Low back pain is a common reason for visiting the doctor. The cause of discomfort in this area can be a series of diseases.
What is ankylosing spondylitis, as evidenced by severe pain in the sacral area radiating to the leg, what studies are performed during diagnosis, the causes of pain in the lower shoulder blades and the most effective treatment methods, in the material?
Low back pain
The sudden appearance of acute pain in the lower back is a fairly common phenomenon. This symptom, characteristic of many pathological conditions, is not always caused by diseases of the spine. The manifestations and causes of pain can vary.
types of pain
By the nature of the pain that occurs in the lumbar region, the main cause of the discomfort can be identified.
Strong
Starting in the sacral area, the intense pain is located in the hip joint. The pain radiates down the leg and is felt in the foot. Similar symptoms are observed in osteochondrosis with the risk of numbness of the extremities.
The mechanism of pain development is compression of the sciatic nerve. The pain worsens when walking quickly, bending over, or coughing. Prolonged compression of the gluteus muscle causes its atrophy.
Sharp
Acute pain occurs suddenly. They are unbearable and very intense, often characterized as "lumbago. "Depending on the cause, the pain may be triggered by physical activity. Accompanied by rigidity of movement (sometimes it is even impossible to straighten up). The slightest movement intensifies the symptoms. Acute pain can persist for up to six weeks.
Pulling and aching
Persistent and painful pain in the lower back is usually due to diseases such as hernia, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain in the lower back may be hernias or protrusions, accompanied by degenerative changes in the spine. The intensity of such manifestations increases with physical exercise and is a consequence of physical inactivity.
Moved
The appearance of such symptoms is secondary. Diseases of the genitourinary system, ovaries, prostate and other internal organs are accompanied by painful symptoms in the lumbar region.
Mechanic
Mechanical pain occurs during or immediately after physical activity.
radiating
These pains are dull and painful. Painful sensations can also radiate to the leg (up to the foot).
Local
They are characterized by the appearance of unpleasant sensations in a certain area of the lower back.
reflected
Referred pain is pain that is felt in a different place than actual pain.
radicals
Radicular syndrome is a neurological manifestation that may be accompanied by numbness and a feeling of loss of sensitivity.
myofascial
This pain is accompanied by muscle spasms and intensifies when touching the muscle.
Causes
The causes of low back pain are very diverse and can be associated with pathological conditions both in the spine itself and in the tissues that surround it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondyloarthritis
This is a systemic disease accompanied by inflammation of the connective tissues of the spine. With spondylitis, fusion of the vertebrae occurs, as a result of which their motor activity is limited and ankylosis (immobility of the joint) is formed. As a result of the ossification of the paravertebral ligaments, the spine gradually becomes a solid, inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, the pain appears in the lumbar region, gradually covering new areas;
- negative symptoms bother you occasionally, but over time they become permanent;
- increases the rigidity of movements.
The expressiveness of the signs is observed at night. In the morning the pain becomes unbearable.
osteochondrosis
Growth, destruction, protrusion of cartilaginous tissue caused by a violation of its nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of osteoarthritis of the spinal joints.
Against this background, dorsalgia (back pain) develops with characteristic manifestations of shooting in the lumbar region, with irradiation to the buttocks and legs. Weakness and a feeling of numbness appear in the lower extremities. In this case, the nerve endings of the roots are pinched, which causes a burning and tingling sensation.
Hernia
Intervertebral hernia is a complication of osteochondrosis. It is characterized by the protrusion of disc fragments and their prolapse into the vertebral canals.
In the initial stage there are no symptoms, but the lack of treatment causes increased pain, while limiting the mobility of the lumbar region. Sensations of acute pain are observed, which increase against the background of exertion and force the person to adopt an anti-pain position.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spine. In the initial stage of spinal curvature deformity, there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic discomfort, but it becomes constant. The pain is painful in nature and intensifies with physical activity.
spondyloarthrosis
With this pathology, the articular cartilage is destroyed and osteophytes (bone growths) form. This causes a narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, severe pain occurs, which intensifies during physical activity and subsides in a calm state. Muscle tension is observed, causing a decrease in motor activity.
Outgoing
The prerequisites for the formation of lumps are spinal injuries, excessive permissible physical activity and muscle weakness due to physical inactivity. In this case, a protrusion of the disc occurs, accompanied by tension in the lumbar area and painful discomfort.
Arthritis
In rare cases, the cause of painful manifestations in the lumbar joints is inflammation of the lumbar region. In the chronic course of the disease, the patient is bothered by "lumbago", which often arises due to hypothermia and overwork.
Osteomyelitis
With osteomyelitis, an inflammatory process of bone tissue is observed. The acute period of the disease is characterized by attacks of severe pain. Lack of treatment causes the disease to become chronic, but the pain syndrome persists.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease presents with stabbing, cutting and pulling sensations of a paroxysmal nature.
spinal stenosis
The pathological condition is caused by complications of hernias and protrusions. Compression of the nerve roots causes discomfort when walking, at rest, and intensifies when bending the back.
facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (which connect the vertebrae from the back). This condition is accompanied by an increased load on muscles and bones and causes an inflammatory process followed by the development of spondyloarthrosis and degenerative changes.
In the affected joint area, pain is felt in the form of cramp attacks when bending and twisting the lower back. One of the symptoms is stiffness of movement in the morning and increasing discomfort at night.
Location
To identify the cause of pain in the lower back, you must first determine the location of the discomfort. To make an accurate diagnosis, it is necessary to contact a specialist.
