Back pain- one of the most frequent complaints of patients with a wide variety of diseases. Almost every person at least once in his life experienced pain, localized most often in the sacral spine, or between the lower edge of the XII pair of ribs and the gluteal folds, i. e.lower back pain(BNS).
Lumbar pain is usually accompanied by muscle tension, often by the presence of painful points. It can radiate (give) to other parts of the body, for example, to the leg, to the gluteal muscles, to the stomach, to the pelvic region, etc.
Acute lower back pain often comes on suddenly and can last from a few minutes to several weeks. Usually, in 90% of cases, lower back pain goes away on its own within 3-4 weeks, however, in the remaining 10% of cases it becomes chronic and can last for years, sometimes worsening, then receding. Most often, the true cause of lower back pain cannot be established.
Back pain in the lumbar region - causes
A variety of diseases can cause back pain in the lumbar region.Lower back pain(BNS) is, in fact, only a symptom that appears with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavity, small pelvis and structures of the spine; in addition, it can be psychogenic.
Pain above the lower back
Back pain above the lower back can occur with gastric ulcer and 12 duodenal ulcer. Reflected pain is often localized in the lower back or slightly higher, less often in the upper quadrant of the body.
With pancreatitis and cholecystitis, pain is often noted in the projection zone of the sixth to eighth intercostal space.
In the pathology of the genitourinary sphere, the reflected pains are often localized in the region of the lumbar and lower thoracic levels of the spine.
Lower back pain, right or left
Right-sided or left-sided lower back pain is most often a sign of kidney stones. In case of kidney stones, a stone growing in the kidney presses on the delicate parenchyma of the kidney from the inside, sometimes causing severe pain in the lower back on the left or right in the kidney where the stone is located.
Lower back pain radiates to the leg
When kidney stones pass through the ureters in the lower back, severe pain occurs, which can radiate to the lower back, leg, abdominal cavity and genitals. Very often, back pain radiating to the leg can be a signrenal colicwith urolithiasis of the kidneys.
In addition, lumbar pain radiates to the leg with lumboishalgia. Ishalgia appears as pain in the leg mainly during recovery.
Side and lower back pain
Lower back pain radiates to the sides on the left and right in acute or chronic inflammation of the kidneys. Pain in the kidneys, lasting for several days in a row, and accompanied by fever, chills, dysuric phenomena (urination disorders) indicates a diseaseacute pyelonephritis. . .
Back pain in the back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral region. Often, however, there are secondary muscle-tonic syndromes (reflex disorders in the small and middle gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) in combination with pathology of the lumbar spine with chronic processes in the organs and tissues of the small pelvis. Such patients need collegial treatment of a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Lower back pain
Tumors of the pelvic bones, especially at the onset of the disease, can mimic lumboischialgia, and in the presence of a concomitant vertebrogenic process, patients sometimes undergo neurosurgical intervention for a hernia at the lower lumbar level. This concernschondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand some others. Mandatory X-ray examination usually solves the diagnostic problem. It should not be forgotten that the general somatic and hematological condition of the patient can determine the oncological aspect of the disease.
Low back and pelvic pain
Difficulties in differential diagnosis are noted in the latent course of tuberculosis of the pelvic bones, when there is no increase in temperature and ESR, and the pain can mimic the lumbar ischialgic syndrome of lumbar osteochondrosis. The process can proceed secretly from childhood and adolescence and reveal itself in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent again, and the doctor must remember about these manifestations of the disease.
Thus, pain in the lumbar region and in the lower back may often have nothing to do with any disease of the spine and are alarming symptoms of completely different diseases of the internal organs. Therefore, in case of back pain, a comprehensive examination is required.
Low back pain in women - causes
Pulling back pain
Low back pain in womenoften associated with premenstrual syndrome. Such pains usually have a pulling character, they occur a few days before menstruation and continue for 2-3 days after its onset and disappear on their own.
Lower back and abdominal pain in women
Lower back and abdominal pain associated with premenstrual syndrome and accompanied by cramps in the lower abdomen and painful periods with heavy bleeding can be symptoms of serious reproductive diseases such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)and etc.
Abdominal pain radiates to the lower back
Abdominal pain in women can radiate to the lower back, to the lower abdomen, radiate to the vagina and external genitalia.
It must be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous disorders in the pelvic area, such as: the formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, the formation of adhesions, cancers of the reproductive organs, etc.
In addition, severe pain in the lower back and lower abdomen (especially on the right or left) in women may be the result of a ruptured ovarian cyst or a symptom of an ectopic pregnancy.
Low back pain during pregnancy
Often, pain in the lower back and abdomen in women indicates natural physiological changes associated with an increase in the size of the uterus during the development of a normal pregnancy.
Low back pain during pregnancyis associated with additional stress on the spine and is normal and does not require special treatment. However, pregnant women with severe lower back pain should always consult with a doctor leading the pregnancy.
Lower back pain in men - causes
Lower back pain in men is most often associated with degenerative diseases of the spine, especially with heavy physical exertion, work associated with lifting weights. In addition, lower back pain can be associated with various diseases of the internal organs.
