Back pain in the lower back is familiar to everyone. According to statistics, she becomes the cause of 25% of all medical care requests. The appearance of it can cause a lot of factors ranging from mild fatigue to quite serious illnesses. So don't let it go, especially if the discomfort occurs frequently and even more frequently over time. In such situations, you should contact a specialist as soon as possible or go directly to a neurologist and get a thorough examination.
This will allow to diagnose the disease in the early stages of development and to take timely measures to prevent its progression. But if before the pain starts to have an injury or a fall is unsuccessful, you need to consult your trauma doctor or spine surgeon immediately.
Characteristics of low back pain and associated symptoms
Back pain can be of varying nature and extent. They can be vigorous, shoot guns, whine, pull, etc. They can intensify with exertion, sit or stand for long periods, and pass when rested or not. All of these are important diagnostic factors that allow the doctor to make an accurate diagnosis and find out the true cause of the patient's condition.
It is fundamentally important in a diagnosis to be whether the pain has spread to the hips, buttocks, knees, feet, and if so, where and how. In addition, an important point is the presence of limitations to spinal mobility, whether the patient is able to freely bend, rotate or reduce the range of motion.
Pain in the spine is called paralysis. If it spreads down the leg, it is called a migraine.
Acute pain is pain that lasts less than 3 months, otherwise they are chronic pain. In the latter case, the disease usually progresses with episodes of exacerbation and remission.
Low back pain rarely occurs individually. In most cases, a complex of other disorders emerged, too, of which patients themselves rarely combined. Usually, back pain is associated with:
- feels like an ant crawling in the back and / or legs, numbness;
- muscle weakness;
- pain in the hip and knee joints;
- disruption of pelvic organs (irregular menstruation, problems with potency, loss of control during urination, defecation);
- is paralyzed.
Similar signs indicate pathology of the spine.
But since they can not only cause the appearance of back pain, there is another group of symptoms that can accompany lower back pain and indicate a pathology of internal organs or cancer. Therefore, you need to be especially careful about your own state when it appears:
- rapid and unnecessary weight loss;
- cuts and pain in the groin and perineum;
- increased urination, soreness;
- increased body temperature, chills;
- change in skin color in the epicenter of pain;
- irregular menstruation, abnormal discharge.
If lower back pain is associated with one or more of the above symptoms, you should seek immediate medical attention. When symptoms appear from the first group, the consultation of a neurologist is required, from the second group, the help of a urologist, gynecologist, endocrinologist or specialist is required. other narrow. A therapist will help you understand exactly which doctor to contact.
Cause of what happened
All causes of lumbar pain can be divided into 2 groups: spinal diseases and visceral diseases, namely gynecological diseases, kidney diseases, gastrointestinal tract, internal disorders. details. However, most of them are often the result of the development of changes in the spine and surrounding muscles. The most common causes of back pain are:
- bone necrosis;
- degenerative vertebrae;
- spondylitis;
- myofascial syndrome;
- ankylosing spondylitis; scoliosis
- ;
- Injury.
However, lower back pain can also be the result of overwork or certain physiological changes. In such situations, they don't need special treatment but simply reduce physical activity and go on a less daily regimen.
Bone tumor and disc herniation
Bone tumors are the most common disease of the spine. Its development is often associated with inevitable age-related changes, as most older people experience its symptoms to a greater or lesser extent.
Osteochondrosis is the price humanity has to pay for the ability to go straight. It is characterized by gradual destruction of the discs, thinner, reduced elasticity and firmness. As a result, they no longer cope with stress and may swell. Hence, disc herniations are formed.
Usually, bone necrosis affects the discs of the lumbar spine. When they protrude the spinal canal or spinal canal, the nerves are almost certainly impaired, leading to acute pain in the lower back and their irradiation to the legs and buttocks.
Spinal degeneration
Spondylolisthesis is a complication of progressive osteoporosis, in which the discs are nearly completely destroyed, and due to ongoing degeneration and an increase in the load on the columnvertebrae, which form bony protrusions called osteomas along the edges of the vertebrae.
Therefore, there is a high risk of pinching and damage to nearby nerves. This causes intense pain that can spread down the leg.
