Low back pain is one of the most common reasons for visiting a neurologist among people of working age.According to statistics, 9 out of 10 people have experienced lower back problems at least once in their lives and about 9% of cases result in disability.The first episode is most often recorded before the age of 30.From 30 to 60 years the risk of morbidity increases.
Unfortunately, young people don't always pay attention to warning signs.Many people believe that back pain is due to overwork, physical activity or sitting at the computer for a long time.But it could actually be a symptom of a serious illness.Low back pain can be caused by various pathologies: from spinal problems to kidney failure.Only a timely visit to the doctor will help determine the cause and carry out the correct treatment.
Possible causes of low back pain: what hurts?
Ankylosing spondylitis
Lower back pain syndrome occurs due to fusion of the vertebrae into one large conglomerate.The back loses mobility in the lower part.In ankylosing spondylitis, calcium deposits are also observed in the ligaments that support the spine, which cause pain even when you try to turn over, stand 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 with a thinning of the intervertebral discs.As a result, the shock-absorbing function of the spine is reduced, the nerve roots are pinched, and the muscles around the affected area spasm.The person feels sharp pain.Without treatment, osteochondrosis progresses, leading to disc protrusions and herniations.The protrusion of the cartilaginous tissue compresses the spinal cord.A person not only suffers from severe pain in the lower back, but also the innervation of the lower extremities is disrupted.
Hallmarks of osteochondrosis:
- the pain intensifies when trying to roll from the back to the stomach, when rising from a horizontal or sitting position, or when bending;
- Patients often report weakness and numbness in one leg or both legs.
Spondyloarthrosis
The lower back can hurt due to degenerative changes in the cartilaginous tissue covering the intervertebral discs.The elastic layers become thinner and osteophytes, i.e. 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 lower back, up to constant stiffness;
- worsens after walking, prolonged sitting, standing and other stress;
- it radiates to the pelvic area and thighs.
Urolithiasis
An attack of pathology is manifested by a sharp, severe pain in the back on the side of the affected kidney.The severity and nature of the sensation do not change depending on the position of the body.The patient cannot find a position in which it would be even a little easier.
An attack of urolithiasis is accompanied by additional specific symptoms:
- back pain in the lower back;
- the volume of urine decreases, its color changes and impurities appear in the blood;
- pain occurs during urination;
- There may be an increase in temperature due to inflammation.
Other causes of pain and cramps in the lower back
Lower 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
Back pain: what to do?Do not make sudden movements, especially if the pain occurs following a fall or a blow.Try to assume the most comfortable position.If the pain is acute and does not decrease when changing position, call an ambulance: renal colic is likely, requiring hospitalization.In other cases, you can use ointments and compresses 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 conducts a more thorough examination and takes the medical history.It is important to clarify the localization, nature, duration of pain, factors that cause exacerbation or, conversely, improve well-being.Your doctor will ask about past injuries and illnesses, starting in early childhood.The medical history helps suggest why the back hurts and which diagnostic procedures will provide more complete information.
The doctor may prescribe:
- General analysis of urine and blood.Based on 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 extent of the spread of the inflammatory process, evaluates the size of the stones in order to correctly build treatment tactics;
- Radiography of the lumbar spine.The images help determine the pathology of the vertebrae and adjacent tissues.To clarify the x-ray, CT or MRI are also prescribed - these are more informative examination methods;
- Ultrasound of the pelvic organs.When a woman suffers from 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 suffers from back pain, this could be a sign of inflammation or prostate cancer.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor can prescribe more targeted procedures.In some cases, consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Treatment of lower back pain
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 to suggest a diagnosis.Therapy for renal colic and osteochondrosis is fundamentally different.
Pharmacological treatment
To reduce pain, nonsteroidal anti-inflammatory drugs are often prescribed in the form of injections, ointments and tablets.The drugs help quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor carefully calculates the dosage and duration of the course for each patient.
If treatment for low back pain does not bring results within 2-3 days, the doctor selects hormonal drugs.Medications are only needed to relieve an acute condition.Antispasmodics, decongestants and B vitamins are prescribed as auxiliary agents. If the patient suffers from low back pain and pain when urinating, antibiotics can be selected.The doctor will tell you why this or that drug is needed and how to take it correctly.
Non-pharmacological treatment
The procedures are performed in cycles after the exacerbation has been relieved.In complex pain treatment the following is used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetotherapy;
- physical therapy: a set of daily exercises selected by a doctor, exercises in the pool;
- massage: therapeutic in the lumbar and buttock area and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to indications.If the patient has back pain and has a temperature that does not decrease while taking medications, removal of the inflammatory focus will be necessary.For tumors and metastases, radical surgery is necessary.
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 removed with the help of medications, the patient is also indicated for surgical treatment.
You cannot tolerate pain and discomfort in your lower back.The body gives you a signal that you need to pay attention to this area.