The lower back is called the lower back - from the area where the ribs end to the tailbone (the lowest protruding vertebra).Most often, when a person has “back pain”, we are talking about the lower back.And if 20 years ago, lower back pain mainly bothered older people, today even quite young patients turn to specialists for help with their backs.
Why does the lower back hurt so often?The fact is that the center of gravity of the human body is located precisely at the level of the lumbar spine and it bears almost the entire load when walking.This is one of the disadvantages of walking upright: vertebrates that move on 4 limbs do not suffer from such conditions.
Causes of lower back pain – what you need to know
Statistical studies tell us the following about the frequency of causal factors for lower back pain:
- 91% of calls are problems with the spine and the muscular framework of the back.
- 5% of complaints are linked to diseases of the urinary system.
- 4% - pathologies of other organs (reproductive system, gastrointestinal tract).
Types of lower back pain
Often, back problems come unexpectedly, like a bolt from the blue.Such sharp pain in the lower back is called "lumbago", and previously one could hear the term "lumbago".The name itself speaks of the vivid and dazzling nature of the sensations.During an attack of lumbago, any movement only intensifies the torment, and the patient involuntarily finds himself in a constrained position, frozen in one position.The lumbago lasts several minutes then disappears.
If the pain is prolonged and painful, then we speak of lumbodynia.These are painful sensations of low intensity but constant in the lumbar region, which intensify during physical activity or hypothermia.
And there is a condition in which there is no back pain per se, but a person feels stiffness and discomfort.In this case, additional diagnostics carried out by specialists are also necessary.Depending on how lower back pain manifests, approaches to treating it vary.
Low back pain, a symptom of an illness?
Back pain itself can signal very different pathological conditions, and it is often not so easy to understand the real cause.
For example, there is displaced pain.This denotes a situation in which the back hurts on the right, left or lower back - and the person thinks that the cause of his torment lies in the spine.However, after research, it turns out that one of the internal organs (kidneys, intestines or organs of the reproductive system) is to blame.The human body is very complex and confusing.Let's look at some possible root causes of lower back discomfort.
Musculoskeletal disorders causing lower back pain
The link between spinal diseases and lower back pain is direct and unambiguous.It was previously mentioned that spinal pathologies are the most common cause of back pain and account for over 90% of all visits.
Intervertebral disc protrusions and herniations deservedly occupy the first place in terms of prevalence.With such destructive pathologies, the intervertebral disc first shifts slightly outward, prolapses (disc protrusion), and as the disease progresses, the integrity of the disc is disrupted in such a way that the inner part (nucleus pulposus) protrudes out of the surrounding annulus fibrosus.
Protrusions most often occur due to traumatic disc injuries or osteochondrosis.
Another painful consequence of osteochondrosis is compression and pinching of the sciatic nerve.The pain is sharp and throbbing - lumbago.
As a result of this compression, the nerve can become inflamed.The general name of such a disease is radiculitis, and if the inflammation involves the sciatic nerve, then it is referred to by the more specific term "sciatica".The pain associated with sciatica is concentrated in the lumbar region and spreads to the buttock and thigh along the sciatic nerve.
Now let's talk about the disease that leads to the development of all of the above - osteochondrosis.Pain in the lower back with osteochondrosis is sharp or dull in character.With the development of the disease (2nd and 3rd degrees), neurological symptoms appear - numbness, tingling sensation in the lower extremities.In the morning, a person is bothered by a feeling of stiffness.The functioning of the gastrointestinal tract, kidneys and reproductive system is disrupted.
The main goal of treatment for osteochondrosis is to relieve pain and stop the destruction of vertebrae and intervertebral discs.It is important to understand that the earlier treatment is started, the better the prognosis.
Kidney, urinary tract and lower back pain
You may have heard.that lower back pain is due to diseased kidneys.In some cases this is actually true.We recommend seeing a urologist if you are concerned about the following symptoms:
- Frequent painful urination, change in urine color.
- Deterioration of health, indifference to life.
- Hyperthermia is a high temperature.
- Decreased appetite, feeling of nausea.
- High blood pressure.
The pain varies.For example, with an exacerbation of chronic pyelonephritis, the pain seems to pull and surround the lower back, and renal colic is acute and short-lived.
It is characteristic that pain in renal pathology is concentrated on one side - since one kidney is involved in the inflammatory process.This is how a kidney stone (stone) appears in the kidney or ureter.
Another important diagnostic criterion is that in nephropathy, the intensity of pain does not change with changes in body position.However, as you understood, it is better to leave the right to make an accurate diagnosis to a specialist.
