Back pain- one of the most common complaints of patients with a wide range of diseases. Almost every person has experienced pain at least once in their life, localized most often in the sacral spine or between the lower edge of the XII pair of ribs and gluteal folds, ie.lower back pain(BNS).
Low back pain is usually accompanied by muscle tension, often the presence of sore spots. It can radiate (give) to other parts of the body, for example, the leg, gluteal muscles, abdomen, pelvic region, etc.
Acute lower back pain often occurs suddenly and can last from a few minutes to a few weeks. Usually in 90% of cases the 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 getting worse and then receding. Most often, the true cause of lower back pain cannot be determined.
Back pain in the lumbar region - causes
Various diseases can cause back pain in the lumbar region.Lower back pain(BNS) is actually just a symptom that occurs with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavities, the small pelvis and the structure of the spine; in addition, it can be psychogenic.
Pain above the lower back
Back pain above the lower back can occur with ulcers of the stomach and duodenum. Reflected pain is often localized in the lower back or slightly higher, less often in the upper quadrant of the body.
In pancreatitis and cholecystitis, pain is often observed in the projection zone of the sixth to eighth intercostal space.
In the pathology of the genitourinary sphere, the reflected pain is often localized in the area of the lumbar and lower thoracic level of the spine.
Pain in the lower back, right or left
Right or left lower back pain is most often a sign of kidney stones. In the case of kidney stones, a stone growing in the kidney presses on the sensitive kidney parenchyma from the inside, sometimes causing severe pain in the lower back left or right in the kidney where the stone is located.
Pain in the lower back radiates to the leg
When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, legs, abdomen and genitals. Very often back pain radiating to the leg can be a signrenal colicwith urolithiasis of the kidney.
In addition, lumbar pain radiates to the leg with lumboischalgia. Ischalgia appears as pain in the leg mainly during recovery.
Pain in the hips and lower back
Pain in the lower back radiates to the hips on the left and right sides in acute or chronic inflammation of the kidneys. Kidney pain, lasting for several days in a row, accompanied by fever, chills, dysuric phenomena (urination disorders) indicate the diseaseacute pyelonephritis. . .
Pain in back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral region. However, there are often secondary muscular-tonic syndromes (reflex disorders in small and medium gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) in combination with lumbar spine pathology with chronic processes in the organs and tissues of the small pelvis. Such patients need peer treatment by a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Lower back pain
Pelvic bone tumors, especially at the beginning of the disease, can mimic lumboischialgia, and in the presence of simultaneous vertebrogenic processes, patients sometimes undergo neurosurgical intervention due to a hernia at the lower lumbar level. This is aboutchondrosarcomas, 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.
Pain in the lower back and pelvis
Difficulties in the differential diagnosis have been observed in the latent course of pelvic tuberculosis, when there is no increase in temperature and ESR, and the pain may mimic the lumbar ischialgia syndrome of lumbar osteochondrosis. The process can take place secretly from childhood and adolescence and can be detected in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent again and the doctor must remember these manifestations of the disease.
Therefore, pain in the lumbar region and lower back often has nothing to do with any disease of the spine and are alarming symptoms of completely different diseases of the internal organs. Therefore, in the case of back pain, a comprehensive examination is needed.
Low back pain in women - causes
Withdrawal of back pain
Low back pain in womenoften associated with premenstrual syndrome. Such pains usually have a traction character, occur a few days before menstruation and continue 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 may be symptoms of serious reproductive diseases such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)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 borne in mind that pain in the abdomen and lower back in women can be a symptom of dangerous disorders in the pelvic area, such as: the formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, formation of adhesions, cancer of the reproductive organs, etc.
In addition, severe pain in the lower back and lower abdomen (especially on the right or left side) in women may be the result of a ruptured cyst on the ovary 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 uterine size during the development of a normal pregnancy.
Low back pain during pregnancyit is 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 a doctor who is managing 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 great physical effort, work related to lifting weights. In addition, lower back pain can be associated with various diseases of the internal organs.
