There is practically no person who at least once in his life does not experience back pain in the lumbar region. This is how we pay for upright walking and our everyday habits.
In addition to the damage that can affect the spine, its muscles, nerves and ligaments, it should be noted that sometimes the back hurts in the lumbar region with internal diseases - diseases of the kidneys, gastrointestinal tract and female genital organs.
Low back pain symptoms can range from dull to sharp. The pain may go away on its own or become chronic (the symptom has been present for more than three months).
Dangerous! You should immediately consult a doctor if:
- pain in the lumbar region arose abruptly after an obvious injury to the back;
- the temperature has risen sharply, there are vegetative disorders, loss of consciousness, sweating, shortness of breath;
- involuntary emptying of the intestines and bladder occurs;
- there is numbness in the groin area;
- there was weakness of the lower extremities, their paresis or paralysis, impaired sensitivity;
- pains in the stomach occur and sharply increase when coughing or sneezing;
- symptoms appeared against the background of strong weight loss, prolonged use of steroids, immunodeficiency;
- in the family history there were cases of cancer, inflammatory or degenerative diseases of bone and cartilage tissue.
Why does the back hurt in the lumbar region?
myofascial pain
A muscle strain or spasm can develop gradually or occur suddenly. With a high load, damage affects not only muscle fibers, but also the ligamentous apparatus and fascia.
Muscle pain in the lower back appears after:
- lifting heavy weights or overexerting yourself at work or playing sports;
- play sports from time to time. Muscles are especially vulnerable if you're inactive during the work week and then spend hours at the gym on the weekends;
- a sharp increase in the weight of the body itself, behind which the muscles do not have time to grow;
- sitting or standing for a long time in an uncomfortable position;
- carry a bag in one of your hands or on your shoulder every day;
- posture disorders. The spine performs its best supporting and protective function when it is not hunched over. Lower back muscles experience less stress when you sit with good support under your lower back and, in a standing position, distribute weight evenly across both legs.
If the back hurts after a bruise, fracture, sprain, hypothermia, an infectious disease or an established helminthic invasion, then myositis (inflammation) of the lower back muscles can be suspected. Severe pain is constantly present due to inflammation of the muscle fibers, "nodules" are felt on the muscles, places of spasm. The inflammation can be acute or take a chronic form. With a prolonged course of the disease, the pain is unstable, aggravated by lying or sitting for a long time, in the late afternoon or when the weather changes. Touching the muscles causes a feeling of pain and discomfort, the muscles of the lower back are in constant tension, inflammatory edema is formed, the temperature rises locally and at the level of the whole organism.
With muscle spasm, the roots of the spinal nerves are infringed, due to which the attacks often resemble a picture of sciatica or sciatica: there are severe burning pains in the back of the thigh and lower leg, limbs become numb and lose sensitivity. Pronounced muscle tone in myositis causes the patient to take a forced position, walk and lie stooped, move with bent legs.
How to treat spinal muscle pain? Nonsteroidal anti-inflammatory drugs and pain relievers are used to eliminate inflammation and pain. Medicines can be taken in the form of tablets, ointments, injections, transdermal patches with a gradual release of active substances. Hot and irritating ointments are also used, which reflexively increase blood flow to the muscles of the lower back. An increased volume of incoming blood contributes to the washing out of the products of inflammation and tissue breakdown.
Reduction of inflammatory edema is facilitated by injections of corticosteroids and vasoconstrictor drugs.
If the cause of myositis is an infection or poisoning of the body with worm toxins, antibiotics or anthelmintic drugs are initially used. In this case, ointments or hot compresses cannot be used.
Spine diseases involving nerve endings
In the lumbar region, the vertebrae are separated by elastic cartilaginous discs, which protect the spine from injury, but are subject to wear and aging.
Normally, the disc is a gelatinous nucleus pulposus surrounded by a denser layer of annulus fibrosus. The elasticity of the core is due to its ability to bind and retain water: when the load increases, it accumulates water and increases elasticity, when the pressure decreases, the core releases water and becomes flatter.
Osteochondrosis in the vertebral region develops when the intervertebral discs are undernourished (their "drying") or with excessive local load. In most cases, low back pain is due to the fact that the lower poles of your intervertebral discs bear the greatest load when sitting, when lifting weights in front of them. At the same time, tears are formed, displacements in the discs, vertebral ligaments are damaged, there is constant pain, pulsations.
Pain in the spine has several mechanisms of development:
- violation of microcirculation in the tissues surrounding the spinal column and, in particular, in the spinal canal, the formation of congestion and edema. Such conditions develop against the background of hypothermia, overheating, inflammatory processes.
- degenerative processes in the fixing ligaments of the spine. An increase in the mobility of the vertebrae leads to their slight displacement and unphysiological compression, which provokes the infringement of nerves, blood vessels and the formation of hernias.
- axial compression of the vertebrae when lifting weights or damage to them during excessive rotation (twist).
- aseptic inflammation. Destruction of the nucleus leads to the release of sensitizing factors in the spinal canal. There is irritation of the nerve endings, which causes a spasm of the muscles that infringe the neighboring vertebrae, above and below the hernia. Gradually, the reaction covers the entire lumbar region and leads to the fact that any movement provokes a sensation of pain.
A weakened disc can rupture, resulting in a bulge, bulge, or prolapse of the nucleus, and eventually a herniation. The occurrence of a hernia puts pressure on the spinal cord and spinal nerve roots. In such conditions, a stabbing pain appears in the lower back, diverging along the strangulated nerve. The most well-known cases of compression of the sciatic nerve (sciatica), manifested by sharp pain in the back of the thigh and lower leg, numbness of the limb on the side of the hernia, muscle weakness, involuntary fold of the legs.
