There are many diseases that manifest themselves as painful sensations in the lower back. They may indicate problems with the spine, joints, muscles, internal organs - kidneys, intestines, liver. This is a rather insidious symptom and without a visit to the doctor it is impossible to determine the true cause of pain in the lower back. Correct treatment is possible only after diagnosis in a medical institution.
Types of pain
During the initial examination, the doctor should ask the patient about the nature of the pain. In duration they can be:
- sharp- occur suddenly, paroxysmally, differ in intensity, last less than 1 month;
- subacute- last 2 to 3 months, most often they are recurrent: they become active for 2 to 5 days, then decrease and return after some time;
- chronicle- last more than 1 year, the course is most often recurrent.
Doctors have found that most often chronic pain in this area is associated with the formation of local muscle spasms, compressions that have certain pain points (the so-called myofascial syndrome). The process also involves the muscles that straighten the spine, the buttock muscles, the pelvic ligaments, and the sacroiliac joint.
The nature of the pain is sharp, aching and dull. By intensity - strong, medium, weak. Depending on the location of the pain, the following types are distinguished:
- lumbodynia- pain in the lumbar or lumbosacral region;
- sciatica- in the lumbar region, radiating to the leg;
- sacralgia- in the sacrum region;
- coccydynia- in the coccyx.
5 facts about low back pain
- About 25% of all clinic visits with complaints of back pain are related to sensations in the lower back.
- According to research, 84% of people have felt pain in the lower back at least once in their lives.
- 44–78% of patients (depending on age and region of residence) experience repeated attacks of lumbodynia.
- Up to 37% of people periodically lose the ability to work due to low back pain.
- In 85% of patients who consult a doctor about pain in the lower back, musculoskeletal disorders are identified, which become the cause of the pain.
- According to statistics, about 90% of patients with acute pain in the lumbosacral region recover within 2 weeks.
Causes of low back pain
Musculoskeletal disorders
In 2006, the European Federation of Neurological Societies officially adopted the following classification of causes of low back pain. They are divided into 3 main groups:
- Compression of the spinal root, peripheral nerve of the lumbar spine. It occurs due to protrusion (degenerative changes) of the intervertebral discs. Less commonly due to dysplasia (disorders in the formation process) of the upper articular processes of the sacrum.
- Spinal diseases caused by tumors, joint injuries, infections, compression fractures, allergic reactions, autoimmune inflammatory processes.
- Musculoskeletal disorders as a result of subluxation, sprain of spinal ligaments, muscle strain, dysfunction of intervertebral joints.
Pathologies of internal organs
- Disorders of the genitourinary system.
Diseases of the urinary system - urolithiasis, cystitis, pyelonephritis - often cause discomfort in the lower back.
Lower back pain in women may indicate dysfunction of the genital organs. Most of the time, the main sensations are concentrated in the lower part of the abdomen and radiate to the sacrolumbar spine. They can appear during menstruation or after sexual intercourse.
One of the possible causes of low back pain in women is ovarian tumors, located in the back of the uterus. Often, discomfort in the lower back becomes a symptom of uterine fibroids. As it grows, the pain can manifest itself in a strong and sharp form and indicate serious disturbances in the blood supply, stretching of the peritoneum and compression of the nerve plexuses in the pelvic region.
Another cause of low back pain in women is pelvic organ prolapse. In this case, the sensations are of a pulling nature. During walking and physical work, its intensity increases.
- Gastrointestinal tract disorders.
Most often, pain is felt in the lower back due to gastric and duodenal ulcers and acute pancreatitis. Patients complain that there are pains of a circular nature. Normally the lower back begins to hurt simultaneously with the right/left hypochondrium, where the most intense sensations are concentrated. In several clinical cases, low back pain accompanies an attack of acute appendicitis, although they are not the main symptoms of this disease. Various inflammations of the intestinal mucosa (proctitis, sigmoiditis) can also cause pain.
10 risk factors for low back pain
- Congenital pathologies of the lumbosacral spine.
- Heavy physical work associated with stress on the lower back, frequent bending and vibrations.
- Acute and chronic stress that causes muscle spasms.
- Sedentary lifestyle and prolonged stay in an unnatural position with load on the lower back.
