The lower part of the back is called the lower back - from the area where the ribs end to the coccyx (the lowest protruding vertebra).Most often, when a person has "back pain", we are talking about the lower back.And if 20 years ago lower back pain mainly bothered the elderly, now even very young patients turn to specialists with their backs.
Why does the lower back suffer so often?The fact is that the center of gravity of the human body is located exactly at the level of the lumbar spine, and it bears almost the entire load while walking.This is one of the disadvantages of vertical walking - vertebrates that move on 4 limbs do not have this disease.
Causes of lower back pain - what you need to know
Statistical studies say the following about the frequency of factors that cause low back pain:
- 91% of calls are related to problems with the spine and back muscles.
- 5% of complaints are related to urinary tract diseases.
- 4% - pathologies of other organs (reproductive system, gastrointestinal tract).
Types of lower back pain
Back problems often appear unexpectedly – like a bolt from the blue.Such acute pain in the lower back is called "lumbago" and you used to hear the term "lumbago".The name itself speaks of the sharp, shooting nature of the feelings.During a lumbago attack, any movement only increases the pain, and the patient involuntarily falls into a forced position, freezes in one position.The lumbago lasts for a few minutes and then subsides.
If the pain is prolonged and painful, then we are talking about lumbodynia.These are low-intensity but constant painful sensations in the lumbar region that intensify during physical activity or hypothermia.
And there is a condition when there is no back pain, but a person feels stiffness and discomfort.In this case, further diagnostics by specialists is also necessary.Depending on how low back pain manifests itself, the treatment methods are different.
Lower back pain as a symptom of illness?
Back pain itself can indicate very different pathological conditions, and often it is not so easy to understand the real cause.
For example, there is such a thing as displaced pain.It indicates a situation when the back hurts in the right, left or lower part of the back - and the person thinks that the cause of his pain is in the spine.However, after research, it turns out that one of the internal organs (kidneys, intestines or organs of the reproductive system) is at fault.The human body is very complex and confusing.Let's look at some possible causes of lumbar back discomfort.
Musculoskeletal diseases that cause back pain
The connection between spinal disorders and low back pain is direct and clear.We have already mentioned that spinal pathologies are the most common cause of back pain and are responsible for more than 90% of all visits.
The prevalence of protrusions and disc herniation rightly ranks first.In such destructive pathologies, the intervertebral disc initially moves slightly outwards, falls out (disc protrusion), and as the disease progresses, the integrity of the disc is broken in such a way that the inner part (nucleus pulposus) comes out of the surrounding fibrous ring.
Protrusions most often occur due to traumatic damage to the disc or osteochondrosis.
Another painful consequence of osteochondrosis is compression and pinching of the sciatic nerve.The pain is sharp and shooting - lumbago.
As a result of this compression, the nerve can become inflamed.The general name of this disease is radiculitis, and if the inflammation refers to the sciatic nerve, it is referred to by the more accurate term "sciatica".Pain caused by sciatica is concentrated in the lumbar region and spreads along the sciatic nerve to the buttocks and thighs.
Now about the disease that leads to the development of all of the above - osteochondrosis.Lower back pain associated with osteochondrosis has a sharp shooting or dull painful character.With the development of the disease (grade 2 and 3), neurological symptoms appear - numbness, a feeling of pins and needles in the lower limbs.In the morning, a person is disturbed by a feeling of stiffness.The functioning of the gastrointestinal tract, kidneys and reproductive system is disturbed.
The main goal of osteochondrosis treatment is to relieve pain and stop the destruction of the vertebrae and intervertebral discs.It is important to understand that the earlier treatment is started, the better the prognosis.
Kidney, urinary tract and lower back pain
You may have heard.that the lower back pain is due to the diseased kidney.In some cases, this is indeed true.We recommend that you see a urologist if you are concerned about the following symptoms:
- Frequent painful urination, change in urine color.
- Deterioration of health, indifference to life.
- Hyperthermia is an elevated temperature.
- Decreased appetite, nausea.
- Arterial hypertension.
The pain varies.For example, with the exacerbation of chronic pyelonephritis, the pain stretches and surrounds the lower back, and renal colic is acute and short-term.
It is typical that in kidney pathology the pain is concentrated on one side - since one kidney is involved in the inflammatory process.This is how a kidney stone (stone) appears in the kidney or ureter.
Another important diagnostic criterion is that the intensity of pain in nephropathies does not change with changes in body position.However, as you understand, it is better to entrust the right to make an accurate diagnosis to a specialist.
