So, let's consider in order the causes of pain syndrome that occurs in the lumbar region:
- Diseases of the spinal column. The rarest but severe pathologies that cause back pain include Bechterew's disease. In this disease, the vertebrae fuse together, calcium deposits in the ligaments, and the affected back loses its mobility. Characteristic features of pain in this pathology - pain increases at rest, with long lying down; movements in the lumbar region are limited. This disease begins more often at a young age and may have a hereditary predisposition.
- Curvature of the spine. Kyphoscoliosis and asymmetric scoliosis (two types of curvature) cause spasms in the deep muscles of the spine. Most often, the pain syndrome is felt in the middle and late stages of the disease, it manifests itself more acutely by the end of the day, along with fatigue. This pathology begins in childhood, and may also have a hereditary predisposition.
- Osteoporosis is a decrease in bone mineral density, which leads to bone fragility and frequent fractures.
- Osteochondrosis - thinning of the intervertebral discs, in the late stage leads to protrusions and herniation of the intervertebral discs - the most common cause of back pain. Moreover, the pain intensifies when changing the position: getting up from a sitting position, trying to lie on the stomach, turn around, bend down.
- Spine injuries, sprains and bruises, fractures.
- Spondylolisthesis - that is, the displacement of the lumbar vertebra in relation to the vertebra below it. The pain is localized in the middle of the back, is felt down the legs and is accompanied by numbness and/or weakness, which is aggravated by standing up or bending over.
- Fibromyalgia is a pathology that causes pain in muscles, ligaments and tendons. There is pain and stiffness in different parts of the body, the pain intensifies when touched. Often the patient complains of bad sleep. Most common in women aged 20-50.
- Soft tissue and kidney injuries. Urolithiasis is characterized by severe, sharp pain from a diseased kidney. Pain can occur in any position of a person. Another disease that has a symptom of discomfort in the lower back is pyelonephritis.
- Infections or infections of the spine and spinal cord, e. g. osteomyelitis, discitis, spinal epidural abscess. The pain caused by this cause progresses, it does not depend on the patient's position or activity. Sometimes there is fever or night sweats.
- Local inflammatory processes, such as appendicitis or cholecystitis.
Pain in the lower back is divided into three types: local, radiating and reflected. Local pain is felt in the same place where its cause is located, this type of pain is most common in lower back syndrome. In this case, the most common cause is osteochondrosis of the spine, degeneration of the intervertebral disc, stretching or spasm of the deep muscles of the spine.
The radiating pain is dull and painful, most often radiating to the leg, and it also happens to the foot itself. It can accompany osteochondrosis in the stage of disc herniation, osteoarthritis or degeneration of the deep muscles of the spine with hemodynamic disturbances along the sciatic nerve.
Referred pain usually means that the cause of the syndrome is in the internal organs. For example, with heart disease, the arm, back and shoulder blade may hurt. The pain is reflected from the internal organs to the lower back and has a deep painful character, it does not depend on movements.
Lower back pain in men and women
In women, back pain can be a consequence of gynecological diseases. In this case, the discomfort is dull, dragging. Among such diseases in women - adnexitis, ovarian cyst torsion, salpingoophoritis, uterine fibroids and endometritis can be expressed as pain in the lower back. Pregnancy, due to the increased load on the spine and weight gain, often causes back pain, and they are also possible during menopause. With an ectopic pregnancy, back pain can also occur - in this case, it is unbearable.
The causes of lower back pain in men are often caused by excessive exercise, heavy lifting, spinal injuries, but they can also indicate exclusively male diseases - prostatitis or epididymitis. Prostate pathology is characterized by pulling, aching pain, the patient often has difficulty urinating.
Diagnosis and treatment of low back pain
Depending on the causes of back pain, different specialists are involved in its treatment. If it is a pathology of the spine, you need to consult a kinesitherapist, if it is a pathology of internal organs, then a therapist, gastroenterologist, gynecologist, urologist, if the pathology is of rheumatic origin, then a rheumatologist, in cases of neoplasm in the lower part of the body, thenoncologist.
First of all, in order to establish a diagnosis, the doctor interviews the patient, recognizing the nature of the pain: whether it is acute or dull, whether it is pulling, whether it depends on movement, activity, body position, whether it is accompanied by other symptoms. or not. After the verbal examination, the doctor examines the patient, palpating the lumbar region, spinal muscles and limbs. Additional examinations, laboratory tests, X-ray, magnetic resonance imaging, tissue biopsy, electromyography may be required.
Different means are used for treatment, also depending on the disease. In cases of osteochondrosis, scoliosis, spondyloarthrosis and other factors that cause spasm and inflammation in the deep muscles of the spine, painkillers and anti-inflammatory drugs are most often used, but they do not directly affect the cause of the pain syndrome, they only eliminate its manifestation and have many side effects. To eliminate the cause of back pain, the following is suggested:
- decompression exercises of the strength and stretching type to relieve spasms of the deep muscles of the spine and eliminate pain,
- therapeutic massage to relieve tension in the muscles of the pathology area,
- cryotherapy for local pain reduction,
- physiotherapeutic methods, such as shock wave therapy, acupuncture, massage with devices, balneotherapy (mud applications, contrast treatments, etc. ),
Prevention of back pain
The main prevention of various diseases of the musculoskeletal system is the prevention of the development of dystrophy, that is, the weakening of the deep muscles of the spine, on whose condition the nutrition of the vertebrae and intervertebral discs depends. Strengthening of the spine muscles should be regular, and the most modern way to do this is the author's method, that is, the use of strength and decompression simulators. But the exercises can be performed without a simulator, there are many of them. It is important to take a break for gymnastics at work, especially if it is sedentary, that is, devote at least 15 minutes to it every 3-4 hours, just walk a couple of times a week for 1. 5-2 hours, and in the morning to recharge.
According to the method, it is recommended to regularly perform several simple exercises to prevent back pain:
- relaxation of the back (the famous exercise "Cat"): in a position on all fours, inhale - raise your head, bend your back down; exhalation - lowering the head, rounding the back;
- stretching step (in yoga this exercise is called "Pigeon Pose"): in a position on all fours, you need to move one knee forward, one foot inward, and the other leg back, lie on your stomach on your thigh, palms under your shoulders. For a more effective stretch, move your arms diagonally to the side and lower your head, stopping for 5-10 seconds. Return to the starting position and repeat for the other side.
- raising the pelvis in a lying position with the legs bent at the knees;
- press: in a lying position, bend your knees and arms at the elbows, holding the back of your head, press your chin to your chest while exhaling, lifting your shoulder blades;
- knee thrust: in a lying position, pull the knees alternately towards the chest, pressing the arms to the body as you exhale, or do it while hanging.
All these exercises are very simple, it is enough to do 10-15 repetitions of each exercise. With regular practice, they will bring you invaluable benefits!
As an additional tip, a comfortable mattress can be placed so that the back muscles can relax at night. If you spend a lot of time driving or working at the computer, take care of the correct body position. The car seat should be adjustable in height and close to the steering wheel, and the backrest should be soft enough to absorb bumps from bumpy roads.
While working or studying at your desk, your elbows should be bent at a right angle. The chair must necessarily have a backrest that supports the lower back, and the gaze (along with it and the neck) should be directed straight or slightly upwards, but not downwards. The light falls properly on the work surface of the table.
Remember, prevention is more important than cure!