- A weak muscular corset, which results in incorrect posture, curvature, scoliosis and kyphoscoliosis.
- Metabolic disorders and excess body weight, which increases the load on the lower spine.
- Increased physical activity and sports participation increases the risk of injury.
- Age over 50 years - due to the development of degenerative processes in the spine.
- Frequent stress, depression.
- Poor nutrition with a lack of B vitamins.
Low back pain as a symptom of various diseases
Osteochondrosis of the lumbar spine
One of the most common diseases, the symptom of which is pain in the lower back. With osteochondrosis, the intervertebral discs, which play a shock-absorbing role between the vertebrae, become thinner. The nerve roots are compressed, muscle spasms occur, and severe sharp pain occurs. Its intensity increases when bending over, lifting heavy objects or when the patient tries to sit up while lying down or get up from a sitting position.
In advanced cases, a hernia forms between the vertebrae, which only increases the pain. Osteochondrosis most often affects the lumbar spine, as it bears the maximum load when sitting and walking.
A serious complication of osteochondrosis is spondylosis. It is characterized by almost complete destruction of intervertebral discs and the formation of sharp bony protrusions - osteophytes. They injure nearby tissues, causing sharp, intense pain that radiates down one or both legs.
Signs of intervertebral hernia
- The patient can rise from a sitting position only with the support of a chair/table or knee.
- Any load on the lower back causes an attack of sharp pain.
- The patient lies face down, placing only a pillow under him.
- A person can only pick up an object from the ground by slowly crouching down.
Ankylosing spondylitis
The disease occurs as a consequence of inflammatory processes in the spine. It is most often diagnosed in men aged between 20 and 35. The patient feels stiffness in the lower back and discomfort in the sacrum in the morning and at rest. Little by little, during the day, this feeling passes, the person "walks from one side to the other. "Many people do not pay attention to this alarming symptom; however, ankylosing spondylitis leads to gradual fusion of the vertebrae, decreased spinal mobility, and disability. Therefore, you need to consult a doctor at the first signs of illness - morning stiffness in the spine.
Spondyloarthrosis
This disease affects the cartilaginous tissue that covers the intervertebral discs. With age, it becomes thinner, destroyed and bone growths form in places where the cartilage breaks. Due to the fact that the intervertebral discs rub against each other, the nerve roots become irritated - this process is accompanied by severe pain in the lower back. The muscles in the problem area of the back are constantly tense and in spasm.
Signs of spondyloarthrosis
- The pain becomes more intense after exercise and disappears after rest.
- The pain appears after standing or walking for a long time.
- Simultaneously with lower back pain, the patient feels discomfort in one of the hips and the hip joint.
Urolithiasis disease
The pain in this pathology is paroxysmal and very intense. Typically, painful sensations arise from the inflamed kidney. It is difficult for the patient to find a position in which they feel better. After crises, urine becomes reddish and its volume decreases.
Inflammation in superficial tissues and fibers
The cause of the pain may be a carbuncle or boil. These are purulent and dense formations on the skin, measuring more than 1 cm in diameter, easy to notice due to their purple color. The painful sensations are sharp, intense and pulsating.
Paranephritis, an inflammation of the perinephric tissue caused by infection, is also painful. The sensations become stronger with inspiration and movement. The patient tries to lie down with his legs bent - in this position the pain is less pronounced. The skin in the affected area swells and turns red.
Inflammation of the spine, spinal cord
Osteomyelitis is an inflammatory process in the bone marrow that affects all bone tissue. The acute form is characterized by increasing pain of a pulling and explosive nature. It is combined with signs of intoxication and fever.
Tuberculosis of the spine occurs due to infection with Koch's bacillus. The first signs of the disease may appear many years after infection. It all starts with a deep pain that appears after exercise. The infection affects the vertebrae, making it difficult for the patient to move, and a characteristic gait is formed.
Other diseases
Low back pain can be a symptom of numerous pathologies, including some quite exotic ones. These include, for example, foot-and-mouth disease, Ebola fever, hemorrhagic fevers and Japanese mosquito encephalitis.
- Cardiovascular diseases - abdominal aortic aneurysm, Loeffler endocarditis.
- Myositis is inflammation and muscle pain in the lower back, which can be caused by infectious diseases such as flu, sore throat and even common ARVI.
