Pain is one of the varieties of protective reactions of an organism in response to exposure to any pathogenic factor. In addition to mobilizing various functional systems, it serves as a kind of signal to the person about the negative events, what changes occur in the body. Among the many different foci localization of discomfort is the lower back pain is the most common.
For a long time, this discomfort is considered only as the manifestation of sciatica, and the patients are sent for consultation to the neurologist.
However, later it was proved that this disease is diagnosed only in 8% of cases, if there is pain in the lower back. Therefore, currently recognized as the only correct hypothesis is that such symptoms can be associated with various lesions of the internal organs, located at the level of the sacrum and lower back.
For the duration of the pain are divided into acute and chronic. About acute form of the syndrome like say, if clinical symptoms continue for more than 3 months.
Therapeutic classification pathology
Clinically, there are several varieties of such syndrome:
- which appears when the muscle spasm.
Local pain in region of lumbar spine is of a permanent character, its intensity may vary depending on the position of the body, it also increases with movement.
Projection lower back pain has a neurological origin. It can be diffuse or concentrated in any one point. Occurs when damage or pinched nerve fibers that transmit pain impulses to the appropriate Department of the brain. When this discomfort can spread along the nerve.
Radicular syndrome all the symptoms of lumbago, that is, occurs suddenly, for no apparent reason. Alone she wears a dull aching in nature, but any movement is accompanied by excruciating sharp shooting pain impulses.
Reflected pain syndrome occurs when damage to internal organs. The discomfort is due to the fact that the tissue close to the pathological focus and a certain area of the spinal column are connected by the same nerve.
Classification according to the patho-genetic mechanism of
- Nociceptive. Appears when the stimulation of specific pain receptors in the result of damage to tissues by trauma, sprains, bruises, inflammation, etc. Such pain is acute, its intensity depends on the severity and duration of the pathological process. However, if the disease affects the bone or muscle tissue, pain becomes dull.
- The defeat of the nerve fibers. As a rule, occurs in lesions of the roots of the vertebrae as the result of a herniated disc. Those who give in the lower limb pain are chronic and accompanied by violation of skin sensitivity, motor disorders.
- Psychogenic. Pain of similar origin occurs very rarely. Usually this diagnosis is made when for six months the doctors were unable to identify the exact causes of discomfort in the spine.
However, not always the causes of such symptoms can be so "harmless". Dangerous in terms of future Outlook are the following diseases:
- The tumor. Diagnosed in fewer than 1% of patients with lower back pain. Risk factors are the presence of oncological diseases in anamnesis, sudden weight loss for no apparent reason, age over 50, pain impulses during sleep or at rest.
- Infection. In favor of such a diagnosis says fever, chronic bacterial lesions of the epidermis, urinary, respiratory system, immunodeficiency States, use of corticosteroids.
- The cauda equina syndrome. The disease is associated with entrapment of a large nerve fiber in the region of the lumbosacral. In this case, the pain is of a moving nature, gives the area of the buttocks and back of her legs. With severe lesions a person loses sensitivity in the lower extremities and the ability to move them fully.
- Compression fracture of the spine. In the vast majority of cases it is preceded by severe trauma, can sometimes develop in combination of of Mature age (over 70 years) and degenerative disc disease.
- Acute abdominal aneurysm. Often, this pathology is asymptomatic and the only clinical manifestation is pain in the lower back.
- The herniated disc. Is accompanied by a sudden pain, muscle weakness in the legs.
In addition, fettered, or Vice versa sharp, aching, stabbing pain in the lower back can be the consequence of congenital anomalies of the spine structure, the protrusion or damage of the intervertebral discs, various lesions of the joints in arthritis, ankylosing spondylitis. In some cases, lower back pain caused by metabolic disorders, osteoporosis, neurological disorders.
Projection pain syndrome occurs when ulcers or tumors of the posterior stomach wall, pancreatitis, inflammation and diverticulitis of the colon. Women have symptoms sometimes due to gynecological diseases, men have tumors of the prostate or prostatitis.
If you abruptly got back in the lumbar region, the pain is unbearable acute character, it may indicate stone disease and the promotion of stones in the ureter.
If the patient appealed to the doctor complaining of back pain, diagnosis and tactics of the further treatment consists in the following:
- A review of person medical history, with particular attention to a symptom, which testifies to the life-threatening conditions.
- If the symptoms of serious diseases do not exist, prescribe therapy analgesia in the acute phase, physiotherapy, massage.
- Identifying the symptoms of a dangerous pathology required further diagnostic laboratory and instrumental methods.
- After diagnosis prescribe certain medications, sometimes surgical intervention is necessary.
If examination of the patient gives no information, and the action of pills and injections does not bring results within six months, recommend consultation with the relevant specialist to exclude or confirm a psychogenic origin of the disease.
Back pain in the lumbar region: the specificity of the symptoms, when to see a doctor, diagnostic methods
Usually, chronic discomfort in the lower back due to certain factors related to the lifestyle of the patient and presence of comorbidities.
Some are quite amenable to non-drug correction, others can be corrected only with the help of drugs, physiotherapy or surgery.
