Low back pain is a common reason for visiting the doctor. The cause of discomfort in this area can be many diseases.
What is ankylosing spondylitis, which is evidenced by severe pain in the sacral area that radiates to the leg, what tests are performed during the diagnosis, the causes of pain in the lower shoulder blades and the most effective treatment methods - in the material.
Lower back pain
Sudden acute pain in the lower back is quite common. These symptoms, which are characteristic of many pathological conditions, are not always caused by diseases of the spine. Manifestations and causes of pain can be different.
Types of pain
Based on the nature of the pain in the lumbar region, the main cause of the discomfort can be identified.
Strong
Starting from the area of the sacrum, the intense pain is localized in the hip joint. The pain radiates down the leg and is felt in the sole of the foot. Similar symptoms are observed in osteochondrosis with the risk of numbness of the limbs.
The mechanism of pain is compression of the sciatic nerve. The pain increases when walking quickly, bending or coughing. Prolonged compression of the gluteal muscle leads to its atrophy.
Acute
Acute pain occurs suddenly. They are unbearable and very intense, often called "lumbago". Depending on the cause, the pain can be triggered by physical activity. It is accompanied by stiffness of movement (sometimes even standing up is impossible). Even the slightest movement intensifies the symptoms. Acute pain can last up to six weeks.
Pulling and pain
The buzzing and aching pain in the lumbar region is most often the result of diseases such as hernia, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain may be a hernia or protrusion in the lower back, which is accompanied by degenerative changes in the spine. The intensity of such manifestations increases with physical exercises and is a consequence of physical inactivity.
Moved
The occurrence of such symptoms is secondary. Diseases of the urogenital system, ovaries, prostate and other internal organs are associated with painful symptoms in the lumbar region.
Mechanical
Mechanical pain occurs during or immediately after physical activity.
Irradiator
Such pains are dull and painful. Painful sensations can also radiate to the legs (all the way to the feet).
Local
They are characterized by the appearance of discomfort in a certain area of the lower back.
reflected
Referred pain is pain that is felt in a place other than the actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation that can be accompanied by numbness and a feeling of loss of sensitivity.
Myofascial
Such pain is accompanied by muscle spasm and increases when the muscle is touched.
Cause
The causes of low back pain are very diverse and can be linked to pathological conditions both in the spine itself and in the tissues around it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
It is a systemic disease accompanied by inflammation of the connective tissues of the spine. In the case of spondylitis, fusion of the vertebrae occurs, as a result of which their motor activity is limited and ankylosis (immobility of the joint) develops. As a result of the ossification of the paravertebral ligaments, the spine gradually becomes solid, inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, pain appears in the lumbar region, gradually covering new areas;
- negative symptoms sometimes bother you, but become permanent over time;
- the stiffness of the movements increases.
The expressiveness of the signs can be observed at night. In the morning, the pain becomes unbearable.
Osteochondrosis
Growth, destruction, protrusion of cartilage tissue due to a violation of their nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of arthrosis of the spinal joints.
Against this background, dorsalgia (back pain) develops in the lumbar region with characteristic manifestations of shooting, irradiation of the buttocks and legs. A feeling of weakness and numbness appears in the lower limbs. In this case, the nerve endings of the roots are pinched, which causes a burning and tingling sensation.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by the protrusion of disc pieces and their fall into the vertebral canals.
In the initial stage, there are no symptoms, but the lack of treatment increases the pain while limiting the mobility of the lumbar region. Acute pain sensations are observed, which increase against the background of exertion, forcing 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 early stages of spinal curvature deformation, there are no negative symptoms. Over time, however, it appears as a manifestation of muscle fatigue that develops into intermittent but constant discomfort. The pain is aching in nature and increases with physical activity.
Spondyloarthrosis
With this pathology, articular cartilage is destroyed and osteophytes (bone growth) 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 relaxed state. Muscle tension is observed, which causes a decrease in motor activity.
Protrusion
Prerequisites for the development of protrusions are spinal injuries, exceeding the permissible physical activity, and muscle weakness due to physical inactivity. In this case, the protrusion of the disc occurs, which is accompanied by tension and painful discomfort in the lower back.
Arthritis
In rare cases, the cause of painful manifestations of the lumbar joints is inflammation of the lumbar region. During the chronic course of the disease, the patient is disturbed by "lumbago", which often occurs due to hypothermia and overexertion.
Osteomyelitis
In osteomyelitis, the inflammatory process of the bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. Lack of therapy leads to the chronicity of the disease, but the pain syndrome persists.
Pancreatitis
Lower back pain is a sign of pancreatitis. The disease manifests itself with paroxysmal stabbing, cutting and pulling sensations.
Scoliosis
The pathological condition is caused by complications of hernias and protrusions. The compression of the nerve roots causes discomfort when walking, at rest, and increases when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae from the back). This condition is accompanied by an increased load on the muscles and bones and triggers an inflammatory process with the subsequent development of spondyloarthrosis and degenerative changes.
