Pain in the lower back is most often due to degenerative and dystrophic changes in the spine.The intervertebral disc is injured when lifting heavy objects, excessive load at rest and during movement, falling.Protrusion of the annulus fibrosus through tears and fissures of the nucleus pulposus forms a hernia.The instability of the spine contributes to the development of osteophytes (spondylosis), damage to the intervertebral joints and ligaments (spondyloarthrosis), osteochondrosis, which is accompanied by pathological processes in the sacroiliac joints.
In addition to changes in compression, pain is caused by reflex irritation of the receptors, the impulse from which goes to the motor neurons of the spinal cord.Muscle tone increases and, over time, pathologies appear in the muscle tissue.Spinal pain can be the result of tumors, multiple myeloma and systemic autoimmune diseases.
Causes of pain and their types
Pain sensations can be dull, sharp, aching, burning and throbbing.They can spread over the entire back, radiate to adjacent areas, or be localized.The unpleasant sensation develops in different ways;it can appear suddenly or grow over a long period of time.
The symptom is also classified depending on the cause of its occurrence:
- primary pain is a consequence of degeneration of the musculoskeletal system, lesions in it;
- the secondary type occurs during pathological processes in the body that are not related to the lower back.
There are two types of pain:
- Periodic are characteristic of strong physical loads, acute diseases and physiological characteristics;they may radiate to another part of the body or spread beyond the affected area.After removing the cause of their occurrence, they stop bothering the person.
- Constant pain is the result of deep damage to the joints, tissues and muscles.With the help of drugs, the symptoms are temporarily eliminated, but they reappear.
Indications for advanced diagnostics
In order to determine the method of pain relief, it is necessary to undergo an additional examination to determine the true cause of the syndrome.The tests should be taken if:
- atypical manifestation of pain (no increase or decrease in discomfort when moving the body), unusual localization (for example, discomfort radiates from the back to the perineum, abdomen, rectum, anus, vagina);
- weakening of symptoms in the standing position and pumping in the lying position;
- changes in the nature of back pain in connection with going to the toilet, eating, sexual intercourse;
- previous injuries to the spine or hip joints;
- pain accompanied by vomiting and increased body temperature;
- diagnosed oncology;
- the presence of mental behavioral disorders.
Additional tests are performed in hospital settings when the patient is hospitalized in neurological or other departments that provide a laboratory for diagnosing the suspected disease.
An X-ray of the spine in several projections, a general blood test and an extended biochemical analysis are made, which show the level of creatinine, calcium, glucose, phosphates and other substances in the blood.The method of computer diagnostics and nuclear magnetic resonance is widely used.Bone scintigraphy is used to examine bone tissue.
Diseases of the musculoskeletal system
Unpleasant sensations in the back arise due to the following reasons:
- Intervertebral osteochondrosis includes several types of pathologies characterized by dystrophy or degeneration.As a result of the disease, the articular cartilage and bones are loosened and destroyed, and nerve endings are included in the pathological change.Osteochondrosis causes the development of hernia, lumbar radiculitis, sciatica, protrusion (protrusion of the intervertebral disc without rupture of the fibrous ring).
- Scoliosis is a curvature of the spine in which the shoulder line is asymmetrical.It is accompanied by a deformity of the skeleton, poor posture, and a protrusion of a hump on the right or left in the intercostal space.It is classified as a congenital or acquired form.
- Spondylosis occurs due to the natural aging of the vertebrae and joints in the lumbar region;over time, the pain increases as the joints wear down and mobility is lost.
- Lumbago is characterized by acute discomfort in the lumbar region due to destructive disorders in the vertebrae.The pain occurs when lifting weights incorrectly and is more common in men.In lumbago, movement in the lower back is limited;lack of treatment is dangerous, as the destructive processes develop in an irreversible stage.
- Ankylosing spondylitis (Bechterev's disease) is characterized by loss of mobility of the lumbar joints and is a chronic inflammation with significant proliferation of connective tissue.
- Osteomyelitis is a purulent-necrotic inflammation of the bone marrow, bones and surrounding soft tissues.The disease occurs due to infection with purulent mycobacteria and pyogenic (pus-producing) bacteria.
- Osteoporosis is formed as a result of improper development of bone tissue due to impaired supply of phosphorus and calcium, while at the same time bone density is reduced, which leads to frequent injuries.
- Congenital or acquired leg length difference (more than 3 cm).
These diseases require a visit to the clinic for examination and serious treatment.Sometimes therapy helps relieve symptoms only for a while, and a surgical method is used for a complete cure.
Renal pathologies
Due to impaired kidney function, discomfort may appear in the lower back, pain may appear on the left, right, and sometimes in the central part of the back.The causes of the symptom can be the following pathologies:
- Kidney prolapse.This is a condition in which the organ moves beyond the permissible norm (displacement from the renal bed down and up by 2 cm is ensured).In nephroptosis, the kidney is called wandering if it can deviate by 10 cm.
- Kidney failure is a condition in which urine is not produced.The patient notes that he has a sharp pain in the lower back and his health condition is rapidly deteriorating.
