Backache- one of the frequent complaints of patients with various types of diseases. Almost everyone at least once in his life experiences pain, most often localized in the sacral spine, or between the lower edge of rib XII and the gluteal fold, viz.lower back pain(BNS).
Low back pain is usually accompanied by muscle tension, often in the presence of pain points. It can radiate (give) to other parts of the body, for example, to the legs, to the gluteal muscles, to the abdomen, to the pelvic area, etc.
Acute lower back pain often arises suddenly and can last from a few minutes to a few weeks. Usually, in 90% of cases, lower back pain disappears on its own in 3-4 weeks, however, in the other 10% of cases, it becomes chronic and can last for years, sometimes worsening, then worsening. Often, the exact cause of lower back pain is unknown.
Back pain in the lumbar region - the cause
Various diseases can cause back pain in the lumbar region.Lower back pain(BNS), in fact, only symptoms that appear with the development of a large number of pathological processes in the organs of the chest and abdominal cavity, small pelvis and spinal structures; in addition, it can be psychogenic.
Pain in the upper part of the lower back
Back pain above the lower back can occur with gastric ulcers and 12 duodenal ulcers. Reflected pain is often localized in the lower back or slightly higher, more rarely in the upper quadrant of the body.
With pancreatitis and cholecystitis, pain is often observed in the projection zone of the sixth to eighth intercostal space.
In genitourinary sphere pathology, the reflected pain is often localized in the lumbar region and the thoracic level below the spine.
Lower back pain, right or left
Lower back pain on the right or left side is often a sign of gallstones. If a kidney stone, a stone that grows in the kidney presses on the delicate renal parenchyma from the inside, sometimes causing severe pain in the lower left or right back of the kidney where the stone is located.
Lower back pain radiating to the legs
When kidney stones pass through the ureter, severe pain occurs in the lower back, which can radiate to the lower back, legs, abdominal cavity and genitals. Often, back pain that radiates to the legs can be a signrenal colicwith renal urolithiasis.
In addition, lumbar pain radiates to the legs with lumboishalgia. Ishalgia appears as pain in the legs especially during recovery.
Back and back pain
Lower back pain radiates to the left and right in acute or chronic kidney inflammation. Pain in the kidneys, lasting for several days in a row, and accompanied by fever, chills, diarrhea (urinary disorders) indicate the diseaseacute pyelonephritis. . .
Back pain in the back
Processes in the pelvic region (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral region. However, there are often secondary muscle-tonic syndromes (reflex disorders of the small and middle gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) in combination with lumbar spine pathology with chronic processes in small pelvic organs and tissues. Such patients require cholological treatment of neurologists-neurosurgeons, urologists, gynecologists, proctologists.
Lower back pain
Pelvic bone tumors, especially at the onset of the disease, can mimic lumboischialgia, and in the presence of a corresponding vertebrogenic process, patients sometimes undergo neurosurgical intervention for hernias at the lower lumbar level. This is worryingchondrosarcomas, Ewing's sarcoma, reticulosarcomas, osteoblastomaand a few others. Mandatory X-ray examination usually resolves diagnostic problems. It should not be forgotten that the somatic and general hematological condition of the patient can determine the oncological aspects of the disease.
Lower back and pelvic pain
Difficulties in differential diagnosis are noted in latent latent pelvic bone tuberculosis, when there is no increase in temperature and ESR, and pain can mimic lumbar ischemic syndrome of lumbar osteochondrosis. This process can run silently since childhood and adolescence and manifests itself in adults in the form of sacroiliitis. In recent years, the problem of tuberculosis has become increasingly urgent, and doctors must remember about the manifestations of this disease.
Therefore, pain in the lumbar and lower back areas may have nothing to do with spinal disease and is a worrying symptom of a completely different organ disease. Therefore, in the event of back pain, a thorough examination is required.
Low back pain in women - the cause
Pulling back pain
Back pain in womenoften associated with premenstrual syndrome. Pain like this usually has an interesting character, it occurs a few days before menstruation and persists for 2-3 days after its onset and disappears on its own.
Back and lower abdomen pain in women
Back and lower abdominal pain associated with premenstrual syndrome and accompanied by cramps in the lower abdomen and painful periods with heavy bleeding can be symptoms of serious reproductive diseases such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)and others
Abdominal pain radiates to the lower back
Abdominal pain in women can radiate to the lower back, to the lower abdomen, radiate to the vagina and external genitalia.
Keep in mind that pain in the abdomen and lower back in women can be a symptom of dangerous disorders in the pelvic area, such as: the formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, adhesion formation, cancer of the reproductive organs, etc.
In addition, severe pain in the lower back and lower abdomen (especially on the right or left side) in women may be due to ruptured ovarian cysts or symptoms of ectopic pregnancy.
Low back pain during pregnancy
Often, pain in the lower back and abdomen in women indicates natural physiological changes associated with an increase in uterine size during normal pregnancy development.
Low back pain during pregnancyis associated with additional stress on the spine and normal and does not require special treatment. However, pregnant women with severe back pain should always see the doctor carrying the pregnancy.
