Low back pain is familiar to almost everyone. It is difficult to find someone who has never experienced this extremely unpleasant symptom at least once. Sometimes it is enough to sit in an uncomfortable position for a while to cause discomfort in the lumbar region of the spine. But this is not a serious problem, but simply a consequence of being in an uncomfortable position for a long time.
But severe back pain almost always has specific reasons and is a reason to go to the doctor. The diagnosis will not always be expected, because osteochondrosis is only one of the possible problems, back pain.
Why the lower back hurts and what to do in such a situation is not difficult to guess. The doctor will diagnose and identify the cause of the pain, after which you will need to start treatment.
Pain syndrome - primary and secondary
Understanding why the lower back hurts, we must not forget that the causes of such pain are numbered in dozens, and a layman will never be able to determine the real source of problems.
In general, the medical classification separates primary and secondary pain syndromes that can affect the lumbar region.
Primary low back pain syndrome occurs as a result of musculoskeletal changes of a morphofunctional nature. It is he who is the cause of the vast majority of cases of back pain in the lumbar region. The most significant of the reasons is degenerative-dystrophic changes occurring in various parts of the spine:
- osteochondrosis, which is a lesion of bone and cartilage tissue, this disease has a dystrophic nature. When it affects the intervertebral disc and adjacent vertebrae, spondylosis begins to develop.
- spondyloarthrosis is a form of osteoarthritis, in which the disease affects the intervertebral joints, which are responsible for the mobility of the spine, or synovial joints.
Secondary pain syndrome has much more varied causes of pain:
- scoliosis, which is a curvature of the spine, as well as some other growth diseases;
- various inflammations of a non-infectious nature. For example, rheumatoid arthritis, Reiter's syndrome;
- a tumor located on the vertebrae, in the spinal cord itself or in the retroperitoneal space, regardless of whether it is primary or caused by metastases;
- fracture of one or more dorsal vertebrae. This is perhaps one of the most serious causes of back pain;
- various infectious diseases that lead to damage to the vertebrae and intervertebral discs (tuberculosis, brucellosis, epidural abscess);
- stroke conditions in which there is a serious violation of the blood supply to the spinal cord. In this case, there may also be a feeling that the lower back hurts;
- diseases of the gastrointestinal tract. For example, acute appendicitis with atypical course, intestinal obstruction;
- often, back pain is of a reflected nature. A similar problem can arise with some diseases of organs located in the pelvic region. For example, renal colic, sexually transmitted diseases (gonorrhea, trichomoniasis, chlamydia, ureaplasmosis, andexitis - all these diseases cause reflected back pain).
What are acute and chronic pain
Low back pain is also divided into acute and chronic, which can be caused by a variety of problems and diseases, both of the nerve endings and of the spine itself.
Displaced pain is also often observed - there is a translation of pain from other organs, which are located much deeper. In other words, it seems to a person that the lower back hurts, although in fact the problem is in a completely different part of the body. But most often, pain from the pelvic organs, pancreas, kidneys, colon or tumors that are located behind the peritoneum is projected into the lumbar region.
Usually people don't know what to do if their lower back hurts. But it is well clear what not to do - it is self-medication. The causes of pain are varied, only a specialist can make the correct diagnosis, and the constant use of painkillers (which many consider to be treatment) can do even more harm.
The specialist, in turn, makes a diagnosis based on data obtained as a result of additional examinations, for example, MRI diagnostics of the spine.
Causes of acute pain
Before deciding what to do when the lower back hurts badly, any serious doctor will first establish the cause of the pain that has appeared. The reasons may be different, but most of them are somehow related to the spine.
One of the simplest and most harmless causes of pain is acute muscle strain. In this case, spasmodic long muscles are the source of pain. With this problem, pain rarely "radiates" to other parts of the body, but rather severely restricts a person's mobility. This reason is very common, often faced by athletes and people whose work is associated with various physical activities.
Another common but much more serious source of pain is a spinal fracture, especially when it comes to compression fractures of the vertebrae. Most often this happens with unsuccessful falls and other back injuries. But if a person is sick with hyperparathyroidism, osteoporosis, Paget's disease or there are tumors in the vertebral region, then the fracture can occur unnoticed by the patient, as they say "out of the blue. "Moreover, a person will not even understand when this fracture occurred.
An equally unpleasant situation, in the event of which an acute pain in the lower back appears, is the displacement of the intervertebral discs in the lumbar spine. Symptoms of this problem are severe, sharp pain in the lower back, which severely restricts mobility. Most often, pain occurs due to compression of the nerve roots. Signs of such compression are:
- sensitivity disorders;
- disappearance or significant decrease in the Achilles reflex;
- absence or decrease in the intensity of the knee reflex;
- unilateral radicular pain.
One of the unpleasant tendencies of this problem is that such a displacement can cause pathology of the lower vertebrae. As a result, pain appears below the lumbar region, and the functions of the rectum and bladder may be impaired. Localization of pain above the lower back is also possible in some cases.
Acute back pain can also occur as a result of facet syndrome. In this case, the cause of pain is compression of the root at the exit from the spinal canal, while the intervertebral disc itself remains intact. This syndrome usually results from enlargement of the upper and lower facets of the intervertebral joint, resulting in narrowing of the intervertebral foramen.
An epidural abscess is one of the most severe diseases that cause severe back pain. This disease requires urgent diagnosis and immediate treatment, and any highly effective measures are recommended, up to surgical intervention, the main thing is to quickly eliminate the compression of the spinal cord.
Diseases of the hip joint are also often the cause of acute lower back pain. They are characterized by pain radiating to the lower part of the lower back, to the legs to knee level.
Causes of Chronic Low Back Pain
One of the causes of chronic pain is spondylosis deformans. With this disease, a dystrophic change in the vertebrae of the lumbar spine occurs, the ligamentous apparatus weakens and bone growth occurs. As a result, the spinal canal narrows, and the bony outgrowths begin to press on the nerve roots. Aching pains can be accompanied by numbness and weakness in the legs, as well as other neurological symptoms. In any case, a full examination will be necessary, according to the results of which the final diagnosis will be established.
Bechterew's disease, also called ankylosing spondypoarthrosis, can also cause chronic pain. It manifests itself as pulling pain in the lower back, a curvature of the spine in the thoracic region appears and rapidly develops. The first symptoms are limited mobility and decreased chest movement during breathing.
Cancer and metabolic disorders often cause lower back pain. But even benign tumors can cause chronic pain that will not be accompanied by neurological symptoms.
Osteomyelitis can also cause aching lower back pain, which can be very long-lasting.
Conclusion
As you can see, back pain can occur as a result of many diseases. At the same time, quite often a person does not even expect that the problem will be not where it hurts. So even if your lower back hurts not constantly, but from time to time - do not pull, consult a doctor. It is easier to cope with any disease at an early stage, and not when it is neglected and will pull a lot of complications along with it.