Pain below the waist
The cause of pain under the lower back is usually pathological conditions in the spine or internal organs. The resulting discomfort may indicate the development of:
- osteoporosis;
- osteochondrosis;
- urolithiasis;
- inflammatory process in the ureter;
- cholecystitis;
- pyelonephritis;
- gastritis;
- problems with the gastrointestinal tract.
In such cases, pain appears most often after lifting heavy objects or walking quickly. Often, painful sensations under the lower back occur after serious injuries or infectious diseases. They are also present during menstruation, pregnancy and menopause.
Pain above the lower back, but below the shoulder blades.
Pain between the lower back and shoulder blades can be caused by the following diseases:
- spinal pathologies in the lumbar and thoracic region or previous injuries in these areas;
- osteoporosis;
- muscle spasm or tension;
- pancreatitis.
Similar manifestations can occur against the background of the development of neoplasms of various etiologies.
Left lower back pain
Painful sensations in the lower back, radiating to the left shoulder blade and covering the left side of the neck, are often the result of a myocardial infarction.
Cutting pain in this area indicates the likelihood of a perforated ulcer.
Additionally, these symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis and poor posture. In such cases, a painful pain is felt that occurs against the background of physical inactivity or exceeding permissible loads.
Right lumbar pain
Suspicion of pathology of the kidneys or genitourinary organs arises when a dull pain appears on the right side. The inflammation may have an infectious etiology or be a consequence of hypothermia.
Sudden sharp pain on the right side indicates the likelihood of a perforated ulcer, burst appendicitis, or signs of internal bleeding. Pain on the right side often indicates muscle strain and radiculopathy.
Lumbar pain when coughing.
Possible causes of lower back pain when coughing:
- osteochondrosis;
- hernia;
- nerve root stenosis, which causes weakness and difficulty walking;
- facet arthropathy, in which muscle tension occurs;
- injured annulus fibrosus;
- pathological condition of the kidneys.
Painful sensations when coughing are often observed against the background of neuralgia.
Low back pain can occur for physiological reasons. These include:
- over weight,
- passive lifestyle,
- excessive physical activity.
Diagnosis
To determine the source causing pain in the lower back, a complete diagnostic examination is necessary. Includes laboratory tests and instrumental procedures.
Main:
- blood test (general, biochemical), urine;
- tumor marker testing;
- x-ray of the lumbar spine;
- endoscopic examination of internal organs;
- Ultrasound (ultrasound examination);
- MRI (magnetic resonance imaging).
It is also necessary to consult a neurologist and chiropractor. An accurate diagnosis is established by a specialist who, based on the results of the examination, will decide how to treat low back pain.
Treatment
The main methods of treating lower back pain:
- medicinal;
- physiotherapy;
- Surgical intervention.
Diseases accompanied by lower back pain can pose a serious danger to human health (even death). Without resorting to self-medication, it is necessary to consult a therapist, neurologist or neurologist. Often, to identify the cause of pain, it is necessary to consult with a urologist and gynecologist.
Surgical
Surgical intervention is relevant only as an emergency measure in oncology. Specialists perform planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Medicine
The first step in relieving pain is nonsteroidal anti-inflammatory drugs (NSAIDs). They are used in various forms: tablets, injections, rectal suppositories, patches, ointments or gels.
Depending on the established diagnosis and the severity of symptoms, glucocorticosteroids are also used - hormonal drugs that relieve pain and inflammation. If there are muscle spasms, muscle relaxants are prescribed.
B vitamins are suitable as an auxiliary therapy to improve nerve conduction. Drug therapy should always be accompanied by non-drug treatment methods: physiotherapy, physiotherapy, massage (only outside of an exacerbation). Depending on the effectiveness/ineffectiveness of the measures taken, the severity of the symptoms and based on the examination, the patient may be recommended surgical treatment: removal of a hernia, removal of compression of the root of the spinal cord.
Treatment depends on the cause of the low back pain. Pathologies of internal organs must be eliminated by specialized specialists; Inflammatory lesions of the skeletal system and systemic inflammation may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and acute symptoms of the disease are eliminated, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetotherapy, transcutaneous electrical stimulation) and exercise therapy.
Additionally, the treating doctor may prescribe acupuncture. Massage sessions are also effective in the treatment of this pathology.
Therapeutic exercises help to strengthen muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises free nerve roots from compression, help normalize blood flow and normalize metabolic processes.
Prevention
To prevent degenerative changes in the spine, it is very important to observe the correct motor regime every day, alternate physical activities and practice walking and swimming. Additionally, it is important to control body weight so that the spine does not experience additional stress.
Most often, the lumbosacral and cervical spine is affected by degenerative changes. The thoracic region, fixed by the rib cage, suffers from osteochondrosis less often. The pain occurs in the lumbar area or in the neck, respectively, in the projection of the spine. At first it may be periodic and moderate in nature.
At this stage, a person can help himself independently. To reduce pain, it is necessary to lie on your back: this is the most comfortable position of the body, in which the intervertebral discs, ligaments and joints of the spine are in the most relaxed state. For the lumbar region, this is usually a lateral position with legs bent. You can take NSAIDs once. It is recommended to apply an ointment or cream with an anti-inflammatory effect locally to the painful area.
As the process progresses, the pain becomes more frequent and increases in intensity. It may radiate to the arm or leg. Numbness (altered sensation) and motor deficit (weakness) often appear in the limb. These symptoms indicate that the spinal roots are involved in the pathological process.
Additionally, preventive measures for low back pain include:
- daily morning exercises;
- balance diet;
- compliance with the drinking regimen;
- Periodic preventive exams.
