Lower back pain is a common reason for a visit to the 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 area radiating to the leg, what tests are performed during diagnosis, the causes of pain in the lower shoulder blades and the most effective methods of treatment - in the material.
Backache
The sudden onset of sharp pain in the lower back is quite common. This symptom, which is characteristic of many pathological conditions, is not always caused by diseases of the spine. Manifestations and causes of pain can be different.
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 area of the sacrum, the intense 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 the 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 over or coughing. Prolonged compression of the gluteal muscle leads to its atrophy.
Sharp
Sharp pain occurs 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 movements (sometimes it is even impossible to stand up). The slightest movement intensifies the symptoms. Acute pain can last up to six weeks.
Pulling and pain
Pressing and aching pain in the lumbar region is most often the result of diseases such as hernia, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain in the lower back can be a hernia or protrusion accompanied by degenerative changes in the spine. The intensity of such manifestations increases with physical exercise and is a consequence of a lack of physical activity.
Moved
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.
Mechanical
Mechanical pain occurs during or immediately after physical activity.
Irradiation
Such pains are dull and painful. Painful sensations can also radiate to the leg (up 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 that is felt in a different location than the actual pain.
radicular
Radicular syndrome is a neuralgic manifestation that can be accompanied by numbness and a sense of loss of sensitivity.
Myofascial
Such pain is accompanied by muscle spasm and increases when the muscle is touched.
reasons
The causes of low back pain are very diverse and can be related to pathological conditions both in the spine itself and in the tissues around it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
It is a systemic disease accompanied by inflammation of the connective tissue of the spine. In 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 ossification of the paravertebral ligaments, the spine gradually turns into hard, inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, the pain appears in the lumbar 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, 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 arthrosis of the spinal joints.
Against this background, dorsalgia (back pain) develops with characteristic manifestations of shooting in the lumbar region, with irradiation to the buttocks and legs. Weakness and a feeling of numbness appear in the lower limbs. In this case, the nerve endings of the roots are pressed, which causes a burning and tingling sensation.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by protrusion of disc fragments and their prolapse into the spinal canals.
In the initial stage, there are no symptoms, but the lack of treatment provokes an increase in pain, while limiting the mobility of the lumbar region. Acute sensations of pain are observed, which increase against the background of effort, they force the person to take an anti-pain position.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spine. In the early stage of spinal curvature deformation, there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic, but growing into constant discomfort. The pain is painful in nature and worsens with physical activity.
Spondyloarthrosis
In this pathology, the articular cartilage is destroyed and osteophytes (bone growths) are formed. This leads to a narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, intense pain occurs, which increases with physical activity and subsides in a calm state. Muscle tension is observed, which leads to a decrease in motor activity.
Protrusion
Prerequisites for the formation of protrusions are injuries to the spine, excess of permissible physical activity and muscle weakness due to lack of physical activity. 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. In the chronic course of the disease, the patient is worried about "lumbago", which often occurs due to hypothermia and overwork.
Osteomyelitis
In osteomyelitis, an inflammatory process of the bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. The lack of therapy leads to the chronification of the disease, but the pain syndrome continues.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease proceeds with piercing, cutting and pulling sensations of a paroxysmal character.
Spinal stenosis
The pathological condition is caused by complications of hernias and protrusions. The compression of the nerve roots provokes discomfort when walking, at rest and increases when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae at the back). This condition is accompanied by an increased load on the 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 spasms during bending and rotation of the lower back. One of the symptoms is stiffness of movements in the morning and increasing discomfort 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 in the lower back is most often pathology 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 occurs most often after lifting heavy objects or walking quickly. Often painful sensations under the lower back appear after severe 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:
- pathologies of the spine in the lumbar and thoracic region or previous injuries to these areas;
- osteoporosis;
- muscle spasm or tension;
- Pancreatitis.
Similar manifestations can occur against the background of the development of neoplasms of different etiology.
Pain in the lower back on the left
Painful sensations in the lower back, radiating to the left shoulder blade and covering the left side of the neck, are often the result of a myocardial infarction.
Cutting pain in this area indicates the possibility of a perforated ulcer.
Also, such symptoms can indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and bad posture. In such cases, painful pain is felt, which occurs against the background of lack of physical activity or exceeding the permissible loads.
Pain in the lower back on the right
A pathology of the kidneys or genitourinary organs is suspected when a dull pain appears on the right. The inflammation may have an infectious etiology or be a consequence of hypothermia.
Sharp, sudden pain on the right side indicates the possibility of a perforated ulcer, ruptured appendicitis, or signals internal bleeding. Pain on the right side often indicates muscle tension and radiculopathy.
Pain in lower back 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. They include:
- Overweight,
- passive lifestyle,
- excessive physical activity.
Diagnosis
In order to determine the source that provokes pain in the lumbar region, it is necessary to conduct 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;
- Echography (ultrasound examination);
- MRI (magnetic resonance imaging).
In addition, it is necessary to seek advice from a neurologist and chiropractor. The exact diagnosis is made by a specialist who, based on the results of the examination, will decide how to treat the pain in the lower back.
Treatment
The main methods of treating back pain:
- medicinal
- physical therapy;
- surgical intervention.
Diseases accompanied by pain in the lower back can pose a serious threat to human health (even death). Without resorting to self-medication, you should consult a therapist, neurologist or neurologist. Often, to determine the cause of the pain, a consultation with a urologist and gynecologist is necessary.
Surgically
Surgical intervention is appropriate 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.
medicines
The first step in pain relief is nonsteroidal 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 there is a muscle spasm, 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: physical therapy, physical therapy, massage (only outside of exacerbation). Depending on the effectiveness / ineffectiveness of the measures taken, the severity of the symptoms and based on the patient's examination, surgical treatment may be recommended - removal of the hernia, removal of compression of the spinal cord root.
Treatment depends on the cause of 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 the acute symptoms of the disease are eliminated, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrical stimulation) and exercises.
In addition, the attending physician may prescribe acupuncture. Massage sessions are also effective in the treatment of this pathology.
Therapeutic exercises help strengthen muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises release the nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Prevention
In order to prevent degenerative changes in the spine, it is very important to observe a correct movement regime every day, to alternate physical activities, to 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 chest area, fixed by the chest, 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 intermittent and moderate in nature.
At this stage, a person is able to help himself. To reduce pain, you should lie on your back: this is the most comfortable position for 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. Local application of ointment or cream with an anti-inflammatory effect on the painful area is recommended.
As the process progresses, the pain becomes more frequent and its intensity increases. It may radiate to the arm or leg. Numbness (impaired sensitivity) and motor deficit (weakness) often appear in the limb. These symptoms indicate that the spinal roots are involved in the pathological process.
Also, preventive measures for lower back pain include:
- daily morning gymnastics;
- balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