Severe back pain
Acute pain in the lumbar spine can occur with unpleasant movements, incorrect load distribution, etc. This pain is usually associated with muscle spasm or movement of the spinal discs. Pain can also be caused by squeezing the root muscles of the nerve endings of the spine.
Back and groin pain
Groin pain in men, which radiates 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 large 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 osteoporoticvertebral fracture, abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal canal stenosis and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the doctor to suspect that the patient has a serious pathology and to examine him purposefully (preferably with the participation of an appropriate specialist) to determine the correct diagnosis and treatment.
Radicular (radicular) pain in the lower back, including sciatica syndrome, is a consequence of spinal root compression.
Management of patients with radicular LNS is the prerogative of a neurologist, with special indications requiring the participation of a neurosurgeon. In practice, such patients often resort to the help of chiropractors.
Among the radicular pains in the lower back are:
- lumbago,orlumbago;
- lumbodynia- prolonged pain only in the lower back;
- lumboishalgia- back pain radiating to the leg.
Nonspecific lower back pain- the most common, which is not associated with any visceral disease, serious pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially associated with heavy lifting, prolonged uncomfortable position during sleep or work, etc.
Therefore, it is quite reasonable that the planned X-ray of the spine is not included in the recommendations for the examination of patients with non-specific lower back syndrome (NLP). Such patients do not require a mandatory consultation with 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 common diagnosis given to patients with complaints of lumbar spine pain. However, it is impossible to identify every case of development of an episode of lower back pain with often present in the patient "degenerative-dystrophic" changes in the spine, making a "normal" diagnosis."Worsening of osteochondrosis"or simply"Osteochondrosis". . .
For lower or lower back pain, a diagnosis such as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization". . . Although the correct diagnosis in this case should sound like this:"Lumbago with sciatica in the background of osteochondrosis of the lumbar spine. Lumbarization. (code M54. 4) ".
It should be noted that there is no nosological unit in any foreign classification of degenerative-dystrophic diseases."osteochondritis of the spine". . . Moreover, not a term"Osteochondrosis", nor any other term that characterizes dystrophic changes in the spine, should not be used as a synonym for clinical diagnosis.
Chondrosisis a dystrophic change in the cartilage of the disc,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, the ignorance of both radiologists and clinicians about the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthritis, spondylosis, fixation of hyperostosis, etc. )leads to overdiagnosis: these types of pathology are found where they are not.
Osteochondrosis is often referred to as all of the above degenerative changes due to ignorance of the differences between them. Misunderstood osteochondrosis includesdisc herniation, which is a consequence of its rupture and, as a rule, a normal disc, and is not altered by a dystrophic process. Although it is as wrong to call a herniated disc osteochondrosis as a rupture of the meniscus in the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends the use of the general term "vertebral dysfunction" (which, by the way, is also not included in the ICD-10 classification of the disease) in cases of the appearance of appropriate clinical symptoms.
Many modern, mostly foreign authors point out the lack of connection between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of lower back pain (LBS), on the other hand, since only 1 in 10 patients with radiological signsdegenerative lesions of the spine clinical manifestation of the disease.
Treatment of back pain at home
For low back pain associated with muscle tension and muscle strain, low back pain ointments can significantly relieve symptoms and help relieve muscle tension.
Ointment and tablets for low back pain
Ointments and creams are used to treat the lower back. Alternatively, you can take tablets that contain nonsteroidal anti-inflammatory drugs (NSAIDs).
At the same time, we must keep in mind that self-treatment at home of 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 likeacute pyelonephritisorrenal colicwhich requires urgent qualified medical care.
Prevention of lumbar pain
People who have had an attack of the disease, especially before the formation of stable remission, should follow certain guidelines for prevention:
- Do not tilt the body without resting on the arm; lift objects off the floor with bent knees.
- Change body position more often, do not stand for long, do not sit.
- Work at a table or workplace, keeping an upright position, as this leg, bent at the knee, is placed in front of the other.
- Beware of performing certain yoga exercises, aerobics without the recommendation of an exercise doctor or a vertebrologist.
- Beware of hypothermia, drafts, as well as prolonged warming in a hot bath, because muscle relaxation deprives the immobilizing protection of the muscular corset for a while.