Low back pain: causes, types and methods of treatment

back pain

We all know from childhood that for any back problems, an urgent need to consult a doctor. However, often when we come to an appointment, we hear from a neurologist that it should have been done earlier, yesterday, but today the disease is already neglected and requires more complex and long-term treatment.

To prevent this from happening, you need to listen to your body - any lumbago or lumbar pain is a reason to visit a doctor immediately. Lumbar discomfort can be a symptom of a variety of conditions.

In our article, we will tell you what to do with lower back pain and what diseases cause it.

The most important signals not to be ignored are:

  • pain and tension in the lower back, especially when the soreness goes further - in the groin, legs, buttocks;
  • a feeling of creepy legs, numbness, a feeling that the legs are "cottony";
  • leg cramps;
  • knee and hip pain;
  • anxiety, sucking in the stomach;
  • in women - painful periods, irregular cycle, problems with conception;
  • in men - erectile dysfunction, problems with potency;
  • pain in the coccyx, small pelvis, especially when they intensify, if you change body position and take a steam bath;
  • gastrointestinal problems that cannot be cured by a gastroenterologist;
  • increased pain when sitting for a long time, which often occurs in drivers and office workers;
  • inability to stand for a long time due to back pain.

Types of back pain

Understanding the nature of the pain is very important, because it will help the doctor immediately make an assumption about the diagnosis and prescribe a more accurate diagnosis.

Pain happens:

  • acute (due to recent injury, lasts up to 1. 5 months);
  • aching;
  • dumb;
  • strong and lasting;
  • subacute (lasts 6-12 weeks);
  • variable (transient);
  • chronic (lasts more than 12 weeks).

Also, lower back pain is divided into primary and secondary.

Primary is associated with chronic changes in the tissues of the spine, muscles. Sometimes the spinal roots are involved in the process.

Secondary pain indicates another disease. It can be arthrosis, arthritis, some kind of pathology of internal organs.

Which doctor should I contact for lower back pain

Usually, you first need to see a therapist, who will already give a referral to a narrow specialist - a neurologist, traumatologist, rheumatologist, osteopath.

If you are sure that you know exactly the origin of pain, then you can contact a specific doctor directly. For example, if you recently fell unsuccessfully, then you need to see a traumatologist.

How is the diagnosis and examination by a doctor going

First of all, the doctor must exclude conditions that are life-threatening. For this purpose, clinical and biochemical blood tests are carried out. They allow you to detect inflammatory processes, excess calcium, which is typical for cancer that metastases to the bone. Also, analyzes reveal myeloma and many other pathologies.

A man over 50 may be prescribed a prostate-specific antigen test to rule out prostate cancer.

X-rays are required to determine the height of the intervertebral discs and identify osteophytes, if any. The latter are growths of bone tissue that appear due to an incorrectly distributed load on the vertebrae and changes in their shape.

MRI and CT are needed to determine if there is a bulging of the intervertebral disc, calcifications, stenosis of the spinal canal. Similar changes can be seen on ultrasound, which is increasingly prescribed instead of CT, since it does not give radiation exposure.

The patient should definitely consult a neurologist and, if necessary, a chiropractor.

When the examination is completed, the doctor can accurately diagnose and determine the tactics of treatment. The success of therapy increases tenfold with early treatment.

How to cure low back pain: basic therapies

Treatment of the lower back depends on the cause of the pain. What works in one case may not work in another. Let's look at the main therapies and how to relieve pain at home.

Conservative treatment

Conservative therapy is rarely self-administered. It usually complements medication.

The conservative methods primarily include physiotherapy. It can be manual therapy, classical or therapeutic massage, acupuncture. Cupping massage with bloodletting at specific trigger points is often prescribed to relieve muscle spasms and restore blood flow.

Sometimes doctors prescribe herbal treatments that improve blood circulation in the spine where spasms are concerned.

Kinesitherapy is becoming more and more popular. This is a special gymnastics that needs to be done on decompression machines. Such devices allow unloading overstrained muscles, forming correct movement patterns in a person.

Medicines

In most cases, back pain does not threaten health and can be treated with certain medications and ointments.

First of all, patients are shown non-steroidal anti-inflammatory tablets. They are good pain relievers that also reduce inflammation.

