Back pain in the lower back

Low back pain is one of the most common reasons that force the patient to seek help from a neurologist or therapist. Lumbosacral spine pain can be permanently disabling, making movement and self-care impossible. Acute low back pain affects men and women equally.

More frequently in middle and old age, low back pain can be seen in adolescents and young adults. This is due to rapid growth, weakness in the fragile muscles of the lower back, injuries. Therefore, lumbosacral spine pain is the most pressing problem anyone can face.

Back pain in the lower back

Low back pain with lumbar osteochondrosis

Low back pain with osteochondrosis can increase with coughing and sneezing, with any movement, especially when the body leans forward. Along with back pain, lumbar osteochondrosis can manifest itself as a violation of the sensation of certain areas of the skin or muscles of the lower half of the trunk and legs, weakening or disappearing tendon reflexes in the legs.

  • As a rule, in osteochondrosis, there is a curvature of the lumbar spine. Depending on the plane in which the curvature occurs, a distinction is made between scoliosis (curvature to the right or left), lordosis (curvature forward) and kyphosis (smoothing of the lumbar spine or even its curvature backwards). In the case where, with osteochondrosis, the spinal cord is clamped, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.
  • However, most often, lumbar osteochondrosis is manifested by radicular pain - that is, developing as a result of pinching the nerve roots that extend from the spinal cord at one level or another. Therefore, one of the best known lumbar syndromes is lumbago. It occurs at times of physical stress or in an inappropriate position of the body, and sometimes for no apparent reason. Suddenly, within a few minutes or hours, there is a sharp, sharp pain ("lumbago"), usually burning and popping ("as if a stake had been driven into the lower back").

The patient freezes in an uncomfortable position, unable to straighten if an attack occurs when lifting the weight. Attempts to get out of bed, cough, or bend the leg are accompanied by a marked increase in pain in the lower back and sacrum. If the patient is asked to stand, then a strong immobility of the entire lower back is revealed due to muscle tension.

Lumbosacral osteochondrosis tests

These tests are used as a way to make preliminary diagnoses, they have the names of the doctors who suggested them.

Dejerine's Symptom if you tighten your abs and listen to your lower back, the pain will get stronger. In this case, there is a high probability that the patient will have osteochondrosis. Neri's Symptom if, when the head is bent sharply forward before touching the chest, there is pain in the lower back, this also indicates spinal problems. lase symptom this can be felt after the following actions: lying on your back, you need to lift each leg in turn. If, after that, the lower back is twisted and the pain is transmitted along the sciatic nerve to the leg, this is evidence of spinal pathology. larrey's symptom if pain occurs in a person along the sciatic nerve, after he gets up forward without bending his knees from a lying position, we are talking about manifestations of chondrosis.

Disc herniation

Disc herniation is an equally rare cause, whose clinical manifestation is lumbosacral back pain. The intervertebral disc (internal nucleus pulposus) with prolonged traumatic exposure, as with age, loses its elastic properties and elastic capacity.

With continuous exposure (overweight, trauma, progressive osteoporosis), the fibrous disc ring becomes thinner and defects form. Through these weaknesses in the annulus fibrosus, the nucleus pulposus of the disc can shift and even protrude.

Causes of Back Pain

Back pain is such a non-specific symptom that it can be caused by several reasons. Due to the intensity with which the back aches in the lumbar region, whether constant or periodic, primary or secondary, there may be reasons that cause this:

Chronic pain:

  • Osteomyelitis;
  • Ankylosing spondylitis;
  • Spondylosis deformans;
  • Growth Diseases - Scoliosis;
  • Infectious lesions of intervertebral discs and vertebrae (epidural abscess, spinal tuberculosis, brucellosis);
  • Metabolic bone diseases - osteomalacia, osteoporosis;
  • Primary tumors and metastatic tumors of the spinal cord, vertebrae, retroperitoneal space;
  • Non-infectious inflammatory diseases - rheumatoid arthritis, Reiter's syndrome, ankylosing spondylitis;
  • Kidney tumors;
  • Atherosclerosis of the abdominal part of the aorta and its branches.

Acute pain:

  • Spondyloarthritis;
  • Hip joint pathology;
  • spinal epiduritis;
  • Protrusion of intervertebral discs in the lumbar region;
  • Spinal osteochondritis;
  • Acute intervertebral hernia;
  • Intestinal obstruction, atypical course of acute appendicitis;
  • Urolithiasis disease;
  • Acute sprains, vertebral fractures;
  • Lumbago, sciatica;
  • Acute disorders of the spinal circulation - stroke;
  • Acute pyelonephritis.

