Pain in the lower back 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 lower back discomfort at least once in their life, and about 9% of cases result in disability.The first episode is usually recorded before the age of 30.From 30 to 60 years of age, the risk of morbidity increases.
Unfortunately, young people don't always pay attention to the warning signs.Many people believe that lower back pain is the result of excessive work, physical activity or sitting for a long time at the computer.But in fact, it can be a symptom of a serious illness.Pain in the lower back can be caused by various pathologies: from spinal column problems to kidney failure.Only a timely visit to the doctor will help in determining the cause and proper treatment.
Possible causes of lower back pain: what hurts?
Ankylosing spondylitis
Lumbar pain syndrome is caused by fusion of the vertebrae into a large conglomeration.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, stand up, or perform any other action.
Recognizable 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 as thinning of the intervertebral discs.As a result, the shock-absorbing function of the spine is reduced, nerve roots are compressed, and 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.The person not only has severe pain in the lower back, but the innervation of the lower extremities is also disturbed.
Recognizable signs of osteochondrosis:
- the pain intensifies when trying to roll over from the back to the stomach, when standing 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 can hurt due to degenerative changes in the cartilage tissue that covers the intervertebral discs.Elastic layers become thinner, and in their place osteophytes appear - hard bone formations.The space between the vertebrae is reduced by simultaneous compression of the spinal canal.
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 in the area of the pelvis and thighs.
Urolithiasis
An attack of the pathology is manifested by a sharp, strong pain in the back on the side of the affected kidney.The severity and nature of the sensations do not change depending on the position of the body.The patient cannot find a position in which it would be even slightly 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 spasms
Lumbar pain syndrome occurs in the following conditions:
- pregnancy, including early pregnancy;
- 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 impact.Try to take the most comfortable position.If the pain is acute and does not subside with a change of position, call an ambulance - renal colic that requires hospitalization is likely.In other cases, you can use ointments and tablets to relieve the condition.See a specialist as soon as possible.The doctor will help relieve even severe pain and prescribe treatment.
Diagnosis of lower back pain
During the first examination, the doctor can make a block to relieve acute pain.When the patient feels better, the doctor performs a more detailed examination and collects the medical history.It is important to clarify the location, nature, duration of pain, factors that cause worsening or, conversely, improve well-being.The doctor will ask about past injuries and illnesses, starting in early childhood.Anamnesis helps to suggest why the back hurts and which 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, identify signs of pathology of the kidneys and digestive organs;
- Ultrasound of the kidneys and urinary system.Examination is necessary if urolithiasis is suspected.Using ultrasound, the doctor determines the localization and the extent of the spread of the inflammatory process, evaluates the size of the stones in order to properly build treatment tactics;
- X-ray of the lumbar spine.The images help to 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 pain in the lower back, it may indicate endometritis or salpingoophoritis.Pregnant women must be examined to determine uterine tone;
- Ultrasound of the prostate.If a man has pain in the lower back, it can be a sign of inflammation or a prostate tumor.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, the doctor can prescribe more targeted procedures.In some cases, a 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 that suggests a diagnosis.The therapy of renal colic and osteochondrosis is essentially different.
Drug treatment
To reduce pain, non-steroidal anti-inflammatory drugs in the form of injections, ointments and tablets are most often prescribed.Medicines help to quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dose and duration of the course for each patient.
If the treatment of pain in the lower back does not bring results within 2-3 days, the doctor chooses hormonal drugs.Medicines are only needed to alleviate the acute condition.Antispasmodics, decongestants and B vitamins are prescribed as auxiliary agents. If the patient has lower back pain and pain during urination, antibiotics can be chosen.The doctor will tell you why this or that medicine is needed and how to take it properly.
Treatment without drugs
Procedures are carried out in courses after alleviation of exacerbation.In the complex treatment of pain, the following is used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetic therapy;
- physical therapy: a set of daily exercises chosen by the 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 performed strictly according to the indications.If the patient has pain in the lower back and a temperature that does not decrease while taking medication, it will be necessary to remove the focus of inflammation.Radical intervention is necessary for tumors and metastases.
In the case of pathology of the female genital organs, when the lower part of the abdomen hurts, diagnostic curettage and laparoscopic operations are performed.If urolithiasis cannot be removed with the help of drugs, surgical treatment is also indicated for the patient.
You cannot tolerate pain and discomfort in the lower back.Your body is giving you a signal that you need to pay attention to this area.