Back pain- one of the most common complaints of patients with a wide variety of diseases. Almost every person at least once in his life has experienced pain, most often localized in the sacral spine or between the lower edge of the XII pair of ribs and the gluteal folds, ie.backache(BNS).
Low back pain is usually accompanied by muscle tension, often the presence of sore spots. It can radiate to other parts of the body, such as the legs, gluteal muscles, stomach, pelvic area, and so on.
Acute lower back pain often occurs suddenly and can last from a few minutes to several weeks. Usually in 90% of cases the lower back pain disappears by itself within 3-4 weeks, but in the remaining 10% of cases it becomes chronic and can last for years, sometimes worsening, then subsiding. Most often, the true cause of low back pain cannot be determined.
Back pain in the lumbar region - causes
Various diseases can cause back pain in the lumbar region.Backache(BNS) is actually only a symptom that occurs with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavities, the pelvis and the structures of the spine; it can also be psychogenic.
Pain over the lower back
Back pain above the lower back can occur with stomach ulcers and 12 duodenal ulcers. The reflected pain is often localized in the lower back or slightly higher, less often in the upper quadrant of the body.
In pancreatitis and cholecystitis, pain is often noted in the projection zone of the sixth to eighth intercostal space.
In the pathology of the urogenital sphere, the reflected pain is often localized in the area of the lumbar and lower thoracic levels of the spine.
Pain in the lower back, right or left
Pain in the lower back with the right or left side is most often a sign of kidney stones. In the case of kidney stones, a stone growing in the kidney compresses the delicate parenchyma of the kidney from the inside, sometimes causing severe pain in the lower back to the left or right of the kidney where the stone is located.
The pain in the lower back radiates to the legs
When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, legs, abdomen and genitals. Very often, back pain radiating to the legs can be a signrenal colicwith urolithiasis of the kidneys.
In addition, lumbar pain radiates to the legs with lumbosacral pain. Ischalgia appears as a pain in the leg mainly during recovery.
Pain in the side and lower back
Lower back pain radiates to the left and right sides in acute or chronic inflammation of the kidneys. Kidney pain lasting several days in a row and accompanied by fever, chills, dysuric phenomena (urinary disorders) indicates a diseaseacute pyelonephritis. . .
Back pain in the back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral area. However, there are often secondary muscular-tonic syndromes (reflex disorders in the small and medium gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysoster syndrome) in combination with pathology of the lumbar spine with chronic processes in the organs and tissues of the pelvis. Such patients need peer treatment by a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Backache
Pelvic tumors, especially at the onset of the disease, may mimic lumbosciatica, and in the presence of a concomitant vertebrogenic process, patients are sometimes subjected to neurosurgical intervention for a lower lumbar hernia. This applies tochondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand some others. Mandatory X-ray examination usually solves the diagnostic problem. It should be remembered that the general somatic and hematological condition of the patient can determine the oncological aspect of the disease.
Low back and pelvic pain
Difficulties in the differential diagnosis are noted in the latent course of pelvic tuberculosis, when there is no increase in temperature and ESR and the pain may mimic the lumbar sciatic syndrome of lumbar osteochondrosis. The process can take place secretly from childhood and adolescence and can be revealed in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent again and the doctor must remember these manifestations of the disease.
Thus, pain in the lumbar region and lower back can often have nothing to do with any disease of the spine and are alarming symptoms of completely different diseases of the internal organs. Therefore, in case of back pain, a thorough examination is required.
Low back pain in women - causes
Pulling back pain
Low back pain in womenoften associated with premenstrual syndrome. Such pains usually have a pulling character, they appear a few days before menstruation and last 2-3 days after its onset and disappear on their own.
Pain in the lower back and abdomen in women
Lower back and abdominal pain associated with premenstrual syndrome and accompanied by lower abdominal cramps and painful periods with heavy bleeding may be symptoms of serious reproductive diseases such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)etc.
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 abdominal and low back pain in women can be symptoms of dangerous disorders of the pelvis, such as: the formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, the formation of adhesions, cancer of the reproductive organs, etc.
In addition, severe pain in the lower back and lower abdomen (especially on the right or left) in women may be the result of a ruptured ovarian cyst or a symptom of an ectopic pregnancy.
Low back pain during pregnancy
Often, low back and abdominal pain 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 during pregnancyis 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 the pregnancy.
Low back pain in men - causes
Low back pain in men is most often associated with degenerative diseases of the spine, especially with heavy exercise, work related to lifting weights. In addition, low back pain can be associated with various diseases of the internal organs.
