So, let's consider in order the causes of the pain syndrome that occurs in the lumbar region:
- Spinal diseases. The rarest but most serious pathologies that cause back pain include Bechterew's disease. With this disease, the vertebrae grow together, calcium is deposited in the ligaments, and the affected back loses mobility. Characteristic features of pain in this pathology - pain increases at rest, with a long lying position; movements in the lumbar region are limited. This disease most often begins at a young age and may have a hereditary predisposition.
- Curvature of the spine. Kyphoscoliosis and asymmetric scoliosis (two types of curvature) cause the deep muscles of the spine to spasm. Most often, the pain syndrome is felt in the middle and late stages of the disease, it manifests itself more intensely at the end of the day, accompanied by fatigue. This pathology begins in childhood and can also have a hereditary predisposition.
- Osteoporosis is a decrease in bone mineral density, resulting in bone fragility, frequent fractures.
- Osteochondrosis - thinning of the intervertebral discs, at a late stage leading to protrusions and herniations of the intervertebral discs - the most common cause of back pain. Also, the pain intensifies when changing positions: getting up from a sitting position, trying to lie on your stomach, turning over, bending over.
- Spinal injuries, sprains and bruises, broken bones.
- Spondylolisthesis - that is, the displacement of the lumbar vertebra relative to the vertebra below. The pain is localized in the middle of the back, is felt along the legs and is accompanied by numbness and/or weakness, worse when standing up or bending backwards.
- Fibromyalgia is a condition that causes pain in the muscles, ligaments and tendons. There is pain and stiffness in various parts of the body, the pain is worse when touched. Often the patient complains of poor sleep. More common in women between the ages of 20 and 50.
- Soft tissue and kidney injuries. Severe acute pain of the diseased kidney is characteristic of urolithiasis. Pain can occur in any position of a person. Another disease that presents a symptom of discomfort in the lower back is pyelonephritis.
- Infections or infections of the spine and spinal cord, eg osteomyelitis, discitis, spinal epidural abscess. The pain caused by this cause progresses, does not depend on the position or activity of the patient. Sometimes there is fever or night sweats.
- Local inflammatory processes, such as appendicitis or cholecystitis.
Low back pain 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 syndromes. 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.
Radiating pain is dull and aching, most often it radiates to the leg, and sometimes it reaches the foot itself. This can accompany osteochondrosis at the stage of herniated disc, osteoarthritis or degeneration of the deep muscles of the spine with hemodynamic disorders 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 can hurt. The pain is reflected from the internal organs to the lower back and has a deep aching character, does not depend on movements.
Lower back pain in men and women
In women, back pain can be the result of gynecological diseases. In this case, the discomfort is dull, pulling. Of these diseases in women - adnexitis, torsion of the ovarian cyst, salpingo-ovaritis, uterine fibroids and endometritis can be expressed as pain in the lower back. Pregnancy, due to the increased load on the spine and increased body weight, 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 loads, injuries to the spine, but can also indicate exclusively male diseases - prostatitis or epididymitis. The pathology of the prostate gland is characterized by pulling and aching pains, the patient often has impaired urination.
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 contact physiotherapists, if it is a pathology of internal organs, then a therapist, a gastroenterologist, a gynecologist, a urologist, If the pathology is of rheumatic origin, then to a rheumatologist, in case of a neoplasm in the lower tier of the body, then to an oncologist .
First of all, for the diagnosis, the doctor asks the patient, recognizing the nature of the pain: whether it is sharp or dull, whether it pulls, whether it depends on the movement, activity, position of the body, whether it is accompanied by other symptoms or not. After a verbal interrogation, the doctor examines the patient, palpates the lumbar region, the muscles of the spine and the limbs. Additional examination, laboratory tests, X-ray, MRI, tissue biopsy, electromyography may be required.
For treatment, also depending on the disease, various means are used. In case of osteochondrosis, scoliosis, spondylarthrosis and other factors causing spasm and inflammation of the deep muscles of the spine, the most commonly used are painkillers and anti-inflammatory drugs, but they do not directly affectthe cause of the pain syndrome, only eliminate its manifestation and have many side effects. To treat the cause of back pain, here are the suggestions:
- decompression exercises such as power and stretching to relieve spasms of the deep muscles of the spine and eliminate pain,
- therapeutic massage to relieve tension in the muscles of the area of pathology,
- cryotherapy to locally reduce pain,
- physiotherapeutic methods, such as shock wave therapy, acupuncture, massage devices, balneotherapy (mud applications, contrast treatments, etc. ),
Back pain prevention
The main prevention of various diseases of the musculoskeletal system is the prevention of the development of dystrophy, namely the weakening of the deep muscles of the spine, on which the nutrition of the vertebrae and intervertebral discs depends. Strengthening the muscles of the spine should be regular, and the most modern way for this is the author's method, that is, the use of power and decompression type simulators. But the exercises can also be performed without simulators, there are many of them. It is important to take a break for gymnastics at work, especially if it is a sedentary type, that is, every 3-4 hours devote at least 15 minutes to it, just walk a few times a weekfor 1. 5-2 hours, and do it in the morning while charging.
Depending on the method, it is recommended to regularly perform several simple exercises to prevent back pain:
- relaxation of the back (the well-known exercise "Cat"): in a position on all fours, inhale - raise your head, bend your back down; exhale - lower the head, round the back;
- stretching step (in yoga, this exercise is called the "Pigeon Pose"): in the position on all fours, you have to bring one knee forward, the foot inwards, and the other leg backwards, lying on your stomach on your thigh, palms under your shoulders. For a more effective stretch, move your arms diagonally to the sides and lower your head, stopping for 5-10 seconds. Return to starting position and repeat for the other side.
- raise the pelvis in the supine 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 as you exhale, raising your shoulder blades;
- Knee press: While lying down, take turns pulling your knees towards your chest, pressing your hands against your body as you exhale, or do this 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!
Among the additional tips, a comfortable mattress can take place so that the back muscles can relax at night. If you spend a lot of time driving or working at a computer, take care of the correct body position. The car seat should be adjustable for height and close to the steering wheel, and the backrest should be soft enough to handle the bumps of rough roads.
When working or studying at the table, the elbows should be bent at right angles. The chair must necessarily have a back to support the lower back, and the gaze (with it and the neck) should be directed straight or slightly up, but not down. The light falls correctly on the worktop of the table.
Remember, prevention is more important than cure!