Pain in the area of the affected joint can be felt in the form of spasmodic attacks during bending and rotation of the lower back. One of the symptoms is stiffness of movement in the morning and increasing discomfort in the evening.
Localization
To identify the cause of pain in the lumbar region, you must first determine the location of the discomfort. For an accurate diagnosis, you should consult a specialist.
Pain below the waist
The cause of pain under the lower back is most often a pathological condition of 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 in the gastrointestinal tract.
In such cases, the pain most often occurs after lifting heavy objects or walking quickly. Painful sensations in the lower back often appear after serious injuries or infectious diseases. They are also present during menstruation, pregnancy and menopause.
Pain in the lower back, but below the shoulder blades
Pain in the lower back and between the shoulder blades can be caused by the following diseases:
- pathologies of the spine 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 different etiologies.
Left lower back pain
Pain in the lower back radiating to the left shoulder blade and covering the left side of the neck is often the result of a heart attack.
Pain in this area indicates the likelihood of a perforated ulcer.
In addition, 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 due to physical inactivity or exceeding the permissible loads.
Right lower back pain
Pathology of the kidneys or urinary organs is suspected when a dull aching pain appears on the right side. The inflammation may have an infectious etiology or may be the result of hypothermia.
Sharp, sudden pain on the right side indicates the likelihood of a perforated ulcer, appendicitis, or 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, which causes weakness and difficulty walking;
- facet arthropathy, in which muscle tension occurs;
- damaged annulus fibrosus;
- pathological condition of the kidneys.
Painful sensations when coughing are often observed against the background of neuralgia.
Low back pain can occur due to physiological reasons. These include:
- overweight,
- passive lifestyle,
- excessive physical activity.
Diagnostics
To determine the source of pain in the lumbar region, a comprehensive diagnostic examination must be performed. This includes laboratory tests and instrumental procedures.
The main ones:
- blood test (general, biochemical), urine;
- examination of tumor markers;
- x-ray of the lumbar spine;
- endoscopic examination of internal organs;
- Ultrasound (ultrasound examination);
- MRI (magnetic resonance imaging).
You should also seek advice from a neurologist and chiropractor. The exact diagnosis is made by a specialist who, based on the test results, decides how to treat the back pain.
Treatment
The main methods of treating lower back pain are:
- medicinal;
- physiotherapy;
- surgical intervention.
Diseases associated with lower back pain can pose a serious threat (even death) to human health. Without resorting to self-medication, you should consult a therapist, neurologist or neurologist. It is often necessary to consult a urologist and gynecologist in order to identify the cause of the pain.
Surgical
Surgical intervention is relevant only as an emergency measure in oncology. Specialists only perform planned operations in the therapeutic treatment of protrusions, hernias and fractures in the absence of positive dynamics.
Medicine
The first step in pain relief is non-steroidal anti-inflammatory drugs (NSAIDs). They are used in different forms - tablets, injections, rectal suppositories, patches, ointments or gels.
Depending on the established diagnosis and the severity of the symptoms, glucocorticosteroids are also used - hormonal drugs that relieve pain and inflammation. If muscle spasm is present, muscle relaxants are prescribed.
B vitamins are suitable as adjuvant therapy for improving nerve conduction. Drug treatment should always be accompanied by non-drug treatment methods: physiotherapy, physical therapy, massage (except for exacerbation). Based on the effectiveness/ineffectiveness of the measures taken, the severity of the symptoms and the examination, surgical treatment of the patient - removal of hernia, elimination of compression of the spinal cord root - can be recommended.
Treatment depends on the cause of your lower back pain. Pathologies of the internal organs must be eliminated by special specialists, inflammatory changes of the skeletal system, systemic inflammations may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and the acute symptoms of the disease disappear, doctors can prescribe physiotherapy treatments (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrical stimulation) and exercise therapy.
In addition, the attending physician may prescribe acupuncture. Massage treatments are also effective in treating this pathology.
Therapeutic exercises help to strengthen the muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises release nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Prevention
In order to prevent degenerative changes of the spine, it is very important to follow a proper motor routine daily, to alternate physical activities, to practice walking and swimming. It is also important to control your body weight so that the spine is not subjected to additional stress.
Lumbosacral and cervical spines are most often affected by degenerative changes. The chest region fixed by the rib cage is less likely to suffer from osteochondrosis. Pain appears in the lower part of the back, and in the neck, in the projection of the spine. At first it can be intermittent and moderate in nature.
At this stage, a person is able to help himself independently. To reduce pain, you should 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 at their most relaxed. For the lumbar region, this is most often lying on the side with bent legs. You can take NSAIDs once. It is recommended to apply an anti-inflammatory ointment or cream locally to the painful area.
As the process progresses, the pain becomes more frequent and increases in intensity. It can spread to the arms or legs. Numbness (impaired sensitivity) and motor deficit (weakness) often occur in the limb. These symptoms indicate that the roots of the spine are involved in the pathological process.
In addition, measures to prevent lower back pain include:
- daily morning exercises;
- a balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
