Lower back pain is quite common. It can be caused by both normal fatigue and serious and pathological injuries. If the pain is severe or does not go away after rest, it is important to see a doctor to rule out a dangerous condition.
What can lower back pain be like?
Pain in the lower back can be sharp or aching, appear suddenly or increase gradually, appear with certain loads or movements (for example, bending over) or persist regardless of what the person does.
The pain can be spot-like or radiating (that is, spreading to other areas). In this case, a person experiences pain not only in the back in the lumbar region, but also in other parts of the body, such as the lower abdomen, perineum, legs or buttocks.
Lower back pain may include stiffness of movement or muscle spasms. The person may have difficulty bending over or getting up from a lying position, standing with a straight back or maintaining posture while walking.
If the pain is caused by muscle spasms or pinched nerves, it can be unbearable and even crippling. Such pain forces you to stay in bed until you receive medical help.
Why does my lower back hurt?
The most common cause of pain in the lower back is one or another pathology of the musculoskeletal system: sprain, pinch, inflammation. They are often found in men who work with their hands, athletes, and young mothers.
Also, discomfort in the lower back can be a sign of acute or chronic diseases of internal organs. This happens due to the fact that pain impulses can be sent along nerve fibers to neighboring areas. In this case, they say that the pain "radiates" to the lower back.
Diseases of the musculoskeletal system cause pain in the lower back
Often, lower back pain is caused by injuries and pathologies of the musculoskeletal system - muscle and ligament sprains, spinal injuries, hernias and protrusions of intervertebral discs, joint inflammation, bone diseases.
Deformation and sprain of muscles and ligaments
Such injuries can occur due to awkward movements if a person lifts something very heavy or does not follow safety precautions when handling large objects. You can also get injured while playing sports or if you just sneeze unsuccessfully.
Lower back pain may occur if you lift heavy objects without following safety precautions.
With sprains and strains, the pain increases during movement, and cramps may appear in the muscles. It may be painful for the person to walk, bend forward, or keep their back straight.
Diagnosis of deformation and sprain of muscles and ligaments is based on data from physical examination and instrumental studies - ultrasound, x-ray, MRI of the lumbar region. If you suspect a sprain or deformation of a muscle or ligament, you should contact an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms using ice packs, pain relievers, and medications to relieve muscle spasms (muscle relaxers). It is important to give the damaged area rest to allow the tissue to recover - this usually takes about 2 weeks. After this, it is important to start rehabilitation: physical therapy exercises aimed at restoring muscle function are indicated.
Without treatment, strains and sprains lead to limited movement: trying not to injure the damaged area, a person reduces activity, which can lead to weight gain, decreased bone strength and loss of muscle mass.
Spinal cord injury
Damage (usually a fracture) to one or more vertebrae occurs as a result of a fall, accident, sports, or home injury. In people with bone density disorders (such as osteoporosis), such damage can be caused by even small exposures.
The treatment of spinal injuries is to prevent further displacement and deformation of the spinal discs. If the damage is not severe, it is recommended to sleep on a hard surface and limit physical activity. If the damage is significant, surgical methods are used for fixation.
Without treatment, damage to the spinal disc can cause stenosis (narrowing) of the spinal canal, nerve disorders, including sciatica - pinched nerve fibers that extend from the spine.
Intervertebral disc pathology
Intervertebral discs are fibrocartilaginous plates with jelly-like contents located between the vertebrae. They act as a shock-absorbing cushion for the vertebrae, ensuring their movement. Discs can dislodge (bulge) or rupture (herniate), causing severe pain and limiting spinal mobility.
Intervertebral hernia and protrusion can occur in people who have weak muscles and are overweight, in those who lead a sedentary lifestyle or lift heavy objects. People who smoke are more prone to intervertebral disc pathology.
Intervertebral hernia - protrusion of the intervertebral disc into the spinal canal
Treatment consists of relieving pain and inflammation - rest, painkillers, ointments and compresses on the inflamed area are recommended. The doctor may prescribe physical therapy or exercise therapy. For moderate damage, the disc can recover if the cause of the herniation or protrusion is excluded - for example, strengthening the muscle corset, reducing weight and not putting excessive pressure on the spine.
If the pain in the lower back is so severe that it interferes with daily activities, it does not subside within 1-1. 5 months, or if symptoms worsen, you should contact your doctor again. In some cases, steroid therapy or surgery may be necessary. With age, it is possible to develop degenerative diseases of the intervertebral discs - they become flatter and perform a worse shock-absorbing function, which can also cause pain. In this case, treatment includes pain relief and general improvement of the body.