You can also give injections for pain, they can stop even very severe pain.

In a hospital setting, such drugs can be administered intravenously. This makes them the fastest and most effective way.

At home, they can be injected intramuscularly into the buttock. Visually divide the buttock into four segments by drawing two lines - horizontally and vertically in the middle. The injection should be done in the upper right part (for the right buttock). With one confident movement, the needle must be inserted to its entire length and then inject the drug by pressing the syringe. The medicine should be administered moderately quickly. Before the injection, be sure to disinfect the skin, and then apply a cotton swab dipped in an antiseptic for about 5 minutes.

Important!We do not recommend self-medication. Always consult your doctor before using any medication!

Let's go back to medication methods of treatment. In some cases, hormonal drugs are prescribed to reduce swelling and pain. They act faster than non-steroidal anti-inflammatory drugs. They are administered under medical supervision or strictly according to the prescribed scheme. At home, you can give intramuscular injections or take the prescribed medication in tablets. In the hospital, droppers are usually given.

Also, hormonal agents are used for therapeutic blockages, that is, they are injected directly into the source of pain.

Many commercials position ointments and gels as the most effective means of dealing with pain. However, in fact, this method of introducing an active substance into the body is considered the most ineffective, because most of the drug does not even pass through the skin.

How to quickly get rid of pain without medication and at home

It won't be possible to get rid of the pain in a minute, but in 5-10 it may well. To do this, you need to do an exercise aimed at relieving muscle spasm and relaxing the lumbar spine.

We offer two options:

Exercise One

  • Starting position - kneeling.
  • The right leg should be bent at a right angle, it should be in front. Place your left foot on the floor with your knee.
  • In this position, you need to find a balance and fix.
  • When you are good at it, reach back with your left hand and grab your left foot.
  • After that, pull your left leg by the heel to the pelvis. The muscles of the thigh should stretch well. You can enhance the effect by squeezing the left buttock.
  • In this position, hold for half a minute, then slowly and carefully lower your left leg, returning to its original position.
  • Then do the right leg exercise.

Exercise two (you need a massage roller)

  • Lie on your back with a massage roller under your sacrum. Important: never place the roller under your spine.
  • Gently pull your right knee up to your chest. The left heel should touch the floor. At this point, you will feel how the anterior thigh muscle is stretched.
  • To tighten the muscle, place your left hand behind your head and swing your bent knee slightly to the right.
  • Hold this position for half a minute.
  • Repeat for the other leg.

Other home remedies for low back pain

If the pain is caused by swelling, a dry cold compress works well. Take ice or something frozen from the freezer, put in a bag and wrap with a cloth. Apply to the lower back for 20 minutes for two days. You can repeat every two hours.

If the pain persists from the cold, then after two days you can try warm compresses. They increase blood circulation in the lower back and relieve pain by interrupting pain signals from nerve endings to the brain. It is best to use an electric heating pad for this. If not, the usual one will do. Or just take a warm bath.

What disease symptoms may be lower back pain

Bechterew's disease

This disease develops gradually. First, mild back pain appears, then they intensify and spread to other parts of the spine. The pain may occur sporadically, but most often it is constant, and only decreases for the duration of the pain medication.

Features of the nature of pain:

  • worse at rest, especially in the morning and late at night when lying down;
  • accompanied by stiffness of movement;
  • passes or decreases after charging;
  • resolves quickly after taking NSAID.

Sometimes the pain is very weak or not at all, and the only symptom is a decrease in the mobility of the spine, which spreads from the bottom up. Some patients also have shoulder pain, their mobility is limited. It happens that the joints of the legs and arms swell and hurt.

Hernia and osteochondrosis

These diseases have similar symptoms and are dependent on each other, so we will look at them together.

With lumbar osteochondrosis, the pain is severe, because the nerve roots are mechanically irritated. In addition, when the membranes and septa of the intervertebral disc rupture, substances that irritate pain receptors enter the bloodstream.

In the late stage of osteochondrosis, the intervertebral discs protrude and a hernia forms. The lower back is most often affected because the holes between the fourth and fifth lumbar vertebrae and between the fifth vertebra and the sacrum are the narrowest, but the nerve roots that pass through them are the most massive. At the same time, the patient feels severe pain, similar to radiculitis. If the hernia is massive, it begins to press on the spinal cord, which leads to decreased sensitivity in the legs and even paralysis.

