Pain is one of the varieties of protective reactions of an organism in response to exposure to any pathogenic factor. In addition to the integration of different functional systems, which serves as a kind of signal to the man himself about the ongoing negative changes in the body. Among the many different foci, localization of the discomfort is low back pain is the most common.
For a long time, this discomfort is considered only as an expression of the sciatica, and patients are sent for consultation to the neurologist.
However, later it turned out that this disease, which is diagnosed only in 8% of cases, when the pain in the lower back. Therefore, it is currently the only right recognized is the hypothesis that these symptoms may be associated with various lesions of the internal organs, which is located at the level of the sacrum and lower back.
The duration of pain is divided into acute and chronic. On the acute form of the syndrome, as I say, if clinical symptoms continue for more than 3 months.
Therapeutic indications for the pathology
Clinically, there are several types of such syndrome:
- appears when muscle spasm.
Local pain in the region of the lumbar spine is a permanent character, its intensity may change depending on the position of the body, also increases with the movement.
The projection of the lower back pain has a neurological origin. This may be diffuse or concentrated in one point. Occurs when damage or a pinched nerve fibers that transmit impulses of pain to the appropriate Section of the brain. When this discomfort can spread along the nerve.
Radicular syndrome has all the symptoms of lumbago, i.e. comes on suddenly, for no apparent reason. Alone she wears a dull pain in nature, but any movement is accompanied by a severe sharp shooting pain impulses.
Reflects the pain syndrome occurs when the injury of internal organs. The discomfort is due to the fact that the tissue close to the pathological focus and particular area of the spine are connected to the same nerve.
Classification according to the patho-genetic mechanism
- Nociceptive. Appears when the stimulation of specific pain receptors in the result of damage to tissues by trauma, sprain, contusion, inflammation etc, Such a pain is acute, its intensity depends on the severity and duration of the pathological process. However, if the disease affects the bones or muscles, the tissues, the pain becomes dull.
- The defeat of the nerve fibers. As a rule, occurs in lesions of the roots of the vertebrae as a result of a herniated disk. Such sources for the lower limb pain are chronic and accompanied by violation of skin sensitivity, motor disorders.
- Psychogenic. Pain of similar origin, which happens very rarely. Typically, such a diagnosis is made, unless within six months the doctors could not identify the exact causes of pain in the spine.
However, it is not always the cause of these symptoms cannot be as "harmless". Dangerous in terms of potential for development are the following diseases:
- The Tumor. Diagnosis in less 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 that says, hay fever, chronic bacterial lesions of the epidermis, urinary, respiratory, immune deficiency States, the use of corticosteroids.
- In cauda equina syndrome. The disease is associated with entrapment a lot of the nerve fibres in the region of lumbosacral. In this case, the pain is moving around in nature, radiates to the buttocks area and the back of her legs. With the severe damage a person loses sensitivity in the lower extremities and the ability to move them in full.
- Compression fracture of the spine. In the vast majority of cases is from serious trauma, it can sometimes develop on the combination of advanced age (over 70 years) and degenerative disk disease.
- Acute abdominal aneurysm. Often this pathology is asymptomatic and the only clinical manifestation is pain in the lower back.
- Is a herniated disc. Accompanied by a sudden pain, muscle weakness in the legs.
In addition, cooling, sharp, or vice versa, nagging, stabbing lower back pain can be the result of congenital anomalies of the spine structure, the protrusion or injury of the intervertebral disks, various damage to the joints in arthritis, ankylosing spondylitis. In some cases, lower back pain due to metabolic disease, osteoporosis, neurological disorders.
The projection of pain syndrome occurs when ulcers or tumors of the posterior stomach wall, pancreatitis, inflammation of and diverticulitis of the colon. Women the symptoms are sometimes due to gynecological diseases, men have tumors of the prostate or prostatitis.
If you suddenly 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, the diagnosis and the tactics of the further treatment includes the following:
- Human review, history taking, with special emphasis on symptoms witness to life-threatening conditions.
- If the symptoms of serious illness does not exist, prescribing therapy analgesia in the acute phase, physiotherapy, massage.
- Identify the symptoms of a dangerous pathology required further diagnostic laboratory and instrumental methods.
- After the diagnosis the prescription of certain medications, sometimes surgical intervention is necessary.
If the examination of the patient, gives no information, and action, pills and injections do not bring results in six months, we 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 pain in the lower back due to some factors, which are associated with the way of life of the patient and presence of comorbidities.
Some are very amenable to non-drug correction, others can be corrected only with the help of medication, physiotherapy or surgery.
If chronic pain in the lumbar region, we need to be aware of the following factors:
- too much load on the spine associated with a professional activity, long stay in an uncomfortable position at work and at home;
- lack of regular physical exercise or too sharp the beginning of the training;
- physically significant load without the proper training of the muscles;
- incorrect posture (scoliosis, kyphoscoliosis, stoop);
- common colds;
- the defeat of the digestive tract;
- Smoking, abuse of coffee drinks.