Radiating pain in some diseases of Organs internal organs:

  • Diseases of Organs pelvic organs. In women - inflammatory processes in the uterine appendages, endometriosis, uterine cancer, ovarian cancer, STDs (chlamydia, ureaplasmosis, gonorrhea, trichomoniasis, etc. ) In men - prostatitis, prostate cancer;
  • Diseases of the stomach, pancreas, duodenum, gallbladder;
  • Bowel diseases - inflammation of the diverticulum, ulcerative colitis, bowel tumors;
  • Kidney disease - kidney colic, kidney stones;
  • Dissecting aortic aneurysm.
lower back pain in a man

physiological causes

Low back pain may occur if you:

  • They are overweight;
  • Additional risk for women;
  • You are pregnant or have recently given birth;
  • Spend a lot of time driving a car or computer;
  • Lead a predominantly sedentary lifestyle (office workers) or stand-up (salesmen, waiters, street signers, surgeons);
  • Do dynamic physical work with a sudden change in body position (especially if your specialty is associated with intense physical activity);
  • Overloading yourself at the gym or fitness club. Be extremely careful if you have recently started training;
  • They enjoy working in summer cottages;
  • They reached post-menopause, which favors the development of osteoporosis.
  • low back pain and pregnancy

    Pregnancy aggravates the manifestations of illnesses that exist in the mother's body. Due to changes in hormone levels and increased load, pathologies often manifest themselves in the second half of pregnancy. In addition to the pain that accompanies the threat of premature birth, the cause of low back pain in a pregnant woman can be:

    • herniated disc;
    • radiculitis;
    • pancreatitis;
    • pyelonephritis;
    • urolithiasis disease (kidney stones).

    Why does the back hurt below the lower back

    When there is back pain below the lumbar, in addition to obvious spinal diseases (sciatica, low back pain, intervertebral hernias, ankylosing spondylitis, etc. ), the possible causes are periodic pain during menstruation in women, diseases of the female genital organs, such as inflammationof the uterine appendices - oophoritis, salpingo-oophoritis (annexitis), as well as diseases of the pelvic peritoneum, intestines, inflammation of the appendix (blind bowel appendix), in men - diseases of the prostate, bladder.

    Pain above the lower back

    If the back hurts on the right side above the lower back - then the liver pain can radiate, with any pathological changes in the liver - hepatitis, liver failure, use of toxic drugs. The pain in this case is most often located in the right hypochondrium.

    If pain is felt on the right or left, just above the lower back, it is very possible that the cause is acute kidney disease. Many chronic kidney diseases, such as polycystic kidney disease, kidney malignancies, chronic pyelonephritis, are accompanied by minor symptoms because the renal capsule is gradually stretched.

    When should you see a doctor?

  • If the back pain radiates to the lower back, it is located a little higher (in the chest area) Pain is accompanied by sweating, vomiting and nausea, shortness of breath.
  • Pain radiates to the peritoneum, chest, neck, jaw.
  • The patient is dizzy and confused.
  • The tachycardia starts.
  • Spinal trauma, accompanied by loss of control over defecation, urination.
  • Legs weaken, buttocks and genitals go numb.
  • back pain in a woman


    To determine which disease causes low back pain, a comprehensive diagnostic test is needed.

    Laboratory methods:

    • General and biochemical analysis of urine and blood.
    • Tests for tumor markers present in the blood during tumor formation.

    Instrumental research methods:

    • X-ray of the spine.
    • Endoscopy of the intestines, stomach and uterus.
    • Ultrasound examination of the abdominal cavity.
    • Magnetic resonance imaging.

    How to treat low back pain?

    How to properly treat the lower back? The approach to back treatment depends entirely on the symptoms of the disease, the doctor's diagnosis, and the stage of the disease. Typically, an integrated approach that includes multiple treatment methods is used.

    Pain medications. . .The ointment helps relieve inflammation, stretching and has a warming effect if your lower back is cold.

    The following groups of ointments are differentiated:

    • combined medications (used for sprains and injuries, together with anti-inflammatory and analgesic effects, have a healing effect due to their constituent substances);
    • anti-inflammatory analgesics (contain medicinal substances with a refreshing effect that relieves irritation - menthol, lavender and analgesics);
    • chondroprotectors (one of the active components of these drugs is a substance used in pathological processes of the cartilage tissue, which contributes to the active restoration of the cartilage surfaces of the joints);
    • irritant drugs (the effect is based on vasodilation and blood flow to the source of pain).

    With the help of therapeutic exercises, the patient will be able to reduce pain, strengthen the muscles, increase the distance between the vertebrae. They will help release pinched nerve roots, normalize blood flow to the affected area and improve metabolic processes.

    In order for such gymnastics to cure, not cripple, all the recommendations of the attending physician must be followed.

  • Movements are done slowly and smoothly, without sharp turns;
  • The room must be ventilated before training;
  • The patient must wear clothing that does not restrict movement;
  • The exercise is done when the patient inhales and when exhaling needs to return to the original position;
  • The load gradually increases. First the number of approaches is about 10 and then they are increased;
  • During gymnastics, you should monitor your well-being. If an acute pain starts, you will need to interrupt your studies.
  • In addition, massage is excellent for relieving pain in the lumbar spine. The positive therapeutic effects of massage include the following:

    • improve the blood supply to the diseased part of the body;
    • kneading muscles, which makes them and ligaments more flexible and elastic;
    • acute pain relief;
    • get rid of toxins accumulated in the muscles and subcutaneous tissue;
    • pleasant sensations due to stimulation of the skin's nerve endings;
    • Positive emotions.

    It can be entrusted to a clinic specialist or performed at home, in any case, its benefits will be invaluable.

    Which doctor should I see?

    For back pain, the cause of which is not known, the first step is to consult a therapist. This will help determine the disease by a combination of symptoms.

    If the reason is obvious: the pain was preceded by an injury, the pain arose in the context of pregnancy, the menstrual cycle, or a chronic illness, it makes sense to immediately contact a more restricted specialist.

    Self-medication is allowed only in cases where the cause of the pain is precisely known.