Backache- one of the most common complaints of patients with a wide variety of diseases. Almost every person at least once in his life experienced pain, most often localized in the sacral spine, or between the lower lip of the XII side of the ribs and the gluteal folds, d. m. th.low back pain(BNS).
Low back pain is usually accompanied by muscle tension, often from the presence of painful points. It can radiate to other parts of the body, for example, the legs, the gluteal muscles, the stomach, the pelvic region, and so on.
Acute low back pain often appears suddenly and can last from a few minutes to several weeks. Usually, in 90% of cases, the back pain goes away on its own within 3-4 weeks, however, in the remaining 10% of cases it becomes chronic and can last for years, sometimes worsening, then receding. Most often, the true cause of low back pain can not be determined.
Back pain in the lumbar region - causes
A variety of diseases can cause back pain in the lumbar region.Pain in the lower back(BNS) is, in fact, only a symptom that appears with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavity, small pelvis and spinal structures; in addition, it can be psychogenic.
Pain in the lower back
Back pain over the lower back can occur with gastric ulcer and 12 duodenal ulcer. The reflected pain is often localized in the lower back or slightly higher, less frequently in the upper quadrant of the body.
With pancreatitis and cholecystitis, pain is often noted in the projection area of the sixth to eight intercostal space.
In genitourinary sphere pathology, the reflected pain is often localized in the lumbar region and lower levels of the thoracic spine.
Pain in the lower back, right or left
Low back pain on the right or left side is most often a sign of kidney stones. In the case of kidney stones, a kidney-growing stone presses on the delicate kidney parenchyma from the inside, sometimes causing severe pain in the lower back on the left or right side of the kidney where the stone is located.
Low back pain radiates to the legs
When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, leg, abdominal cavity, and genitals. Too often, radiating back pain in the legs can be a signrenal colicwith renal urolithiasis.
In addition, low back pain radiates to the legs with lumboishalgia. Ishalgia appears as leg pain mainly during healing.
Lateral and lumbar pain
Low back pain radiates to the left and right sides in acute or chronic inflammation of the kidneys. Kidney pain, which lasts for several days and is accompanied by fever, chills, dysuric phenomena (urinary disorders) indicates a diseaseacute pyelonephritis. . .
Back pain in the back
Processes in the pelvic area (uterus, appendages, bladder, intestines) cause pain localized in the lumbosacral region. However, there are often secondary musculoskeletal syndromes (reflex disorders in the small and medium gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) in combination with lumbar spine pathology with chronic processes in the pelvis and organs. small. Such patients need collegial treatment of a neurologist-neurosurgeon, urologist, gynecologist, proctologist.
Pain in the lower back
Pelvic bone tumors, especially at the onset of the disease, can mimic lumboischialgia, and in the presence of an accompanying vertebrogenic process, patients sometimes undergo neurosurgical intervention for a lower lumbar hernia. This is aboutchondrosarcoma, Ewing sarcoma, reticulosarcoma, osteoblastomaand some others. Mandatory X-ray examination usually solves the diagnostic problem. It should not be forgotten that the general somatic and hematological condition of the patient can determine the oncological aspect of the disease.
Low back and pelvic pain
Difficulties in differential diagnosis are observed in the latent course of pelvic bone tuberculosis, when there is no increase in temperature and ESR, and the pain may mimic lumbar ischialgic syndrome of lumbar osteochondrosis. The process can go on secretly from childhood and adolescence and reveal itself to an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has become urgent again and the doctor should be reminded of these manifestations of the disease.
Thus, pain in the lumbar region and in the lower back often may not be related to any spinal disease and are alarming symptoms of completely different diseases of the internal organs. Therefore, in case of back pain, a comprehensive examination is required.
Low back pain in women - causes
Withdrawal of back pain
Low back pain in womenis often associated with premenstrual syndrome. Such pains usually have an attractive character, they occur a few days before menstruation and continue for 2-3 days after its onset and disappear on their own.
Pain in the lower back and abdomen in women
Lower back and abdominal pain associated with premenstrual syndrome and associated cramps in the lower abdomen and painful periods with heavy bleeding can be symptoms of serious reproductive diseases such as: endometriosis, uterine fibroids, polycystic ovary disease (PCOS)and etc.
Abdominal pain radiates to the lower back
Abdominal pain in women can radiate to the lower back, to the lower abdomen, to radiate to the vagina and external genitalia.
It should be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous disorders in the pelvic area, such as: formation of uterine fibroids, spreadendometrioid tissueoutside the uterus, the formation of adhesions, cancers of the reproductive organs, etc.
Furthermore, severe pain in the lower back and lower abdomen (especially on the right or left side) in women may be the result of a ruptured ovarian cyst or a symptom of an ectopic pregnancy. .
Low back pain during pregnancy
Often, pain in the lower back and abdomen in women shows natural physiological changes accompanied by an increase in the size of the uterus during the development of a normal pregnancy.
Low back pain during pregnancyis associated with additional stress on the spine and is normal and does not require special treatment. However, pregnant women with severe back pain should always consult a doctor who manages a pregnancy.
Pain in the lower back in men - causes
Lower back pain in men is most often associated with degenerative spinal diseases, especially with severe physical exertion, work associated with lifting weights. In addition, low back pain can be associated with various diseases of the internal organs.