Excessive exercise and lower back pain
Our spine has adapted to physical activity.Therefore, the appearance of back pain after going to the gym should alert you.Normally, the pain due to the accumulation of lactic acid in the back muscles disappears within 1-2 hours, and if this does not happen, pathology should be suspected.
Back pain after sports can be caused by an old injury or a hidden problem of the intervertebral discs - for example, a protruding disc.In this case, stopping exercise does not lead to healing, but only hides the course of the devastating spinal disease.
Also, back pain after exercise is typical of myofascial syndrome.It is not life-threatening, but it significantly reduces its quality.
At the same time, physical activity can also contribute to the elimination of back pain - for example, an overweight patient is more likely to get rid of back pain as a result of losing weight.
Do not forget that constant and periodic pain in the lower back after physical activity should be reported to the doctor.
Hypothermia and back pain
Prolonged exposure to cold air and wind can lead to hypothermia.If the lower back was not protected from harmful environmental factors, unpleasant conditions may occur, such as myositis.This is the name of inflammation of the skeletal muscles.The pain is of an aching nature, the back muscles tense up to touch (palpation).
Characteristics of lower back pain in women and the mechanism of their occurrence
It's no secret that women's well-being is closely related to their hormonal levels, which undergo dramatic changes not only throughout their lives, but also every month.Therefore, at a certain stage of the menstrual cycle every month, women may experience nagging pain in the lower back.Unfortunately, this is a variant of the physiological norm.
During pregnancy, discomfort in the lower back is considered normal - if it goes away after rest.After all, significant hormonal changes occur in the female body during this period, the uterus expands - which changes the curvature of the lower back and shifts the center of gravity.In addition, the weight of a pregnant woman naturally increases, which also means an increased load on the spine.
If we talk about other causes of pain in the lumbar region of women, back pain can indicate the approach of menopause.This is due to a decrease in estrogen levels and changes in several other sex hormones.
Therefore, the diagnosis of the causes of lower back pain in women should be carried out with particular care in order not to miss important symptoms of serious diseases and not to describe the pathological causes of lower back pain in women.In fact, such terrible diseases can include cysts, apoplexy or inflammation of the ovaries, and even cervical cancer.Ignoring and premature diagnosis of such conditions can lead to infertility and critical complications.
What diseases can cause back pain?
Symptoms and nature of pain |
Presumptive diagnosis with MRI |
| Lower back pain when coughing, sneezing, bending. | Protrusion (bulging) of the intervertebral disc of the L1/L2 (L2/L3, L3/L4, L4/L5) vertebra |
| Numbness, tingling not only in the back, but also in the buttocks and lower limbs. | Symmetrical dorsal (posterior) protrusion of the discs of the L1/L2 (L2/L3, L3/L4, L4/L5) vertebrae |
| Weakness of the leg muscles, motor reflexes deteriorate. | Dorsal (posterior) median protrusion of the discs of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, shooting pains;the patient cannot straighten up even during a seizure. | Circular protrusions of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Staying in one position for a long time causes aching pain. | Diffuse extensions of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Symptoms can be absent for a long time and are discovered accidentally. | Median disc protrusion of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pain in the lower back - also known as "lumbago". | Disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Pain in the leg that extends below the knee, "pins and needles" feeling in the leg. | Lumbar disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Often asymptomatic, patients report only mild discomfort. | Schmorl's hernia of L1, L2, L3, L4, L5 vertebrae |
| The bowels, bladder and reproductive system are disrupted. | Paramedian disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| In the early stages, the course is asymptomatic.Pain occurs when the tumor spreads beyond the disc. | Hemangiolipoma and hemangioma in the L1 vertebral body (L2, L3, L4, L5) |
| The pain depends on the degree of displacement of the vertebra.If changes occur in the joints, movement disorders can be observed. | Retrolisthesis and antithesis of the L1 vertebra (L2, L3, L4, L5) |
| The pain is intermittent at first and then becomes constant.Physical activity increases. | Ventral wedge-shaped deformity of the L1 vertebral body (L2, L3, L4, L5) |
| Aching pain in the lower back, on the left or right side, along the spine.Numbness, "pins and needles" feeling.Muscle tension. | MRI image, signs of degenerative-dystrophic changes (osteochondrosis) of the lumbar spine |
| Rsharp pain from exertion or careless movement.Change in gait, dysfunction of the urogenital system. | Osteochondrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
| Pain in the buttocks and legs, discomfort when sitting in a chair for a long time and during a long walk. | Spondyloarthrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
What to do if you have lower back pain?
