Low back pain is one of the most common reasons for visiting the neurologist among people of working age.According to statistics, 9 out of 10 people have experienced lower back discomfort at least once in their lives, and approximately 9% of cases end in disability.The first episode occurs most frequently before the age of 30.From 30 to 60 years of age the risk of morbidity increases.
Unfortunately, young people don't always pay attention to 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.Low back pain can be caused by a variety of pathologies: from spinal problems to kidney failure.Only a timely visit to a doctor will help determine the cause and carry out the correct treatment.
Possible causes of low back pain: what hurts?
Ankylosing spondylitis
Low back 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 support the spine, which also causes pain when trying to turn, get 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 a thinning of the intervertebral discs.As a result, the shock absorption function of the spine is reduced, nerve roots are pinched, and the muscles around the affected area go into spasm.The person feels sharp pain.Without treatment, osteochondrosis progresses and causes disc protrusions and herniations.The protrusion of cartilaginous tissue compresses the spinal cord.A person not only has severe lower back pain, but also the innervation of the lower extremities is disturbed.
Distinctive signs of osteochondrosis:
- the pain intensifies when trying to roll over from the back to the stomach, when getting up from a horizontal or sitting position, or when bending;
- 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 formations) appear in their place.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 lumbar area, up to constant stiffness;
- worse after walking, sitting or standing for a long time, and other types of stress;
- It radiates to the pelvic area and thighs.
Urolithiasis
An attack of pathology is manifested by intense, sharp 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 is a little easier.
An attack of urolithiasis is accompanied by additional specific symptoms:
- back pain in the lumbar area;
- the volume of urine decreases, its color changes, and impurities appear in the blood;
- pain occurs when urinating;
- There may be an increase in temperature due to inflammation.
Other causes of pain and cramps in the lower back.
Low back pain syndrome is observed in the following conditions:
- pregnancy, including early gestation;
- algomenorrhea in women;
- osteomyelitis;
- appendicitis;
- inflammation of the pancreas;
- intestinal pathologies;
- back injury;
- tumor in the lumbar region;
- inflammatory processes in the female genital organs;
- prostatitis in men, etc.
Expert opinion
Low back pain: what to do?Do not make sudden movements, especially if the pain occurs as a result of a fall or blow.Try to adopt the most comfortable position.If the pain is sharp and does not go away when changing positions, call an ambulance;renal colic requiring hospitalization is likely.In other cases, ointments and pills can be used to relieve the condition.Contact a specialist as soon as possible.The doctor will help relieve even severe pain and prescribe treatment.
Diagnosis of low back pain.
At the first appointment, the doctor may perform a block to relieve acute pain.When the patient feels better, the doctor performs a more thorough examination and collects a history.It is important to clarify the location, nature, duration of pain, factors that provoke exacerbation or, conversely, improve well-being.The doctor will ask about past injuries and illnesses, starting in early childhood.The history helps suggest why your back hurts and what diagnostic procedures will provide more complete information.
The doctor may prescribe:
- General urine and blood tests.According to the results, they diagnose inflammatory processes, determine signs of pathology of the kidneys and digestive organs;
- Ultrasound of the kidneys and urinary system.An examination is necessary if urolithiasis is suspected.Using ultrasound, the doctor determines the localization and degree of spread of the inflammatory process, evaluates the size of the stones in order to correctly design treatment tactics;
- X-ray of the lumbar spine.The images help determine the pathology of the vertebrae and adjacent tissues.For clarification, an x-ray, CT scan or MRI are additionally prescribed;these are more informative examination methods;
- Ultrasound of the pelvic organs.When a woman has lower back pain, this may indicate endometritis or salpingo-oophoritis.Pregnant women should be examined to determine the tone of the uterus;
- Ultrasound of the prostate gland.If a man has lower back pain, 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 may prescribe more specific procedures.In some cases, consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Low back pain treatment
The 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 suggesting a diagnosis.Therapy for renal colic and osteochondrosis is fundamentally different.
Pharmacological treatment
To reduce pain, non-steroidal anti-inflammatory drugs are most often prescribed in the form of injections, ointments and tablets.Medications help quickly relieve inflammation and muscle spasms.Non-steroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dosage and duration of treatment for each patient.
If treatment for low back pain does not give results within 2 or 3 days, the doctor selects hormonal medications.Medications are only necessary to relieve an acute condition.Antispasmodics, decongestants and vitamin B are prescribed as auxiliary agents. If the patient has lower back pain and pain during urination, antibiotics can be selected.The doctor will tell you why this or that medication is necessary and how to take it correctly.
Non-pharmacological treatment
The procedures are carried out in courses after the exacerbation subsides.In the complex treatment of pain the following is used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetotherapy;
- physiotherapy - a series of daily exercises selected by a doctor, exercises in the pool;
- massage: therapeutic in the lumbar area and buttocks and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to indications.If the patient has lower back pain and has a temperature that does not decrease while taking medications, removal of the inflammatory focus will be necessary.Radical intervention is necessary for tumors and metastases.
In case of pathology of the female genital organs, when the lower abdomen hurts, diagnostic curettage and laparoscopic operations are performed.If urolithiasis cannot be eliminated with the help of medications, the patient is also indicated for surgical treatment.
Pain and discomfort in the lower back cannot be tolerated.The body gives you a signal that you should pay attention to this area.