Low back pain is one of the most common reasons for consulting a neurologist among people of working age.According to statistics, 9 out of 10 people have experienced discomfort in the lower back at least once in their lifetime and around 9% of cases result in disability.The first episode is most often recorded before the age of 30.From 30 to 60 years of age, the risk of morbidity increases.
Unfortunately, young people don't always pay attention to the warning signs.Many people believe that low back pain is due to overwork, physical activity or sitting at a computer for a long time.But in fact, it can be a symptom of a serious illness.Low back pain can be caused by a variety of pathologies: from spinal problems to kidney failure.Only a timely visit to the doctor will help determine the cause and carry out the correct treatment.
Possible causes of low back pain: what hurts?
Ankylosing spondylitis
Low back pain syndrome occurs due to the fusion of the vertebrae into one large conglomerate.The back loses mobility at the bottom.In ankylosing spondylitis, calcium deposits are also seen in the ligaments that support the spine, which also causes pain when trying to turn, stand up or perform any other action.
Distinctive symptoms of the pathology:
- stiffness of body movements in the lower back;
- increased pain after prolonged immobility, especially after a night's sleep.
Osteochondrosis
The disease manifests itself as thinning of the intervertebral discs.As a result, the shock-absorbing function of the spine is reduced, the nerve roots are compressed, and the muscles around the affected area spasm.The person feels a sharp pain.Without treatment, osteochondrosis progresses, leading to bulges and herniated discs.The protrusion of cartilaginous tissue compresses the spinal cord.A person not only feels severe pain in the lower back, but also the innervation of the lower extremities is impaired.
Distinctive signs of osteochondrosis:
- the pain intensifies when trying to roll over from the back onto the stomach, when getting up from a horizontal or sitting position or when bending over;
- Patients often report weakness and numbness in one or both legs.
Spondyloarthrosis
The lower back may hurt due to degenerative changes in the cartilaginous tissue covering the intervertebral discs.The elastic layers become thinner and osteophytes – hard bone formations – appear in their place.The distance between the vertebrae decreases with simultaneous compression of the spinal canal.
The nature of pain in spondyloarthrosis:
- accompanied by limited mobility of the spine in the lumbar region, up to constant stiffness;
- worsens after walking, prolonged sitting, standing and other types of stress;
- radiates to the pelvic region and thighs.
Urolithiasis
An attack of pathology is manifested by sharp, intense pain in the back, on the side of the affected kidney.The severity and nature of the sensation do not change depending on the position of the body.The patient cannot find a position in which it is a little easier.
An attack of urolithiasis is accompanied by additional specific symptoms:
- back pain in the lower back;
- the volume of urine decreases, its color changes and blood impurities appear;
- pain occurs when urinating;
- There may be an increase in temperature due to inflammation.
Other causes of pain and cramps in the lower back
Low back pain syndrome is observed in the following conditions:
- pregnancy, including early pregnancy;
- algomenorrhea in women;
- osteomyelitis;
- appendicitis;
- inflammation of the pancreas;
- intestinal pathologies;
- back injury;
- tumor in the lower back;
- inflammatory processes in the female genital organs;
- prostatitis in men, etc.
Expert opinion
Low back pain: what to do?Do not make sudden movements, especially if the pain occurs as a result of a fall or blow.Try to be in the most comfortable position.If the pain is sharp and does not subside with changing position, call an ambulance - renal colic is likely, which requires hospitalization.In other cases, you can use ointments and pills to alleviate the condition.Contact a specialist as soon as possible.The doctor will help relieve even severe pain and prescribe treatment.
Diagnosis of low back pain
At the first appointment, the doctor may perform a block to relieve acute pain.When the patient feels better, the doctor does a more in-depth examination and takes a history.It is important to clarify the location, nature, duration of pain, factors causing exacerbation or, conversely, improving well-being.The doctor will ask about past injuries and illnesses, dating back to early childhood.The history helps suggest why the back hurts and which diagnostic procedures will provide more complete information.
The doctor may prescribe:
- General analysis of urine and blood.Based on the results, they diagnose inflammatory processes, determine signs of pathology of the kidneys and digestive organs;
- Ultrasound of the kidneys and urinary system.An examination is necessary if urolithiasis is suspected.Using ultrasound, the doctor determines the location and extent of the spread of the inflammatory process, assesses the size of the stones in order to correctly build treatment tactics;
- X-ray of the lumbar spine.The images help determine the pathology of the vertebrae and surrounding tissues.To clarify the x-ray, computed tomography or magnetic resonance imaging are additionally prescribed - these are more informative examination methods;
- Ultrasound of the pelvic organs.When a woman has lower back pain, it may indicate endometritis or salpingo-oophoritis.Pregnant women should be examined to determine the tone of the uterus;
- Prostate ultrasound.If a man has lower back pain, it could be a sign of inflammation or a tumor in the prostate.The doctor performs a TRUS to determine the structure of the gland.
After a general examination, your doctor may prescribe more targeted procedures.In some cases, consultation with a surgeon, therapist, gynecologist and other specialists is necessary to clarify the diagnosis.
Low back pain treatment
Therapy is strictly individual.The doctor begins treating the patient when he receives the most complete information about his condition or at least has data suggesting a diagnosis.Therapy for renal colic and osteochondrosis is fundamentally different.
Drug treatment
To reduce pain, nonsteroidal anti-inflammatory drugs are most often prescribed in the form of injections, ointments and tablets.Medicines help quickly relieve inflammation and muscle spasms.Nonsteroidal anti-inflammatory drugs have side effects, so the doctor accurately calculates the dosage and duration of the course for each patient.
If treatment for lower back pain does not bring results within 2-3 days, the doctor will select hormonal medications.Medications are only needed to alleviate an acute condition.Antispasmodics, decongestants and B vitamins are prescribed as auxiliary agents.If the patient experiences low back pain and urination, antibiotics may be selected.The doctor will tell you why this or that medicine is needed and how to take it correctly.
Non-drug treatment
The procedures are carried out in courses after the exacerbation has subsided.In complex pain treatment the following are used:
- physiotherapy: radiofrequency neuromodulation, electrophoresis, phonophoresis, magnetic therapy;
- physiotherapy: set of daily exercises selected by the doctor, exercises in the pool;
- massage: therapy for the lower back and glutes and general strengthening;
- acupuncture, hirudotherapy and other procedures.
Surgical treatment
The operation is carried out strictly according to indications.If the patient has low back pain and a temperature that does not decrease while taking medication, it will be necessary to remove the inflammatory focus.Radical intervention is necessary for tumors and metastases.
In case of pathology of the female genital organs, when the lower abdomen hurts, diagnostic curettage and laparoscopic operations are performed.If urolithiasis cannot be removed with the help of medication, the patient is also recommended for surgical treatment.
You cannot tolerate pain and discomfort in your lower back.The body gives a signal that you need to pay attention to this area.