Lumbar pain is one of the most common reasons that compel a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can be persistent, making movement and self-care impossible. Acute low back pain affects men and women equally frequently. With a greater frequency in middle and old age, low back pain can often be observed in adolescents and young adults. This is due to rapid growth, weakness in the delicate muscles of the lower back, and injury. Hence, lumbar spine pain is the most pressing problem that anyone can face.
Possible causes of back pain in the lumbar region
Pain in the lumbosacral spine can be associated with processes that occur both inside the spine itself and outside it. . . Consider the main pathological conditions in which acute lower back pain can be observed.
- The most common problem and cause of pain is lumbosacral osteochondrosis. . . It is caused by age-related involutive changes in the spine, dystrophy (malnutrition) of the corresponding segments of the spine and cartilage, and a decrease in vertebral height. These pathological processes lead to bone growth and damage to the nerve roots at the site of the narrowing. As a result, severe pain develops in the lumbosacral back (spine). Osteochondrosis of the lumbosacral region develops much more often in overweight people, as well as in those who have experienced prolonged physical exertion and contribute to the wear and tear of all structures of the vertebra. Frequent injuries, falls on the back, carrying weights and the accompanying osteoporosis aggravate the clinical picture and the course of the disease. Pain in the lumbosacral region is also associated with involvement of paravertebral muscle fibers (which cause muscle tension) and ligaments.
- A herniated disc is an equally rare causewhose clinical manifestation is pain in the lumbosacral back. The intervertebral disc (inner nucleus pulposus) loses its elastic properties and elasticity with prolonged traumatic exposure and with increasing age. With prolonged exposure (obesity, trauma, progressive osteoporosis), the annulus fibrosus of the intervertebral disc becomes thinner and defects form in it. Through these weak points in the annulus fibrosus, the nucleus pulposus of the intervertebral disc can shift and even protrude.
A herniated disc occurs when the annulus fibrosus ruptures and the nucleus pulposus compresses the elements of the nerve roots that exit the spinal cord. Compression makes the lumbar pain extremely intense, sometimes unbearable. Pain in the lumbar spine with a herniated disc can be accompanied by impaired sensitivity and varying degrees of numbness in the corresponding decompression segments (compression). Lower back pain radiates to the lower extremities and causes muscle tension due to cramps. If it is prolonged, a herniated disc causes chronic pain in the lumbosacral area. Constant muscle tension in the back exacerbates the pain syndrome and leads to chronification.
- Stenosis (narrowing) of the spinal canal- Pain in the lumbosacral back is noted in association with prolonged walking or physical exertion. Acute pain in the lower back can be accompanied by weakness in the legs, symptoms of cramps in the lumbar and buttock muscles. Significant damage can lead to disorders of the sensory functions.
- Tumor lesion of the segments of the lumbosacral vertebraeoften manifests itself in varying degrees of pain in the lumbar region. Typically, low back pain gets worse as the process progresses. The type of tumor lesion can be both benign (vertebral cysts) and malignant (a tumor of the spine or metastatic lesions from a distant tumor). Due to its morphological nature, the tumor can be an osteosarcoma, hemangioma, or develop as a result of myeloma. Pain in the lumbosacral region with this pathology often disturbs the patient both during the day and at night (constantly, without gaps in the light), increases at rest, when shaking and knocking. Lower back pain is accompanied by muscle tension, cramps, sensory disorders, weight loss, blood changes (anemia).
- Osteoporosis (bone loss)- Very often it is the cause of pain in the bones of various localizations. Osteoporosis is caused by the accelerated excretion of calcium from the bones, which makes all bones fragile and, with little mechanical stress (often domestic), prone to fractures. Pain in the lumbosacral back in osteoporosis is combined with other pains in the bones, has an average degree of pain syndrome. Lumbar pain can lead to muscle tension and cramps, often combined with a decrease in the patient's height. The most common form of osteoporosis is postmenopausal, which develops in women after ovarian function has died out.
- Ankylosing spondylitisIn addition to pain in the entire spine, pain in the lumbar region and in the ileosacral joint are often characterized. The disease leads to stiffness of the spine over time and the involvement of other peripheral joints in the chronic process.
In addition to these conditions, lumbar pain may be caused by any of the following that are not associated with vertebral defects:
- Diseases of the kidneys, renal pelvis(Exacerbation of chronic pyelonephritis), urolithiasis of the kidneys, neoplastic diseases of the kidneys and metastases of tumors of the kidney. At the same time, pain in the lumbar region is localized a little higher (instead of the projection of the kidneys), pain in the lumbar region is not very typical. The pain is accompanied by other characteristic changes (frequent urination, dysuria, changes in urinalysis, temperature reaction);
- Diseases of the upper level of the digestive tract(Peptic ulcer, pancreatitis, pancreatic cancer) sometimes express in a certain location as pain in the lumbosacral area. However, back pain is not associated with movements, it can be combined with other ailments (vomiting, stool disorders, nausea, burning sensation along the esophagus);
- in some cases acute back pain can occurin various inflammatory diseases of the female genital area(Adnexitis, endometriosis), cancer (uterine cancer), myomas, tumors of the abdominal cavity. Lower back pain in women sometimes occurs during or just before menstruation. During pregnancy, there may also be a feeling of heaviness and pain in the lumbar region and sacrum;
- deforming osteoarthritis of the hip joint(Coxarthrosis), especially with an exacerbation of the process, in addition to gait disorders, difficulty walking, there may be pain in the lumbosacral area, in the area of the muscles of the gluteal region on the corresponding side of the lesion, tension in the muscles of the lower back and theButtocks.
Acute back pain: what to do?
If the patient has acute lower back pain in the lumbar region, it is necessary to immediately consult a qualified specialist to diagnose the cause of the pain that has occurred. More often, the patient goes to a neurologist, where, after appropriate diagnostics (X-ray examination, computed tomography, MRI) and a neurological examination, he is diagnosed with a spinal disease.
In the absence of convincing data on the pathology of the spine (osteochondrosis, herniated disc), additional methods (ultrasound imaging of internal organs, densitometry, pelvic ultrasound) and consultations with related specialists (oncologist, gynecologist, endocrinologist) may be necessary.
Treatment of back pain in the lumbar region
Acute back pain, as prescribed by the doctor, is relieved by non-steroidal anti-inflammatory drugs (in the form of tablets or injections), the appointment of muscle relaxants, rest, bed rest, the use of anti-inflammatory ointments, the application of compresses. Treatment in the acute phase can be carried out as an inpatient or in a polyclinic.
Prescribe drugs that improve microcirculation, blockade is used for acute back pain. Sometimes they resort to surgical treatment (with compression of the nerve roots) due to the ineffectiveness of other therapeutic effects. In combination with osteoarthritis, chondroprotectors have long been used in osteoporosis - calcium and vitamin D3 preparations. Physiotherapeutic effects (provided there are no contraindications), physiotherapeutic exercises and, in the rehabilitation phase, follow-up treatments can be carried out in sanatoriums.