There is practically no person who has not experienced back pain in the lumbar region at least once in his life. Thus we pay for walking straight and for our daily habits.
In addition to damage that can affect the spine, its muscles, nerves and ligaments, it should be borne in mind that sometimes pain occurs in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs. .
Symptoms of low back pain can range from dull to severe. The pain may go away on its own or be chronic (symptoms have been present for more than three months).
dangerous! You should consult a doctor immediately if:
- pain in the lumbar region appeared suddenly after a pronounced back injury;
- there is a sharp increase in temperature, vegetative disorders, loss of consciousness, sweating, difficulty breathing;
- There is an involuntary emptying of the intestines and bladder;
- There is numbness in the groin area;
- there was weakness of the lower extremities, their paresis or paralysis, impaired sensitivity;
- The pain is given to the abdomen and increases sharply when coughing or sneezing;
- Symptoms appeared against the background of sharp weight loss, prolonged use of steroids, immunodeficiency;
- There were cases of cancer, inflammatory or degenerative diseases of the bone and cartilage tissue in the family history.
Why does the back hurt in the lumbar region?
myofascial pain
Muscle strains or spasms can develop gradually or occur suddenly. With high loads, damage affects not only muscle fibers, but also ligaments and fascia.
Muscle pain in the lower back appears after:
- lifting heavy weights or at work or playing sports;
- Doing sports from time to time. Muscles are especially weak if you are inactive during the work week and then spend hours at the gym on the weekends;
- a sharp increase in your own body weight, behind which the muscles do not have time to grow;
- prolonged sitting or standing in an uncomfortable position;
- carry the bag in one hand or on the shoulder every day;
- Posture disorders. The spine performs its best supporting and protective function when you are not bent over. When you sit with good support under your lower back, and in a standing position, the weight is equally on both feetWhen distributed, the muscles of the lower back experience the least tension.
If back pain occurs after injury, fracture, sprain, hypothermia, an infectious disease or an established worm invasion, myositis (inflammation) of the muscles of the lower back can be suspected. The cause is persistent pain, "nodules" are felt in the muscles - places of spasm. Inflammation can be acute or take a chronic form. With a long course of the disease, the pain is unstable, with prolonged lying or sitting, the pain increases at the end of the afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the muscles of the lower back are under constant tension, inflammatory edema is formed, the temperature is localized and throughoutrises to the level of the organism.
With muscle spasms, the roots of the spinal nerves are violated, so the attacks often resemble the picture of sciatica or sciatica - there is severe pain in the back of the thigh and lower leg, the limbs go numb, they lose sensitivityThe pronounced muscle tone in myositis leads the patient to a forced position, he walks and lies down, walking on bent legs.
How to treat spinal muscle pain? Non-steroidal anti-inflammatory drugs and analgesics are used to eliminate inflammation and pain. Drugs can be taken in the form of tablets, ointments, injections, transdermal patches with gradual release of active substances. Irritating and warming. Also used ointments, which markedly increase blood flow to the muscles of the lower back. A large amount of blood flow contributes to washing away the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictive drugs.
If the cause of myositis is infection or poisoning of the body with worm toxins, then initially antibiotics or anthelmintic drugs are used. In this case, warming ointments or compresses cannot be used.
diseases of the spine involving nerve endings
In the lumbar region, the vertebrae are separated by elastic cartilaginous discs, which protect the spine from injury, but are themselves subject to wear and aging.
Normally, the disc is a jelly-like nucleus pulposus surrounded by a denser layer of the annulus fibrosus. The elasticity of the core is due to its ability to bind and retain water: when the load increases, it stores water. , and the elasticity increases, when the pressure decreases, the core releases the water and becomes flatter.
Osteochondrosis in the vertebral region develops when the intervertebral discs are malnourished (their "drying") or with excessive local loads. Most often, pain in the lower back occurs due to the fact that the lower pole of its intervertebral discsWhen sitting, lifting weights in front of them bear the most weight. At the same time, disc tears, displacements form, vertebral ligaments are damaged, there is constant pain, palpitations.
There are several mechanisms of development of pain in the spine:
- Violation of microcirculation in the tissues surrounding the spine and, in particular, in the spinal canal, the formation of congestion and edema. Such conditions develop against the background of hypothermia, overheating, inflammatory processes.
- Degenerative processes in fixing the ligaments of the spine. Increased mobility of the vertebrae leads to their slight displacement and non-anatomical compression, which leads to a violation of nerves, blood vessels and the formation of hernias.
- Axial compression of the vertebrae when lifting weights or damaging them during excessive twisting (bend).
- Aseptic inflammation. The destruction of the nucleus leads to the release of sensory factors into the spinal canal. The nerve endings are irritated, which causes muscle spasms that innervate neighboring vertebrae above and below the hernia. -Gradually, the reaction covers the entire lumbar region and leads to the fact that any movement causes a sensation of pain.
A weakened disc may rupture, resulting in bulging, protrusion or prolapse of the nucleus and eventually a herniation. The presence of a hernia puts pressure on the spinal cord and the nerve roots of the spinal cord. In such situations, the backThere is a sharp pain in the lower part of the groin, which is separated along the strangulated nerve. The most famous cases of compression of the sciatic nerve (sciatica), manifested by sharp pain along the thigh and lower leg, on the side of the herniaFrom limb numbness, muscle weakness, involuntary tuck leg.
