Lower back pain is a common reason to see a doctor. The cause of discomfort in this area can be a number of diseases.
What is ankylosing spondylitis, as evidenced by severe pain in the sacral region, radiating to the leg, what studies are carried out when diagnosing, the causes of pain in the lower shoulder blades and the most common treatment methodseffective - in the material.
Lower back pain
The sudden onset of sharp pain in the lower back is a fairly common occurrence. This symptom, characteristic of many pathologies, is not always caused by diseases of the spine. The manifestations and causes of pain may vary.
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 region, severe pain is localized in the hip joint. The pain radiates down the leg and is felt in the foot. Similar symptoms are observed in osteochondrosis with a risk of numbness of the limbs.
The mechanism of pain development is compression of the sciatic nerve. The pain is worse when walking quickly, bending, or coughing. Prolonged compression of the gluteal muscle leads to its atrophy.
Acute
Sharp pain occurs suddenly. They are unbearable and very intense, often described as "lumbago". Depending on the cause, the pain may be triggered by physical activity. Accompanied by stiffness of movement (sometimes it is even impossible to straighten up). The slightest movement intensifies the symptoms. Acute pain may persist for up to six weeks.
Pull and hurt
Shooting and aching pain in the lumbar region most often results from diseases such as herniation, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain in the lower back may be a hernia or protrusion, accompanied by degenerative changes in the spine. The intensity of these manifestations increases with physical exercise and is a consequence of physical inactivity.
Moved
The occurrence 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.
Mechanical
Mechanical pain occurs during or immediately after physical activity.
Irradiating
Such pains are dull and aching. Painful sensations can also radiate up the leg (to the foot).
Local
They are characterized by the appearance of unpleasant sensations in a certain area of the lower back.
Reflected
Referred pain is pain felt in a different location than actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation which can be accompanied by numbness and a feeling of loss of sensitivity.
Myofascial
Such pain is accompanied by muscle spasms and intensifies upon contact with the muscle.
Causes
The causes of low back pain are very diverse and can be associated with pathological conditions both in the spine itself and in the tissues surrounding it.
Experts have identified the main pathologies that cause lower back pain.
Ankylosing spondylitis
This is a systemic disease accompanied by inflammation of the connective tissues of the spine. With spondylitis, fusion of the vertebrae occurs, which limits their motor activity and ankylosis (immobility of the joint) is formed. Thanks to the ossification of the paravertebral ligaments, the spine gradually becomes a solid and inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, pain appears in the lumbar region, gradually covering new areas;
- negative symptoms bother you occasionally, but over time they become permanent;
- the stiffness of movements increases.
The expressiveness of signs is observed at night. In the morning, the pain becomes unbearable.
Osteochondrosis
Growth, destruction, protrusion of cartilaginous tissue caused by a violation of their nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of osteoarthritis of the vertebral joints.
Against this background, dorsalgia (back pain) develops with characteristic manifestations of shooting in the lumbar region, with irradiation of the buttocks and legs. Weakness and a feeling of numbness appear in the lower extremities. In this case, the nerve endings in the roots are pinched, which causes a burning and tingling sensation.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by the protrusion of disc fragments and their prolapse into the vertebral canals.
There are no symptoms at the initial stage, but lack of treatment causes increased pain, while limiting mobility in the lumbar region. Acute painful sensations are observed, increasing against the background of exertion, they force the person to take a pain-relieving position.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of curvature of the spine. In the early stage of curvature deformity of the spine, there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic discomfort, but progressing to constant discomfort. The pain is aching in nature and intensifies with physical activity.
Spondyloarthrosis
With this pathology, articular cartilage is destroyed and osteophytes (bone growths) are formed. This leads to narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, severe pain appears, intensifying during physical activity and subsiding in a calm state. Muscle tension is observed, leading to a decrease in motor activity.
Projection
Prerequisites for the formation of protrusions are spinal injuries, excess permitted physical activity and muscle weakness due to physical inactivity. In this case, a 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. During the chronic course of the disease, the patient is bothered by "lumbago", which often occurs due to hypothermia and overwork.
Osteomyelitis
With osteomyelitis, an inflammatory process in bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. Lack of treatment leads to chronic disease, but the pain syndrome persists.
Pancreatitis
Lower back pain is a sign of inflammation of the pancreas. The disease manifests itself as stabbing, cutting and pulling sensations 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 is intensified when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae from behind). This condition is accompanied by an increased load on muscles and bones and causes an inflammatory process followed by the development of spondyloarthrosis and degenerative changes.
At the affected joint, pain is felt in the form of cramping attacks when bending and rotating the lower back. One of the symptoms is stiffness of movements in the morning and increasing discomfort in the evening.
Location
To identify the cause of pain in the lumbar region, you must first determine the location of the discomfort. To make an accurate diagnosis, you need to contact a specialist.
Pain below the waist
The cause of pain below the lower back is most often pathological conditions of 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, pain most often appears after lifting heavy objects or walking quickly. Often, painful sensations in the lower back occur after serious injuries or infectious diseases. They are also present during menstruation, pregnancy and menopause.
