Lower back pain is a common reason to visit 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 area, radiating to the leg, what studies are carried out during diagnosis, the causes of pain in the lower shoulder blades and the most effective treatment methods - in the material.
Lumbar back pain
The sudden onset of acute pain in the lower back is a fairly common occurrence. This symptom, characteristic of many pathological conditions, is not always caused by diseases of the spine. The manifestations and causes of pain can vary.
Types of pain
By the nature of the pain that occurs in the lumbar region, it is possible to identify the main cause of the discomfort.
Strong
Starting from the sacral area, 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 gets worse when you walk fast, bend over, or cough. Prolonged compression of the gluteal muscle leads to its atrophy.
Acute
Sharp pain comes on suddenly. They are unbearable and very intense, often characterized as "low back pain". Depending on the cause, pain can be triggered by physical activity. Accompanied by stiffness of movements (sometimes it is even impossible to straighten up). The slightest movement intensifies the symptoms. Acute pain can persist for up to six weeks.
Pulling and hurting
Nagging and aching pain in the lumbar region is often due to 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 bumps, 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.
Radiant
Such pains are boring 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.
Reflex
Referred pain is pain felt in a different location than actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation that may be accompanied by numbness and a sensation of loss of sensation.
Myofascial
Such pain is accompanied by muscle spasms and intensifies when touching the muscle.
Causes
The causes of low back pain are very different and can be associated with pathological conditions of both the spine itself and the tissues surrounding it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
This is a systemic disease accompanied by 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 solid, rigid 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 turn into permanent ones;
- the rigidity of the 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 causes the development of arthrosis of the spinal joints.
In this context, dorsalgia (back pain) develops with characteristic shooting manifestations in the lumbar region, with irradiation to the buttocks and legs. Weakness and numbness appear in the lower limbs. In this case, the nerve endings of the roots are pinched, causing 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.
In the initial phase, no symptoms are noted, but the lack of treatment causes an increase in pain, limiting the mobility of the lumbar region. Sharp pain sensations are observed, which increase against the background of effort, force the person to take a pain-relieving position.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spine. In the initial stage of spinal curvature deformity there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic, but constantly developing discomfort. The pain is aching in nature and intensifies with physical activity.
Spondyloarthrosis
With this pathology, the articular cartilage is destroyed and osteophytes (bony growths) are formed. This leads to narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, intense pain occurs, which intensifies during physical activity and subsides in a calm state. Muscle tension is observed, which causes a decrease in motor activity.
Overhang
Prerequisites for the formation of bumps are spinal injuries, excess permissible physical activity and muscle weakness due to physical inactivity. In this case, a protrusion of the disc 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 disturbed by "low back pain", 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. The lack of therapy causes the disease to become chronic, but the pain syndrome persists.
Pancreatitis
Lower back pain is a sign of inflammation of the pancreas. The disease manifests itself with stabbing, cutting and tearing 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 while walking, at rest and intensifies when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (which connect the vertebrae from the back). This condition is accompanied by an increased load on muscles and bones and causes an inflammatory process resulting in the development of spondyloarthrosis and degenerative changes.
In the area of the affected joint, pain is felt in the form of cramp 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 under the lower back is 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 these cases, pain appears more often 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 over the lower back, but under 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 various etiologies.
Pain in left lower back
Painful sensations in the lower back, radiating to the left scapula and covering the left side of the neck, often result from a myocardial infarction.
Cutting pain in this area indicates the likelihood of a perforated ulcer.
Furthermore, such symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, aching pain is felt, which occurs against the background of physical inactivity or exceeding permissible loads.
Pain in right lower back
Suspicion of pathology of the kidneys or genitourinary organs arises when a dull, aching pain appears on the right. Inflammation may have an infectious etiology or be a consequence of hypothermia.
Sudden, sharp pain on the right side indicates the likelihood of a perforated ulcer, burst appendicitis, or signals internal bleeding. Pain on the right side often indicates muscle strain and radiculopathy.
Lower back pain when coughing
Possible causes of back pain when coughing:
- osteochondrosis;
- hernia;
- nerve root stenosis, which causes weakness and difficulty walking;
- facet arthropathy, in which muscle strain occurs;
- damaged fibrous ring;
- 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.
Diagnostics
To determine the source causing pain in the lumbar region, it is necessary to conduct a comprehensive diagnostic examination. Includes laboratory tests and instrumental procedures.
The main:
- 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).
You also need to seek advice from a neurologist and chiropractor. An accurate diagnosis is established by a specialist who, based on the results of the examination, will decide how to treat low back pain.
Treatment
The main methods of treating low back pain:
- medicinal;
- Physiotherapy;
- Surgery.
Diseases accompanied by low back pain can pose a serious danger to human health (even death). Without resorting to self-medication, you need to consult a therapist, neurologist or neurologist. Often, to identify the cause of pain, it is necessary to consult a urologist and a gynecologist.
Surgical
Surgical intervention is relevant only as an emergency measure for oncology. Specialists carry out planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Drug
The first step in pain relief is nonsteroidal anti-inflammatory drugs (NSAIDs). 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, hormonal drugs that relieve pain and inflammation, are also used. If muscle spasm is present, muscle relaxants are prescribed.
B vitamins are suitable as an auxiliary therapy to improve nerve conduction. Drug therapy must always be accompanied by non-pharmacological treatment methods: physiotherapy, physical therapy, massage (only outside of exacerbations). Depending on the effectiveness/ineffectiveness of the measures taken, the severity of the symptoms and based on the examination, the patient may be recommended surgical treatment: 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 and systemic inflammation may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and the acute symptoms of the disease disappear, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrical stimulation) and physical therapy.
Additionally, your doctor 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 the nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Prevention
To prevent degenerative changes in the spine, it is very important to observe the correct physical regime every day, alternating physical activities and practicing walking and swimming. Additionally, it is important to control your body weight so that your spine does not experience additional stress.
Most often, the lumbosacral and cervical spine is affected by degenerative changes. The thoracic region, fixed by the rib cage, suffers less often from osteochondrosis. The pain occurs in the lower back or neck, respectively, in the projection of the spine. Initially it may be periodic and moderate in nature.
At this stage, a person is able to help himself. To reduce pain, you need to 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 lower back, this is often a sideways position with the legs bent. You can take NSAIDs once. It is recommended to apply an ointment or cream with an anti-inflammatory effect 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 (reduced sensitivity) 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 low back pain include:
- daily morning exercises;
- balanced diet;
- compliance with the alcohol consumption regime;
- regular preventive exams.