Excessive exercise and lower back pain
Our spine is adapted to physical activity.Therefore, the appearance of back pain after going to the gym should alert you.Normally, pain in the back muscles due to the accumulation of lactic acid disappears within 1-2 hours, and if this does not happen, pathology should be suspected.
The cause of pain in the spine after playing sports may be old injuries or hidden problems with the intervertebral discs - for example a disc protrusion.In this case, the elimination of physical exercise will not lead to recovery, but will only mask the course of a destructive disease of the spine.
In addition, back pain after exercise is characteristic of myofascial syndrome.It is not a threat to life, but it significantly reduces its quality.
At the same time, physical activity can also contribute to the disappearance of back pain - for example, an overweight patient is more likely to get rid of back pain through weight loss.
Remember that constant and periodic pain in the lower back after physical activity should be a reason to consult a doctor.
Hypothermia and lower back pain
Prolonged exposure to cold air and wind can lead to hypothermia.If the lower back is not protected from harmful environmental factors, an uncomfortable condition such as myositis can occur.This is the name for inflammation of the skeletal muscles.The pain is aching in nature and on palpation (palpation) there is a tightening of the back muscles.
Characteristics of lower back pain in women and mechanism of its occurrence
It's no secret: women's well-being is closely linked to their hormonal levels, which undergo dramatic changes not only throughout their lives, but also every month.Therefore, every month, at a certain phase of the menstrual cycle, women may experience nagging pain in their lower back.Alas, this is a variation of the physiological norm.
And during pregnancy, discomfort in the lower back is considered normal - if it disappears after rest.After all, significant hormonal changes occur in a woman's body during this period, the uterus expands, which changes the deviation of the lower back and shifts the center of gravity.Additionally, a pregnant woman's weight naturally increases, which also puts increased pressure on the spine.
If we talk about other causes of pain in the lumbar region in women, back pain can indicate the approach of menopause.This is due to a decrease in estrogen levels and changes in a number of other sex hormones.
Therefore, the diagnosis of the causes of lower back pain in women should be carried out with special attention so as not to miss important symptoms of serious diseases and not to ignore the pathological causes of lower back pain in women.Indeed, among these formidable diseases there can be a cyst, apoplexy or inflammation of the ovary, and even tumors of the cervix.Ignoring or inappropriately diagnosing such pathologies can lead to infertility and critical complications.
What diseases can cause lower back pain?
Symptoms, nature of pain |
Presumed diagnosis by MRI |
| Pain in the lower back when coughing, sneezing, bending over. | Protrusion (bulging) of the intervertebral disc of the L1/L2 vertebra (L2/L3, L3/L4, L4/L5) |
| Numbness, tingling not only in the back, but also in the buttocks and lower limbs. | Symmetrical dorsal (posterior) protrusion of the discs of the L1/L2 vertebra (L2/L3, L3/L4, L4/L5) |
| Weakness of leg muscles, motor reflexes worsen. | Medial dorsal (posterior) protrusion of the discs of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pains;the patient cannot even stand up during an attack. | Circular protuberances of the vertebrae L1/L2, L2/L3, L3/L4, L4/L5 |
| Staying in the same position for a long time causes painful pain. | Diffuse protuberances of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Symptoms may be absent for a long time and are discovered by chance. | Medial disc protrusion of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pain in the lower back – also called “lumbago”. | Herniated discs of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Pain in the leg extending below the knee, tingling sensation in the leg. | Dorsal disc herniation of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| It is often asymptomatic, with patients reporting only mild discomfort. | Schmorl's hernia of the L1, L2, L3, L4, L5 vertebrae |
| The functioning of the intestines, bladder and reproductive system is disrupted. | Paramedian disc herniation of the L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| In the early stages, the development is asymptomatic.Pain occurs when the tumor spreads beyond the disc. | Hemangiolipoma and hemangioma of the L1 vertebral body (L2, L3, L4, L5) |
| The pain depends on the degree of displacement of the vertebra.If changes occur in the joints, movement disorders are noted. | Retrolisthesis and antilisthesis of the L1 vertebra (L2, L3, L4, L5) |
| The pain is periodic at first, then becomes constant.Increased by physical activity. | Ventral wedge-shaped deformity of the L1 vertebral body (L2, L3, L4, L5) |
| Aching pain in the lower back, left or right, along the spine.Numbness, “pins and needles” sensation.Muscle tension. | MRI image, signs of degenerative-dystrophic changes (osteochondrosis) of the lumbar spine |
| A.sharp pain due to exertion or careless movement.Changes in gait, dysfunction of the genitourinary system. | Osteochondrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
| Pain in the buttocks and legs, discomfort from prolonged sitting in a chair and prolonged walking. | Spondyloarthrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
What to do if you have lower back pain?