Typical signs of a hernia:

  • it is impossible to stand up without leaning on a chair or knee, because the load on the disc responds with a severe attack of pain;
  • you cannot lie on your stomach just like that, but only with a pillow;
  • it is impossible to bend over to pick up something off the floor, but you need to squat gently to do this.

Kyphosis and scoliosis

There is no pain in the early stages. Perhaps a feeling of severe fatigue of the back muscles, in the evening I really want to go to bed as soon as possible. At the second stage, neurological disorders appear:

  • hands go numb;
  • shoulders and forearms weaken;
  • my back starts to hurt.

Spondyloarthrosis

Spondylosis develops simultaneously with it. With it, the cartilage of the intervertebral disc is destroyed, bony protrusions grow around the changed disc. This can lead to narrowing of the spinal canal and compression of the spinal cord, in which the legs become numb or even taken away, and the function of the pelvic organs is disrupted.

Main symptoms:

  • back pain, which in rare cases radiates to the thigh closer to the hip joint;
  • pain relief after rest or cessation of exercise;
  • soreness and tension in the muscles of the lower back;
  • limited mobility of the spine.

The pain intensifies while standing and walking, there is a feeling of heaviness and stiffness in the lower back in the morning. Usually, stiffness and heaviness disappear after exercising in the morning.

The pain is mild and can become chronic. This is due to constant irritation of the nerve roots and nerves.

Protrusion

Protrusions occur where mobility is highest, and therefore wear. Therefore, the lower back is most often affected.

The symptoms are mild for a long time, so people do not even suspect that this is not ordinary fatigue, but a serious diagnosis. However, then the manifestations intensify:

  • discomfort in the lower back gradually turns into pain, which becomes stronger and more frequent, it hurts a person to move, the pain radiates to the legs and eventually passes to them;
  • leg pain extends to the buttocks, numbness, tingling, cramps may occur;
  • I'm worried about backache;
  • there is a constant sharp or aching pain;
  • in the last stages, without treatment, the muscles of the legs are weakened, motor activity decreases;
  • pains occur in the right and / or left hypochondrium.

Arthritis

The symptoms of lumbar osteoarthritis are similar to those of osteochondrosis. With this disease, the nutrition of the intervertebral discs is disturbed, the joints become inflamed. In the later stages, limitation of mobility and even paralysis may occur.

Arthritis is a chronic disease, so you need to follow all doctor's orders for life to maintain a normal quality of life.

Main symptoms:

  • aching dull back pain;
  • lumbago in the back against hypothermia;
  • violation of sensitivity in different parts of the body;
  • the inability to move due to pain after a person has been in one position for a long time.

Osteomyelitis

With this disease, there are constant aching pains in the lower back, which intensify with movement and do not go away at rest. Pain may worsen at night and can be relieved with a warm dry compress.

Other symptoms are also present:

  • signs of general intoxication of the body - sweating, chills, weight loss, a slight increase in body temperature;
  • a local abscess, due to which the nerve roots are compressed and the functions of the organs innervated by them are disrupted;
  • paresis and paralysis (in severe cases).

Pancreatitis

If only the head of the pancreas is affected, then the pain occurs in the right hypochondrium, if its body is "under the spoon", if the tail is in the left hypochondrium.

If the entire gland is inflamed, then the pain is of a girdle nature, radiates to the back, under the left shoulder blade.

In some cases, pain radiates to the left thigh, groin, tailbone, perineum.

The nature of the pain can be different - acute, pulling, periodic. Usually it starts to hurt 2-3 hours after eating, but sometimes almost immediately - after 10-15 minutes. During physical exertion, the capsule of the gland is stretched, which also causes pain.

Spinal stenosis

Occurs due to hernia, protrusion or sequestration. Compresses the lower spinal nerves that innervate the lower extremities. The pain spreads along the affected nerve root, from the lower back to the foot, disturbs when walking and at rest, increases when a person tries to straighten the spine, and subsides when bending forward.

Facet Syndrome

This is a disease of the intervertebral joints, which are called "facet" joints. The pain can be localized only at the site of the lesion or be given to the tailbone, groin, back of the thigh. The unpleasant sensations intensify when rotating in the lower back and bending over, after physical exertion and in the evening.

