Low's pain is the symptom that is rarely paid to.Most people associate her with work in a sitting position, lifting weights or osteochondrosis and are in no hurry to see a doctor.In fact, this condition can signal the diseases of the kidneys, liver or intestines, and problems with the musculoskeletal system will not pass by themselves.Only a timely inspection of a specialist and a full examination will help to identify the cause of pain and choose the right treatment.
General information
The lower back is an area experiencing a significant load due to being in an upright position.The spinal column is represented by five large vertebrae, which are additionally strengthened by the muscle frame.9 out of 10 cases of pain in this area are provoked precisely by the pathology of the musculoskeletal system: osteochondrosis, muscle spasm, hernia of the intervertebral disc, pinching of the nerve root.
The remaining 10% of cases are associated with diseases of the internal organs located in the projection of the lower back: kidneys, genitourinary system, intestines, liver.Even a doctor, when examining, can not always determine the cause of pain, which is why this condition requires a thorough laboratory and instrumental diagnosis.
Types of pain
The first thing the doctor asks is the nature of the sensations.Depending on the cause that caused it, the lower back pain may be:
- Acute: usually arises sharply, characterized by high intensity;The duration of sensations is no more than 1.5 months;
- subacute: lasts 6-12 weeks;
- chronic: sensations of any intensity that lasts 12 weeks or more;
- Transfer (variable): appears periodically;
- aching;
- dumb;
- Strong, average intensity, weak.
This division is conditional.Depending on the situation and circumstances, the nature and duration of sensations may vary.It is important to describe them as fully as possible.
Reasons
The reasons why the back begins to hurt in the lower back.Most often, provoking factors serve:
- hypothermia;
- weight lifting;
- uneven load distribution (against the background of pregnancy, posture disorders, pathology of the musculoskeletal system);
- infectious lesion;
- diseases of the musculoskeletal system;
- inflammatory processes, including autoimmune;
- long stay in an uncomfortable position;
- change in the composition of bone tissue (osteoporosis);
- Volumetric processes: benign and malignant tumors, abscesses;
- hormonal changes (menstruation, pregnancy, menopause);
- kidney diseases (urolithiasis, pyelonephritis, glomerulonephritis, abscesses);
- pathology of the gastrointestinal tract;
- Diseases of the uterus and appendages in women, prostate in men, etc.
Diseases
Low's pain can be a symptom of various diseases of the musculoskeletal system and internal organs.The main task of the doctor is to find out what exactly caused the deterioration of the condition and take the necessary measures.
Here are pathologies that are most common.
Ankylosing spondylitis
This is a systemic inflammatory disease, in which individual vertebrae in a single conglomerate occurs.At the same time, calcium deposit in ligaments stabilizing the spine occurs, as a result of which the affected area almost completely loses mobility.
Distinctive features of lower back pain with ankylosing spondylitis include:
- an increase in intensity at rest, especially with prolonged finding in a horizontal position;
- constraint of movements in the lumbar region;
Osteochondrosis of the lumbar spine
This is a very common disease, in which the intermittent disks are thinner, performing the role of shock absorbers.As a result, nerve roots and cramps of the surrounding muscles causing severe pain are irritated.At the late stage of the disease, a hernia of the intervertebral disc is formed, which can press on the spinal cord, enhancing pain.
With osteochondrosis, the pain intensifies:
- when lifting from a sedentary or horizontal position;
- when trying to lie on the stomach;
- With inclinations.
If the disease causes the formation of a massive hernia, pain in the lower back is often accompanied by numbness and either the weakness of one or both legs.
The curvature of the spine in the lumbar region (kyphosis, scoliosis)
Pain in this pathology occurs at the middle and late stage of the development of the disease.Discomfort usually occurs by the end of the day and is often accompanied by fatigue of the spinal muscles.The pain is more often caused by cramping of the muscles of the spine, and it is also possible to explore the muscles at removal (gluteal, periosemantal muscles of the upper and lower extremities).
Spondylarthrosis
This is a degenerative-dystrophic disease of cartilage, covering intervertebral discs.It is gradually thinner and destroyed, bone growths (osteophytes) appear around the area of the lesion.As a result of a reduction in the distance between the vertebrae, the spinal canal narrow, the nerve roots and spinal cord are irritated.
Pain with this pathology:
- intensifies after the load (long -term stay in a standing position, walking) and passes after rest;
- accompanied by stiffness of movements, first in the morning, then constant;
- It can be given to the thigh and the area of the hip joint.
The muscles in the area of the lesion are spasmodic and constantly in tension, which also enhances pain.
Uroline disease
An attack of urolithiasis is characterized by severe lumbar pain from the affected kidney.At the same time, sensations do not change depending on the pose, a person cannot find a position in which they are at least a little weaken.The attack is often accompanied by a reduction in the amount of urine and a change in its color to the reddish.
