Back pain is a common reason to see a doctor. The cause of concern in this area can be a number of diseases.
What is ankylosing spondylitis, as evidenced by severe pain in the sacral area, radiating to the legs, what studies are performed during diagnosis, the causes of pain in the lower shoulders and the most effective methods of treatment - in the material.
Pain in the lower back
The sudden onset of acute lower back pain is a fairly common occurrence. This symptom, which is characteristic of many pathological conditions, is not always caused by diseases of the spine. Manifestations and causes of pain can vary.
Types of pain
From the nature of the pain that appears in the lumbar region, the main cause of the discomfort can be identified.
Strong
Starting in the sacrum area, severe pain is localized in the hip joint. The pain radiates down the leg and is felt in the leg. Similar symptoms are observed in osteochondrosis with the risk of limb numbness.
The mechanism of pain development is compression of the sciatic nerve. The pain gets worse when you walk fast, bend over or cough. Prolonged compression of the gluteal muscle leads to its atrophy.
Acute
Acute pain appears suddenly. They are unbearable and very intense, often characterized as "lumbago". Depending on the cause, the pain can be triggered by physical activity. Accompanied by stiffness of movement (sometimes it is even impossible to straighten). The slightest movement intensifies the symptoms. Acute pain can last up to six weeks.
Withdrawal and pain
Annoying and painful pain in the lumbar region most often results from diseases such as hernia, protrusion and inflammation of the sciatic nerve.
chronic
The cause of constant pain in the lower back can be hernias or protrusions, accompanied by degenerative changes in the spine. The intensity of such manifestations increases with physical exercise and is a consequence of physical inactivity.
moving
The appearance 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.
Engineering
Mechanical pain occurs during or immediately after physical activity.
Radiation
Such pains are dull and painful. Painful sensations can also radiate to the legs (up to the feet).
cafeteria
They are characterized by the appearance of unpleasant sensations in a certain area of the lower back.
REFLECT
Referred pain is pain that is felt in a place other than the actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation that can be accompanied by numbness and a feeling of loss of sensation.
myofascial
Such pain is accompanied by muscle spasm and intensifies when the muscle is touched.
Causes
The causes of low back pain are very different and can be associated with pathological conditions both in the spine itself and in the tissues that surround it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
This is a systemic disease associated with inflammation of the connective tissues of the spine. With spondylitis, fusion of the vertebrae occurs, as a result of which their motor activity is limited and ankylosis (immobility of the joint) is formed. As a result of the ossification of the paravertebral ligaments, the spine gradually becomes a strong and rigid bone.
The pathological condition is characterized by increasing symptoms:
- First, the pain appears in the middle region, gradually covering new areas;
- negative symptoms bother you from time to time, but over time they develop into permanent ones;
- stiffness of movements increases.
The expressiveness of the signs is observed at night. In the morning the pain becomes unbearable.
Osteochondrosis
Growth, destruction, elongation of cartilage tissue caused by a violation of their nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of arthrosis of the spinal joints.
Against this background, dorsalgia (back pain) develops with characteristic manifestations of shooting in the lumbar region, with radiation to the buttocks and legs. Weakness and numbness appear in the lower extremities. In this case, the nerve endings of the roots are compressed, which causes a burning and tingling sensation.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by the elongation of the disc fragments and their prolapse in the vertebral canals.
There are no symptoms in the initial stage, but the lack of treatment provokes an increase in pain, limiting the mobility of the lumbar region. Acute pain sensations are observed, increasing against the background of exertion, they force the person to take a position against pain.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spine. In the early stage of the curvature of the spine, there are no negative symptoms. But over time, muscle fatigue appears with periodic occurrence, but developing into constant discomfort. The pain is aching in nature and intensifies with physical activity.
Spondyloarthrosis
With this pathology, the articular cartilage is destroyed and osteophytes (bone growth) 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, which intensifies during physical activity and subsides in a calm state. Muscle tension is observed, causing a decrease in motor activity.
Extension
The prerequisites for the formation of protrusions are injuries to the spine, exceeding the allowed physical activity and muscle weakness due to physical inactivity. In this case, disc protrusion appears, 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. In the chronic course of the disease, the patient suffers from "lumbago", which often occurs due to hypothermia and overwork.