- Pyelonephritis is an inflammation of the renal pelvis that affects the nearby tissues of the genitourinary system.In this disease, the diversion of urine may not be disturbed, and the pain in the lower back on the right and left is due to the intensity of the inflammatory process.
- Gout causes discomfort when standing up from a sitting position or during other movements.When the disease occurs, the natural metabolism of uric acid is disturbed;accumulates in the lumbar joints, limiting their mobility.
- Renal colic is a common pathology.In him, the pain occurs for various reasons.The most common are damage to the ureter by a stone, its kinking, or obstruction of the upper urinary tract due to a blood clot, mass, pus, or mucus.Low back pain caused by renal colic is characterized by an acute onset at any time of the day, during movement or at rest.
- Diabetic nephropathy is more characteristic of people with diabetes (75%) and is a complex damage to the arteries, glomeruli and renal tubules as a result of changes in carbohydrate and lipid metabolism in the kidney tissues.The pain with this pathology radiates to any part of the back, as well as to the groin and lower abdomen.
- Glomerulonephritis is inflammation of the glomeruli (kidney glomeruli) and can lead to kidney failure.A rapidly progressive and chronic form is noted.
- Kidney stone disease is not always accompanied by low back pain;it can be difficult to determine its location.
- Hydronephrosis is characterized by enlargement of the renal pelvis and discomfort.Requires additional diagnostics.
Gynecological diseases
Pain syndrome occurs in women due to diseases:
- The frequent localization of discomfort due to uterine fibroids, vulvitis, adnexitis and neoplasms of the genital organs is the lower abdomen, but the pain can appear in the lower back on the left and right.
- During pregnancy, the lower back hurts and hurts when walking, but such symptoms occur for natural reasons and are explained by the load of the growing fetus on the musculoskeletal system, so they do not require treatment.
- Menopause is accompanied by pain due to impaired blood supply to the internal organs of the small pelvis, which in turn is a consequence of hormonal imbalance during this period.
- Unpleasant sensations can constantly arise due to psychosomatics.In this case, the woman should visit a psychotherapist and psychologist.
- The consequences of the operation, for example, abortion, can be accompanied by discomfort in the lower abdomen and spread to the lumbar vertebrae due to involuntary contractions of the uterus or developing inflammation.
- Hormonal disturbances during the menstrual cycle, the release of the follicle from the ovary and its movement through the fallopian tubes, the increase of the uterus during menstruation provoke pain in the lower back and lower back.
Other causes of lower back pain
Discomfort in the lumbar region can be caused by diseases of the human body systems:
- Rheumatoid arthritis is a systemic pathology and most often affects women.It is a chronic inflammation that develops in the lumbar joints and involves the nearby cartilage and muscles.The disease occurs due to autoimmune disorders in the body.
- Thrombophlebitis and phlebothrombosis develop due to partial or complete stoppage of blood flow in the deep veins.Discomfort in the lower back is felt after long walking or standing.This pain radiates to the buttock and leg.
- Atherosclerosis in the final stage causes discomfort in the lower back.
Treatment of pain due to musculoskeletal problems
To eliminate the discomfort in the lower back caused by impaired functionality of the musculoskeletal system, different drugs are used depending on the root cause and the stage of the underlying disease.
They are used in several forms - from tablets to intramuscular injections.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs are used to reduce pain.These drugs lower body temperature, relieve inflammation and fever.
NSAIDs from the group of phenylacetic acid derivatives are popular in the treatment of lower back pain.These drugs are safe and effective and have an advantage over other pain relievers because they do not negatively affect the metabolic processes in the intervertebral disc.The therapeutic dose, sufficient to relieve severe discomfort, varies from 75 to 150 mg per day, the norm is consumed in several doses.To accelerate the analgesic effect, rectal suppositories are used or the drug is administered intramuscularly.
Muscle relaxants
If NSAIDs do not give a positive effect in the treatment of pain, then muscle relaxants are used.These drugs reduce the tone of skeletal muscles and reduce their movement - sometimes to the point of complete cessation of function.Start therapy with a standard dose and maintain it for several weeks.Practice shows that the addition of muscle relaxants to complex pain treatment provides lasting regression of discomfort and improves joint mobility.Combinations of different types of these drugs are not used.
Analgesics and corticosteroids
To relieve back pain, if it is very painful, narcotic analgesics are used, which have long been relevant in medicine.They are based on opioids, thanks to which the drugs provide relief.Such drugs are prescribed by a doctor (they are sold in pharmacies only by prescription);you cannot treat the pain yourself with these drugs.
To eliminate the syndrome, corticosteroids are used in the case of degenerative disorders in joint tissues.
Medicines partially restore the cartilage and prevent its further destruction.
injections
Injections are used if the previous drugs did not have the necessary effect.For blockade directly in the lumbar region, drugs of the ester group and the amide series are used.
Blockade is a procedure to relieve muscle spasms at the site of pain;injections are administered in the nerve plexuses, including the paravertebral area through a catheter.Its effect is short-lived, but it helps relieve severe attacks.
