Back ache- one of the most frequent complaints of patients with a wide variety of diseases. Almost every person at least once in his life has felt pain, most often localized in the sacred spine, or between the lower edge of the 12th pair of ribs and the gluteal folds, that is.lower back pain(BNS).
Low back pain is usually accompanied by muscle tension, often the presence of pain points. It can radiate (donate) to other parts of the body, for example to the leg, gluteal muscles, stomach, pelvic area, etc.
Acute lower back pain often comes on suddenly and can last from a few minutes to several weeks. Usually in 90% of cases lower back pain goes away on its own within 3 to 4 weeks, however in the remaining 10% of cases it becomes chronic and can last for years, sometimes getting worse and then later. regressing. Most often, the true cause of lower back pain cannot be established.
Back pain in the lumbar region - causes
Various diseases can cause back pain in the lumbar region.Lower back 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, small pelvis and 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. Reflective 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 from the sixth to the eighth intercostal space.
In the pathology of the genitourinary sphere, the reflected pains are often localized in the region of the lower lumbar and thoracic levels of the spine.
Pain in lower back, right or left
Lower back pain on the right or left side is most often a sign of kidney stones. In kidney stones, a stone growing in the kidney presses on the delicate parenchyma of the kidney from the inside, sometimes causing severe pain in the lower back to the left or right in the kidney where the stone is located.
Lower 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 genitals. Very often, a back pain radiating to the leg can be a signrenal colicwith urolithiasis of the kidneys.
In addition, the lower back pain radiates to the leg with low back pain. Fiscal pain appears as pain in the leg mainly during recovery.
Lateral and lower back pain
Lower back pain radiates to the left and right sides in acute or chronic inflammation of the kidneys. Pain in the kidneys, lasting several days in a row, and accompanied by fever, chills, dysuric phenomena (urinary disorders) indicates an illnessacute 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 musculo-tonic syndromes (reflex disorders of the gluteus minima and medias, piriformis syndrome, pelvic floor syndrome, symphysysternal syndrome) associated with pathology of the lumbar spine with chronic processes in the organs and organs. tissues of the small pelvis. These patients need collegial treatment from a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Lower back pain
Pelvic bone tumors, especially early in the disease, can mimic low back pain, and with a concomitant vertebrogenic process, patients sometimes undergo neurosurgery for a lower lumbar hernia. This concernschondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand a few others. Mandatory x-ray examination usually resolves the diagnostic problem. It should be remembered that the general somatic and hematological condition of the patient can determine the oncological appearance of the disease.
Lower back and pelvic pain
Difficulties in differential diagnosis are noted in the latent course of pelvic bone tuberculosis, when there is no increase in temperature and SV, and pain may mimic lumbar ischial syndrome of osteochondrosis. lumbar. The process can take place secretly from childhood and adolescence and reveal itself in adults in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent again, and the doctor should remember these manifestations of the disease.
So, pain in the lumbar region and lower back can often have nothing to do with a disease of the spine and are alarming symptoms of completely different diseases of the internal organs. Therefore, in case of back pain, a full examination is required.
Low back pain in women - causes
Pull back pain
Low back pain in womenoften associated with premenstrual syndrome. Usually these pains have a pulling character, they occur a few days before menstruation and continue for 2-3 days after their onset and go away on their own.
Lower back and abdominal pain in women
Lower back and abdominal pain associated with PMS and accompanied by cramps in the lower abdomen and painful periods accompanied by 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 of the pelvic area, such as: formation of uterine fibroids, overgrowthendometrioid tissueoutside the uterus, the formation of adhesions, cancers of the reproductive organs, etc.
Additionally, severe pain in the lower back and abdomen (especially on the right or left) in women may be the result of a ruptured ovarian cyst or a symptom of an extra pregnancy. -uterine.
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 pregnancyis associated with additional stress on the spine and is normal and does not require special treatment. However, pregnant women with severe lower back pain should always see a pregnancy doctor.
Lower back pain in men - causes
Low back pain in men is most often associated with degenerative diseases of the spine, in particular, with heavy physical exertion, work associated with lifting weights. In addition, lower back pain can be associated with various diseases of internal organs.
Severe back pain
Sharp pain in the lumbar spine can occur during awkward movements, improper load distribution, etc. This pain is usually associated with muscle spasm or displacement of the spinal discs. Pain can also be caused by muscle clamping of the roots of nerve endings in the spine.
