Pain in the lower back is a common reason for visiting the doctor. The cause of discomfort in this area can be numerous diseases.
What is ankylosing spondylitis, what is evidenced by severe pain in the sacral area, which radiates to the leg, what studies are carried out during the diagnosis, the causes of pain in the lower shoulder blades and the most effective methods of treatment - in the material.
Lower back pain
Sudden onset of acute lower back pain is quite common. This symptom, which is characteristic of many pathological conditions, is not always caused by spinal diseases. Manifestations and causes of pain can be different.
Types of pain
By the nature of the pain that occurs in the lumbar region, the main cause of the discomfort can be identified.
Strong
Starting from the sacrum, intense pain is localized in the hip joint. The pain spreads down the leg and is felt in the foot. Similar symptoms are observed in osteochondrosis with the risk of limb numbness.
The mechanism of pain development is compression of the sciatic nerve. The pain is worse when walking quickly, bending or coughing. Long-term compression of the gluteal muscle leads to its atrophy.
Acute
Acute pain occurs suddenly. They are unbearable and very intense, often characterized as "lumbago". Depending on the cause, the pain can be triggered by physical activity. It is accompanied by stiffness of movement (sometimes it is even impossible to stand up). The slightest movement intensifies the symptoms. Acute pain can last up to six weeks. .
Pulling and pain
Agonizing and aching pains in the lumbar region are most often the result of diseases such as hernia, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain in the lower back can be hernias or protrusions, accompanied by degenerative changes in the spine. The intensity of such manifestations increases with physical exercise and is a consequence of physical inactivity.
Moved
The appearance of such symptoms is secondary. Diseases of the genitourinary system, ovaries, prostate and other internal organs are accompanied by painful symptoms in the lumbar region.
Mechanically
Mechanical pain occurs during or immediately after physical activity.
Radiation
Such pains are dull and painful. Painful sensations can also radiate into the leg (all the way to the foot).
Locally
They are characterized by the appearance of unpleasant sensations in a certain area of the lower back.
Reflected
Referred pain is pain that is felt in a different place than the actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation that can be accompanied by numbness and a feeling of loss of sensitivity.
Myofascial
Such pain is accompanied by muscle spasm and intensifies when the muscle is touched.
Causes
The causes of pain in the lower back are very diverse and can be related to pathological conditions both in the spine itself and in the tissues surrounding it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
This is a systemic disease accompanied by inflammation of the connective tissue of the spine. In spondylitis, fusion of the vertebrae occurs, due to which their motor activity is limited and ankylosis (immobility of the joint) is formed. As a result of ossification of the paravertebral ligaments, the spine gradually becomes solid, inflexible bone.
The pathological condition is characterized by increased symptoms:
- First, the pain appears in the lumbar region, gradually covering new areas;
- negative symptoms bother you from time to time, but over time they become permanent;
- stiffness of movement increases.
The expressiveness of the signs is observed at night. In the morning, the pain becomes unbearable.
Osteochondrosis
Growth, destruction, protrusion of cartilage tissue caused by violation of their nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of arthrosis of the spinal joints.
Against this background, dorsalgia (back pain) develops with characteristic manifestations of shooting in the lumbar region, with radiation to the buttocks and legs. Weakness and a feeling of numbness appear in the lower extremities. In this case, the nerve endings of the root are compressed, which causes burning and tingling.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by the protrusion of disc fragments and their prolapse into the vertebral canals.
In the initial stage, there are no symptoms, but the lack of treatment causes an increase in pain, while limiting the mobility of the lumbar region. Acute sensations of pain are observed, which increase against the background of effort, forcing a person to take a position against pain.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spinal column. In the early stage of spinal deformity, there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic, but develops into constant discomfort. The pain is painful in nature and is intensified by physical activity.
Spondyloarthrosis
This pathology leads to the destruction of joint cartilage and the formation of osteophytes (bone growths). This leads to a narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, intense pain occurs, which intensifies during physical activity and subsides in a calm state. Muscle tension is noticed, which causes a decrease in motor activity.
Protrusion
Prerequisites for the appearance of protrusions are spinal injuries, excess of permitted physical activity and muscle weakness due to physical inactivity. In this case, disc protrusion occurs, accompanied by tension in the lower back and painful discomfort.
Arthritis
In rare cases, the cause of painful manifestations in the lumbar joints is inflammation of the lumbar region. In the chronic course of the disease, the patient suffers from "lumbago", which often occurs due to hypothermia and excessive work.
Osteomyelitis
In osteomyelitis, an inflammatory process of bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. Lack of therapy leads to the disease becoming chronic, but the pain syndrome persists.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease occurs with stabbing, cutting and pulling of a paroxysmal nature.
Spinal stenosis
The pathological condition is caused by complications of hernias and protrusions. Compression of the nerve roots causes discomfort when walking, at rest, and increases when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae from the back). This condition is accompanied by an increased load on muscles and bones and causes an inflammatory process with the subsequent development of spondyloarthrosis and degenerative changes.
Pain is felt in the area of the affected joint in the form of spasms when bending and rotating the lower back. One of the symptoms is stiffness of movements in the morning and increased discomfort in the evening.
Localization
To identify the cause of pain in the lumbar region, you must first determine the place of discomfort. In order to make an accurate diagnosis, it is necessary to contact a specialist.