Severe back pain
Acute pain in the lumbar spine can occur with awkward movement, improper load distribution, etc. This pain is usually associated with either muscle spasm or displacement of the spinal discs. The pain can also be caused by tightening the muscles of the roots of the nerve endings of the spine.
Back and groin pain
Pain in the groin area in men, radiating to the lower back may be associated with prostate adenoma, testicular torsion, oncology, urological diseases and others.
Classification of back pain
The classification, widely used in a number of countries aimed at optimizing the provision of medical care for LPS, distinguishesspecific, radicular and nonspecific BNS. . .
Specific back painis a symptom of a certain disease, often severe and even life-threatening (cancer, including metastases in the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc . ; inflammatory, - for example, ankylosing spondylitis and other spondylothyroid arthritis; vertebrae, 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 doctor suspect that the patient has a serious pathology and purposefully examine him (preferably with the participation of an appropriate specialist) to establish the correct diagnosis and treatment.
Radical (radicular) pain in the lower back, including sciatica syndrome, is a consequence of spinal root compression.
Management of patients with radicular LNS is the prerogative of a neurologist, with special indications requiring the participation of a neurosurgeon. In practice, such patients often resort to the help of chiropractors.
Among the radicular pain in the lower back are:
- lumbago,orlumbago;
- lumbodinia- prolonged pain only in the lower back;
- lumbosacral pain- back pain radiating to the legs.
Nonspecific low back pain- the most common, unrelated to any visceral disease, serious pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially associated with heavy lifting, prolonged awkward position during sleep or work, etc.
Therefore, it is perfectly reasonable that the planned X-ray of the spine is not included in the recommendations for the examination of patients with non-specific lower back pain (NLP) syndrome. Such patients do not require mandatory consultation with a neurologist, but should be treated by a family physician, district therapist, or general practitioner.
Low back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most common diagnosis, which is given to patients with complaints of pain in the lumbar spine. However, it is impossible to identify any case of an episode of lower back pain with often "degenerative-dystrophic" changes in the spine that are actually present in the patient, making a "normal" diagnosis."Exacerbation of osteochondrosis"or just"Osteochondrosis". . .
Low back or low back pain is often diagnosed as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization ". . . However, the correct diagnosis in this case should sound like this:"Lumbago with sciatica on the background of osteochondrosis of the lumbar spine. Lumbarization. (code M54. 4) ".
It should be noted that in none of the foreign classifications of degenerative-dystrophic diseases there is a nosological unit. "osteochondritis of the spine". . . Besides, neither the term"Osteochondrosis", no other term characterizing dystrophic changes in the spine should be used as a synonym for a clinical diagnosis.
Chondrosisis a dystrophic change in the disc cartilage,osteochondrosis- dystrophic changes in the disc and adjacent vertebrae. However, ignorance of both radiologists and clinicians about the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthritis, spondylosis, fixative hyperostosis, etc. )leads to overdiagnosis: these types of pathology are found where they are not.
Often osteochondrosis is called all the listed degenerative changes due to ignorance of the differences between them. Misunderstood osteochondrosis includesdisc herniation, which is a consequence of its rupture and, as a rule, a normal disc and is not altered by a dystrophic process. However, calling a disc herniation osteochondrosis is just as wrong as a rupture of the meniscus in the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends the use of the general term "vertebral dysfunction" (which, incidentally, is also not included in the classification of diseases according to ICD-10) in cases of appropriate clinical symptoms.
Many contemporary, mainly foreign authors emphasize the lack of connection between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of lower back pain (LBS), on the other hand, as only 1 of10 patients with radiological signs of degenerative spinal lesions are clinical manifestations of the disease.
Treatment of back pain at home
For low back pain associated with muscle tension and muscle tightness, 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 low 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 urgent qualified medical care.
Prevention of lumbar pain
Individuals who have had an attack of the disease, especially before the formation of a stable remission, should follow certain instructions for prevention:
- Do not tilt the body without arm support; lift objects off the floor with your knees bent.
- Change the position of the body more often, do not stay for a long time, do not sit.
- Work at a table or workplace, keeping an upright position, with one leg bent at the knee in front of the other.
- Beware of performing specific yoga exercises, aerobics without the recommendation of an exercise doctor or a vertebrologist.
- Beware of hypothermia, drafts, and prolonged heating in a hot bath, as muscle relaxation deprives for some time the immobilizing protection of the muscular corset.