If the symptoms of pain in the back in the lumbar region do not go away or do not decrease within 3 days, you should consult a doctor.What to do before seeing a doctor?
What you can do yourself against lower back pain
If the cause of the pain is unknown:
- take your temperature to detect inflammation in your body.
- determine accompanying symptoms (vomiting, diarrhea or other)
- call a doctor at home or go to the emergency room.
If the cause of the pain is known (bruise, sprain or back injury):
- take a non-steroidal anti-inflammatory drug (NSAID) - diclofenac, ibuprofen or others.
- local application of cold helps reduce swelling and dulls pain.
- tightly tighten the lumbar area with a towel or orthopedic belt to fix the injured area in one position.
- Consult a doctor for a complete diagnosis and determine further treatment tactics.
What not to do in case of back pain
- Do not under any circumstances heat the painful area of your back!Heat increases blood flow, and if there is inflammation, it worsens the situation: it increases pain and leads to the spread of the infectious process.For the same reason, avoid visiting baths and saunas.
- You won't be able to relieve pain for long if you have persistent and unexplained back problems.Ignoring the root cause can only worsen the course of the disease and lead to serious complications.
- You should not try to straighten the vertebrae or massage your back roughly.Without a diagnosis, such activities can cause vertebral dislocation and unnecessary further injury.
Which doctor should I see for lower back pain?
It happens that a person would like to see a specialist, but does not know which doctor to go to with a complaint of back pain.Let's clarify this question a bit.
First of all, it is worth making an appointment with a family doctor.He will make a differential diagnosis and determine which doctor you should continue treatment with.It could be:
- Neurologist - for neurological symptoms and nerve involvement in the process.
- Urologist - in case of suspicion of urinary tract (kidney) diseases.
- Gynecologist - for the treatment of diseases of the female reproductive system.
A complete blood count (CBC) and general urinalysis (UCA), X-ray examination of the spine (especially MRI), ultrasound of the pelvic organs, kidneys and other tests may be prescribed according to the indications.
It is important to remember that self-medication and other home remedies for lower back pain are a waste of money and time.Moreover, if you postpone a visit to a specialist, you risk acquiring an advanced form of the disease, thereby condemning yourself to long-term, expensive and often less successful (than in the early stages) treatment.
How to cure lower back pain: basic treatment methods
Of course, the question may arise: if self-medication is not effective, then how can lower back pain be cured?A competent specialist has many techniques in his arsenal, including conservative and surgical treatment.
Conservative treatment consists of the following points:
- Taking oral and topical anti-inflammatory drugs (NSAIDs) and pain relievers.
- Physiotherapy (shock wave therapy, acupuncture).
- Kinesiotherapy.
- Therapeutic massage.
- Physical therapy and gymnastics.
Physiotherapy procedures and massage should be performed after the acute phase of the disease, when the pain syndrome has subsided.
Surgical treatment is justified in advanced cases of spinal diseases, when conservative methods cannot achieve significant results.However, with timely diagnosis and correctly prescribed treatment, the need for surgical interventions can be delayed or completely avoided.
Prevention of back pain
Usually, painful sensations appear in the back and lower back due to a careless attitude to health.After all, a sedentary lifestyle is typical for many of us, which is burdened by sedentary work and forced long-term staying in one position.Excessive physical activity without preparation (stretching) and weight lifting with incorrect back support are no less harmful.It is no wonder that the majority of the world's population experiences lower back pain.
Doctors' advice to prevent back pain:
- Pay attention to your posture, keep your back straight.
- Avoid uncomfortable positions at work.You can place a small pillow under your lower back to support your back.Try it out!
- When sitting at a longer desk, it is recommended to get up from time to time (every hour), ideally you can warm up together or go for a walk.
- It is advisable to sleep on an orthopedic mattress;quite hard and flexible at the same time.
- Start your day with exercises that strengthen your back and core muscles.
How to lift weights correctly?
If you have to pick up and carry something heavy, bend that knee, not your back.That is, first you need to sit down, take the load, and then straighten your knees, leaving the back line straight.
Pain in the lower back: what to do?
Now that you have read the most common causes of lower back pain, you know what you need to know and what you need to do, the question arises - where should you turn?In any case, when choosing a clinic, preference should be given to a medical center where different specialists can constantly examine you.That is, you do not have to go to the other end of the city for further diagnostics, and in one place a complete comprehensive treatment plan for back pain in the lumbar region is prepared.
Equally important is the training of doctors and the availability of appropriate equipment.After all, back pain caused by osteochondrosis and myositis requires different approaches to therapy.