- Benign and malignant neoplasms of the spine and spinal cord.
- Kidney pathologies - glomerulonephritis, renal vein thrombosis, pyelonephritis, cyst.
- Lower back pain in men occurs with prostate cancer.
Why does my lower back hurt when I cough?
Coughing causes muscle tension in the affected area, resulting in pain. Often, patients first learn about the development of a disease when they experience pain when coughing. Most often, these sensations are a sign of:
- intervertebral hernia,
- osteochondrosis,
- neuralgia,
- facet arthropathy,
- kidney diseases.
Diagnosis
As noted above, pain in the sacrolumbar region can be a symptom of many diseases. Therefore, to identify objective causes, you should consult a doctor at the first signs. You can make an appointment with an orthopedic doctor, neurologist or surgeon. In the future, you may need to see a rheumatologist, urologist, or gastroenterologist.
- Initial examination.The doctor evaluates tissue sensitivity, muscle function and reflexes in the affected area.
- Radiography.The examination shows changes in the structure of bones, cartilage and joints.
- Blood and urine tests.With their help, you can determine the presence of infections and inflammatory processes.
- Functional diagnosis.Includes methods for assessing nerve conduction and muscle performance - electroneurography, electromyography.
- Computed tomography and magnetic resonance imaging.Allows a detailed examination of the condition of bone, muscular, nervous and vascular structures.
- Ultrasoundcarried out if there is suspicion of pathology of the pelvic organs, prostate or kidneys.
It is important to exclude (or confirm the presence of) a tumor, to differentiate between compression of the spinal roots and pain syndrome of a musculoskeletal nature. Based on the diagnostic data, the doctor will determine the true cause of the pain and prescribe an effective treatment program.
Is bed rest necessary?
None of the recommendations for the treatment of low back pain in diseases of the musculoskeletal system contain instructions on absolute bed rest. On the contrary, patients are advised to return to normal activities as soon as possible in order to prevent the formation of chronic pain syndrome. Strict immobilization is advisable for 1–3 days in severe cases, i. e. with severe pain. For sharp pain in the lower back, you can use a fixation belt. However, long-term lumbar fixation is not recommended unless there is trauma or spondylolisthesis. Gradually you need to include special exercises to strengthen the spine and muscles.
Low back pain treatment
Most of the time, a combination of medicinal and non-medicinal agents is needed to resolve the problem.
Medicine
The basis of drug therapy is nonsteroidal anti-inflammatory drugs (NSAIDs). They affect peripheral mechanisms of pain formation and are prescribed for exacerbation of pain syndrome. In most clinical cases, treatment is carried out in courses - no more than 12 weeks.
In most cases, patients receive B vitamins to improve nerve conduction, decongestants and sedatives. In the chronic course of the disease, it is possible to take antidepressants. For severe muscle spasms and pain - muscle relaxants, weak opioids.
Non-medicated
Additionally, the patient can receive manual therapy, acupuncture (acupuncture). The procedures aim to activate metabolism and blood circulation in the affected area. This allows for better tissue nutrition.
According to doctors, physiotherapy, exercises to strengthen the muscles of the lower back, traction therapy and transcutaneous electrical neurostimulation have little effect. Most often, these procedures are prescribed in the absence of a pronounced effect from taking medications for 4-6 weeks. There is no scientific evidence of the effectiveness of massage, physical therapy, or the use of various belts.
What to do for prevention
- In the morning, exercise with simple stretching exercises for your spine and muscles.
- Eat rationally, excluding fatty, fried, smoked, salty, spicy foods and alcohol.
- Watch your own weight.
- Drink at least 1. 5 liters of liquid (preferably water) daily.
- Once every 6 months, take a classical massage course.
- Avoid staying in the same position for a long time.
Conclusion
Painful sensations in the lower back can be a symptom not only of pathologies of the musculoskeletal system, but also of internal organs. Many patients self-diagnose and treat, for example, a muscle strain, although the problem may actually be kidney inflammation. Such treatment only aggravates the situation - a person focuses on a non-existent disease and triggers a serious pathology. That's why it's important to seek qualified help and identify the true cause of the pain. Self-prescribing medication is strictly discouraged.