Pain above the lower back, but below the shoulder blades
Pain between the lower back and shoulder blades can be caused by the following diseases:
- spinal pathologies in the lumbar and thoracic region or previous injuries in these areas;
- osteoporosis;
- muscle spasms or tension;
- pancreatitis.
Similar manifestations can occur against the background of the development of neoplasms of various etiologies.
Left lower back pain
Painful sensations in the lower back, radiating to the left shoulder blade and covering the left side of the neck, often result from myocardial infarction.
Cutting pain in this area indicates the likelihood of a perforated ulcer.
Also, these symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, aching pain is felt against the background of physical inactivity or exceeding permissible loads.
Right lower back pain
Suspicion of a pathology of the kidneys or genitourinary organs arises when a dull, aching pain appears on the right. The inflammation may have an infectious etiology or be a consequence of hypothermia.
Sudden sharp pain in the right side indicates the likelihood of a perforated ulcer, burst appendicitis or signals internal bleeding. Right-sided pain often indicates muscle tension and radiculopathy.
Lower back pain when coughing
Possible causes of lower back pain when coughing:
- osteochondrosis;
- hernia;
- stenosis of nerve roots, causing weakness and difficulty walking;
- facet arthropathy, in which muscle tension occurs;
- injured annulus fibrosus;
- pathological condition of the kidneys.
Painful sensations when coughing are often observed against the background of neuralgia.
Low back pain can occur for physiological reasons. These include:
- Overweight,
- passive lifestyle,
- excessive physical activity.
Diagnostic
To determine the source that causes pain in the lumbar region, it is necessary to carry out a comprehensive diagnostic examination. It includes laboratory tests and instrumental procedures.
The main ones:
- blood test (general, biochemical), urine;
- tumor marker tests;
- x-ray of the lumbar spine;
- endoscopic examination of internal organs;
- Ultrasound (ultrasound examination);
- MRI (magnetic resonance imaging).
It is also necessary to seek advice from a neurologist and a chiropractor. An accurate diagnosis is made by a specialist who, based on the results of the examination, will decide how to treat lower back pain.
Treatment
The main methods of treating lower back pain:
- medicinal;
- physiotherapy;
- surgical intervention.
Diseases accompanied by lower back pain can pose a serious danger to human health (even death). Without resorting to self-medication, you should consult a therapist, neurologist or neurologist. Often, in order to identify the cause of pain, it is necessary to consult a urologist and gynecologist.
Surgical
Surgical intervention is only relevant as an emergency measure in oncology. Specialists carry out planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Medicine
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the first step in pain relief. They are used in various forms: tablets, injections, rectal suppositories, patches, ointments or gels.
Depending on the established diagnosis and the severity of the symptoms, glucocorticosteroids are also used - hormonal drugs that relieve pain and inflammation. In case of muscle spasms, muscle relaxants are prescribed.
B vitamins are suitable as auxiliary therapy to improve nerve conduction. Drug treatment should always be accompanied by non-drug treatment methods: physiotherapy, physiotherapy, massage (only outside of exacerbations). Depending on the effectiveness / ineffectiveness of the measures taken, the severity of the symptoms and the examination, surgical treatment may be recommended to the patient - removal of a hernia, elimination of compression of the root of the spinal cord.
Treatment depends on the cause of the lower back pain. Pathologies of internal organs must be eliminated by specialized specialists; inflammatory lesions of the skeletal system, systemic inflammation may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and acute symptoms of the disease are eliminated, doctors may prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetotherapy, transcutaneous electrical stimulation) and exercise therapy.
Additionally, the attending physician may prescribe acupuncture. Massage sessions are also effective in treating this pathology.
Therapeutic exercises help to strengthen muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises free nerve roots from compression, help to normalize blood flow and normalize metabolic processes.
Prevention
To prevent degenerative changes in the spine, it is very important to observe a correct motor regime daily, alternate physical activities and practice walking and swimming. Additionally, it is important to control your body weight so that the spine does not experience additional stress.
Most often, the lumbosacral and cervical spine are affected by degenerative changes. The thoracic region, fixed by the rib cage, less often suffers from osteochondrosis. The pain occurs in the lower back or neck, respectively, in the projection of the spine. At first, it may be periodic and moderate.
At this stage, a person is capable of helping themselves. To reduce pain, you need to lie on your back: this is the most comfortable body position, in which the intervertebral discs, ligaments and joints of the spine are in the most relaxed state. For the lumbar region, it is most often a lateral position with the legs bent. You can take NSAIDs once. It is recommended to locally apply an ointment or cream with an anti-inflammatory effect to the painful area.
As the process progresses, the pain becomes more frequent and its intensity increases. It can radiate to the arm or leg. Numbness (impaired sensation) and motor deficit (weakness) often appear in the limb. These symptoms indicate that the spinal roots are involved in the pathological process.
Additionally, preventative measures for lower back pain include:
- daily morning exercises;
- Balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
