Lower back pain is quite common. It can be caused by both ordinary fatigue and serious injuries and pathologies. If the pain is severe or does not go away after rest, it is important to see a doctor to rule out dangerous conditions.
What can lower back pain look like?
Low back pain can be sharp or aching, come on suddenly or gradually, occur with exercise or certain movements (such as bending over), or persist regardless of what the person is doing.
The pain can be localized or radiating (that is, it can spread to other areas). In this case, the person has pain not only in the back, in the lumbar region, but also in other parts of the body, for example, in the lower abdomen, perineum, legs or buttocks.
Lower back pain may include stiffness of movement or muscle spasms. The person may have difficulty bending over or rising from a lying position, standing up with a straight back, or posture while walking.
If the pain is caused by a muscle spasm or a pinched nerve, it can be unbearable and even disabling. Such pain forces you to stay in bed until you get medical help.
Why does my back hurt?
The most common cause of pain in the lower back is one or another pathology of the musculoskeletal system: sprains, pinching, inflammation. They are often found in men who work with their hands, athletes and young mothers.
In addition, discomfort in the lower back can be a sign of acute or chronic diseases of the internal organs. This is due to the fact that pain impulses can be transmitted along nerve fibers to neighboring regions. In this case, the pain is said to "radiate" to the lower back.
Diseases of the musculoskeletal system that cause pain in the lower back
Most often, lower back pain is caused by injuries and pathologies of the skeletal and muscular system - muscle and ligament sprains, spinal injuries, herniation and protrusion of intervertebral discs, arthritis, bone diseases.
Deformations and sprains of muscles and ligaments
Such injuries can occur due to awkward movement when a person lifts a very heavy object or does not follow safety precautions when handling bulky objects. You can also get injured during sports or if you simply sneeze unsuccessfully.
Lower back pain when lifting heavy objects without following safety precautions.
In the case of sprains and strains, the pain intensifies during movement, and spasms may occur in the muscles. It may be painful for the person to walk, bend forward or keep their back straight.
The diagnosis of deformation and sprain of muscles and ligaments is based on the data of physical examination and instrumental examinations - ultrasound, X-ray, MRI in the lumbar region. If you suspect a sprain or deformation of muscles or ligaments, consult an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms using ice packs, pain relievers, and muscle spasm-relieving medications (muscle relaxants). It is important to rest the injured area to allow the tissue to heal - this usually takes about 2 weeks. After that, it is important to start rehabilitation: physical therapy exercises aimed at restoring muscle function are recommended.
Without treatment, strains and sprains lead to limited movement: the injured area should not be injured, the person reduces activity, which can lead to weight gain, decreased bone strength and decreased muscle mass.
Spinal injuries
Damage to one or more vertebrae (usually a fracture) occurs as a result of falls, accidents, sports or household injuries. Even minor exposures can cause such damage in people with bone mineral density disorders (such as osteoporosis).
The treatment of spinal injuries is the prevention of displacement and further deformation of the spinal discs. If the injury is not serious, it is recommended to sleep on a hard surface and limit physical activity. If the damage is significant, surgical methods are used to fix it.
Without treatment, damage to the discs can cause narrowing (narrowing) of the spinal canal, neurological disorders, including sciatica - pinching of nerve fibers extending from the spine.
Pathologies of the intervertebral disc
Intervertebral discs are fibrocartilaginous discs that have jelly-like contents between the vertebrae. They serve as shock-absorbing cushions for the vertebrae, ensuring their mobility. Discs can become displaced (protruding) or ruptured (herniated), which can cause severe pain and limit spinal mobility.
Intervertebral hernia and protrusion can occur in people with weak muscles and overweight people, sedentary people or people who lift heavy objects. People who smoke are more prone to intervertebral disc pathologies.
Intervertebral hernia - protrusion of an intervertebral disc into the spinal canal
Treatment consists of pain and inflammation relief - rest, painkillers, ointments and poultices are recommended for the inflamed area. The doctor may prescribe physical therapy or exercise. In the case of moderate damage, the disc can be repaired if the cause of the herniation or protrusion is ruled out - for example, by strengthening the ligament, reducing weight and not putting too much stress on the spine.
If the lower back pain is so severe that it interferes with daily activities, does not go away within 1-1. 5 months, or the symptoms worsen, consult a doctor again. In some cases, steroid therapy or even surgery may be necessary. As age progresses, a degenerative disease of the discs can develop - they become flatter and perform a worse shock-absorbing function, which can also cause pain. In this case, treatment includes pain relief and general improvement of the body.
