So, let's consider in order the causes of the pain syndrome that occurs in the lumbar region:
- Diseases of the spine. The most rare but severe pathologies that cause back pain include Bechterew's disease. With this disease, the vertebrae fuse together, calcium is deposited in the ligaments, and the affected back loses mobility. Characteristic features of pain in this pathology - the pain increases at rest, with long lying; movements in the lumbar region are constrained. 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) provoke spasms of 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 can also have a hereditary predisposition.
- Osteoporosis is a decrease in bone mineral density, leading to bone fragility and frequent fractures.
- Osteochondrosis - thinning of the intervertebral discs, at a late stage leading to protrusions and hernias of the intervertebral discs - the most common cause of back pain. Moreover, the pain intensifies when changing position: rising from a sitting position, trying to lie on the stomach, turn around, bend over.
- Spinal injuries, sprains and bruises, fractures.
- Spondylolisthesis - that is, the displacement of the lumbar vertebra relative 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, aggravated by standing up or bending back.
- Fibromyalgia is a pathology that causes pain in the muscles, ligaments and tendons. There is pain and stiffness in various parts of the body, the pain is aggravated when touched. Often the patient complains of poor sleep. Most common in women aged 20-50.
- Injuries of soft tissues and kidneys. Severe sharp pain from the diseased kidney is characteristic of urolithiasis. 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, eg osteomyelitis, discitis, spinal epidural abscess. Pain caused by this cause progresses, does not depend on the position or activity of the patient. Sometimes there is a fever or night sweats.
- Local inflammatory processes, such as appendicitis or cholecystitis.
Lower 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, it most often radiates to the leg, and it happens that it reaches the very foot. This may accompany osteochondrosis at the stage of herniated disc, 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 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. Among such diseases in women - adnexitis, ovarian cyst torsion, salpingo-oophoritis, uterine fibroids and endometritis can be expressed as pain in the lower back. Pregnancy, due to the increased load on the spine and an increase in body weight, often provokes back pain, and they are also possible during the 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 can also indicate exclusively male diseases - prostatitis or epididymitis. Pathology of the prostate is characterized by pulling, aching pain, 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 this is a pathology of the spine, then you need to contact kinesitherapists, if it is a pathology of internal organs, then to a therapist, gastroenterologist, gynecologist, urologist, If the pathology is of rheumatic origin, then to a rheumatologist, in cases of a neoplasm in the lower floor of the body, then to an oncologist.
First of all, for 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 a verbal questioning, the physician examines the patient, palpates the lumbar region, muscles of the spine and 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 cases of osteochondrosis, scoliosis, spondyloarthrosis and other factors that cause spasm and inflammation in the deep muscles of the spine, the most commonly used are painkillers and anti-inflammatory drugs, but they do not directly affect the cause of the pain syndrome, eliminate only its manifestation and have many side effects. To address the cause of back pain, the following are suggested:
- decompression exercises of power and stretching type to relieve spasm 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 reduce pain locally,
- physiotherapeutic methods, such as shock wave therapy, acupuncture, apparatus massage, 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, namely the weakening of the deep muscles of the spine, on the condition of 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 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 of a sedentary type, that is, every 3-4 hours, devote at least 15 minutes to this, just walk a couple of times a week for 1. 5-2 hours, and do it in the morningcharging.
According to 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 the position on all fours, inhale - raise the head, bend the back down; exhalation - lowering the head, rounding the back;
- stretching step (in yoga this exercise is called the "Pose of the Pigeon"): in the position on all fours, you need to move one knee forward, the foot to the inside, and the other leg back, lie on your stomach on your thigh, palms under your shoulders. For more effective stretching, 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.
- lifting the pelvis in the supine position with legs bent at the knees;
- press: in the supine 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: in a prone position, pull your knees in turn to your chest, pressing your hands to your 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!
Of 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 seat in the car should be adjustable in height and close to the steering wheel, and the backrest should be soft enough to contain bumps from rough roads.
While 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 look (along with it and the neck) should be directed straight or slightly up, but not down. Light fall correctly on the work surface of the table.
Remember, prevention is more important than cure!