Pain below the waist
The cause of pain under the lower back is most often pathological conditions in the spine or internal organs. The resulting discomfort may indicate the development of:
- osteoporosis;
- osteochondrosis;
- urolithiasis;
- inflammatory process in the ureter;
- cholecystitis;
- pyelonephritis;
- gastritis;
- problems with the gastrointestinal tract.
In such cases, the pain most often occurs after lifting heavy objects or walking quickly. Often painful sensations under the lower back occur after severe injuries or infectious diseases. They are also present during menstruation, pregnancy and menopause.
Pain above lower back but below shoulder blades
Pain between the lower back and shoulder blades can be caused by the following diseases:
- pathologies of the spine in the lumbar and thoracic region or previous injuries to these areas;
- osteoporosis;
- muscle spasm or tension;
- pancreatitis.
Similar manifestations can appear against the background of the development of neoplasms of different etiology.
Pain in the left lower back
Painful sensations in the lower back, radiating to the left shoulder blade and covering the left side of the neck, are often the result of a myocardial infarction.
Cutting pain in this area indicates the likelihood of a perforated ulcer.
Also, such symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, aching pain is felt, which occurs against the background of physical inactivity or exceeding the permissible loads.
Pain in the right lower back
Suspicion of pathology of the kidneys or genitourinary organs occurs when a dull aching pain appears on the right side. Inflammation can have an infectious etiology or be a consequence of hypothermia.
Sharp, sudden pain on the right side indicates the likelihood of a perforated ulcer, ruptured appendix, or signals internal bleeding. Pain on the right side often indicates muscle strain and radiculopathy.
Lower back pain when coughing
Possible causes of lower back pain when coughing:
- osteochondrosis;
- hernia;
- stenosis of the nerve root, which causes weakness and difficulty walking;
- facet arthropathy, in which muscle strain occurs;
- injured fibrous annulus;
- pathological condition of the kidneys.
Painful sensations when coughing are often observed against the background of neuralgia.
Lower back pain can occur for physiological reasons. This includes:
- overweight,
- passive lifestyle,
- excessive physical activity.
Diagnostics
In order to determine the source that causes pain in the lumbar region, it is necessary to conduct a comprehensive diagnostic examination. It includes laboratory tests and instrumental procedures.
Main:
- blood test (general, biochemical), urine test;
- tests for tumor markers;
- x-ray of the lumbar spine;
- endoscopic examination of internal organs;
- Ultrasound (ultrasound examination);
- MRI (magnetic resonance imaging).
It is also necessary to seek the advice of a neurologist and chiropractor. An accurate diagnosis is made by a specialist who, based on the results of the examination, will decide how to treat pain in the lower back.
Treatment
The main methods of treating lower back pain:
- medical;
- physiotherapy;
- surgical intervention.
Diseases accompanied by pain in the lower back can pose a serious threat to human health (even death). Without resorting to self-medication, you should consult a therapist, neurologist or neurologist. Often, in order to determine the cause of the pain, it is necessary to consult a urologist and a gynecologist.
Surgical
Surgical intervention is relevant only as an emergency measure for oncology. Specialists perform planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Medicines
The first step in pain relief is non-steroidal anti-inflammatory drugs (NSAIDs). They are used in different forms - tablets, injections, rectal suppositories, plasters, ointments or gels.
Depending on the diagnosis and the severity of the symptoms, glucocorticosteroids are also used - hormonal drugs that relieve pain and inflammation. If muscle spasm is present, muscle relaxants are prescribed.
B vitamins are suitable as an adjunctive therapy to improve nerve conduction. Drug therapy should always be followed by non-drug treatment methods: physiotherapy, physical therapy, massage (only outside of exacerbation). Depending on the effectiveness/inefficiency of the measures taken, the severity of the symptoms and based on the examination, the patient may be recommended surgical treatment - removal of the hernia, removal of compression of the spinal cord root.
Treatment depends on the cause of lower back pain. Pathologies of internal organs must be eliminated by specialized specialists; inflammatory lesions of the bone system, systemic inflammation may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and the acute symptoms of the disease are eliminated, doctors can prescribe physiotherapeutic sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrostimulation) and exercise.
In addition, the doctor may prescribe acupuncture. Massage sessions are also effective in treating this pathology.
Therapeutic exercises help strengthen muscles, increase the distance between the vertebrae and remove painful manifestations. Specially selected exercises release nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Prevention
In order to prevent degenerative changes in the spine, it is very important to adhere to a proper motor regime every day, alternate physical activities and practice walking and swimming. In addition, it is important to control your body weight so that the spine does not experience additional stress.
Lumbosacral and cervical spine are most often affected by degenerative changes. The thoracic region, fixed by the chest, less often suffers from osteochondrosis. The pain occurs in the lower back or neck, in the projection of the spine. In the beginning, it can be periodic and moderate in nature.
At this stage, the person is able to help himself. To reduce pain, you need to lie on your back: this is the most comfortable position of the body, in which the intervertebral discs, ligaments and joints of the spine are in the most relaxed state. For the lumbar part, this is most often a side position with bent legs. You can take NSAIDs once. Local application of ointment or cream with anti-inflammatory effect on the painful area is recommended.
As the process progresses, the pain becomes more frequent and its intensity increases. It can radiate to an arm or a leg. Numbness (impaired sensitivity) and motor deficit (weakness) often occur in the limbs. These symptoms indicate that the spinal roots are involved in the pathological process.
Also, preventive measures against lower back pain include:
- daily morning exercises;
- balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