Scoliosis of the lumbar spine
Spinal curvature is the displacement of the spinal column to the right or left relative to the vertical axis. The pathology leads to increased pressure in some areas of the intervertebral discs and vertebrae, as well as pinching of tissues and nerve fibers. Scoliosis can cause severe pain in the right or left lower back – where the most stress is placed – and severely limit spinal mobility.
The curvature of the spine can cause severe pain in the lower back, where there is a lot of stress
Scoliosis can occur due to the weakening of the muscular ligament in the absence of sufficient physical activity, a sedentary lifestyle (in schoolchildren, office workers). In such cases, it is difficult for the muscles to maintain the physiological position of the back, and curvatures develop.
The treatment includes the introduction of balanced physical activity (physiotherapy, swimming), massage and manual therapy, muscle strengthening physiotherapy procedures such as electrical stimulation. In case of severe injuries, it is recommended to wear a corset, which helps to maintain the correct position of the spine.
Arthritis and arthrosis
Inflammation and degenerative processes occurring in the joints of the spine can also cause severe back pain. There are many forms of arthritis, including osteoarthritis (damage to the cartilage and adjacent tissues), ankylosing spondylitis (spondylitis ankylopoetica - damage to the joints of the spine that leads to fusion of the vertebrae).
Arthritis can be caused by natural aging, genetic predisposition or autoimmune diseases.
Depending on the form of arthritis treatment, it may include the use of non-steroidal and steroidal anti-inflammatory and pain relievers, physiotherapy procedures (magnet therapy, electrophoresis), therapeutic massage and physical therapy.
Physiotherapy procedures help relieve pain due to joint pathologies
Spondylolisthesis
Displacement of a vertebra relative to the spinal column (spondylolisthesis) occurs as a result of spinal injury or degenerative processes. The pathology occurs in athletes, the elderly, or people with a hereditary predisposition to bone diseases (for example, osteoporosis - a disorder of bone density). Spondylolisthesis can cause severe pain in the lower back, buttocks, and legs, and cause leg cramps or weakness.
Treatment involves relieving pain and inflammation caused by compression of adjacent tissues by the vertebra. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal pain relievers in tablets or injections of corticosteroid drugs. At the same time, physiotherapy procedures and exercise therapy are prescribed to strengthen the muscles and restore the position of the vertebrae. If spondylolisthesis is accompanied by very severe pain, surgical treatment is used.
In traumatic and non-infectious pathologies of the musculoskeletal system, pain in the lower back usually decreases or decreases when the person assumes a comfortable position.
If spondylolisthesis is accompanied by severe pain, your doctor may prescribe corticosteroid injections.
Infectious diseases of the spine
Inflammation of the bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe lower back pain. These pathologies are usually secondary in nature, that is, they appear as a complication of inflammation in other organs (the infection enters the tissues through the bloodstream).
Treatment involves hospitalization, lasting up to 1 month, followed by rehabilitation, which lasts 6-12 months.
Tumor diseases of the spine
Tumors can develop as a result of hereditary or external factors (for example, radiation), but they most often appear as recurrent foci (metastases) in cancers of other organs - lung, mammary gland, prostate, thyroid gland, kidney.
One of the most characteristic symptoms of tumor pathologies is pain that does not subside when changing position or after rest. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sudden rise in body temperature with chills may also occur. Without treatment, symptoms worsen.
Treatment depends on the type, location, and symptoms of the tumor and may include chemotherapy, radiation therapy, and surgical removal of tumors. Pain relief is done with non-hormonal or steroid drugs. In order to stabilize the spine, your doctor may prescribe wearing a brace.
The orthopedic brace helps to stabilize the spine
Diseases of internal organs that cause pain in the lower back
Lower back pain can occur in diseases that are not related to pathologies of the spine and adjacent tissues. Acute or painful, it can accompany inflammation of internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. In women, pain in the lower back may develop due to gynecological pathologies.
Urolithiasis disease
A disease in which stones form in the kidneys and bladder - hard formations from the sediment of the chemical components of urine. Lower back pain is one of the main signs of pathology. Depending on their size and location, kidney stones can cause a dull aching pain that comes and goes periodically, or a very sharp pain that does not go away on its own and requires emergency medical attention.
