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, evidenced by severe pain in the sacral region, 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.
Pain in the lower back
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 lower back, the main cause of the discomfort can be identified.
Strong
Starting in the sacral region, 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 a risk of numbness of the limbs.
The mechanism of pain development is compression of the sciatic nerve. The pain worsens when walking quickly, bending over, or coughing. Prolonged compression of the gluteal muscle leads to its atrophy.
Acute
Acute 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 straighten up). The slightest movement intensifies the symptoms. Acute pain may persist for up to six weeks.
Pulling and hurting
Dull, aching pain in the lower back often results from diseases such as hernia, protrusion, and inflammation of the sciatic nerve.
Chronicle
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.
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 lower back.
Mechanic
Mechanical pain occurs during or immediately after physical activity.
Radiating
These pains are uncomfortable and painful. Painful sensations can also radiate down the leg (up to the foot).
Local
They are characterized by the appearance of unpleasant sensations in a certain region of the lower back.
Reflected
Referred pain is pain felt in a different location than the actual pain.
Root
Radicular syndrome is a neuralgic manifestation that can be accompanied by numbness and a sensation of loss of sensitivity.
Myofascial
This pain is accompanied by muscle spasm and intensifies when touching 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 that surround 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. In spondylitis, fusion of the vertebrae occurs, as a result of which their motor activity is limited and ankylosis is formed (immobility of the joint). As a result of ossification of the paravertebral ligaments, the spine gradually becomes a solid, inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, the pain appears in the lower back, gradually covering new areas;
- negative symptoms bother you occasionally, but over time they become permanent;
- the stiffness of movements increases.
The expressiveness of the signals is observed at night. In the morning the pain becomes unbearable.
Osteochondrosis
Growth, destruction, protrusion of cartilaginous tissue caused by a violation of its nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of arthrosis of the spinal joints.
In this context, dorsalgia (back pain) develops with characteristic shooting manifestations in the lumbar region, radiating to the buttocks and legs. Weakness and a feeling of 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 protrusion of disc fragments and their prolapse into the vertebral canals.
In the initial phase there are no symptoms, but lack of treatment causes an increase in pain, while limiting mobility in the lower back. Sensations of acute pain are observed, which increase with the context of effort, forcing the person to assume an anti-pain position.
Kyphosis and scoliosis
Pain in the lower back 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 periodic discomfort, but evolves 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 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, intensifying during physical activity and decreasing in a calm state. Muscle tension is observed, causing a decrease in motor activity.
Boss
The prerequisites for the formation of bumps are spinal injuries, excessive permissible physical activity and muscle weakness due to physical inactivity. In this case, 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 lower back. In the chronic course of the disease, the patient is bothered by "lumbago", which often occurs due to hypothermia and overwork.
Osteomyelitis
In 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 persists.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease occurs with sensations of stabbing, cutting and pulling 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 intensifies when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the joints (connecting the vertebrae from behind). This condition is accompanied by 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 during flexion and rotation of the lower back. One of the symptoms is stiffness of movement in the morning and increased discomfort at night.
Location
To identify the cause of lower back pain, you first need to 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 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, the pain appears more often after lifting heavy objects or walking quickly. Often, painful sensations below 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 spasm or tension;
- pancreatitis.
Similar manifestations can occur against the background of the development of neoplasms of various etiologies.
Left 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.
In addition, these symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, intense pain is felt that occurs against the background of physical inactivity or excessive permitted loads.
Right back pain
Suspicion of pathology of the kidneys or genitourinary organs arises when a dull pain appears on the right. Inflammation may have infectious etiology or be a consequence of hypothermia.
Sharp, sudden pain in the right side indicates the likelihood of a perforated ulcer, burst appendicitis, or signs of internal bleeding. Right-sided pain often indicates muscle strain and radiculopathy.
Lower back pain when coughing
Possible causes of lower back pain when coughing:
- osteochondrosis;
- hernia;
- nerve root stenosis, causing weakness and difficulty walking;
- facet arthropathy, in which muscle tension occurs;
- injured 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.
Diagnosis
To determine the source that provokes pain in the lower back, it is necessary to carry out a comprehensive diagnostic examination. Includes laboratory tests and instrumental procedures.
The main ones:
- blood test (general, biochemical), urine;
- tests for tumor markers;
- lumbar spine x-ray;
- endoscopic examination of internal organs;
- Ultrasonography (ultrasound examination);
- MRI (magnetic resonance imaging).
Additionally, it is necessary to consult a neurologist and a 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;
- surgical intervention.
Diseases accompanied by back pain can pose a serious danger to human health (even death). Without resorting to self-medication, it is necessary to consult a therapist, neurologist or neurologist. Often, to identify the cause of pain, consultation with a urologist and gynecologist is necessary.
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.
Medicine
The first step to pain relief is nonsteroidal anti-inflammatory drugs (NSAIDs). They are used in a variety of forms – tablets, injections, rectal suppositories, patches, ointments or gels.
Depending on the established diagnosis and the severity of symptoms, glucocorticosteroids are also used - hormonal drugs that relieve pain and inflammation. If there is muscle spasm, muscle relaxants are prescribed.
B vitamins are suitable as auxiliary therapy to improve nerve conduction. Drug therapy should always be accompanied by non-drug treatment methods: physiotherapy, physiotherapy, massage (only outside of exacerbation). 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 hernia, elimination of compression of the root of the spinal cord.
Treatment depends on the cause of the low 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 are eliminated, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, 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 vertebrae and eliminate painful manifestations. Specially selected exercises free 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 motor regime daily, alternate physical activities and practice 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 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 in nature.
At this stage, the person is able to help themselves independently. To reduce the pain, you need to lie on your back: this is the most comfortable position on the body, in which the intervertebral discs, ligaments and joints of the spine are most relaxed. For the lower back, this is usually a side position with 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 (impaired 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 lower back pain include:
- daily morning exercises;
- Balanced diet;
- compliance with the drinking regime;
- regular preventive checkups.
