressure decreases, the core releases water and becomes flatter.
In the vertebral region, osteochondrosis develops when the intervertebral discs are malnourished ("dry out") or in case of excessive local load. Most often, lower back pain is due to the fact that the lower poles of the intervertebral discs bear the greatest load when sitting, when lifting weights in front of them. At the same time, ruptures and dislocations develop in the discs, the vertebral ligaments are damaged, constant aching pain, throbbing.
Spinal pain has several development mechanisms:
- violation of microcirculation in the tissues surrounding the spine and especially in the spinal canal, the development of congestion and edema. Such conditions develop against the background of hypothermia, overheating, and inflammatory processes.
- degenerative processes in the ligaments of the spine. The increased mobility of the vertebrae leads to their slight displacement and non-physiological compression, which causes damage to nerves and blood vessels and the formation of hernias.
- axial compression of the vertebrae during weight lifting or their damage during excessive rotation (rotation).
- aseptic inflammation. The destruction of the nucleus leads to the release of sensitizing factors into the spinal canal. Irritation of the nerve endings occurs, which causes a spasm of the muscles affecting the neighboring vertebrae - above and below the hernia. Gradually, the reaction covers the entire lumbar region and leads to the fact that every movement causes a feeling of pain.
A weakened disc can rupture, resulting in bulging, protrusion or prolapse of the nucleus, and eventually herniation. The appearance of a hernia puts pressure on the spinal cord and spinal nerve roots. Under these conditions, a sharp throbbing pain occurs in the lower back, which diverges along the pinched nerve. The most well-known cases of compression of the sciatic nerve (sciatica), which are manifested by sharp pain in the back of the thigh and leg, numbness of the limb on the side of the hernia, muscle weakness, and involuntary contraction of the chest. legs.
Pain in the lumbar spine increases when sitting and standing, when turning, when tilting. Often there is a protective muscle reaction - a painful contraction of the muscles (formation of rollers) on both sides of the spine, which isolates the ward from unnecessary movement. Osteochondrosis subsequently leads to the appearance of sciatica (inflammation of the roots of the spinal nerves).
Radicular syndrome is dangerous when the nerves of the lower back responsible for the innervation of the internal organs (horns of the cauda equina) are pinched. At the same time, pain occurs in the stomach, the functioning of the bladder and intestines causes disturbance, potency problems in men, and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, take pain-relieving positions - turn the body to the left, if the right side hurts, lie on the right side. If the hernia is on the left side. The appearance of strong pain when pressing on the hernia in the intervertebral space (ringing symptom) is also typical.
How to treat back pain with osteochondrosis:
- during a pain attack, you can take an anesthetic position - lie on your back and put a roller under your knees. It is also recommended to sleep on a hard surface;
- of pain-relieving drugs, NSAIDs can be taken orally or by injection on both sides of the spine in the lumbar hotel;
- use local irritants as distraction therapy - mustard plasters, iodine mesh, wine plaster and ointments;
- elimination of myotic spasm with the help of manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- mud treatment, ozocerite, and warm-up can be used to alleviate the acute period.
Treatment of pain in radicular syndrome includes:
- ensuring bed rest, lumbar traction (dry or underwater);
- the use of novocaine blockades at the site of the violation, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with painkillers.
The indications for the operation are constant acute pain, impaired functioning of the internal organs, paralysis of the limbs, isolation of the hernia in the spinal canal.
Degenerative inflammatory changes
Spondylarthrosis (inflammation of the facet joints of the vertebrae) is associated with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back occurs due to overstretching of the capsule and increased pressure on the surface of the intervertebral joints. As a result of the pain, the patient bends more in the lower back, thus increasing the overload of the intervertebral joints. Discomfort in the lower back is especially aggravated by wearing high heels, long walks, dismounting from an elephant, postures where the body turns backwards, for example, when looking at something overhead.
In patients with this diagnosis, stiffness is observed in the lower back in the morning, the pain increases during the day or after exercise. It has a diffuse nature, the boundaries are difficult to clearly identify: in men, the discomfort occurs in the buttock muscles, the groin region, the lower abdomen and the scrotum. This spondyloarthrosis differs from radicular syndrome when you can pinpoint the source of the pain.
What should be done to relieve the pain? Bending the legs at the hip and knee joints usually helps when lying on your back.
Their medications are non-steroidal anti-inflammatory drugs and non-narcotic pain relievers.
Muscle relaxants are also added as they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect, as chronic pain leads the patient to a state of depression.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. With this disease, the connective tissue structures are calcified with the formation of growths - osteophytes - along the edges of the vertebrae. 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 the mobility of this department is also limited.
Vertebral osteophytes are abnormal growths that damage nerves and blood vessels.
The treatment is usually conservative, using anti-inflammatory drugs, pain relievers, and vitamins. Electrophoresis with novocaine, lidase, manual therapy, physiotherapy (amplipulse, laser installation, shock wave therapy to destroy compacted elements and increase the mobility of the spine) gives a good effect.
Note! In an advanced stage, osteophytes do not dissolve. While their size is small, the goal of the treatment is to eliminate inflammation, pain, and improve metabolism. If the back does not hurt much, then nothing is done with the growths. If the osteophytes cause persistent pain or are large, they can be removed during surgery.
Cancerous diseases
Lumbar pain can result from compression of the spinal cord from the outside (extramedullary formations) and from the inside (intramedullary, arising from the cerebrospinal substance itself) by the tumor.
Cells of various tissues can grow abnormally:
- fatty - a lipoma is formed;
- nerve roots - neuroma;
- spinal cord vessels - hemangioma;
- auxiliary tissue - glioma;
- bone tissue - osteosarcoma;
- cartilage - chondrosarcoma.
The neoplastic process, especially the malignant, pain syndrome reminiscent of sciatica (can be unilateral or bilateral), general deterioration of the patient's condition and exhaustion.
If the pathology affects the area of the I-IV lumbar vertebrae, then there is a burning pain in front and on the side of the upper part of the thigh, incomplete paralysis of this area.
With damage to the IV lumbar - II sacral segments, numbness of the paragenital region, motor and sensory innervation of the gluteal muscles, the back of the thigh, calf, fecal and urinary incontinence is observed.
Expressed dysfunction of the pelvic organs in the case of a tumor located in the region of the V-III sacral vertebrae. The patient suffers from sexual impotence or menstrual disorders, constipation or faecal and urinary incontinence.
Tumor treatment is specific, and pain relievers and anticancer drugs are prescription drugs.
As you can see, lower back pain is usually caused by musculoskeletal pathologies. They can be diagnosed based on clinical symptoms and research data, the main task of which is to correctly determine the nature of the disease, and should not be confused with oncological causes, diseases of internal organs or trauma. If you experience lower back pain, we recommend that you always seek the advice of a neurologist or orthopedist.