Lumbar spine scoliosis
Scoliosis (curvature) of the spine is a displacement of the spinal column to the right or left relative to the vertical axis. Pathology leads to increased pressure on certain areas of the intervertebral disc and vertebrae, as well as pinched tissue and nerve fibers. Scoliosis can cause severe pain in the lower back on the right or left side—where most of the pressure is placed—and severely limits spinal mobility.
Scoliosis (curvature) of the spine can cause severe pain in the lower back area where a lot of pressure is placed
Scoliosis can occur due to the weakness of the muscle corset in the absence of sufficient physical activity, an inactive lifestyle (in schoolchildren, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and the shape of the curvature.
Treatment involves the introduction of balanced physical activity (physical therapy, swimming), massage and manual therapy, physiotherapeutic procedures to strengthen muscles, such as electrical stimulation. For severe injuries, wearing a corset is recommended, which helps maintain the correct position of the spine.
Arthritis and arthrosis
Inflammatory and degenerative processes in the spinal joints can also cause severe back pain. There are many forms of arthritis, including osteoarthritis (damage to the cartilage and adjacent tissues), ankylosing spondylitis (ankylosing spondylitis - damage to the spinal joints, which leads to fusion of the vertebrae).
Arthritis can be caused by natural aging, genetic predisposition, or autoimmune disease.
Arthritis treatment, depending on its form, may include the use of anti-inflammatory and nonsteroidal and steroidal painkillers, physiotherapeutic procedures (magnetic therapy, electrophoresis), therapeutic massage and physical therapy.
Physiotherapy procedures help relieve pain due to joint pathology
Spondylolisthesis
Vertebral displacement relative to the spine (spondylolisthesis) occurs as a result of injury or degenerative processes in the spine. Pathology occurs in athletes, the elderly or people with a hereditary predisposition to bone diseases (for example, osteoporosis - a disorder of bone density). Spondylolisthesis can cause severe pain in the lower back, buttocks, and legs, and cause stiffness or weakness in the legs.
Treatment involves relieving the pain and inflammation that occurs due to the compression of neighboring tissues by the vertebrae. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal pain relievers in the form of tablets or corticosteroid injections. At the same time, physiotherapeutic procedures and exercise therapy are prescribed to strengthen the muscles and restore the position of the vertebrae. If spondylolisthesis is accompanied by very severe pain, surgical treatment is used.
In traumatic and non-infectious pathologies of the musculoskeletal system, pain in the lower back usually decreases or decreases when the person takes a comfortable position.
If spondylolisthesis is accompanied by severe pain, your doctor may prescribe corticosteroid injections.
Infectious diseases of the spine
Inflammation of bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe back pain. This pathology, as a rule, is of a secondary nature, that is, it arises as a complication of inflammation of other organs (infection enters the tissue through the bloodstream).
Treatment involves hospitalization, lasts up to 1 month, and then requires rehabilitation, which takes from 6 to 12 months.
Tumor disease of the spine
Neoplasms can develop under the influence of hereditary or external factors (for example, radiation), but often they appear as recurrent foci (metastases) in cancer of other organs - lung, mammary gland, prostate, thyroid gland, kidney.
One of the most characteristic symptoms of tumor pathology is pain that does not subside when changing position or after resting. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sudden increase in body temperature with chills are also possible. Without treatment, symptoms worsen.
Treatment depends on the type of tumor, its location and symptoms and may include chemotherapy, radiotherapy and surgery to remove the tumor. Pain relief is done with non-hormonal or steroid drugs. To stabilize the spine, your doctor may prescribe a brace.
Orthopedic corsets help stabilize the spine
Diseases of internal organs cause pain in the lower back
Lower back pain can occur with diseases that are not associated with the pathology of the spine and adjacent tissues. Acute or painful, it can accompany inflammation of internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. In women, pain in the lower back can develop due to gynecological pathology.
Urolithiasis disease
A disease in which stones are formed in the kidneys and bladder - hard formations from the sediment of the chemical components of urine. Back pain is one of the main symptoms of pathology. Depending on the size and location, gallstones can cause a dull, aching pain that comes and goes periodically, or a very sharp pain that does not go away on its own and requires emergency medical attention.