Causes of back pain

Let's consider the main causes of lower back pain, taking into account their location.

Pain above the lower back, but below the shoulder blades

The main reasons why it hurts in this area:

  • diseases of the spine (primary pain);
  • injury - from a fall, improperly performed exercise, blow;
  • muscle strain, spasm;
  • cardiovascular diseases;
  • tumors, including malignant;
  • gastrointestinal diseases.

Lower back pain

Soreness of the lower back occurs due to diseases of the spine or internal organs. In the second case, the pain is called "reflected". Most often, pain occurs after a long walk, prolonged sitting, bruises and injuries, infectious diseases, heavy lifting.

Often, lower back pain is associated with unhealthy and improper stress on the spine. Less commonly, it can be diseases of the gastrointestinal tract and genitourinary system - cholecystitis, cystitis, pyelonephritis, gastritis, constipation.

Signs of reflected pain:

  • rare or frequent and painful urination;
  • bloating;
  • lower abdominal pain;
  • increased body temperature;
  • nausea, vomiting;
  • diarrhea or constipation.

In women, the causes of lower back pain can be: pregnancy and its complications, menopause, menstruation.

If there are no other symptoms besides pain, then they say that this is associated with problems with the musculoskeletal system. If the pain is localized in the pelvic region, then this may be the result of a previous disease of the hip joint.

Left lower back pain

The nature of the pain is aching, it does not go away at rest, occurs when walking, exercising, running, after prolonged sitting.

If after rest the pain does not go away, then its causes may be:

  • scoliosis;
  • osteochondrosis;
  • spinal infections;
  • circulatory disorders.

If pain occurs when walking and disappears after rest, it can be sciatica, diabetes mellitus, spinal displacement, pinched nerve root.

Aching pain above the lower back on the left occurs with a sedentary lifestyle and may indicate the presence of osteochondrosis, recent hypothermia or improper posture.

Acute, girdle pain in the side, which radiates to the left shoulder blade, may be one of the symptoms of myocardial infarction. A stomach ulcer gives off to the same area, the pain is sudden, sharp, cutting.

Right back pain

  • Cramping pain is characteristic of diseases of the genitourinary system.
  • Increasing soreness indicates an inflammatory process, including an abscess.
  • Dagger pain is an emergency, that is, internal bleeding, ulcer, rupture of an organ, thromboembolism.
  • Lumbago is typical for diseases of the spine, when the spinal roots are involved.
  • Constant dull and monotonous pain is characteristic of diseases of the parenchymal organs, such as the liver.
  • Pulling pain occurs with injuries of the musculoskeletal system, including trauma.

Lower back pain when coughing

The most common causes of cough pain are:

  • Hernia - accompanied by loss of limb sensitivity. Pain also occurs when bending forward.
  • Stenosis. At the same time, it is difficult to walk, there is weakness in the legs. Inspection shows a decrease in disc thickness.
  • Facet arthropathy. The lower back hurts when you cough, but the pain goes away if you bend over to the side of the injury. Muscles are overstrained on the affected side.
  • Injury to the annulus fibrosus. The pain increases with bending, movements, long sitting.
  • Osteochondrosis. It reduces the function of the spine.
  • Kidney disease.
  • Neuralgia - girdle pain.

Ways to prevent low back pain

In order not to hurt the lower back, you must:

  • Provide yourself with an adequate load - do exercises in the morning, simple exercises to stretch the muscles and spine.
  • Periodically take massage courses - classical, cupping for trigger points.
  • Do warming up or take a cryotherapy course as directed by a doctor.
  • Eat right to exclude gastrointestinal pathologies. It is necessary to maintain a balance of proteins, fats, carbohydrates, consume enough vegetable fiber. Alcohol, fatty, fried, salty and spicy should be excluded from the diet. Do not abuse smoked meats and canned food, fast food. Another important point is the drinking regimen: you need to drink 1. 5-2 liters of liquid a day (along with soups, tea, etc. ).
  • At the first sign of illness, you should see a doctor. In the early stages, almost any disease can be cured quickly and easily, without any consequences. If you have a predisposition to problems with the lower back, a neurologist should be visited for prevention at least once a year.