Lower back pain is one of the most common and therefore many people simply do not pay attention to it. However, pain in the lumbar region can not only limit a person's mobility, but also signal diseases of the internal organs of the abdominal cavity. Therefore, if you feel the slightest discomfort in your back, it is important to seek help from a doctor who will perform an examination and prescribe an effective treatment.
Types of pain
The first thing a doctor is interested in when examining a patient is the intensity and frequency of pain. Depending on the cause, lower back pain can be of the following nature:
subacute – starts suddenly and can last from 6 to 12 weeks;
acute - occurs suddenly, is characterized by high intensity, can last about 1. 5 months;
variable (transient) – occurs periodically;
chronic - can have a weak or strong intensity, lasts for 12 weeks or longer;
boring;
painful;
weak, medium intensity, strong.
Pain can vary depending on the cause. In this case, the duration and intensity of the sensation may vary. Therefore, when visiting the doctor, it is important to describe your feelings as precisely as possible.
Common causes of lower back pain
In the lumbar region, there are the following systems that can cause pain:
Musculoskeletal– pain usually occurs as a result of spinal injury, as well as damage or strain of the muscles of the lower back.
Digestive- usually "shooting" pain in the lower back, which is caused by disorders in the work of the gallbladder, pancreas, intestines, liver and stomach. This is observed in gastritis, the presence of stones in the bile ducts, intoxication, pancreatitis, poisoning, stomach ulcers andvarious forms of obstruction.
Nervous- pain occurs due to the formation of a hernia, neuropathy, nerve entrapment, curvature of the spine, protrusion and inflammatory processes that occur in the vertebrae.
Sexual and urinary- pain syndrome occurs if a person has urolithiasis, bladder and kidney problems, ovarian and uterine lesions of various types.
The most common diseases that cause low back pain
Spinal curvatures (scoliosis, kyphosis)
In this case, a person experiences pain when the disease occurs in the middle and late stages. As a rule, the pain syndrome manifests itself at the end of the working day and may be accompanied by back muscle fatigue. The pain syndrome manifests itself in the form of spasms of the periarticular muscles of the lower and upper extremities, as well as the muscles of the spine and gluteal muscles.
Ankylosing spondylitis
It is an inflammatory systemic disease characterized by the fusion of individual vertebrae into a single unit. In parallel, there is an accumulation of calcium in the ligaments that stabilize the spinal column. This can lead to a complete loss of mobility.
Ankylosing spondylitis is accompanied by the following lower back pain:
stiffness of movement in the lumbar region;
a strong increase in intensity when a person rests for a long time.
Urolithiasis disease
Attacks are manifested in the form of severe pain in the lumbar region, which is caused by the affected kidney. The pain does not disappear or subside, even if the person changes the position of the body. Typically, attacks are accompanied by a change in the color of urine (it becomes red) and a decrease in its quantity.
Pain syndrome can be a consequence of:
inflammatory process in the pancreas;
intestinal obstruction;
painful menstruation (algomenorrhea);
osteomyelitis;
pregnancy;
appendicitis.
Osteochondrosis of the lumbar region
One of the most common diseases, characterized by thinning of the intervertebral discs, which act as shock absorbers. This leads to spasms of the surrounding muscles and irritation of the nerve roots, which causes severe pain. If the disease is diagnosed at an advanced stage, it is most likely accompanied by a herniated disc, which puts pressure on the spinal cord, which leads to increased pain in the lower back.
The pain syndrome intensifies if the person:
rises from a lying or sitting position;
leans to the sides;
he tries to lie on his stomach.
If, as a result of the development of the disease, a massive hernia is formed in the spine, the pain in the lumbar region will only intensify. In addition, the pain syndrome may be accompanied by weakness or numbness in one or both legs.
Spondyloarthrosis
It is a degenerative-dystrophic disease of the cartilage tissue that covers the intervertebral discs. The tissue becomes thinner over time, which leads to its destruction; osteophytes (specific bone growths) form around the lesion. This leads to a reduction in the distance between the vertebrae, a narrowing of the spinal canal, which causes irritation of the nerve roots and the spinal cord itself.
Pain in spondyloarthrosis is of the following nature:
in the initial phase it appears only in the morning, and later it becomes permanent;
increases after physical activity (after walking, standing) and decreases after rest;
it can be accompanied by pain in the hip joint and thigh.
The pain syndrome in spondyloarthrosis intensifies as a result of muscle spasms that are constantly under tension. Eliminating lower back pain in this case is extremely difficult.
Which specialist should you contact when your lower back hurts?