Lower back pain in men - the reason
Lower back pain in men is most often associated with degenerative diseases of the spine, especially with strenuous physical activity, work associated with heavy lifting. In addition, back pain can be associated with various diseases of internal organs.
Severe back pain
Acute pain in the lumbar spine can occur with awkward movements, improper load distribution, etc. This pain is usually associated with muscle spasm or transfer of a vertebral disc. Pain can also be caused by pinching of the root muscles of the spinal nerve endings.
Back pain and groin pain
Pain in the groin area in men, which radiates to the lower back can be associated with prostate adenoma, testicular torsion, oncology, urological diseases, etc.
Classification of back pain
The classification, widespread in several countries, aimed at optimizing the provision of medical care for LPS, distinguishesBNS is specific, radicular and non -specific. . .
Certain back painare symptoms of certain diseases, often severe and even life -threatening (cancer, including metastases to the spine; infectious - tuberculosis, spinal osteomyelitis, epidural abscesses, etc . ; inflammation, - for example, ankylosing spondylitis and other spondyloarthritis; traumatic fractures andosteoporotic of the vertebrae; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal canal stenosis and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by a "red flag" feature of the underlying disease, which helps physicians to suspect a patient has serious pathology and deliberately examine it (preferably with appropriate specialist involvement) to determine proper diagnosis and treatment.
Radicular pain (radicular) in the lower back, including sciatica syndrome, is the result of spinal root compression.
Management of patients with radicular LNS is the prerogative of neurologists, with special indications required the participation of a neurosurgeon. In practice, such patients often use the help of a chiropractor.
Among the radicular pain in the lower back are distinguished:
- lumbago,orlumbago;
- lumbodynia- long -term pain only in the lower back;
- lumboishalgia- back pain radiating to the legs.
Nonspecific lower back pain- the most common, unrelated to visceral diseases, serious pathology of the spine, spinal cord and its roots. It can be caused by overuse of the lumbar spine, especially those related to weight lifting, prolonged uncomfortable positions during sleep or work, etc.
Therefore, it is desirable that planned spinal x-rays not be included in the examination recommendations of patients with nonspecific lower back pain syndrome (NLP). Such patients do not require mandatory neurologist consultation, but should be treated by a family physician, district therapist or general practitioner.
Back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most frequent diagnosis, given to patients with complaints of pain in the lumbar spine. However, it is impossible to identify every case of development of episodes of pain in the lower back with those often found in patients "degenerative-dystrophic" changes in the spine, making a "habitual" diagnosis"Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .
For pain in the lower back or lower back, the diagnosis is often written as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Softening". . . Although, the correct diagnosis in this case should be like this:"Lumbago with sciatica on the background of osteochondrosis of the lumbar spine. Lumbariization. (Code М54. 4)".
It should be noted that there is no nosological unit in any classification of foreign degenerative-dystrophic diseases. "osteochondritis of the spine". . . Moreover, neither is the term"Osteochondrosis", or other terms characterizing dystrophic changes in the spine, should not be used as synonyms for clinical diagnosis.
Chondrosisis a dystrophic change in the disc cartilage,osteochondrosis- dystrophic changes in the discs and adjacent vertebral bodies. However, indifference by radiologists and doctors about the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, fixing hyperostosis, etc. )leads to overdiagnosis: this type of pathology is found where not.
Often, osteochondrosis is referred to as all the listed degenerative changes because of not knowing the differences between them. By misunderstanding, osteochondrosis encompassesherniated disc, which is a consequence of its rupture, and, as a rule, a normal disc, and is not altered by the process of dystrophy. Although, calling osteochondrosis a disc herniation is as bad as the rupture of the meniscus at the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends using the general term "vertebral dysfunction" (which, by the way, is also not included in the ICD-10 disease classification) in cases of the appearance of appropriate clinical symptoms.
A large number of modern authors, especially foreign ones, emphasize the absence of a relationship between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of pain in the lower back (LBS), on the other, as only 1 in 10 patientswith radiological signs of degenerative spinal lesions are clinical manifestations of the disease.
Back pain treatment at home
For back pain associated with muscle tension and muscle tightness, back pain ointment can significantly reduce symptoms and help reduce muscle tension.
Ointments and pills for back pain
Ointments and creams are used to treat the lower back. Alternatively, you can take pills that contain nonsteroidal anti-inflammatory drugs (NSAIDs).
At the same time, it must be remembered that self -treatment at home for back pain with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease that causes this pain, and very sad consequences. Self -medication of the lower back is very dangerous for such kidney diseasesacute pyelonephritisorrenal colicrequire qualified emergency medical treatment.
Prevention of lumbar pain
People who experience an attack of this disease, especially before the formation of a stable remission, need to follow certain guidelines for prevention:
- Do not tilt the body without support on the arms; lift the object off the floor with the knees bent.
- Change body position more often, do not stand for long, do not sit.
- Work at a desk or workplace, maintain an upright position, for this one leg, bend at the knee, place in front of the other.
- Be careful not to do yoga, aerobics exercises without the recommendation of an exercise therapist or vertebrologist.
- Beware of hypothermia, drafts, and prolonged warming in a hot bath, as muscle relaxation temporarily removes the protection of an immobile muscle corset.