Inflammatory diseases of the spine
Usually spondylitis occurs in young people, mainly in men. They cause severe pain even at night, that's their specific difference. As it progresses, if not treated promptly, the pain will become more severe and often bother the patient.
It is not uncommon for a patient to seek medical help several years after symptoms first appear. As a result of such a prolonged inflammatory process in the spine, irreversible changes can occur, leading to immobility and disability.
Sometimes, in addition to lower back pain, there is discomfort in the joints of the legs and arms. In such cases, the cause of discomfort can be arthritis, osteomyelitis.
Myofascial syndrome
Myofascial syndrome is a common condition in which pain occurs after a long time in an uncomfortable position or after exertion. A little more often, myofascial syndrome occurs in women. Along with that, back pain occurs after careless or exertion. Its distinctive feature is the presence of the so-called trigger point on the spasmodic muscles in the lumbar and buttocks, pressing on it leads to sudden pain. Myofascial syndrome significantly reduces a person's quality of life, but is not a serious threat.
Bechterew Disease
Ankylosing spondylitis or ankylosing spondylitis is a chronic joint disease in which the sacrum, the joints of the spine, and surrounding soft tissues are primarily affected. With this disease, people often worry about lower back and sacral pain and stiffness with movement, but symptoms usually go away without a trace in the afternoon and night.
In addition, physical activity has a beneficial effect on the patient's health and contributes to the elimination of pain syndrome. A fairly specific symptom of ankylosing spondylitis is stooping, scoliosis and gradual restriction of mobility.
Scoliosis curvature
Scoliosis is the lateral curvature of the spine. It can be of varying severity, which directly affects the intensity of back pain and other symptoms. Because a deformed spine leads to displacement of all anatomical structures, nerves are often compressed, causing intense pain. In addition, other neurological signs may appear, including a feeling of numbness and numbness.
Compression fracture
In elderly people with osteoporosis and trauma, lower back pain can be the result of an undetected spinal compression fracture. As a result, the vertebrae are flattened and occupy an abnormal position, leading to an incorrect distribution of load onto the spine, degenerative processes in the intervertebral discs, and the appearance of pain.
Physiological causes of low back pain
Doing strenuous physical activities, intense exercise creates an increased load on the muscles, as a result of which lactic acid accumulates in it causing pain. Back pain is not uncommon when you have to wear uncomfortable shoes for long periods of time, especially with heels.
Also, lower back pain is common during pregnancy. In such situations, they are due to a change of focus and increased stress on the spine.
Diagnosis
To determine the cause of lower back pain, you should consult a neurologist. Initially, you can get advice from a therapist, but most likely, the doctor will still refer the patient to a neurologist.
At the appointment, the specialist will thoroughly examine the patient, find out what worries the patient, how the patient's lifestyle, etc. v. . . In addition, it is necessary to examine, in which the doctor will evaluate the degree of reflexes, examine the nerves and evaluate the motor ability of the patient. Based on the results obtained, the doctor can make a preliminary diagnosis and understand what types of violations lead to the onset of back and lower back pain.
To confirm existing assumptions, to find out the exact cause of pain, conduct a thorough examination of the patient, which may include:
- general and biochemical blood tests - with their help, changes in the blood are detected, indicating inflammatory processes in the body, the presence of infection or a tumor;
- general urine analysis - used to distinguish kidney diseases that cause pain in the lumbar region;
- X-rays - show the presence of changes in the bone structure of the spine, signs of fracture, provide information about bone density and allow you to diagnose major diseases of the spine, alsosuch as osteoporosis (finding pathologies of the spine is the reason for closer examination with CT or MRI);
- CT is a modern radiation diagnostic method that allows you to very clearly visualize all bone structures and detect the smallest deviations from standards;
- MRI - provides comprehensive information about the state of soft tissues and cartilage, including disc, with the help of MRI can diagnose disc herniation of all sizes, changes ofblood vessels, tumors.
Low back pain treatment
Back pain treatment is strictly individualized. At the same time, it is always complex and includes symptomatic therapy, lifestyle changes, and treatments that aim to eliminate detected causes of lower back pain. Therefore, if the first 2 components of therapy are common and are prescribed to all patients, etiotropic therapy is developed individually, taking into account the existing disease.