Pain in the lumbar spine is aggravated by twisting, bending, in sitting and standing positions. Often there is a protective muscle reaction - a painful contraction of the muscles on both sides of the spine (formation of rollers), which allows the departmentDistinguishes 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 in the lower back, which are responsible for innervation of the internal organs (horns of the cauda equina), are pinched. There is also abdominal pain, impaired bladder and bowel function. There is a problem of potency in men and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, take analgesic postures - they turn the body to the left, if the right side hurts, then lie down on the right. If the hernia is on the left. IntervertebralThe presence of severe pain when pressing on the hernia in space (ringing symptom) is also characteristic.
How to treat if your back hurts with osteochondrosis:
- During an attack of pain, you can take an anesthetic posture - lie on your back, and put a roller under your knees. It is also recommended to sleep on a hard surface;
- From analgesic drugs, NSAIDs can be taken orally in the lumbar hotel or as an injection on either side of the spine;
- use local irritants as a distraction therapy - mustard plasters, iodine nets, pepper patches and ointments;
- elimination of myotic spasms through manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- During attenuation of the acute period, sludge treatment, ozocerite, warming up can be used.
Treatments for pain in radicular syndrome include:
- providing bed rest, lumbar traction (dry or under water);
- use of novocaine blockade at the site of infringement, use of NSAIDs or weak opiates;
- Physiotherapy - electrophoresis with microcurrent stimulation, analgesics.
Indications for surgery are persistent acute pain, as well as impaired function of internal organs, the development of paralysis of the limbs, the sequelae of a hernia in the spinal canal.
degenerative inflammatory lesions
Spondylarthrosis (inflammation of the facet joints of the vertebrae) is accompanied by degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back is manifested by excessive stretching of the capsule and increased pressure on the surface of the intervertebral joints. Paincauses the patient to bend more in the lower back, thereby increasing the overload of the intervertebral joints. Discomfort especially in the lower back wearing high heels, long walks, descending from the hands, the back of the bodyThe state of deviating, for example, is aggravated when looking at something above the head.
In patients with this diagnosis, stiffness in the lower back is observed in the morning, pain increases during the day or after exercise. It has a diffuse character and it is difficult to clearly show the boundaries: discomfort gluteal muscles, inguinalThe area is determined in the lower abdomen and scrotum in men. It differs from spondyloarthrosis radicular syndrome when you can pinpoint the source of the pain.
What to do to relieve pain? It helps to take a supine position, usually by bending the legs at the hip and knee joints.
His medications are preferred to non-steroidal anti-inflammatory drugs and non-narcotic analgesics.
Muscle relaxants are also added as they relieve muscle tension and improve mobility of the spine.
Psychotherapy has a positive effect, as chronic pain brings the patient to a state of depression.
Spondylosis, in contrast to osteochondrosis, more commonly affects the fibrous ring and anterior longitudinal ligament of the intervertebral disc. With this disease, calcification of connective tissue formations is accompanied by the development of the edge of the vertebrae - osteophytes. These formations microcirculation near nerve rootsand lead to the fact that the lower back hurts, and the mobility of this department is also limited.
Vertebral osteophytes are pathological growths that damage nerves and blood vessels.
Treatment is usually conservative, with the use of anti-inflammatory drugs, analgesics, vitamins. Novocaine by electrophoresis, lidase, manual therapy, physiotherapy (amplitude, laser installation, shock wave therapy to destroy compact elements and increase mobility of the spine) gives a good impression.
Comment! In the advanced stage, osteophytes do not resolve. While their size is small, treatment is aimed at relieving inflammation, pain, and improving metabolism. If there is no severe back pain, growth does nothing. If osteophytes persistIf they cause pain or are large, they can be removed during surgery.
diseases of a tumor nature
Lower back pain can result from compression of the spinal cord by tumors from the outside (extramedullary formation) and from the inside (intramedullary, originating from the cerebrospinal substance itself).
Cells of different tissues can develop pathologically:
- fatty - a lipoma is formed;
- nerve roots - neuroma;
- spinal vessels - hemangioma;
- supporting tissue - glioma;
- bone tissue - osteosarcoma;
- Cartilage - chondrosarcoma.
The tumor process, especially malignant, is characterized by a pain syndrome resembling sciatica (it can be unilateral and bilateral), general deterioration in the patient's condition and exhaustion.
If the pathology affects the region of the I-IV lumbar vertebrae, there is a burning pain on the sides of the front and upper thigh, incomplete paralysis of this area.
With a lesion in the IV lumbar region - II sacral segment, numbness of the paragenital region, impaired motor and sensory innervation of the gluteal muscles, posterior thigh, calf, fecal and urinary incontinence are noted.
A pronounced disturbance in the functioning of the pelvic organs is accompanied by a neoplasm in the region of the V-III sacral vertebra. The patient suffers from sexual impotence or menstrual disorders, constipation or fecal and urinary incontinence.
Tumor treatment is specific, pain relievers and anticancer drugs are prescription drugs.
As you can see, pain in the lower back is usually caused by musculoskeletal pathology. They can be diagnosed by clinical signs and research data, the main task of which is to accurately determine the nature of the disease and treat itNot to be confused with oncological causes, diseases of internal organs or trauma. If you experience low back pain, we recommend that you always seek the advice of a neurologist or orthopedist.