Low back pain

According to medical statistics, approximately 80% of people experience periodic low back pain.It has a different character: painful, sharp, radiating to the lower extremities.Most of the time, people between 30 and 55 years old complain of pain.

There are many causes of pain in the lower back and not all of them are associated with pathologies of the musculoskeletal system.If the discomfort appears regularly and reduces the quality of life, it is advisable to visit a doctor who will help you identify the cause.After proper therapy, it will disappear on its own.As a rule, pain can be relieved with conservative methods, but in advanced cases surgery is necessary.Preventative measures will help maintain the health of your back and prevent pain.

Causes of low back pain.

The question of why the lower back hurts is quite relevant.The human spine is a complex structure consisting of vertebrae, the discs between them, the spinal cord, nerve roots and surrounding tissues (muscles, ligaments, tendons).When problems arise with any of these components, back pain appears.Although in some cases discomfort in the lumbar region occurs due to alteration of other organs.

Sprain is one of the most common causes of pain in the lower spine.Discomfort occurs when muscles, ligaments, or muscle spasms are damaged.The causes of sprains can be the following human actions:

• Improper lifting of an object.
• Weightlifting.
• Sudden movements.

Violation of the structure of the spine is another common reason why the lower back hurts.Low back pain associated with structural problems is usually caused by the following diseases:

• Intervertebral disc rupture.When the integrity of the disc is violated, compression of the nerve bundles increases, which manifests itself as pain.
• Protrusion (bulging of a disc between the vertebrae without rupture of the annulus fibrosus) or intervertebral hernia.Then, pressure on the nerve bundles in the lower segment of the spine increases and severe pain appears in the lower back.
• Sciatica (compression or inflammation of the sciatic nerve) often occurs due to a bulging or herniated disc.The pain then spreads from the lower back to the back of the thigh.
• Arthritis of the lumbar region.
• Scoliosis is a disease in which there is a lateral curvature of the spine.
• Compression fractures (compression injury to the vertebrae) of the lower back can also cause severe pain.
• Osteoporosis is a pathology in which bone density decreases and the vertebrae become porous.This disease increases the risk of compression fractures.

Additionally, pain in the lumbar region may be due to the following reasons:

• Cauda equina syndrome is damage to the bundle of nerves arising from the terminal portion of the spinal cord.Then a dull pain appears in the lower back, the upper part of the buttocks, the sensitivity in the pelvis is disturbed, and the control of urination and defecation disappears.
• Spinal tumors can compress nerves and cause pain.
• Spinal infections (osteomyelitis, discitis, spinal tuberculosis) cause pain, fever and hyperthermia in the lower back.
• Infectious diseases, for example, cystitis or inflammation of the kidneys (glomerulonephritis, pyelonephritis, urolithiasis), also cause pain.
• Shingles is a viral disease that can damage the nerve bundles in the lower back.

Also, pain in the upper lumbar region may occur with an atypical course of pancreatitis (inflammation of the pancreas).Discomfort is often caused by sleep disorders or by resting on a poor mattress that does not support the spine well.

Everyday activities also cause pain in the lower back:

• Sitting for a long time in an uncomfortable position.
• The person usually pushes or pulls something.
• Lifts or carries objects.
• When you stand for a long time, your back also hurts.
• Prolonged bending or frequent twisting.
• Excessive tension or overstretching of the muscles in the lower back.

Serious discomfort in the lower back appears with prolonged tension in the neck, which is directed forward, for example, if a person is sitting at a computer or driving.

Reference.Lumbago is an acute pain that occurs when the back is too cold or under dynamic loads.Lumbodylia is a painful sensation caused by prolonged static loads.Lumboischialgia is a pain syndrome that extends from the lower back to the leg due to an intervertebral hernia.

at-risk group

Most often, pain in the spine is provoked by the following factors:

• frequent stress;
• pregnancy, which is associated with enlargement of the uterus and tension of its ligaments;
• prolonged sitting associated with work characteristics;
• old age and associated changes in the spine;
• mental disorders;
• excessive body weight;
• smoking;
• hard physical work.

Reference.According to statistics, women suffer from back discomfort more often than men.

The likelihood of low back pain increases after long-term use of steroids, drug addiction, and in patients between 30 and 55 years of age.