Use of ointments, creams and patches
With the help of gels and creams, the discomfort condition is also removed.Apply directly to the affected area.You can use products based on NSAIDs.Combined products have a stronger effect.
For distracting and local irritating effects, warming ointments with a restorative chondroprotective effect are used, which dilate blood vessels, which leads to improved nutrition of spinal tissues and cartilages and acceleration of metabolic processes in them.
The use of patches is popular due to the convenient method of application and quick action.The product is impregnated with the drug and applied to the site of pain.With this method, overdose is excluded.
Other methods of affecting painful areas
Physiotherapy treatment allows you to warm up the muscles, improve blood supply and improve the therapeutic effect of the main drugs.
Paraffin applications are used, which are effective for shooting pains.The procedure consists of layer-by-layer application of wax or paraffin to the skin with a total thickness of 1 cm, which is covered with polyethylene, then with a warm blanket.The duration is at least one hour, with daily use the course of treatment is a month.Physical therapy is effective when used during periods of mild disease.Exercise also reduces the risk of recurring back pain.
Massage is not done in all cases, because in some pathologies it can harm the body.In this case, the effect is not on the affected area, but on the surrounding areas.The procedure must be performed by an experienced massage therapist;you don't have to do this alone.
The mud healing method is also used as a distraction.
Pain relief for gynecological problems
Complex antibacterial agents are used to eliminate the initial cause of the pain.Special drugs are used to reduce bacterial infection of the vagina.An ointment containing antibiotics and antiseptics is used in the vulva area.
Inflammation of the glands of an infectious nature, accompanied by pain in the lower back, is treated with antibiotics, taking into account the sensitivity of the microorganism, and ultrasound is used as a physiotherapeutic effect.Abscesses of the genital organs, in particular the abscess of the Bartholin's gland, are surgically eliminated by opening.If the pain is moderate and the tumor does not bother the patient, then hormonal drugs are prescribed, which are considered only as prophylaxis before surgery.
GnRH antagonists reduce the amount of estrogen in the body.They are used for uterine fibroids, hyperplasia and endometriosis.Hormonal drugs are effective as a means of reducing the size of the uterus before surgery.However, their long-term intake leads to the development of osteoporosis.
In some cases, after treatment, the nodules begin to grow and cause back pain.Unpleasant sensations are relieved with the help of oral contraceptives.Antigonadotropin therapy is used to alleviate well-being when pain occurs in the lumbar region.These drugs have many side effects, so they are used in rare cases.
If the growth of the tumor leads to severe pain and threatens health, then an operation is necessary to remove it.During menopause and if the woman does not plan to have a child, complete removal of the uterus is recommended.In other cases, only the fibroid is removed by laparoscopy (through small incisions in the abdomen).
Popular hormonal drugs are NSAIDs.Antispasmodic drugs are also used.
Help with kidney pain
Acute pain in the kidneys is relieved by taking antispasmodic drugs, which can increase the lumen of the ureter and provide diversion of urine.
Acute symptoms require the use of combined drugs containing both an analgesic and an antispasmodic with anti-inflammatory components.You can take 2 tablets at once;in severe cases, intramuscular injections are given.Analgin-based antipyretics help relieve kidney pain.
Traditional methods of treatment
Traditional recipes help relieve pain in the lower back, but before using them, you need to make sure that there are no diseases dangerous to human life and health that require timely treatment with drugs or even surgery.The most popular methods:
- A cloth soaked in a mixture of St. John's wort, thyme, chamomile flower and black elder is applied to the sore spot.For cooking, take 1 tsp.raw or dried raw materials, pour a glass of boiling water and leave for half an hour.Then remove the compress and go to bed.
- Garlic ointment helps a lot.To prepare it, take a head, grind it in an affordable way and mix it with a small portion of petroleum jelly and lemon juice.Apply the prepared mixture to the sore spot on the back.
- A mustard bath relieves pain.To do this, take a cup of mustard powder and pour it into warm water.Take a bath until it cools down, then rinse the skin with clean water and cover with a blanket.
- A compress of honey and vinegar (1 tablespoon each) relieves pain.The resulting mixture is placed on a cabbage leaf and applied to the problem area.
- Radishes or horseradish are grated, mixed with sour cream and placed on a napkin made of natural material.The compress is fixed with a warm scarf or handkerchief.
- Dry leaves of large burdock, steamed with boiling water, are applied to the sore spot and isolated.
- To improve blood flow in the tissues, rub the back with honey.The massage is performed without pressure, but the movements must be intense.In the same way, use alcohol tincture with eucalyptus, which is purchased at the pharmacy.
- Make a compress from grated beets, squeeze the mass and mix the resulting cake from one vegetable with 1 liter.kerosene.With the help of a napkin, the composition is transferred to the sore spot and fixed and wrapped.This compress is left on all night.
- Use grated laundry soap along with white frankincense, mix them in equal amounts, add 2 beaten egg yolks.The product is applied to the back, a napkin is placed on top and secured with a bandage.It lasts for about 2-3 hours.
Treatment of back pain is carried out in different ways, but diagnosis of the underlying disease causing unpleasant symptoms is always necessary.