If the symptoms of back pain in the lumbar region do not disappear or decrease within 3 days, you should consult a doctor.What to do before seeing a doctor?
What you can do yourself for lower back pain
If the cause of the pain is unknown:
- take your temperature to detect inflammation in the body.
- determine the accompanying symptoms (vomiting, diarrhea or others)
- call a doctor at home or go to the emergency room.
If the cause of the pain is known (bruise, sprain, or lower back injury):
- take a nonsteroidal anti-inflammatory drug (NSAID) - diclofenac, ibuprofen or other.
- local application of cold will help reduce swelling and ease pain.
- firmly squeeze the lumbar area with a towel or orthopedic belt to fix the injured area in one position.
- Consult a doctor for a complete diagnosis and determine further treatment tactics.
What not to do for lower back pain
- Under no circumstances should you heat a painful area of the back!Heat will increase blood flow and, in case of inflammation, aggravate the situation: it will increase pain and lead to the spread of the infectious process.For the same reason, you should avoid visiting public baths and saunas.
- You cannot relieve pain for a long time if you have persistent, unexplained back problems.Ignoring the root cause can only worsen the course of the disease and lead to serious complications.
- You cannot try to straighten the vertebrae on your own or roughly massage your back.Without diagnosis, such actions can cause vertebral displacement and cause unnecessary additional injury.
Which doctor should I consult if I have pain in the lumbar region?
It happens that a person would be happy to consult a specialist, but does not know which doctor to contact if there is pain in the lower back.Let’s bring some clarity to this question.
First of all, you need to make an appointment with a general practitioner.He will carry out a differential diagnosis and determine with which doctor you should continue treatment.This could be:
- Neurologist – for neurological symptoms and the involvement of nerves in the process.
- Urologist – if diseases of the urinary system (kidneys) are suspected.
- Gynecologist – for the treatment of diseases of the female reproductive system.
Depending on indications, a complete blood count (CBC) and general urinalysis (UCA), radiological examination of the spine (including MRI), ultrasound of the pelvic organs, kidneys and other studies may be prescribed.
It is important to remember that self-medication and other home remedies for lower back pain are a waste of time and money.In addition, by delaying a visit to a specialist, you risk developing an advanced form of the disease, thus condemning yourself to long-term, expensive and often less effective treatment (than at the beginning).
How to cure lower back pain: basic treatment methods
You may naturally ask yourself a question: if self-medication is not effective, then how can you treat lower back pain?A competent specialist has many techniques in his arsenal, including conservative and surgical treatment.
Conservative treatment includes the following points:
- Take anti-inflammatories (NSAIDs) and analgesics orally and locally.
- Physiotherapy (shock wave therapy, acupuncture).
- Physiotherapy.
- Therapeutic massage.
- Therapeutic exercises and gymnastics.
Physiotherapeutic procedures and massages should be carried out after the acute phase of the disease, when the pain syndrome has been relieved.
Surgical treatment is indicated in advanced cases of spinal diseases, when conservative methods do not give any significant results.However, with timely diagnosis and correctly prescribed treatment, the need for surgical interventions can be delayed or even avoided altogether.
Prevention of lower back pain
As a rule, painful sensations in the back and lower back are caused by a negligent attitude towards one's health.After all, a sedentary lifestyle, burdened by sedentary work and forced prolonged stay in the same position, is typical for many of us.Excessive physical activity without preparation (stretching) and lifting weights with poor back position are no less harmful.It's no wonder that the majority of the world's population suffers from lower back pain.
Doctors' advice to prevent back pain:
- Watch your posture, keep your back straight.
- Avoid awkward postures in the workplace.You can place a small pillow under your lower back to support your back.Try it!
- When sitting at a desk for a long time, it is recommended to get up from time to time (every hour), ideally by warming up your joints, or simply to walk.
- It is advisable to sleep on an orthopedic mattress;it is quite hard and, at the same time, elastic.
- Start the day with exercises to strengthen your back and core muscles.
How to lift weights correctly?
If you have to lift and carry something heavy, you should do it with your knees bent, not your back.That is, you must first sit down, take the load, and then straighten your knees, leaving the back straight.
Back pain: what to do?
Now that you have read the most common causes of lower back pain, know what you need to know and what to do, the question arises: where to turn?Of course, when choosing a clinic, it is worth giving preference to a medical center where you can be systematically examined by different specialists.That is, you will not need to go to the other end of the city for additional diagnostics, and a complete and comprehensive treatment plan for back pain in the lumbar region will be developed in one place.
The qualifications of doctors and the availability of appropriate equipment play an equally important role.After all, lower back pain due to osteochondrosis and myositis requires different therapeutic approaches.