Lower back pain is a common reason for visiting a doctor. The cause of discomfort in this area can be a number of diseases.
What is ankylosing spondylitis, as evidenced by severe pain in the sacral area, radiating to the leg, what studies are carried out during diagnosis, the causes of pain in the lower shoulder blades and the most effective methods of treatment - in the material.
Lower back pain
Sudden onset of acute pain in the lower back is a fairly common occurrence. This symptom, which is characteristic of many pathological conditions, is not always caused by diseases of the spine. Manifestations and causes of pain may 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 sacrum area, intense pain is localized 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 limbs.
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 gluteal muscle leads to its atrophy.
Acute
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 stiffness of movement (sometimes it is even impossible to straighten up). The slightest movement intensifies the symptoms. Acute pain may persist for up to six weeks.
Pulling and aching
Nagging and aching pain in the lumbar region most often results from diseases such as hernia, protrusion and inflammation of the sciatic nerve.
Chronic
The cause of constant pain in the lower back can 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 occurrence 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.
Mechanical
Mechanical pain occurs during or immediately after physical activity.
Irradiating
Such pains are dull and aching. Painful sensations can also radiate to the leg (all the way 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 location than the actual pain.
Radicular
Radicular syndrome is a neuralgic manifestation that may be accompanied by numbness and a feeling of loss of sensitivity.
Myofascial
Such pain is accompanied by muscle spasm 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 surrounding it.
Experts have identified the main pathologies that cause pain in the lower back.
Ankylosing spondylitis
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 ossification of the paravertebral ligaments, the spine gradually becomes a solid, inflexible bone.
The pathological condition is characterized by increasing symptoms:
- First, pain appears in the lumbar region, gradually covering new areas;
- negative symptoms bother you occasionally, but over time they develop into permanent ones;
- stiffness of movements increases.
The expressiveness of the signs is observed at night. In the morning the pain becomes unbearable.
Osteochondrosis
Growth, destruction, protrusion of cartilage tissue caused by a violation of their nutrition. This disease causes destructive changes in the intervertebral discs and provokes the development of arthrosis 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 protrusion of disc fragments and their prolapse into the vertebral canals.
There are no symptoms at the initial stage, but lack of treatment provokes an increase in pain, while limiting the mobility of the lumbar region. Acute pain sensations are observed, increasing against the background of exertion, they force the person to take an anti-pain position.
Kyphosis and scoliosis
Pain in the lumbar region is a consequence of the curvature of the spinal column. At the early stage of spinal curvature deformity, there are no negative symptoms. But over time, muscle fatigue appears with the manifestation of periodic, but developing into constant discomfort. The pain is aching in nature and intensifies with physical activity.
Spondyloarthrosis
With this pathology, articular cartilage is destroyed and osteophytes (bone growths) are formed. This leads to narrowing of the spinal canal and compression of the nerve roots. As a result of these changes, intense pain occurs, intensifying during physical activity and subsiding in a calm state. Muscle tension is observed, causing a decrease in motor activity.
Protrusion
The prerequisites for the formation of protrusions are spinal injuries, excess of permissible physical activity, and muscle weakness due to physical inactivity. In this case, disc protrusion occurs, accompanied by tension in the lower back 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 occurs 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 therapy leads to the disease becoming chronic, but the pain syndrome persists.
Pancreatitis
Pain in the lower back is a sign of inflammation of the pancreas. The disease occurs 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 provokes discomfort while walking, at rest, and intensifies when bending the back.
Facet syndrome
Destructive changes in the intervertebral discs cause degeneration of the facet joints (connecting the vertebrae from the back). This condition is accompanied by an increased load on muscles and bones and provokes an inflammatory process with the subsequent development of spondyloarthrosis and degenerative changes.
In the area of the affected joint, pain is felt in the form of cramping attacks during bending and rotation of the lower back. One of the symptoms is stiffness of movement in the morning and increasing discomfort in the evening.