In most cases, the patient is initially on conservative treatment, the main component being drug therapy. In more complex cases, you should conduct a course of physiotherapy procedures, manual therapy and exercise therapy.
But under any circumstances, all patients with low back pain should:
- Give up heavy lifting and tired sports;
- for weight loss when obese;
- take regular breaks to warm up if one is forced to sit for long periods of time;
- increases the level of physical activity, but avoids overwork and hard work (daily walking, morning exercise, performing a complex special exercise therapy, swimming);
- uses a support bandage to reduce the load on the lower back and thus facilitate early recovery of the spine.
Depending on the source of the pain, the patient may be advised to lie in bed for several days or vice versa, increasing their level of physical activity, but within reasonable limits. For example, pain from pinching nerves causes you to rest your back for a few days. In contrast, in other diseases, moderate physical activity is one of the required components of therapy. It helps to increase effectiveness of drug treatment, reduce the risk of complications and prevent disability.
But unfortunately, it's not always possible to use conservative therapy to treat low back pain. In some cases, it becomes ineffective and does not yield any results even after a few months of not changing compliance with medical recommendations. In other situations, autopsy results show the presence of a pathology that can no longer be eliminated by any non-surgical method. In such situations, the patient should consult a neurosurgeon and perform appropriate surgical intervention to restore the normal anatomy of the spine.
Drug treatment
To improve the patient's condition and relieve pain quickly, the following medications are prescribed:
- NSAIDs in the form of tablets, injections and topical preparations - have analgesic and anti-inflammatory properties; Corticosteroid
- - used in short courses to control severe inflammation; Muscle relaxant
- - needed to reduce muscle spasm, usually the body's response to pain and aggravates the pain;
- B vitamins - improves neurotransmission by normalizing the nutrition of nerve fibers and speeding up transmission of nerve impulses.
For intolerable intense pain, a blockade can be performed. This procedure involves injecting the anesthetic solution directly into the affected area or via nerve fibers. Thus, it is possible for a while to completely put an end to the pain syndrome and improve the patient's health.
However, the blockade has only temporary effect and its implementation is only possible in a medical setting, as usually one has to inject the drug into the points located just near the spine, whereThere are many passing nerves. As a result, an illiterate person performing the procedure can lead to serious and sometimes fatal consequences.
In addition to the drugs listed above, several other drugs are also prescribed to help get rid of the underlying disease that is causing the pain syndrome. Therefore, patients may also be prescribed antibiotics, chondroprotectors, immunomodulators, and drugs of other groups.
Physiotherapy
Physical therapy is often indicated for patients with spinal disorders. Thanks to the precisely selected method of physical action and the frequency of the procedure, it is possible to achieve a pronounced anti-inflammatory, analgesic effect, as well as improve microcirculation, accelerate the elimination of local edema, muscle spasm, . . . Physiotherapy significantly increases the effectiveness of other treatments, but is mainly used only after acute elimination. process.
Usually, the patient is prescribed:
Electrophoresis- ;
- UHF;
- ultrasound therapy;
- magnetotherapy; reflexology
- ;
- diadynamic currents, v. v.
As a rule, a process course consists of 8-10 sessions, which are conducted at regular intervals.
Manual therapy
With osteoporosis, scoliosis and other ailments, manual sessions can have a truly amazing effect on the condition of the spine. But only a qualified chiropractor can master a manual session that will benefit the patient, not the harm.
The use of special techniques of manual exposure not only allows for improved microcirculation, relaxation of overly firm and overly relaxed muscles, but also increased spacing between vertebrae, as well asnormalize their position. A qualified chiropractor can find out where the nerve is pinched and relieve the pressure on the anatomical structures on it.
Literally, after the first session, the majority of patients notice an improvement in their health and a significant decrease in the severity of the pain syndrome until it is eliminated. completely. But to reinforce the results, you should undergo a full manual therapy and in the future should participate in support courses.
exercise therapy
Physical therapy exercises help the body cope with stress. For each disease, a special exercise set has been developed, which is routinely performed allowing to tackle the most important tasks in the current situation. So with the help of a properly selected combination of physical therapy exercises, you can return your muscles to their normal state and strengthen them. As a result, the spine will be less stressful, effectively blocking the progression of the disease and creating favorable conditions for the disease to recover.