Since the organs in the abdominal cavity are located quite close to each other, the symptoms of the disease can be mixed. Moreover, aching pain that is present for a long time can be dangerous in nature. Therefore, before treatment, it is important to undergo diagnostics, one of the specialists can refer you to an examination:
A neurologist– when the patient experiences acute pain with "shooting" in the spine, which is accompanied by a partial loss of sensitivity and mobility. When the pain intensifies after changing the position of the body or prolonged rest.
Surgeon or traumatologist– due to a fall, injury or intense sports.
Nephrologist or urologist- with frequent or difficult urination, which is accompanied by painful pains in the lumbar region, as well as if there is acute pain on one side of the lumbar region.
Gastroenterologist- when the pain syndrome is accompanied by an increase in body temperature, weakness and disorders of the digestive system. If the pain is present only on one side and is pulling in nature.
Gynecologist- if the pain is felt on one or both sides, it may be accompanied by general weakness and increase during physical activity. When the pain is felt during the menstrual cycle or pregnancy.
If a person knows the cause of pain in the lower back, then there is no need to contact a specialist (heavy physical activity - the pain usually disappears in one or two days). In other cases, you should pay attention to such symptoms and go to see a specialist.
How to diagnose lower back pain - diagnostic methods:
Ultrasound- if there is a suspicion of diseases of the pelvic or abdominal organs. It can be prescribed even to children, but it does not always allow to see the real cause of pain in the lower back.
x-ray- if the patient has hernias, injuries, scoliosis. But this method allows you to see only the bone tissue.
CT- if there are hernias, neuropathy, protrusions, neoplasms or spinal injuries. Computed tomography is ideal for patients in whom magnetic resonance is contraindicated.
MRI– indications are similar to CT. The method is very precise and allows for the most detailed examination of the necessary organs.
Colonoscopy and gastroscopy- if the patient has been diagnosed with a disease of the digestive system. These examinations allow you to take a good look at the abdominal organs and, if necessary, take tissue samples for analysis.
Methods of treatment of lower back pain
Methods of treatment of low back pain are determined by the cause of its occurrence. When musculoskeletal disorders are present, treatment without drugs, drugs, or surgery may be necessary.
Treatment methods other than drugs:
physical therapy - the course of treatment is chosen individually based on the existing diseases. It is important to perform a set of exercises regularly in order to achieve the desired effect;
physiotherapy - includes laser treatment of the lesion, magnetic therapy, electrophoresis and other procedures;
acupuncture;
therapeutic and restorative massage - can be used only if the patient does not have an aggravation of the disease;
manual therapy and work with an osteopath.
Treatment without drugs is usually supplemented with drugs.
Drug treatments
NSAIDs (non-steroidal anti-inflammatory drugs) are used as the main therapy. Medicines are prescribed in the form of intramuscular and intravenous injections, tablets, ointments and creams, as well as rectal suppositories and patches that are applied locally.
The dose and duration of treatment is determined by the doctor. Uncontrolled use of drugs can lead to side effects.
If taking NSAIDs does not give the desired effect, then the doctor prescribes corticosteroids (hormonal drugs). Taking them allows you to stop the inflammation process and relieve pain.
If the patient has muscle spasms in the lower back, he is prescribed antispasmodics. Such drugs can relieve muscle spasms in the lower back and improve general well-being.
Drugs such as:
B vitamins, which improve nerve conduction;
decongestants that relieve the swelling of the pinched root;
sedative drugs.
Surgical methods of treatment
If the doctor identifies a patient with indications for surgery, then the patient undergoes surgery. However, surgery is not prescribed if the patient has a herniated disc, as this is not an indication for surgery, regardless of size. If the patient has indications for the removal of a hernia, a tumor or there is a need to relieve compression of the spinal cord root, then surgical intervention is performed. The decision on the need to perform any operation is made by the doctor on an individual basis, depending on the indications and the condition of the patient.
Prevention of lower back pain
Moderate physical activity and a healthy lifestyle are the keys to a healthy back. It is important to organize a comfortable place to sleep and constantly monitor your posture. If you spend a lot of time sitting in a sitting position, then you need to get up from time to time and warm up a little. If you do not like to exercise, then it is advisable to walk as much as possible.
Giving up bad habits and maintaining a proper diet will help prevent the development of diseases of the internal organs. This is especially important for people who have already been diagnosed with diseases of the pancreas, stomach, kidneys and liver. In addition, you need to try to keep the lower back always warm. The fact is that cold air can cause the development of diseases of internal organs and cause inflammation of the nerves.
If there is a need to lift any heavy objects, then it should be done using the legs, while the back should be straight. This will shift the load from the lower back muscles. And finally, do not ignore pain in the lower back, even if it does not cause severe discomfort. It is better to get examined and start treatment in time than to deal with serious consequences.