Chronic pain is usually occurs after regression of the acute, and independent, in the initial symptom. The most common causes of its formation are instability of the spine, on the basis of degenerative disc disease, myofascial syndrome, osteoarthritis of the facet joints of the spine. Usually the discomfort is worse when walking, movement, rotation or inclination of the body.
Acute pain in the lumbar region is usually associated with damage to bones, connective or muscle tissue of the ridge, falling. The sudden appearance of such feelings can mean the release of kidney stones and its downward movement on the urinary ways. Often women complain of pain in the back in the lumbar region after the the birth of the child due to a heavy load and pelvic, and sacral spine.
Similar symptoms experienced by each person, but not all, go to the doctor. So, when should I schedule a consultation?
Indications for investigation, if the back pain in the lumbar region, the following risk factors:
- the presence of chronic diseases of the musculoskeletal system;
- concomitant infectious pathology;
- fever, symptoms of General intoxication, loss of appetite and weight loss;
- the presence of blood in the urine, tachycardia, abdominal pain and other signs of damage to internal organs.
Determine the cause of the pain in the lumbar region doctors use the following diagnostic methods:
- The X-rays. Administered in most cases, is the main method for the detection of fractures of the vertebrae. On the image, you can set the height of the gap between the vertebrae, the deformation of the intervertebral disc, degenerative changes of the crest of the tumor. In some cases, the conventional x-ray is not enough, repeat the process with the charged (tilt forward or to the side, etc).
- Electromyography. Assists in determining the functional excitability and conductivity of nerve endings. Prescribed for radiculopathy clear the reason, if the back pain in the lumbar region, before the surgery.
- Densitometry (procedure for determining the density of bone tissue). Called for the detection of osteoporosis and its severity.
- Computer and magnetic resonance tomography. Are more informative alternative to radiological research. Allows a single process to make a few predictions for the determination of the presence of lesions in the spinal cord or disease of the myelin sheath. In addition, CT and MRI have a lower exposure to radiation.
- Scintigraphy. The study was carried out with the use of a contrast radioactive isotopes. Mostly prescribed for diagnosis of malignant tumors.
- Myelography. The procedure when the contrast solution is injected directly on the affected area. This study allows to identify precisely the contours and the localization of intervertebral hernia, and if back pain in the lumbar region.
Also called General analysis of blood, studies to determine the concentration of calcium, phosphorus, alkaline phosphatase. According to the testimony of tests for the detection of rheumatoid factor and other specific markings of arthritis. If it is necessary to do chest x-ray, ultrasound examination of abdominal cavity and urinary tract.
However, each patient is prescribed, not all the methods listed. These are required for the differential diagnosis of life-threatening conditions. Generally, if back pain in the lumbar region, the exact reasons given direction on the x-ray, CT, MRI or some lab tests.
What to do if back pain in the lower part of the back: treatment, folk remedies
So in acute lumbalgia shown:
- Bed rest with restriction of physical activity for a period of from 2 to 5 days.
- Cold or heat packs, which are used in the first days for 10 - 20 minutes every 2 hours.
- Wearing a brace. It is a very common recommendation, what to do when back pain in the lower back.
- The use of nonsteroidal anti-inflammatory drugs.
- The use of muscle relaxants, which are used for more than 14 days.
- Local warming ointments.
- According to the testimony of blockades with local anesthetics.
When deciding on what to do if back pain in the lower back, you can use the recipes of alternative medicine. For example:
- It takes 4-5 roots of the turnips, wash and cut into small pieces, pour a glass of boiled water and put half an hour in the oven. Then grind in puree, leave to cool and use for compresses. The process takes an hour and a half.
- RUB fresh horseradish root, and grind them sore once in two days.
- In acute pain need to take some root of the radish, wash and mince. On rarely, has been 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.
- A spoonful of thyme herb grind into powder and mix with butter in the ratio of 1:3. Apply to the affected area twice a day.
- We also recommend bath. For the preparation of 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 process takes 15 minutes. This can be done only with the permission of the doctor.
- Two tablespoons of grass, clover, and 4 tablespoons of chamomile pour a glass of boiling water, and cook in a water bath 15 minutes, cool, drain, squeeze the medicinal product raw materials and to increase the volume of infusion with boiled water to 200 ml. It is used in the form of heat, such as polishing.
- Mix 10 g chamomile flowers and Linden, pour a glass of boiling water, bring to a boil and take half glass three times a day.
Lower back pain can occur for a variety of reasons. This period in women, disease of the prostate in men, the stress, the more serious diseases of the locomotor apparatus. However, to solve the issue of what to do if the pain in the back, the cross needs a doctor. Own methods of treatment is allowed only for local use, anti-inflammatory and warming ointments for a maximum of 10 days.