Urolithiasis - the formation of stones in the kidneys and bladder
If you suspect kidney stones, you should contact a urologist or nephrologist. The doctor will prescribe tests and instrumental studies (ultrasound, X-ray examination, computed tomography, including with the use of contrast agents) to make a diagnosis and choose treatment tactics.
Treatment is prescribed taking into account the size, nature, location of the stone and other factors. If the stone is small (5–10 mm) and there are no other indications for surgical removal, drug treatment is used. If there are no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
Abdominal aortic wall weakness (aneurysm) can lead to life-threatening conditions such as aortic rupture and intra-abdominal bleeding. As a rule, pathology occurs in older people: risk groups include men over 65 years old and women over 70 years old, including smokers, those who suffer from vascular disease (high blood pressure), previously had an aneurysm or have a hereditary predispositionto them.
Pain in the lower back due to abdominal aortic aneurysm does not subside over time and may be accompanied by pain in the abdomen and legs.
If an aneurysm is suspected, abdominal ultrasound and computed tomography are prescribed.
Treatment depends on the size of the aneurysm. Small changes require monitoring with instrumental checks twice a year and lifestyle adjustments. Significant (more than 5 cm, with a high risk of rupture) is an indication for abdominal or minimally invasive surgery.
How to avoid back pain
Since lower back pain is most often caused by traumatic injuries to the muscles, fascia, joints or bones, the main recommendations for prevention are following safety precautions, maintaining a strong muscle corset, and healthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet including vitamins and minerals necessary to maintain healthy bones and muscle tissue and joints;
- maintain a healthy weight;
- regular physical activity: exercise to prevent lower back pain should include strength training to develop the muscle skeleton, stretching to relieve muscle tension and spasms, and cardio training to maintain blood supply and tissue nutrition;
- compliance with safety precautions when playing sports - for example, the first class in the gym must be supervised by a qualified trainer;
- compliance with safety precautions at home - many injuries can be avoided if you wear comfortable shoes, hold on to the railing on the stairs, take your time when it's slippery outside;
- observe safety precautions when lifting heavy objects - the load on the spine will be less if you approach the object as close as possible (don't reach there), and when lifting objects from the floor, bend your legs instead of leaning your body.
Yoga and Pilates classes help relieve spasms and tension in the lower back
Smoking affects blood circulation and affects tissue nutrition, increasing the risk of damage and injury.
What to do if your lower back hurts
If your lower back hurts, the reasons may be different, which means the treatment tactics are also different.
In case of severe physical fatigue, the back should be given rest - perhaps this will be enough for the muscles to recover and the mobility of the spine to return.
If the pain does not go away within 1-2 days or if it is very severe, you should see a doctor. While waiting for the doctor, you can try to relieve acute pain with painkillers.
At the appointment, the doctor will conduct an examination, determine the cause of the pain and give recommendations for treatment. This will help eliminate dangerous conditions and prevent the development of complications.
Heating (lumbar pepper patch, hot water bottle, sauna) is contraindicated for inflammation, but can relieve acute pain in the lower back if it is caused by muscle fatigue or pinched nerves. This method can only be used after consulting a doctor.
Which doctor should I contact with complaints of back pain?
If you suspect a pathology of the musculoskeletal system, you should contact a neurologist and orthopedic traumatologist.
Diagnosis is carried out during a physical examination and using instrumental methods: magnetic resonance therapy, computed tomography, X-ray and ultrasound. It is also possible to prescribe a myelogram (x-ray or CT study with a contrast agent injected into the spinal canal) and electromyography - a study that allows you to assess the condition of nerve fibers and muscles.
If you suspect kidney disease, you should contact a urologist, nephrologist or therapist. The doctor will analyze the complaint and conduct a physical examination, and then prescribe laboratory and instrumental tests to clarify the diagnosis.
Based on blood and urine tests, the doctor will be able to determine whether there is inflammation in the organs of the urinary system, and ultrasound and x-ray studies will help visualize the organs, determine the cause of the pain and choose the most effective treatment. tactics.
If the origin of pain in the lower back is not clear, you should consult a general practitioner or therapist.
The doctor will collect anamnesis (medical history), analyze hereditary risks, conduct a physical examination and prescribe tests that will identify inflammatory processes or disorders in the function of internal organs.
General blood tests help identify the inflammatory process.
If necessary, the doctor will refer you for an instrumental study (ultrasound, x-ray, MRI) or recommend contacting a specialist for further diagnosis and treatment.