Low's pain can also be a consequence:
- algomenor (painful menstruation);
- pregnancy;
- pancreatic inflammation;
- osteomyelitis;
- intestinal obstruction;
- appendicitis, etc.
Pain in various parts of the back
Localization of pain can say a lot about their cause.Pain in the upper part of the lumbar region may be a consequence:
- spine diseases;
- injuries;
- muscle spasm against the background of their overvoltage;
- cardiovascular diseases;
- tumors;
- diseases of the gastrointestinal tract.
If the epicenter is located at the bottom of the lower back, the list of probable reasons includes, in addition to diseases of the spine:
- kidney pathology (pyelonephritis, urolithiasis);
- intestinal disruption (constipation, flatulence);
- spasms or inflammatory process in the pelvic organs (salpingoophorite, endometritis);
- physiological causes, in particular, pregnancy;
- Pinching the sciatic nerve.
The displacement of pain to the right or to the left may indicate the lesion of the corresponding spine of the spinal cord, kidneys.
Diagnostics
Diagnosis of lower back pain requires a comprehensive examination.The first stage of searching for the reason is the survey.The doctor clarifies:
- Localization of pain;
- its character and duration;
- causes that cause an attack or enhance pain;
- Circumstances in which the condition improves (a certain pose, immobility, taking drugs, etc.).
Data on the injuries and diseases, already identified chronic pathologies are collected without fail.A further possible diagnostic search at the discretion of the doctor includes:
- General test of blood and urine: helps to identify the inflammatory process in the body, kidney pathology;
- Biochemical blood test to identify signs of kidney damage, pancreas, liver and gall bladder, etc.;
- Ultrasound of the abdominal organs and pelvis, in men - ultrasound of the prostate gland;
- Ultrasound of the kidneys;
- radiography, CT or MRI of the lumbar spine;
- X -ray of the chest.
In case of suspicion of any pathology after a review diagnosis and inspection, more targeted tests, examinations and consultations of narrow specialists are prescribed.They allow you to clarify or refute the diagnosis.
Treatment
The treatment of pain in the lower back depends on its cause.A neurologist, a urologist, a gynecologist, and a surgeon can engage in a pathology.If we are talking about diseases of the musculoskeletal system, doctors use medical, non-drug and surgical methods for improving the patient's condition.
Drug treatment
The most common means of eliminating lumbar pains are non -steroidal anti -inflammatory drugs (NSAIDs).They are prescribed in the form of tablets, intravenous and intramuscular injections, rectal suppositories, as well as creams, ointments and plasters for local use.The decision on the dosage of the product, as well as the duration of the course, is made by the doctor, since the uncontrolled use of these drugs can cause unpleasant side effects.
If the NSAIDs are ineffective, doctors prescribe hormonal drugs (corticosteroids).They also stop the inflammatory process and help reduce pain.
The third group of drugs that improve the condition of the patient is antispasmodics.They remove muscle cramps in the lower back.
Additionally, they can be appointed:
- decongestants to reduce edema of a pinched root;
- B vitamins to improve nervous conduction;
- sedatives.
Non -drug methods
Non -drug treatment complements medicinal schemes.Depending on the clinical situation, it may include:
- physiotherapeutic procedures (magnetotherapy, laser effect, electrophoresis, etc.);
- physiotherapy exercises: the course of exercises is developed individually in accordance with the main and related diseases;Gymnastics should be performed regularly, not only in the clinic’s office, but also at home, only in this case it has an effect;
- general strengthening and therapeutic massage (carried out outside the exacerbations);
- acupuncture;
- Manual therapy and assistance to osteopath.
Surgical treatment
Surgeon help is necessary if the attending physician on the basis of the general picture reveals one of the indications for surgical treatment.The presence of a hernia of the intervertebral disc is not an indication for surgical treatment, regardless of its size.Depending on the indications, doctors can remove the hernia of the intervertebral disc, eliminate the compression of the spinal cord roots, remove the tumor, etc.The decision to conduct a particular operation is made individually.
Prevention
The most effective way to prevent lower back pain is to adjust your lifestyle in order to spare the kidneys, the spine, and the pelvic organs, but if the pain often arose, this should be the reason for an extraordinary appeal to a specialist:
- avoid hypothermia;
- prevent hypodynamia;
- play sports at an amateur level (swimming is especially beneficial affects the condition of the spine and back muscles);
- Correctly and balanced to eat: prevent overeating, minimize fatty, spicy, overly salted food;
- exclude alcohol and nicotine;
- drink at least 1.5 liters of pure water daily without taking into account tea, coffee or juices;
- Keep the body mass index at a normal level: excess weight does not affect the condition of the spine, and the deficiency can cause the kidney veneration.
If a person has already diagnosed the pathology of the musculoskeletal system, preferably at least twice a year, according to European recommendations for the rehabilitation of the pathology of the spine, to undergo preventive courses in accordance with the appointment of a doctor.