Osteomyelitis
With osteomyelitis, an inflammatory process of bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. Lack of therapy causes the disease to become chronic, but the pain syndrome continues.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease appears with stabbing, cutting and pulling sensations of a paroxysmal nature.
Spinal stenosis
The pathological condition is caused by complications of hernias and protrusions. The compression of the nerve roots provokes discomfort while walking, at rest and intensifies when you bend your back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae from the back). This condition is associated with an increased load on muscles and bones and provokes an inflammatory process with the subsequent development of spondyloarthrosis and degenerative changes.
In the area of the affected joint, pain is felt in the form of cramping attacks while bending and rotating the lower back. One of the symptoms is stiffness of movement in the morning and increased restlessness in the evening.
Localization
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 under the lower back is most often pathological conditions in 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 under 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 back and shoulders can be caused by the following diseases:
- pathologies of the spine in the lumbar and thoracic region or previous injuries in these areas;
- osteoporosis;
- muscle spasm or tension;
- pancreatitis.
Similar manifestations can occur against the background of the development of neoplasms of various etiologies.
Pain in the lower left back
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 possibility of a perforated ulcer.
Also, such symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, pain is felt that appears against the background of physical inactivity or exceeding the permissible loads.
Pain in the lower back on the right
Suspicion of the pathology of the kidneys or genitourinary organs arises when dull pain appears on the right. The inflammation may have an infectious etiology or be a consequence of hypothermia.
Sharp and sudden pain on the right side indicates the possibility of a perforated ulcer, burst appendicitis or signals internal bleeding. Pain on the right side often indicates muscle strain and radiculopathy.
Pain in the lower back when coughing
Possible causes of back pain during coughing:
- osteochondrosis;
- hernia;
- stenosis of the nerve roots, causing weakness and difficulty walking;
- facet arthropathy, in which muscle strain occurs;
- damaged 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. This includes:
- overweight,
- passive lifestyle,
- excessive physical activity.
Diagnosing
To determine the source that provokes 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;
- tests for tumor markers;
- 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 chiropractor. An accurate diagnosis is made by a specialist who, based on the results of the examination, will decide how to treat back pain.
Treatment
The main methods of treating low back pain:
- medicinal;
- physiotherapy;
- Surgical intervention.
Diseases associated with pain in the lower back can pose a serious risk to human health (even death). Without using self-medication, you should consult a therapist, neurologist or neurologist. Often, to identify the cause of the pain, it is necessary to consult a urologist and gynecologist.
surgery
Surgical intervention is important only as an emergency measure for oncology. Specialists perform planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Treatment
The first step in pain relief is non-steroidal anti-inflammatory drugs (NSAIDs). They are used in different 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. If muscle spasm is present, muscle relaxants are prescribed.
B vitamins are suitable as an adjunctive therapy to improve nerve conduction. Drug therapy should always be accompanied by non-drug treatment methods: physiotherapy, physiotherapy, massage (only out of irritation). Depending on the effectiveness/ineffectiveness of the measures taken, the severity of the symptoms and on the basis of the examination, the patient may be recommended surgical treatment - removal of a hernia, elimination of compression of the spinal cord root.
Treatment depends on the cause of the 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 the acute symptoms of the disease are eliminated, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrical stimulation) and exercise therapy.
In addition, the attending physician may prescribe acupuncture. In the treatment of this pathology, massage sessions are also effective.
Therapeutic exercises help to strengthen the muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises release nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Preventing
To prevent degenerative changes in the spine, it is very important to observe the correct motor regime every day, alternate physical activities and practice walking and swimming. In addition, 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, suffers less often from osteochondrosis. The pain appears in the lower back or neck, respectively, in the projection of the spine. At first it may be intermittent and moderate in nature.
At this stage, a person is able to help himself independently. To reduce pain, you should lie on your back: this is the most comfortable position of the body, in which the intervertebral discs, ligaments and joints of the spine are in the most relaxed state. For the lumbar region, this is most often a side position with bent legs. You can take NSAIDs once. It is recommended that an ointment or cream with an anti-inflammatory effect be applied locally 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 limbs. These symptoms indicate that the spinal roots are involved in the pathological process.
Also, preventive measures for back pain include:
- daily morning exercises;
- Balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