Pain in the lumbar spine is aggravated in the sitting and standing position, when turning, bending over. Often there is a protective muscle reaction - a painful contraction of the muscles (roll formation) on both sides of the spine, which isolates the department from unnecessary movements. Osteochondrosis subsequently leads to the appearance of sciatica (inflammation of the spinal nerve roots).
Radicular syndrome is dangerous when the nerves of the lower back, which are responsible for the innervation of the internal organs (horns of the cauda equina), are pinched. At the same time, pain in the stomach occurs, the function of the bladder and intestines is disturbed, there are problems with potency in men, and gynecological diseases in women.
Many patients, due to the fact that the lower back hurts a lot, adopt analgesic postures: they deviate the body to the left, if the right side hurts, they lie on the right side. If the hernia is to the left. Also characteristic is the appearance of severe pain when pressing on a hernia in the intervertebral space (symptom of buzzing).
How to treat if your back hurts with osteochondrosis:
- during an attack of pain, you can take an anesthetic posture - lie on your back and put a roller under your knees. Sleeping on a hard surface is also recommended;
- of analgesic drugs, NSAIDs can be taken orally or as injections on both sides of the spine in the lumbar hotel;
- use local irritants as distraction therapy - mustard plasters, iodine mesh, pepper patch and ointments;
- eliminate miotic spasm by manual therapy, acupuncture, vacuum massage, reflexology, gymnastics;
- during the attenuation of the acute period, mud treatment, ozokerite, heating can be used.
Treatment of pain in radicular syndrome includes:
- provide bed rest, lumbar traction (dry or underwater);
- the use of novocaine blockades at the site of the violation, the use of NSAIDs or weak opiates;
- physiotherapy - microcurrent stimulation, electrophoresis with analgesics.
Indications for surgery are constant acute pain, as well as impaired function of internal organs, the development of paralysis of the limbs, sequestration of a hernia in the spinal canal.
degenerative inflammatory lesions
Spondyloarthrosis (inflammation of the facet joints of the vertebrae) occurs with degeneration, a decrease in the height and volume of the intervertebral discs. Pain in the lower back appears due to overstretching the capsule and increasing pressure on the surface of the intervertebral joints. The pain causes the patient to bend more in the lower back, thus increasing the overload on the intervertebral joints. Especially discomfort in the lower back is aggravated by wearing shoes with heels, long walks, descending from elephants, positions in which the body deviates backwards, for example, when looking at something above the head.
In patients with this diagnosis, stiffness in the lower back is noted in the morning, pain increases during the day or after exercise. It has a diffuse character, and it is difficult to clearly show the boundaries: discomfort is determined in the gluteal muscles, inguinal region, lower abdomen, and in the scrotum in men. This spondyloarthrosis differs from radicular syndrome, in which the origin of the pain can be identified.
What to do to relieve the pain? It usually helps to get into a supine position, bending your legs at the hip and knee joints.
Its drugs are the nonsteroidal anti-inflammatory drugs and the preferred non-narcotic analgesics.
Muscle relaxants are also added, as they relieve muscle tension and improve spinal mobility.
Psychotherapy has a positive effect, since chronic pain puts the patient in a state of depression.
Spondylosis, unlike osteochondrosis, affects more the fibrous ring of the intervertebral disc and the anterior longitudinal ligaments. With this disease, calcification of connective tissue structures occurs with the formation of growths along the edge of the vertebrae - osteophytes. These formations provoke a violation of the microcirculation near the nerve roots and cause back pain in the lower back, and the mobility of this department is also limited.
Vertebral osteophytes are pathological growths that damage nerves and blood vessels.
The treatment is usually conservative, with the use of anti-inflammatories, analgesics, vitamins. Novocaine electrophoresis, lidase, manual therapy, physiotherapy (amplpulse, laser installation, shock wave therapy to destroy compacted elements and increase mobility of the spine) give a good effect.
Note! In the advanced stage, the osteophytes do not resolve. Although its size is small, the treatment is aimed at eliminating inflammation, pain and improving metabolism. If the back does not hurt much, then nothing is done about the growths. If the osteophytes cause persistent pain or are large, they may be removed during surgery.
Diseases of a tumor nature.
Low back pain can occur due to compression of the spinal cord by a tumor from the outside (extramedullary formations) and from the inside (intramedullary, originating from the cerebrospinal substance itself).
Cells of various tissues can grow pathologically:
- fatty - a lipoma is formed;
- nerve roots - neuroma;
- spinal cord vessels - hemangioma;
- auxiliary tissue - glioma;
- bone tissue - osteosarcoma;
- cartilage - chondrosarcoma.
The tumor process, especially the malignant one, is characterized by a pain syndrome similar to sciatica (it can be unilateral or bilateral), a general deterioration of the patient's condition and exhaustion.
If the pathology affects the area of the I-IV lumbar vertebrae, then there is a burning pain in the front and on the sides of the upper thigh, incomplete paralysis of this area.
With a lesion in the region of the IV lumbar - II sacral segments, numbness of the paragenital region, impaired motor and sensory innervation of the gluteal muscles, posterior thigh, calf, fecal and urinary incontinence are observed.
A pronounced disturbance in the functioning of the pelvic organs occurs with a neoplasm in the region of the V-III sacral vertebrae. The patient suffers from sexual impotence or menstrual disorders, constipation or fecal and urinary incontinence.
The treatment of tumors is specific, pain relievers and anticancer drugs are prescription drugs.
As you can see, low back pain is usually caused by musculoskeletal pathologies. They can be diagnosed by clinical signs and research data, the main task of which is to correctly determine the nature of the disease and not confuse it with oncological causes, diseases of internal organs or trauma. If you experience low back pain, we recommend that you always seek the advice of a neurologist or orthopaedist.