Severe back pain
Sharp pain in the lumbar spine can occur with awkward movement, improper load distribution, etc. This pain is usually associated with either muscle spasm or displacement of the vertebral discs. Pain can also be caused by muscle clamping of the roots of the nerve endings of the spine.
Back pain and groin pain
Pain in the groin area in men, radiating to the lower back can be associated with prostate adenoma, testicular torsion, oncology, urological diseases, etc.
Classification of back pain
The classification, widespread in a number of countries, aimed at optimizing the provision of medical care for LPS, distinguishesspecific, radicular and nonspecific BNS. . .
Specific back painis a symptom of a certain disease, often severe and even life-threatening (cancer, including metastases to the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc. ; inflammatory, - for example, ankylosing spondylitis and other spondyloarthritis; traumatic and osteoporotic fracture of the vertebra; aneurysms of the abdominal aorta, gynecological, urological and renal diseases, stenosis of the spinal canal and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the doctor to suspect a serious pathology in the patient and purposefully examine him (preferably with the involvement of an appropriate specialist) to establish the correct diagnosis and treatment.
Radicular (radicular) pain in the lower back, including sciatica, is a consequence of compression of the spinal root.
The management of patients with radicular LNS is the prerogative of a neurologist, with special indications the participation of a neurosurgeon is required. In practice, however, such patients often resort to the help of chiropractors.
Among radicular lower back pain, there are:
- lumbago,orlumbago;
- lumbodynia- long-term pain only in the lower back;
- lumboishalgia- back pain radiating to the leg.
Nonspecific lower back pain- the most common, not associated with any visceral disease, serious pathology of the spine, spinal cord and its roots. It can be caused by overloading of the lumbar spine, especially associated with heavy lifting, prolonged uncomfortable position during sleep or work, etc.
Therefore, it is quite reasonable that a planned spinal x-ray is not included in the recommendations for examining patients with nonspecific lower back pain (NLP) syndrome. Such patients do not need the obligatory consultation of a neurologist, but should be treated by a family doctor, district therapist or general practitioner.
Low back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most frequent diagnosis, which is given to patients with complaints of pain in the lumbar spine. However, it is impossible to identify each case of the development of an episode of pain in the lower back with often actually present in the patient "degenerative-dystrophic" changes in the spine, making a "habitual" diagnosis"Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .
For pain in the lower back or lower back, a diagnosis is often written such as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization ". . . Although, the correct diagnosis in this case should sound like this:"Lumbago with sciatica on the background of osteochondrosis of the lumbar spine. Lumbarization. (code М54. 4) ".
It should be noted that there is no nosological unit in any of the foreign classifications of degenerative-dystrophic diseases. "osteocondritis of the spine". . . Moreover, neither the term"Osteochondrosis", nor any other term characterizing dystrophic changes in the spine, should not be used as a synonym for clinical diagnosis.
Chondrosisis a dystrophic change in disc cartilage,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, ignorance by both radiologists and clinicians of the signs of degenerative changes in the spine(chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, fixing hyperostosis, etc. )leads to overdiagnosis: these types of pathology are found where they are not.
Often, osteochondrosis is called all of the listed degenerative changes due to ignorance of the differences between them. By misunderstanding, osteochondrosis includesherniated disc, which is a consequence of its rupture, and, as a rule, a normal disc, and not altered by a dystrophic process. Although, calling a disc herniation osteochondrosis is just as wrong as a meniscus rupture in the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends using the general term "vertebral dysfunction" (which, by the way, is also not included in the ICD-10 classification of diseases) in cases of the appearance of appropriate clinical symptoms.
Many modern, mainly foreign, authors emphasize the absence of a connection between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of pain in the lower back (LBS), on the other, since only 1 out of 10 patients with radiologicalsigns of degenerative lesions of the spine are clinical manifestations of the disease.
Back pain treatment at home
For low back pain associated with muscle tension and muscle tightness, low back pain ointments can significantly relieve symptoms and help relieve muscle tension.
Low back pain ointment and pills
Ointments and creams are used to treat the lower back. Alternatively, you can take non-steroidal anti-inflammatory drugs (NSAIDs) tablets.
At the same time, it must be remembered that self-treatment at home for lower back pain with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease that causes these pains, and very sad consequences. Self-medication of the lower back is especially dangerous for kidney diseases such asacute pyelonephritisorrenal colicrequiring emergency qualified medical care.
Prevention of lumbar pain
Persons who have had an attack of the disease, especially before the formation of a stable remission, need to follow certain instructions for prevention:
- Do not tilt the body without support on the arm; pick up objects from the floor with your knees bent.
- Change body position more often, do not stand for a long time, do not sit.
- Work at a table or workplace, keeping an upright position, for this one leg, bent at the knee, put in front of the other.
- Beware of performing specific yoga exercises, aerobics without the recommendation of an exercise therapy doctor or a specialist vertebrologist.
- Beware of hypothermia, drafts, as well as prolonged heating in a hot bath, since muscle relaxation deprives for some time the immobilizing protection of the muscle corset.