Symptoms

If you have low back pain, pay attention to the nature of the pain;It can be sharp, dull, painful, burning.Sometimes unpleasant sensations such as tingling and numbness appear.Pain in the lower back can spread to the buttocks, from the back of the leg to the foot.The severity of the pain syndrome also differs: from mild to unbearable, which does not allow movement.

Often, the patient may experience pain in the lower back due to kidney pathologies.To determine if this sensation is caused by a kidney problem, pay close attention to your symptoms.In kidney disease, pain is not associated with physical activity, fever appears (from 37.5°), difficulty urinating, and urine becomes cloudy.When the kidney area is touched, severe pain appears.

As mentioned, atypical forms of pancreatitis can also be accompanied by severe pain in the lower back.

With osteochondrosis, aching pain appears, radiating to the legs, intensifying when walking, and sometimes "lumbago" occurs.Over time, the sensitivity of the lower part of the body (buttocks, groin, legs) is affected.The lower extremities freeze quickly and sweat production is affected.There is no fever with osteochondrosis.

With neuralgia, pain spreads along the affected nerve.The pain is sharp, burning, comes on quickly and disappears suddenly.The color of the skin in the affected area changes, sweating increases during an attack, and the muscles tremble.

You should seek medical help if you have back pain and at least one of the following symptoms:

• weight loss;
• temperature increase (of 37.5°);
• swelling in the lower back;
• the pain does not go away even when the patient is lying down;
• the pain radiates to the legs;
• recently injured his lumbar spine;
• control of urination and defecation is disturbed;
• The sensitivity of the groin area, buttocks or legs is altered.

To understand what exactly is wrong and what are the causes of discomfort, you need to undergo a medical examination.

Diagnostic measures

If your lower back hurts, you should see a therapist or orthopedist.If you suspect neurological disorders, visit a neurologist.Physiological examination and medical history often help establish the diagnosis.

If injuries, diseases of the spine or other organs or neuralgia are suspected, the doctor prescribes instrumental studies:

• The x-ray will help identify lumbar injuries, inflammation of the vertebrae and imbalance of the elements of the spine.
• MRI or CT scan will show intervertebral hernias, structural disorders of the spine, problems with surrounding tissues (nerves, muscles, blood vessels).
• Bone scan is used to detect bone tumors and compression fractures.During the study, a radioactive drug is used, which is injected into a vein and then accumulates in areas with increased metabolism.
• Electroneuromyography is effective in identifying compression of nerve bundles that occurs in the context of an intervertebral hernia or spinal stenosis.This diagnostic method allows you to identify any damage to the neuromuscular system.

If an infectious disease is suspected, the patient will be prescribed laboratory blood tests.

If the doctor suspects that pain in the lower back is caused by problems with the kidneys, pelvic organs or pancreas, a series of appropriate tests is prescribed.

Conservative treatment

If you don't know how to get rid of lower back pain, consult a doctor first.With timely diagnosis, treatment is carried out at home.Over-the-counter pain relievers are used to relieve pain.

Patients should know how to relieve pain if it surprises them.If the discomfort is caused by osteochondrosis, then you should act according to the following plan:

• warm your lower back with a wool scarf or belt;
• lie down on a hard surface;
• take NSAIDs;
• Treat your back with an anti-inflammatory ointment.

Carefully.Do not take NSAIDs if you have problems with the digestive organs, as they damage the mucous membranes.

NSAIDs and antispasmodics will help relieve neuralgia pain.In addition, complete rest must be observed.If the pain is very intense, the patient must be hospitalized.

If you have lower back pain caused by kidney disease, you should urgently call an ambulance.The patient should lie down and take antipyretics (antipyretics) and antispasmodics to normalize the temperature.It is necessary to monitor blood pressure and body temperature whenever possible.Other actions are carried out by the doctor.

Carefully.It is strictly prohibited to use warm compresses or take a hot bath if you have inflammation of the kidneys!

The pain in the lower back due to inflammation of the pancreas (atypical form) is very intense.During an attack, it is necessary to call a doctor.Before the doctors arrive, you are not allowed to eat;It is necessary to adopt a comfortable position and drink water in small sips.It is advisable to have someone close to the patient.The knee-elbow or fetal position will help reduce discomfort.

Regardless of the cause of the pain, the patient should rest for 1 to 2 days.A longer rest threatens to weaken the muscles, so the episodes may recur more frequently.

