Backache- one of the most frequent complaints of patients with a wide variety of diseases. Almost every person at least once in their life has experienced pain, located most often in the sacral spine, or between the lower edge of the XII pair of ribs and the gluteal folds, i. e.lumbar back pain(SNB).
Low back pain is usually accompanied by muscle tension, often by the presence of painful spots. It can radiate (give) to other parts of the body, for example to the leg, gluteal muscles, stomach, pelvic region, etc.
Acute low back pain often comes on suddenly and can last from a few minutes to several weeks. Usually, in 90% of cases, low back pain goes away on its own within 3-4 weeks, however, in the remaining 10% of cases it becomes chronic and can last for years, sometimes worsening, then receding. Very often, it is not possible to establish the true cause of lower back pain.
Back pain in the lumbar region - causes
A variety of diseases can cause back pain in the lumbar region.Lumbar back pain(BNS) is, in fact, only a symptom that appears with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavity, in the small pelvis and in the structures of the spinal column; moreover, it can be psychogenic.
Pain above the lower back
Back pain above the lower back can occur with gastric ulcer and 12 duodenal ulcer. Reflex pain is often localized in the lower back or slightly higher, less often in the upper quadrant of the body.
With pancreatitis and cholecystitis, pain is often noted in the projection zone from the sixth to the eighth intercostal space.
In the pathology of the genitourinary sphere, reflex pains are often localized in the region of the lumbar and lower thoracic levels of the spine.
Lower back pain, right or left
Right or left lower back pain is most often a sign of kidney stones. In the case of kidney stones, a stone growing in the kidney presses on the delicate parenchyma of the kidney from the inside, sometimes causing severe pain in the lower back to the left or right in the kidney where the stone is located.
Lower back pain radiates to the leg
When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, leg, abdominal cavity, and genitals. Most often, back pain radiating to the leg can be a signrenal colicwith urolithiasis of the kidneys.
Additionally, lower back pain radiates to the leg with low back pain. Ishalgia appears as pain in the leg mainly during recovery.
Lateral and lumbar pain
Lower back pain radiates to the left and right sides in acute or chronic inflammation of the kidneys. Kidney pain, which lasts for several consecutive days and accompanied by fever, chills, dysuric phenomena (urinary disorders) indicate a diseaseacute pyelonephritis. . .
Back pain in the back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral region. Often, however, secondary musculo-tonic syndromes are present (small and middle gluteus reflex disorders, piriformis syndrome, pelvic floor syndrome, symphysisternal syndrome) in combination with pathologies of the lumbar spine with chronic processes in the organs and tissues of the small pelvis. Such patients need collegial treatment from a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Lumbar back pain
Tumors of the pelvic bones, especially early in the disease, can mimic low back pain and, in the presence of a concomitant vertebrogenic process, patients sometimes undergo neurosurgery for a lower lumbar hernia. This concernschondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand some others. Mandatory radiographic examination usually solves the diagnostic problem. It should not be forgotten that the general somatic and hematological condition of the patient can determine the oncological aspect of the disease.
Lower back and pelvic pain
Difficulties in the differential diagnosis are noted in the latent course of tuberculosis of the pelvic bones, when there is no increase in temperature and ESR, and pain can mimic the lumbar ischialgic syndrome of lumbar osteochondrosis. The process can proceed secretly from childhood and adolescence and reveal itself in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has again become urgent, and the doctor must remember these manifestations of the disease.
Therefore, pain in the lumbar region and lower back can often have nothing to do with any spinal disease and are alarming symptoms of completely different diseases of the internal organs. Therefore, in case of back pain, a full examination is required.
Low back pain in women - causes
Pull back the pain
Low back pain in womenoften associated with PMS. Such pains usually have a dragging character, occur a few days before menstruation and continue for 2-3 days after their appearance and disappear on their own.
Lower back and abdominal pain in women
Lower back and abdominal pain associated with PMS and accompanied by cramps in the lower abdomen and painful periods with heavy bleeding can be symptoms of serious reproductive diseases such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)and so on.
Abdominal pain radiates to the lower back
Abdominal pain in women can radiate to the lower back, lower abdomen, radiate to the vagina and external genitalia.
It should be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous ailments in the pelvic area, such as: formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, formation of adhesions, tumors of the reproductive organs, etc.
Also, severe pain in the lower back and lower abdomen (especially on the right or left) in women can be the result of a ruptured ovarian cyst or a symptom of an ectopic pregnancy.
Low back pain in pregnancy
Often, pain in the lower back and abdomen in women indicates natural physiological changes associated with an increase in the size of the uterus during the development of a normal pregnancy.
Low back pain in pregnancyit is associated with additional stress on the spine and is normal and does not require special treatment. However, pregnant women with severe lower back pain should always consult a doctor leading a pregnancy.
Back pain in men - causes
Back pain in men is most often associated with degenerative diseases of the spine, especially with heavy physical exertion, work associated with weight lifting. In addition, back pain can be associated with various diseases of the internal organs.