Urolithiasis - formation of stones in the kidneys and bladder
If kidney stones are suspected, consult a urologist or nephrologist. The doctor prescribes examinations and instrumental tests (ultrasound, X-ray examination, computed tomography, including contrast material) to establish a diagnosis and choose a treatment tactic.
Treatment is prescribed based on the size, nature, location and other factors of the stones. If the stone is small (5-10 mm) and there are no other indications for surgical removal, drug treatment is used. If there are no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
Weakening of the wall of the abdominal aorta (aneurysm) can lead to life-threatening conditions such as aortic rupture and intra-abdominal bleeding. The pathology usually occurs in the elderly: the risk group includes men over 65 and women over 70, including smokers, people with vascular diseases (high blood pressure), who have had an aneurysm in the past, or who have had an aneurysm. hereditary tendency to them.
Lower back pain due to an abdominal aortic aneurysm does not decrease over time and may be accompanied by abdominal and leg pain.
If an aneurysm is suspected, abdominal ultrasound and computed tomography are prescribed.
Treatment depends on the size of the aneurysm. Minor changes require twice-yearly monitoring with instrumental testing and lifestyle changes. Indication for significant (over 5 cm, high risk of fracture) abdominal or minimally invasive surgery.
How to prevent back pain
Since lower back pain is most often caused by traumatic injury to muscles, fascia, joints, or bones, the main recommendations for prevention are to follow safety precautions, maintain strong ligaments, and maintain healthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet that contains the vitamins and minerals needed to maintain healthy bone and muscle tissue and joints;
- maintaining a healthy weight;
- regular exercise: exercises for the prevention of lower back pain should include strength exercises for the development of the muscular skeleton, stretching to relieve muscle tension and spasms, and cardio exercises to maintain blood supply and tissue nutrition;
- observing safety precautions during sports - for example, the first lessons in the gym must be supervised by a qualified trainer;
- taking safety precautions at home - many injuries can be avoided by wearing comfortable shoes, sticking to handrails on stairs, taking your time when it's slippery outside;
- observing safety precautions when lifting heavy objects - the load on the spine will be less if you approach the object as close as possible (do not touch it), and when lifting objects from the floor, bend your legs, do not tilt your body.
Yoga and pilates classes help relieve spasms and tension in the lower back
Smoking impairs blood circulation and impairs tissue nutrition, increasing the risk of damage and injury.
What to do if your lower back hurts
If your back hurts, the reasons may be different, which means that the treatment tactics will also be different.
In case of severe physical fatigue, the back should be rested - perhaps this will be enough for the muscles to recover and the mobility of the spine to return.
If the pain does not go away within 1-2 days or is very strong, you should see a doctor. While you wait to see a doctor, you can try to relieve acute pain with pain relievers.
During the appointment, the doctor performs an examination, determines the cause of the pain and gives recommendations for treatment. This helps to eliminate dangerous conditions and prevent the development of complications.
Warming up (lumbar pepper patch, hot water bottle, sauna) is contraindicated in case of inflammation, but can relieve acute back pain if it is caused by muscle fatigue or a pinched nerve. These methods can only be used after consultation with a doctor.
Which doctor should I consult with a complaint of lower back pain?
If you suspect pathology of the musculoskeletal system, consult a neurologist and orthopedic traumatologist.
The diagnosis is made during a physical examination and with instrumental methods: magnetic resonance therapy, computerized tomography, X-ray and ultrasound. It is possible to prescribe a myelogram (X-ray or CT scan with a contrast agent injected into the spinal canal) and electromyography - a test that allows assessing the condition of nerve and muscle fibers.
If you suspect kidney disease, see a urologist, nephrologist or therapist. The doctor analyzes the complaints and performs a physical examination, then prescribes laboratory and instrumental tests to clarify the diagnosis.
On the basis of blood and urine tests, the doctor can determine whether there is inflammation in the organs of the urinary tract, and ultrasound and X-ray examinations help to visualize the organs, determine the cause of the pain and choose the most effective treatment. tactics.
If the origin of lower back pain is unclear, consult a general practitioner or therapist.
The doctor collects an anamnesis (medical history), analyzes hereditary risks, performs a physical examination, and prescribes tests that identify inflammatory processes or disorders of the functioning of internal organs.
A general blood test helps to identify the inflammatory process.
If necessary, the doctor refers to instrumental tests (ultrasound, X-ray, MRI) or recommends that you consult a specialist for further diagnosis and treatment.