Exercise therapy also helps to improve blood circulation in the affected area, helps speed up the inflammatory process and leads to a complete recovery soon. Correct exercise for many conditions can help reduce lower back pain and reduce its frequency of occurrence.
Training program developed individually for each patient. This not only takes into account the type of pathology detected and its severity, but also takes into account the presence of concomitant diseases, the patient's physical level, his age and other factors. . Only a specialist can precisely choose the most effective and safest exercises.
First classes were held under his supervision. In the process, the patient learns how to correctly perform each of the proposed exercises in a beneficial manner. Gradually, the load is increased, bringing it back to the optimal level. But don't increase the number of repetitions of the exercises yourself or complicate them. Any change to the physiotherapy program is recommended by a specialist only.
Patients only need to strictly adhere to the doctor's recommendations and exercise every day in a comfortable environment. All exercises are performed at a slow pace. Any sudden movement is not allowed. But if pain occurs during work, stop the exercise immediately and consult your doctor as soon as possible.
Back pain surgery
Usually, the help of a spinal surgeon is needed for disc herniation, the formation of a herniated disc has led to an invasion of the spinal roots and development of pain. Glass. If a bulge has formed, it cannot be pulled back with modern non-invasive methods. The only way to get rid of it and at the same time get rid of low back pain is to operate a surgical herniated disc.
There are several types of surgery used for disc herniation. Specific surgical intervention strategies are defined based on the type, location and size of the herniation block:
- Enlargement and dilation is a percutaneous surgical method that allows partial removal of the marrow nucleus through a puncture of tissues several centimeters in diameter and reduces the size of the hernia mass.
- Microdiscectomy is a thorough way of solving the problem of disc herniation, that is, removing it or the entire disc through an incision up to 3 cm long. The nerve is pinched even in the most difficult part of the spine.
- Laparoscopic surgery - involves the removal of a disc herniation through punctures up to 1 cm in diameter with special equipment with a video camera. It can be used to remove a hernia of any size, but this technique cannot be used to remove tumors in difficult to anatomic sites.
Also, need the help of a spinal surgeon for scoliosis. In this case, all forces are directed to restore the normal axis of the spine. Previously, this required making a large incision that spanned almost the entire back. But today it is possible to correct the deformation of the spine with minimal invasive through miniature incisions.
Many different types of metal structures are used to restore the normal axis of the spine, but their nature is almost the same. This structure is fixed on the vertebrae with special screws and by adjusting its tension at different points it is possible to bring the displaced vertebrae back to their position and fix them in place. location. Modern types of metal structures allow, over time, to improve the initial outcome of activity without re-interfering with the body. This is achieved by adjusting the position of the installed structure with special screws.
Surgical intervention cannot be avoided in the event of a spinal fracture. In such situations, it is possible to get rid of back and lower back pain only by restoring the normal shape, size and position of the vertebra. Recently, chiropractic and chiropractic surgery have been performed for this purpose. The essence of both activities draws from the fact that through a thin needle, a special bone cement injected into the vertebra is destroyed by trauma. 
It fills all free space and hardens after 10 minutes. But in cases of severe compression fractures, chiropractic surgery is preferred, as it can also restore the normal shape of the vertebra, which will ensure correct distribution of the load. future spine and reduce the risk of complications. This activity involves inserting a special balloon into the pre-destroyed vertebrae, which is gradually inflated, returning the vertebra to its original shape. Then, the ball is lowered and removed, and the forming cavity is filled with bone cement.
As such, back pain could be the result of normal physiological changes, muscle fatigue, or a symptom of serious diseases of the spine or internal organs. So if they happen frequently and especially against the background of the same factors, you should not hesitate and ignore the problem. Contact a specialist who has expertise for the fastest and easiest treatment. And if the disease cannot be recognized in the early stages of development, then the modern level of neurosurgery will be able to remove it surgically with minimal risk of complications.