Lower 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 discomfort in the lower back at least once throughout their lives, and about 9% of cases result in disability.The first episode is most often recorded before the age of 30 years.From 30 to 60 years of age, the risk of morbidity increases.
Unfortunately, young people do not always pay attention to warning signs.Many people believe that lower back pain is due to overwork, physical activity, or sitting at the computer for a long time.But in fact, it may be a symptom of a serious illness.Lower back pain can be caused by a variety of pathologies: from problems of the spinal column to kidney failure.Only a timely visit to a doctor will help determine the cause and carry out the correct treatment.
Possible causes of lower back pain: what hurts?
Ankylosing spondylitis
Lumbar pain syndrome occurs due to the fusion of vertebrae into a large conglomerate.The back loses mobility in the lower part.With ankylosing spondylitis, calcium deposits are also observed in the ligaments that hold the spine, which also causes pain when trying to turn around, 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 as 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 acute pain.Without treatment, osteochondrosis progresses, leading to protrusions and disc herniations.The protrusion of cartilage tissue compresses the spinal cord.A person not only has severe lower back pain, but also the innervation of the lower extremities is disrupted.
Distinctive signs of osteochondrosis:
- the pain intensifies when trying to roll over from your back to your stomach, when getting up from a horizontal or sitting position, or while bending over;
- Patients often report weakness and numbness in one leg or both legs.
Spondyloarthrosis
The lower back may hurt due to degenerative changes in the cartilage 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 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;
- radiates to the pelvic area and thighs.
Urolithiasis
An attack of pathology is manifested by 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 blood impurities appear;
- pain occurs when urinating;
- There may be an increase in temperature due to inflammation.
Other causes of pain and cramping in the lower back
Lumbar 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
Lower back pain: what to do?Do not make sudden movements, especially if the pain occurs as a result of a fall or blow.Try to take the most comfortable position.If the pain is acute 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 alleviate 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 make a blockade to relieve acute pain.When the patient feels better, the doctor conducts a more thorough examination and collects anamnesis.It is important to clarify the location, nature, duration of pain, factors that cause exacerbation or, conversely, improve well-being.The doctor will ask about past injuries and illnesses, starting in early childhood.The history helps to 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 spread of the inflammatory process, assesses the size of the stones in order to correctly build 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 examination methods;
- Ultrasound of the pelvic organs.When a woman has lower back pain, this may indicate endometritis or salpingo-oophoritis.Pregnant women must be examined to determine the tone of the uterus;
- Ultrasound of the prostate gland.If a man has lower back pain, this may be a sign of inflammation or a tumor of the prostate.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor may prescribe more targeted procedures.In some cases, consultation with a surgeon, therapist, gynecologist, and other specialists is required 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.Therapy for 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.The drugs help to quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dosage and duration of the course for each patient.
If treatment for lower back pain does not bring results within 2-3 days, the doctor selects hormonal medications.Medicines are needed only to relieve an acute condition.Antispasmodics, decongestants, and B vitamins are prescribed as auxiliary agents. If the patient has lower 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-drug treatment
The procedures are carried out in courses after the exacerbation is relieved.In the complex treatment of pain the following is used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetic therapy;
- physical therapy: a set of daily exercises selected by a doctor, exercises in the pool;
- massage: therapeutic in the lower back and buttocks and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to indications.If the patient has lower back pain and has a temperature that does not decrease while taking medications, removal of the inflammatory focus will be required.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 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 the lower back.The body gives you a signal that you need to pay attention to this area.