When chronic back pain in the lumbar region, you should pay attention to the following factors:
- too much load on the spine associated with a professional activity, long stay in an uncomfortable position, as in the workplace and at home;
- lack of regular physical exercise or too sharp the beginning of the training;
- physically significant load without proper training of the muscles;
- incorrect posture (scoliosis, kyphoscoliosis, stoop);
- frequent colds;
- the defeat of the digestive tract;
- Smoking, abuse of coffee drinks.
Chronic pain usually occurs after regression of the acute, and independent of it in the initial symptom. The most common causes of its occurrence are the instability of the spine on the background of degenerative disc disease, myofascial syndrome, osteoarthritis of the facet joints of the spine. Usually the discomfort is worse when walking, movements, rotations or inclinations of the body.
Acute pain in the lumbar region is usually associated with injuries of bone, connective or muscular tissue of the ridge, falling. The sudden appearance of such feelings may indicate the release of kidney stones and its downward motion on the urinary ways. Quite often women complain that back pain in the lumbar region after childbirth due to heavy load and the pelvis and the sacral region of the spine.
Similar symptoms experienced by each person, but not all go to the doctor. So when should I schedule a consultation?
Indications for the examination, if back pain in the lumbar region, is the following risk factors:
- old age;
- the presence of chronic diseases of musculoskeletal system;
- concomitant infectious pathology;
- a fever, symptoms of General intoxication, loss of appetite and weight loss;
- the presence of blood in the urine, tachycardia, pain in the abdomen and other signs that indicate the defeat of the internal organs.
To determine the cause of pain in the lumbar region doctors use the following diagnostic methods:
- The x-rays. Administered in the majority of cases, is the main method for detection of vertebral fractures. On the image, you can set the height of the gap between the vertebrae, deformation of the intervertebral disc, degenerative changes of the spine, tumors. In some cases, a conventional x-ray is not enough, repeat procedure with the loads (bending forward or to the side, etc.).
- Electromyography. Helps to determine the functional excitability and conductivity of nerve endings. Prescribed for radiculopathy unclear reason, if back pain in the lumbar region, before surgery.
- Individual stars (the procedure for determining the density of bone tissue). Appoint for the detection of osteoporosis and its severity.
- Computer and magnetic resonance tomography. Are more informative alternative to radiological research. Allows one procedure to do the several projections to determine the presence of a lesion in the spinal cord or disease of the myelin sheath. In addition, CT and MRI have lower radiation exposure.
- Scintigraphy. The study was conducted using a contrast of radioactive isotopes. Mostly prescribed for diagnosis of malignant tumors.
- Myelography. Procedure when contrast solution is injected directly into the affected area. This study allows to define precisely the contours and the localization of intervertebral hernia, and if back pain in the lumbar region.
Also appoint the General analysis of blood, studies to determine the concentration of calcium, phosphorus, alkaline phosphatase. According to the testimony of tests for detection of rheumatoid factor and other specific markers of arthritis. If necessary do x-ray of the chest, ultrasound examination of abdominal cavity and urinary system.
However, the specific patient is prescribed, not all of the methods listed. They are only needed for differential diagnosis of life-threatening conditions. Usually when back pain in the lumbar region, to determine the exact reasons given direction on an x-ray, CT, MRI or some lab tests.
What to do if back pain in the lower back: treatments, folk remedies
So, if acute lumbalgia shown:
- Bed rest with restriction of physical activity for a period from 2 to 5 days.
- Cold or heat packs, are used during the first days for 10 - 20 minutes every 2 hours.
- Wearing a brace. Is a very common recommendation, what to do if back pain in the lower back.
- The use of nonsteroidal anti-inflammatory drugs.
- The use of muscle relaxants, used for no longer than 14 days.
- Local application of warming cream.
- According to the testimony of the blockade with local anesthetics.
When deciding what to do if back pain in the lower back, you can use the recipes of alternative medicine. For example:
- Take 4-5 roots turnip, wash and cut into small pieces, pour a glass of boiling water and put in half an hour in the oven. Then grind to a puree, cool and use for compresses. The procedure lasts half an hour.
- RUB fresh horseradish root, and grind them sore once in two days.
- In acute pain need to take a few root radish, wash and mince. The slurry was applied to the back for 10-15 minutes.
- Take 20 g of dried fruit of physalis, chop and mix with 80 g of butter. Lubricate the lumbar region, twice a day.
- Tablespoon of herbs thyme grind into powder and mix with butter in a ratio of 1:3. Apply to the affected area twice a day.
- Also recommended bath. To prepare a medicinal decoction pounds of oat straw pour 10 liters of water and boil for 20 minutes. After that, the solution was poured into a pre-prepared tub. The procedure lasts 15 minutes. It can be carried out only with the permission of the doctor.
- Two tablespoons of grass clover and 4 tablespoons of chamomile pour a glass of boiling water and simmer in a water bath 15 minutes, cool, drain, squeeze medicinal raw materials and to increase the volume of infusion with boiled water to 200 ml. Used in the form of heat as polishing.
- Mix 10 g chamomile flowers and Linden, pour a glass of hot water, bring to a boil and take half glass three times a day.
Discomfort in the lower back can occur for a variety of reasons. This periods in women, prostate diseases in men, the stress, the more serious pathologies of the locomotor apparatus. However, to solve the question of what to do if back pain in the lower back, the doctor should. Of self treatment methods is allowed only for local use anti-inflammatory and warming ointments for a maximum of 10 days.