Back pain- one of the most frequent complaints from patients with a wide variety of diseases. Almost everyone at least once in their life experienced pain, most often located in the sacral spine, or between the lower edge of the twelfth pair of ribs and the gluteal folds, that is.lumbar pain(BNS).
Low back pain is often accompanied by muscle tension, often by the presence of sore spots. It can radiate (yield) to other parts of the body, for example, the leg, the gluteal muscles, the stomach, the pelvic region, etc.
Acute low back pain often comes on suddenly and can last from a few minutes to several weeks. Usually in 90% of cases, low back pain goes away on its own in 3-4 weeks, however in the remaining 10% of cases it becomes chronic and can last for years, sometimes getting worse and then disappearing. Very often, the true cause of low back pain cannot be established.
Back pain in the lumbar region - causes
A variety of diseases can cause back pain in the lower back.Lumbar pain(BNS) is, in fact, only a symptom that appears with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavity, the small pelvis and the structures of the spine; in addition, it can be psychogenic.
Pain above the lower back
Back pain above the lower back can occur with gastric ulcer and duodenal ulcer. The reflected pain is often localized in the lower back or slightly higher, less often in the upper quadrant of the body.
With pancreatitis and cholecystitis, pain is often noted in the area of projection of the sixth to eighth intercostal space.
In pathology of the genitourinary sphere, the reflected pains are often localized in the region of the lumbar and lower thoracic levels of the spine.
Low back pain, right or left
Low back pain on the right or left side is usually a sign of kidney stones. In the case of kidney stones, a stone growing in the kidney presses on the delicate kidney parenchyma from the inside, sometimes causing severe pain in the lower back to the left or right of the kidney where it is located. the calculation.
Low back pain radiates to the leg.
When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, leg, abdominal cavity, and genitalia. Very often, back pain radiating to the leg can be a signrenal colicwith urolithiasis of the kidneys.
Also, the low back pain radiates to the leg with lumboishalgia. Ishalgia appears as pain in the leg mainly during recovery.
Back and side pain
Low back pain radiates to the left and right sides in acute or chronic inflammation of the kidneys. Pain in the kidneys, which lasts for several days in a row, and is accompanied by fever, chills, dysuric phenomena (urinary disorders) indicates a disease.acute pyelonephritis. . .
Back pain in the back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause localized pain in the lumbosacral region. However, there are often secondary musculo-tonic syndromes (reflex disorders in the small and medial gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysternal syndrome) in combination with pathology of the lumbar spine with chronic processes in the organs and tissues of thesmall pelvis. These patients need collegiate treatment from a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Lumbar pain
Pelvic bone tumors, especially early in the disease, can mimic lumboischialgia and, in the presence of a concomitant vertebrogenic process, patients sometimes undergo neurosurgical intervention for a lower lumbar hernia. This concernschondrosarcomas, Ewing sarcomas, reticulosarcomas, osteoblastomasAnd some others. Mandatory X-ray examination usually solves the diagnostic problem. It should not be forgotten that the patient's general somatic and hematological condition can determine the oncological aspect of the disease.
Lumbar and pelvic pain
Difficulties in differential diagnosis are observed in the latent course of tuberculosis of the pelvic bones, when there is no increase in temperature and ESR, and pain can simulate the lumbar ischialgic syndrome of lumbar osteochondrosis. The process can proceed secretly from childhood and adolescence and reveal itself in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent, and the doctor must remember these manifestations of the disease.
Therefore, pain in the lower back and lower back often has nothing to do with any disease of the spine and are alarming symptoms of completely different internal organ diseases. Therefore, in case of back pain, a full examination is required.
Low back pain in women - causes
Pulling back pain
Low back pain in womenoften associated with PMS. These pains generally have a drawing character, occur a few days before menstruation and continue for 2-3 days after its onset and disappear on their own.
Lumbar and abdominal pain in women
Lower back and abdominal pain associated with PMS 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 ovarian disease (PCOS)and etc.
Abdominal pain radiates to the lower back
Abdominal pain in women can radiate to the lower back, lower abdomen, radiate to the vagina and external genitalia.
It should be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous disorders in the pelvic area, such as: formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, the formation of adhesions, cancers of the reproductive organs, etc.
Also, severe pain in the lower back and lower abdomen (especially on the right or left side) in women can be the result of a ruptured ovarian cyst or a symptom of an 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 the size of the uterus during the development of a normal pregnancy.
Low back pain during pregnancyit is associated with additional stress on the spine and is normal and does not require special treatment. However, pregnant women with severe low back pain should always see a doctor who is pregnant.
Low back pain in men - causes
Low back pain in men is most often associated with degenerative diseases of the spine, especially with intense physical exertion, work associated with lifting weights. Also, low back pain can be associated with various diseases of the internal organs.
Severe back pain
Acute pain in the lumbar spine can occur with uncomfortable movements, improper load distribution, etc. This pain is usually associated with muscle spasms or displacement of the vertebral discs. Pain can also be caused by pinching of the muscles at the roots of the nerve endings in the spine.