Back pain and groin pain
Pain in the groin area in men, radiating to the lower back, can be associated with prostate adenoma, testicular torsion, oncology, urological diseases, etc.
Classification of back pain
The classification, widespread in many countries, aimed at optimizing the medical management of LPS, distinguishesBNS specific, root and non-specific. . .
Specific back painis a symptom of a certain disease, often serious and even potentially fatal (cancer, including metastases to the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc. ; inflammatory, - for example, spondyloarthritisankylosing and other spondylitis; traumatic and osteoporotic fracture of the vertebra; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal stenosis and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by characteristic "red flags" of the underlying disease, which help the physician to suspect that the patient has serious condition and to examine it on purpose (preferably with the participation of an appropriate specialist. ) to establish the correct diagnosis and treatment.
Root (root) pain in the lower back, including sciatica syndrome, is a consequence of compression of the spinal root.
The management of patients with radicular LNS is the prerogative of a neurologist, with specific indications the participation of a neurosurgeon is required. In practice, these patients often seek help from chiropractors.
Among the radicular pain of the lower back, we can distinguish:
- lumbago,orlumbago;
- lumbodynia- long-term pain only in the lower back;
- lumboishalgia- back pain radiating to the leg.
Nonspecific low back pain- the most frequent, not associated with visceral disease, serious pathology of the spine, the spinal cord and its roots. It can be caused by an overload of the lumbar spine, especially associated with carrying heavy loads, prolonged uncomfortable posture while sleeping or working, etc.
Therefore, it is quite reasonable that a planned spinal x-ray is not included in the recommendations for the examination of patients with nonspecific low back pain syndrome (NLP). These patients do not need the mandatory consultation of a neurologist, but should be treated by a family doctor, district therapist or general practitioner.
Low back pain and "lumbar osteochondrosis"
Lumbar osteochondrosis(Osteochondrosis of the lumbar spine)- the most frequent diagnosis, which is given to patients complaining of back pain. However, it is impossible to identify every case of development of a painful episode in the lower back with often actually present in the patient "degenerative-dystrophic" changes of the spine, making a diagnosis "usual"."Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .
For pain in the lower back or lower back, a diagnosis is often written such as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization ". . . However, the correct diagnosis in this case should look like this:"Lumbago with sciatica on 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. "osteocondritis of the spine". . . Moreover, neither the term"Osteochondrosis", or any other term characterizing 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 by radiologists and clinicians of the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondylarthrosis, spondylosis, fixing hyperostosis, etc. )leads to overdiagnosis: these types of pathologies are found where they are not.
Often osteochondrosis is called all the listed degenerative changes due to ignorance of the differences between them. By misunderstanding, osteochondrosis includesherniated disc, which is a consequence of its rupture, and, as a rule, a normal disc, and not altered by a dystrophic process. However, to call a herniated disc osteochondrosis is just as wrong as a rupture of the meniscus in the knee joint - osteoarthritis.
The International Association of Vertebroneurologists recommends using the general term "vertebral dysfunction" (which, by the way, is also not included in the ICD-10 classification of diseases) in case ofappearance of appropriate clinical symptoms.
Many modern authors, mainly foreign, emphasize the lack of link between the presence of radiological signs of degenerative alterations in the spine, on the one hand, and the appearance or intensity of pain in the lower back (LBS), on the other hand, since only 1 in 10 patients with radiological signs of degenerative spinal injury are clinical manifestations of the disease.
Treatment of back pain 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.
Ointment and pills for lower back pain
Ointments and creams are used to treat the lower back. Alternatively, you can take pills containing nonsteroidal anti-inflammatory drugs (NSAIDs).
At the same time, it should be remembered that self-treatment of lower back pain at home with creams, ointments, mustard dressings and other procedures can lead to neglect of the underlying disease. origin of 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 lower 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 tilt the body without support on the arm; pick up objects on the floor with the knees bent.
- Change body position more often, do not stand for a long time, do not sit.
- Work at a table or workplace, keeping an upright position, for that leg, bent at knee level, placed in front of the other.
- Beware of specific yoga, aerobic exercises without the recommendation of an exercise therapy doctor or specialist vertebrologist.
- Be careful with hypothermia, drafts, as well as prolonged heating in a hot bath, because muscle relaxation deprives the immobilizing protection of the muscle corset for a while.