Severe back pain
Sharp pain in the lumbar spine can occur with clumsy movements, improper load distribution, etc. This pain is usually associated with muscle spasm or displacement of the vertebral discs. Pain can also be caused by muscle tightening of the roots of the nerve endings in the spine.
Back pain and groin pain
Pain in the groin area in men, which radiates to the lower back, can be associated with prostate adenoma, testicular torsion, oncology, urological diseases, etc.
Back pain classification
The classification, widespread in several countries, aimed at optimizing the provision of medical care for LPS, distinguishesSNB. specific, root and non-specific. . .
Specific back painis a symptom of a certain disease, often serious and even life-threatening (cancer, including metastases to the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc. ; inflammatory, - for example, ankylosing spondylitis andother spondyloarthritis; traumatic and osteoporotic fracture of the vertebra; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal canal stenosis and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the physician to suspect that the patient has a serious illness and intentionally examine him (preferably with the involvement of an appropriate specialist) to establish the correct diagnosis and treatment.
Radicular (radicular) pain in the lower back, including sciatica syndrome, is a consequence of spinal root compression.
The management of patients with radicular LNS is the prerogative of a neurologist, with particular indications the participation of a neurosurgeon is required. In practice, such patients often resort to the help of chiropractors.
Among the radicular pain in the lower back are distinguished:
- lumbago,orlumbago;
- lumbodynia- long-term pain only in the lower back;
- low back pain- back pain that radiates to the leg.
Nonspecific lumbar pain- the most common, not associated with any visceral disease, severe pathology of the spine, spinal cord and its roots. It can be caused by the overload of the lumbar spine, especially associated with heavy lifting, prolonged uncomfortable position while sleeping or working, etc.
Therefore, it is quite reasonable that a planned spinal radiograph is not included in the recommendations for examining patients with non-specific low back pain syndrome (NLP). Such patients do not need the mandatory consultation of a neurologist, but should be treated by a family doctor, district therapist or general practitioner.
Low back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most frequent diagnosis, which is given to patients with lumbar spine pain disorders. However, it is impossible to identify every case of the development of an episode of pain in the lower back with "degenerative-dystrophic" changes in the spine often actually present in the patient, making a "habitual" diagnosis."Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .
For pain in the lower back or lower back, a diagnosis is often written such as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization". . . However, the correct diagnosis in this case should sound like this:"Low back pain with sciatica against the background of osteochondrosis of the lumbar spine. Lumbarization. (Code М54. 4)".
It should be noted that there is no nosological unit in any of the foreign classifications of degenerative-dystrophic diseases."osteochondritis of the spine". . . Furthermore, neither the term"Osteochondrosis"nor any other term that characterizes dystrophic changes in the spine should not be used as a synonym for clinical diagnosis.
chondrosisis a dystrophic change in the disc cartilage,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, the ignorance by both radiologists and clinicians of the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondylarthrosis, spondylosis, fixative hyperostosis, etc. )leads to overdiagnosis: these types of pathology are found where they are not there.
Often, osteochondrosis is called all the listed degenerative changes due to ignorance of the differences between them. Misunderstanding, osteochondrosis includesslipped disc, which is a consequence of its rupture, and, as a rule, a normal disc and not altered by a dystrophic process. However, calling a herniated disc osteochondrosis is just as wrong as a rupture of the meniscus in the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends using the general term "vertebral dysfunction" (which, by the way, is also not included in the ICD-10 disease classification) in case of the appearance of appropriate clinical symptoms.
Many modern authors, mainly foreigners, point out the absence of a connection between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of pain in the lower back (LBS), on the one hand. 'other, as only 1 in 10 patients with radiological signs of degenerative spinal injury are clinical manifestations of the disease.
Back pain treatment at home
For low back pain associated with muscle tension and muscle stiffness, low back pain ointments can significantly relieve symptoms and help relieve muscle tension.
Ointment and pills for low back pain
Ointments and creams are used to treat the lower back. Alternatively, you can take pills that contain non-steroidal anti-inflammatory drugs (NSAIDs).
At the same time, it should be remembered that self-treatment at home for back pain with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease that causes these pains and very sad consequences. Self-medication of the lower back is especially dangerous for kidney diseases such asacute pyelonephritisorrenal colicrequiring qualified emergency medical care.
Lower back pain prevention
People who have had an attack of the disease, especially before the formation of a stable remission, must follow some instructions for prevention:
- Do not lean the body without resting on the arm; pick up objects from the floor with bent knees.
- Change your body position more often, do not stand for long, do not sit down.
- Work at a table or workplace, maintaining an upright position, for this one leg, bent at the knee, placed in front of the other.
- Be careful about performing specific, aerobic yoga exercises without the recommendation of a physical therapy doctor or specialist vertebrologist.
- Beware of hypothermia, drafts and prolonged heating in a hot bath, as muscle relaxation deprives the immobilizing protection of the muscle corset for some time.