Lower back pain is one of the most common reasons for consulting a neurologist among people of working age.According to statistics, 9 out of 10 people have experienced discomfort in the lower back at least once during their life, and about 9% of cases lead to disability.The first episode is most often recorded before the age of 30.From 30 to 60 years old, the risk of morbidity increases.
Unfortunately, young people don't always pay attention to the warning signs.Many people think that lower back pain is caused by overwork, physical activity, or sitting in front of the computer for a long time.But in reality, it can be a symptom of a serious illness.Lower back pain can be caused by various pathologies: from spinal problems to kidney failure.Only a timely visit to a doctor will help determine the cause and carry out appropriate treatment.
Possible causes of lower back pain: what hurts?
Ankylosing spondylitis
Lower back pain syndrome is caused by the fusion of the vertebrae into a large conglomerate.The back loses mobility in the lower part.In ankylosing spondylitis, calcium deposits are also seen in the ligaments that hold the spine, which also causes pain when trying to turn over, stand up, or perform any other action.
Distinctive symptoms of 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 by thinning of the intervertebral discs.As a result, the shock absorption function of the spine is reduced, nerve roots are pinched, and the muscles around the affected area contract.The person feels acute pain.Without treatment, osteochondrosis progresses, leading to bulges and herniated discs.The protrusion of the cartilaginous tissue compresses the spinal cord.A person not only suffers from severe pain in the lower back, but the innervation of the lower extremities is also disrupted.
Distinctive signs of osteochondrosis:
- the pain intensifies when you try to turn over from your back to your stomach, when you get up from a horizontal or sitting position, or when bending over;
- Patients often report weakness and numbness in one or both legs.
Spondyloarthrosis
The lower back may be painful due to degenerative changes in the cartilaginous tissue that covers the intervertebral discs.The elastic layers become thinner and osteophytes, hard bone formations, appear in their place.The distance between the vertebrae decreases with the 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 or standing, and other stresses;
- radiates to the pelvic region and thighs.
Urolithiasis
An attack of pathology is manifested by sharp, intense pain in the back on the side of the affected kidney.The severity and nature of the sensation does not change depending on body position.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 blood impurities appear;
- pain occurs when urinating;
- There may be an increase in temperature due to inflammation.
Other Causes of Lower Back Pain and Cramps
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 results from a fall or blow.Try to take the most comfortable position.If the pain is sharp and does not subside when changing position, call an ambulance - renal colic is likely, which requires hospitalization.In other cases, you can use ointments and tablets to relieve the condition.Contact a specialist as soon as possible.The doctor will help relieve even severe pain and prescribe treatment.
Diagnosis of lower back pain
At the first appointment, the doctor may perform a blockade to relieve acute pain.When the patient feels better, the doctor does a more thorough examination and takes a history.It is important to clarify the localization, nature, duration of pain, factors that cause exacerbation or, conversely, improve well-being.The doctor will ask about previous injuries and illnesses, starting in early childhood.The history helps suggest why the back hurts and what 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, assesses the size of the stones in order to correctly develop treatment tactics;
- X-ray 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 additionally prescribed - these are more informative methods of examination;
- Ultrasound of the pelvic organs.When a woman has lower back pain, it may indicate endometritis or salpingo-oophoritis.Pregnant women should be examined to determine the tone of the uterus;
- Ultrasound of the prostate.If a man suffers from lower back pain, it may be a sign of inflammation or a tumor in the prostate.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor can prescribe more targeted interventions.In some cases, a consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Treatment of lower back pain
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.The treatment of renal colic and osteochondrosis is fundamentally different.
Drug treatment
To reduce pain, nonsteroidal anti-inflammatory drugs are most often prescribed in the form of injections, ointments and tablets.Medications help quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dosage and duration of treatment for each patient.
If treatment of lower back pain does not bring results within 2-3 days, the doctor selects hormonal drugs.Medications are only needed to relieve acute illness.As auxiliary agents, antispasmodics, decongestants and B vitamins are prescribed.If the patient has lower back pain and pain when urinating, antibiotics may be selected.The doctor will explain to you why this or that medication is needed and how to take it correctly.
Non-drug treatment
The procedures are carried out ongoing after the exacerbation is relieved.In the complex treatment of pain, the following are used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetotherapy;
- physiotherapy: a set of daily exercises selected by a doctor, exercises in the pool;
- massage: therapeutic of the lower back and buttocks and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to the indications.If the patient suffers from lower back pain and has a temperature that does not decrease while taking medications, elimination of the inflammatory focus will be necessary.Radical intervention is necessary for tumors and metastases.
In case of pathology of the female genital organs, when the lower abdomen hurts, diagnostic curettage and laparoscopic operations are carried out.If urolithiasis cannot be eliminated with the help of medications, the patient is also indicated for surgical treatment.
You cannot tolerate the pain and discomfort in your lower back.The body signals you that you need to pay attention to this area.