Severe back pain
Acute back pain can occur with difficult movements, inadequate load distribution, etc. This pain is usually accompanied by either muscle spasm or displacement of the vertebral discs. Pain can also be caused by muscle contraction at the roots of the nerve endings of the spine.
Back pain and groin pain
Pain in the groin area in men, radiation in the lower back can be associated with prostate adenomas, testicular rotation, oncology, urological diseases, etc.
Classification of back pain
The classification, spread across a number of countries, aimed at optimizing the delivery of medical care for LPS, makes the differenceSpecific, radicular and nonspecific BNS. . .
Specific back painis a symptom of a certain disease, often severe and even life-threatening (cancer, including metastases in the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc . ; inflammatory, - for example, ankylosing spondylitis andother spondyloarthritis; traumatic and osteoporotic vertebral fractures; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal canal stenosis and cauda equina syndrome, etc. ).
Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the physician suspect that the patient has a serious pathology and deliberately examine it (preferably with the involvement of an appropriate specialist) to establish the correct diagnosis and treatment.
Radicular (radicular) pain in the lower back, including sciatica, is a consequence of spinal cord compression.
The management of patients with radicular LNS is the prerogative of a neurologist, with special indications the participation of a neurosurgeon is required. In practice, such patients are often referred to the help of chiropractors.
Among the radicular pains in the lower back are:
- lumbago,orlumbago;
- lumbodinia- long-term pain only in the lower back;
- lumboishalgia- back pain radiating to the legs.
Nonspecific back pain- most common, is not associated with any disease of internal organs, serious pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially accompanied by heavy lifting, prolonged uncomfortable position during sleep or work, etc.
Therefore, it is quite reasonable that a planned x-ray of the spine should not be included in the recommendations for examination of patients with nonspecific low back pain syndrome (NLP). Such patients do not need mandatory consultation with a neurologist, but should be treated by a family physician, district therapist, or general practitioner.
Low back pain and "lumbar osteochondrosis"
Osteochondrosis mesit(Osteochondrosis of the lumbar spine)- the most common diagnosis given to patients with complaints of low back pain. However, it is impossible to identify each case of the development of a lower back pain episode with often degenerative-dystrophic changes of the patient in the spine, making a "common" diagnosis"Worsening of osteochondrosis"or simply"Osteochondrosis". . .
For lower back or lower back pain, a diagnosis is often written as:"Dorsopathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization". . . Although, the correct diagnosis in this case should sound like this: "Lumbago with sciatica on the background of osteochondrosis of the lumbar spine. Lumbarization. (Code М54. 4)".
It should be noted that there is no nosological unit in any of the foreign classifications of degenerative-dystrophic diseases."Spinal osteochondritis". . . Moreover, neither term"Osteochondrosis", nor any other term characterizing dystrophic changes in the spine, should not be used as a synonym for clinical diagnosis.
Kondrozais a dystrophic change in the disc cartilage,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, ignorance by radiologists and clinicians of the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthritis, spondylosis, fixative hyperostosis, etc. )leads to overdiagnosis: these types of pathologies are found where they are not.
Often, osteochondrosis is called all the degenerative listed changes due to not recognizing the differences between them. By misunderstanding, osteochondrosis involvesdisc hernia, which is a consequence of its rupture and, as a rule, a normal disc and unchanged by a dystrophic process. However, calling an osteochondrosis disc herniation is as wrong as a meniscus tear at the knee joint - osteoarthritis.
The International Association of Vertebro-Neurologists recommends the use of the general term "vertebral dysfunction" (which, by the way, is also not included in the classification of ICD-10 diseases) in cases of occurrence of appropriate clinical symptoms.
Many modern authors, mostly foreigners, emphasize the lack of a link between the presence of radiological signs of degenerative changes in the spine, on the one hand, and the appearance or intensity of lower back pain (LBS), on the other hand, since only1 in 10 patients with radiological signs of degenerative spinal lesions are clinical manifestations of the disease.
Treatment of back pain at home
For low back pain associated with muscle tension and muscle cramps, low back pain oils can significantly relieve symptoms and help relieve muscle tension.
Ointments and pills for low back pain
Ointments and creams are used to treat the lower back. Alternatively, you can take pills containing non-steroidal anti-inflammatory drugs (NSAIDs).
At the same time, it should be remembered that self-treatment at home for low back pain with creams, oils, mustard plasters and other procedures can lead to neglect of the underlying disease that causes these pains and very sad consequences. Self-medication of the lower back is especially dangerous for kidney diseases like p. sh.acute pyelonephritisorrenal colicrequiring qualified emergency medical care.
Prevention of low back pain
People who have had an attack of illness, especially before the formation of a lasting remission, should follow certain prevention guidelines:
- Do not tilt the body without arm support; pick up items from the floor with bent knees.
- Change body position more often, do not stand for a long time, do not sit.
- Work at a desk or workplace, holding a vertical position, for this one leg, bent at the knee, placed in front of the other.
- Beware of performing specific yoga, gymnastics exercises without the recommendation of an exercise therapy doctor or a specialist vertebrologist.
- Beware of hypothermia, drafts, and prolonged heating in a hot bath, as muscle relaxation deprives for some time the immobilizing protection of the muscular corset.