Back pain and groin pain
Pain in the groin area in men, radiating to the lumbar area, may be associated with prostate adenoma, testicular torsion, oncology, urological diseases, etc.
Back pain classification
The classification, extended in several countries, aimed at optimizing the provision of medical care for LPS, distinguishesSpecific, root and nonspecific SNB. . .
Specific back painis a symptom of a certain disease, often serious and even life-threatening (cancer, including spinal metastases; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc . ; inflammatory, - for example, ankylosing spondylitis and othersspondyloarthritis; traumatic and osteoporotic fracture of the vertebra; aneurysms of the abdominal aorta, gynecological, urological and renal diseases, stenosis of the spinal canal and cauda equina syndrome, etc. ).
Specific LPS are often accompanied by "red flags" characteristic of the underlying disease, which help the physician to suspect that the patient has a serious condition and examine the patient on purpose (preferably with the involvement of an appropriate specialist) to establish the diagnosis. and correct treatment.
Radicular (radicular) pain in the lower back, including sciatica syndrome, is a consequence of spinal root compression.
The management of patients with root LNS is the prerogative of a neurologist, with special indications the participation of a neurosurgeon is required. In practice, these patients often seek the help of chiropractors.
Among the radicular pains in the lumbar area are distinguished:
- lumbago,orlumbago;
- lumbodynia- Prolonged pain only in the lower back;
- lumboishalgia- back pain that radiates to the leg.
Nonspecific low back pain- the most common, not associated with any visceral disease, serious pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially associated with heavy lifting, prolonged awkward position during sleep or work, etc.
Therefore, it is quite reasonable that a planned spinal radiograph is not included in the recommendations for the examination of patients with nonspecific low back pain syndrome (PNL). Such patients do not need the mandatory consultation of a neurologist, but must be treated by a family doctor, a district therapist or a general practitioner.
Low back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most frequent diagnosis, which is given to patients with complaints of pain in the lumbar spine. However, it is impossible to identify each case of development of an episode of pain in the lumbar area with many times in the patient "degenerative-dystrophic" changes in the spine, making a "usual" diagnosis."Exacerbation of osteochondrosis"Or simply"Osteochondrosis". . .
For pain in the lower back or lumbar, a diagnosis is often written as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization". . . Although, the correct diagnosis in this case should sound like this:"Lumbago with sciatica against the background of osteochondrosis of the lumbar spine. Lumbarization. (Code М54. 4)".
It should be noted that there is no nosological unit in any of the foreign classifications of degenerative-dystrophic diseases. "osteochondritis of the spine". . . Furthermore, neither the term"Osteochondrosis", or any other term that characterizes dystrophic changes in the spine, should not be used as a synonym for clinical diagnosis.
Chondrosisis a dystrophic change in the cartilage of the disc,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, the ignorance of both radiologists and physicians of the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, fixative hyperostosis, etc. )leads to overdiagnosis - these types of pathology are found where they are not.
Osteochondrosis is often referred to as all the listed degenerative changes due to ignorance of the differences between them. By misunderstanding, osteochondrosis includesherniated disc, which is the consequence of its rupture and, as a general rule, a normal disc, and not altered by a dystrophic process. However, calling a herniated disc osteochondrosis is as incorrect as a torn meniscus in the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends using the blanket term "vertebral dysfunction" (which, incidentally, is also not included in the ICD-10 classification of diseases) when appropriate clinical symptoms appear.
Many modern authors, mainly foreign, emphasize the absence of a connection 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 lumbar area (LBS), on the other. since only 1 in 10 patients with radiological signs of degenerative spinal lesions are clinical manifestations of the disease.
Back pain treatment at home
For low back pain associated with muscle tension and muscle stiffness, low back pain ointments can significantly relieve symptoms and help relieve muscle tension.
Low back pain ointments and pills
Ointments and creams are used to treat the lower back. Alternatively, you can take pills that contain non-steroidal anti-inflammatory drugs (NSAIDs).
At the same time, it should be remembered that self-treatment at home for low back pain with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease causing these pains, and very sad consequences. Self-medication of the lower back is especially dangerous for kidney diseases such asacute pyelonephritisorrenal colicrequiring qualified emergency medical attention.
Prevention of low back pain.
People who have had an attack of the disease, especially before the formation of a stable remission, should follow certain prevention instructions:
- Do not lean your body without support on your arm; lift objects off the ground with your knees bent.
- Change the position of the body more often, do not stand for a long time, do not sit.
- Work at a table or workplace, maintaining an upright position, for this leg, bent at the knee, placed in front of the other.
- Be careful with performing specific yoga, aerobic exercises without the recommendation of a physiotherapy doctor or a specialist vertebrologist.
- Beware of hypothermia, drafts and prolonged warming in a hot bath, as muscle relaxation deprives for some time of the immobilizing protection of the muscle corset.