Localization
To identify the cause of pain in the lumbar region, you first need to determine the location of the discomfort. To make an accurate diagnosis, you need to contact a specialist.
Pain below the waist
The cause of pain below the lower back is most often 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 most often appears after lifting heavy objects or walking quickly. Often, painful sensations below the lower back occur after severe 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:
- pathologies of the spine in the lumbar and thoracic region or previous injuries to 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, often result from myocardial infarction.
Cutting pain in this area indicates the likelihood of a perforated ulcer.
Also, such symptoms may indicate the presence of diseases and pathological conditions such as radiculitis, osteochondrosis, and poor posture. In such cases, aching pain is felt that occurs against the background of physical inactivity or exceeding permissible loads.
Right lower back pain
Suspicion of pathology of the kidneys or genitourinary organs arises when dull aching pain appears on the right. Inflammation may have an infectious etiology or be a consequence of hypothermia.
Sharp, sudden pain on the right side indicates the likelihood of a perforated ulcer, burst appendicitis, or signals internal bleeding. Pain on the right side often indicates muscle strain and radiculopathy.
Lower back pain when coughing
Possible causes of lower back pain when coughing:
- osteochondrosis;
- hernia;
- nerve root stenosis, causing weakness and difficulty walking;
- facet arthropathy, in which muscle strain 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:
- overweight,
- passive lifestyle,
- excessive physical activity.
Diagnostics
To determine the source that provokes pain in the lumbar region, it is necessary to conduct a comprehensive diagnostic examination. It includes laboratory tests and instrumental procedures.
The main ones:
- blood test (general, biochemical), urine;
- tests for tumor markers;
- x-ray of the lumbar spine;
- endoscopic examination of internal organs;
- Ultrasound (ultrasound examination);
- MRI (magnetic resonance imaging).
It is also additionally necessary to seek advice from a neurologist and chiropractor. An accurate diagnosis is established by a specialist who, based on the examination results, will decide how to treat lower back pain.
Treatment
The main methods of treating low 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, you need to consult a therapist, neurologist or neurologist. Often, in order 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 for oncology. Specialists perform planned operations only in the absence of positive dynamics in the therapeutic treatment of protrusions, hernias and fractures.
Medication
The first step in pain relief is non-steroidal 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 muscle spasm is present, 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, physical therapy, massage (only outside of exacerbation). Depending on the effectiveness/ineffectiveness of the measures taken, the severity of symptoms and based on the examination, the patient may be recommended surgical treatment - removal of a hernia, elimination of compression of the spinal cord root.
Treatment depends on the cause of lower back pain. Pathologies of internal organs must be eliminated by specialized specialists; inflammatory lesions of the skeletal system, systemic inflammation may require antibiotic therapy.
Rehabilitation
When the patient's condition improves and the acute symptoms of the disease are eliminated, doctors can prescribe physiotherapy sessions (electrophoresis, laser therapy, ultrasound, magnetic therapy, transcutaneous electrical stimulation) and exercise therapy.
In addition, the attending physician may prescribe acupuncture. Massage sessions are also effective in treating this pathology.
Therapeutic exercises help strengthen muscles, increase the distance between the vertebrae and eliminate painful manifestations. Specially selected exercises release 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 regimen every day, alternate physical activities, and practice walking and swimming. In addition, it is important to control your 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. Pain occurs in the lower back or neck, respectively, in the projection of the spine. At first it may be periodic and moderate in nature.
At this stage, a person is able to help himself independently. To reduce pain, you need 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 most often a side position with bent legs. 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 its intensity increases. It can radiate to the arm or leg. Numbness (impaired sensitivity) and motor deficit (weakness) often appear in the limb. These symptoms indicate that the spinal roots are involved in the pathological process.
Also, preventive measures for lower back pain include:
- daily morning exercises;
- balanced diet;
- compliance with the drinking regime;
- regular preventive examinations.