Acute pain in the lower back appears suddenly and lasts a maximum of 12 weeks.Constant pain during the chronic process develops slowly and persists for 3 months or more.Many patients present with both acute and chronic pain, making diagnosis very difficult.

If home treatment for low back pain is not effective, doctors prescribe NSAIDs to patients.Narcotic pain relievers, such as codeine or hydrocodone, relieve severe pain.However, these drugs are used only in extreme cases and the doctor must monitor the patient's condition.To relieve symptoms, your doctor may prescribe antidepressants, such as amitriptyline.

Treatment can be complemented with physiotherapy procedures.An excellent therapeutic effect has electrophoresis, ultrasound, electrical stimulation, magnetic therapy, etc.These procedures help to accelerate metabolic processes, blood circulation, improve tissue trophism, accelerate the healing of damaged areas and relax spasmodic muscles.

Therapeutic exercises can help strengthen muscles and ligaments, make them more elastic, and correct posture.The complex for each patient is drawn up by a doctor, taking into account age, symptoms, the cause of pain and general condition.Training should be carried out in the stage of remission, when the pain syndrome subsides.With regular exercise, the patient will be able to prevent recurrent attacks.

Cortisone injections (a synthetic corticosteroid) will help relieve pain if the above methods are not effective.After the procedure, the inflammation decreases and the discomfort disappears.The therapeutic effect lasts 6 weeks.

The following methods can help relieve pain and improve your overall condition:

• Osteopathy helps restore the structure of the musculoskeletal system using only the hands of a doctor.
• Chiropractic is a manual technique to correct spinal defects.
• Acupressure - impact on energy points with a specialist's fingers and elbows to eliminate discomfort and relax muscles.
• Reflexology is the introduction of special needles into biologically active points on the body.After the procedure, the production of endorphins is stimulated and pain is reduced.
• Yoga.By performing certain postures and movements, the muscular corset is strengthened and posture improves.However, the exercises must be performed under the supervision of a specialist, otherwise the pain syndrome may intensify.

The decision on how to treat low back pain is made by the doctor after a thorough diagnosis and identification of the causes of the discomfort.

surgical intervention

The question of what to do if your lower back hurts constantly for a long time (more than 6 months) is quite relevant.In this case, doctors may prescribe surgery.As a rule, surgical intervention is indicated for intervertebral hernia, especially if the disease is accompanied by neurological disorders (numbness of the groin, legs, involuntary urination, defecation).

The following surgical techniques will help cure serious diseases of the lumbar segment of the spine, which are accompanied by pain:

• Spinal fusion is an operation to fuse two or more adjacent vertebrae, between which an implant is inserted.Unstable column elements are fixed with special fastening materials (metal plates, screws).
• Intervertebral disc replacement.During the procedure, the destroyed disc is removed and an artificial one is installed in its place.
• A discectomy is the removal of part of a disc that is compressing a nerve bundle or spinal cord.
• Laminectomy is the removal of a vertebral arch that compresses the nerve roots leaving the spinal cord.

There are many more surgical techniques that will help stabilize displaced vertebrae, free nerve bundles and other tissues from compression, and restore spinal functionality.

Prevention of low back pain

To prevent pain in the lumbar region, these rules must be followed:

• Perform exercises to strengthen your muscles and develop flexibility.
• Quit smoking, as people with this bad habit are more likely to suffer from back pain than their non-smoking peers.
• Control your weight and eat well.
• Watch your posture when standing or sitting.
• If you spend a lot of time sitting at work, get up every 2 hours and do back exercises.
• Correctly configure your workplace, purchase a chair with an orthopedic backrest.
• Sleep on an orthopedic mattress.
• When lifting heavy objects, transfer your weight from your back to your buttocks and legs.
• Wear orthopedic shoes.

These rules will help maintain the health of your lower back for a long time.

The most important thing

As you can see, lower back pain can occur for various reasons: sprains, structural disorders, cancer, infectious diseases of the spine, everyday activities, poor posture, etc.The risk group includes patients who lead a sedentary lifestyle, do heavy physical work, are overweight, often experience stress or have bad habits.If the pain syndrome is accompanied by fever, swelling in the back or neurological disorders, you should urgently seek medical help.Treatment tactics depend on the cause of the discomfort.Conservative methods are the most used.Surgery is prescribed if the pain does not go away for a long time or if there are neurological disorders.Remember that low back pain is easier to prevent than to treat.