Lower back pain is quite common. It can be caused by ordinary fatigue as well as by serious injuries and pathologies. If the pain is severe or does not go away after rest, it is important to consult a doctor to rule out a dangerous situation.
What might lower back pain feel like?
Lower back pain can be sharp or aching, appear suddenly or gradually increase, appear with loads or certain movements (for example, bending) or persist regardless of what the person does.
The pain can be punctual or radiating (that is, spreading to other areas). In this case, a person feels pain not only in the back, in the lumbar region, but also in other parts of the body, such as the lower abdomen, perineum, leg or buttock.
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 when walking.
If the pain is caused by a muscle spasm or pinched nerve, it can be unbearable or even disabling. 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: sprains, pinching, 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 the internal organs. This is because pain impulses can be transmitted along nerve fibers to neighboring regions. In this case, the pain is said to "radiate" to the lower back.
Diseases of the musculoskeletal system causing lower back pain
Most often, lower back pain is caused by injuries and pathologies of the musculoskeletal system - muscle and ligament sprains, spinal injuries, herniation and protrusion of intervertebral discs, inflammation of the joints, bone diseases.
Deformities and sprains of muscles and ligaments
Such injuries can occur due to clumsy movements if a person lifts something very heavy or fails to follow safety precautions when handling large objects. You can also get injured while playing sports or if you just sneeze unsuccessfully.
Lower back pain can occur if you lift heavy objects without following safety precautions.
With sprains and strains, pain increases with movement and spasms may occur in the muscles. It may be painful for the person to walk, bend forward, or keep their back straight.
The diagnosis of deformation and sprain of muscles and ligaments is based on data from a physical examination and instrumental studies - ultrasound, x-ray, MRI of the lumbar region. If you suspect a sprain or deformation of muscles or ligaments, you should contact an orthopedic traumatologist.
Treatment involves relieving acute pain and muscle spasms using ice packs, pain relievers, and medications to relieve muscle spasms (muscle relaxants). It is important to allow the damaged area to rest to allow the tissues to recover – this usually takes around 2 weeks. After that, it is important to start rehabilitation: physiotherapy exercises aimed at restoring muscle function are indicated.
Left untreated, strains and sprains lead to limited mobility: trying not to injure the damaged area causes a person to reduce activity, which can lead to weight gain, decreased bone strength, and loss of muscle mass. .
Spinal Injuries
Damage (usually a fracture) to one or more vertebrae occurs as a result of falls, accidents, sports or household injuries. In people with bone density disorders (such as osteoporosis), such damage can be caused by even minor exposures.
Treatment of spinal injuries involves preventing displacement and subsequent deformation of the intervertebral 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.
If left untreated, damage to the intervertebral discs can cause stenosis (narrowing) of the spinal canal, neurological disorders including sciatica - pinched nerve fibers extending from the spine.
Intervertebral disc pathologies
Intervertebral discs are fibrocartilaginous plates with gelatinous contents located between the vertebrae. They act as shock absorbers for the vertebrae, ensuring their mobility. Discs can become dislodged (protrude) or rupture (herniated), causing severe pain and limiting spinal mobility.
Hernias and intervertebral protrusions can occur in people with weak muscles and excess weight, in those who lead a sedentary lifestyle or lift heavy objects. People who smoke are more susceptible to intervertebral disc pathologies.
Intervertebral hernia – protrusion of an intervertebral disc into the spinal canal
Treatment involves relieving pain and inflammation – rest, painkillers, ointments and compresses to the inflamed area are recommended. The doctor may prescribe physical therapy or exercise therapy. In case of 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 stress on the spine.
If the pain in the lower back is so severe that it interferes with daily activities, does not subside within 1 to 1. 5 months, or if the symptoms worsen, you should contact your doctor again. In some cases, corticosteroid therapy or even surgery may be necessary. With age, it is possible to develop degenerative disease 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.
Scoliosis of the lumbar spine
Scoliosis (curvature) of the spine is a shift of the spine to the right or left in relation to the vertical axis. The pathology leads to increased pressure on certain areas of the intervertebral discs and vertebrae, as well as pinching of tissues and nerve fibers. Scoliosis can cause intense pain in the lower back, on the right or left, where most stress is concentrated, and considerably limit the mobility of the spine.
Scoliosis (curvature) of the spine can cause severe pain in the lower back area where a lot of stress is placed.
Scoliosis can occur due to weakening of the muscular corset in the absence of sufficient physical activity, a sedentary lifestyle (in schoolchildren, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and bends are formed.
Treatment involves the introduction of balanced physical activity (physiotherapy, swimming), massage and manual therapy, physiotherapeutic procedures to strengthen muscles, such as electrical stimulation. In case of serious injuries, wearing a corset is recommended, which helps maintain the correct position of the spine.
Arthritis and osteoarthritis
Inflammation and degenerative processes in the joints of the spine can also cause severe lower back pain. There are many forms of arthritis, including osteoarthritis (damage to the cartilage and adjacent tissues), ankylosing spondylitis (ankylosing spondylitis - damage to the joints of the spine, leading to fusion of the vertebrae).
Arthritis can be caused by natural aging, genetic predisposition or autoimmune diseases.
Treatment of arthritis, depending on its form, may include the use of non-steroidal and steroidal anti-inflammatories and analgesics, physiotherapeutic procedures (magnetotherapy, electrophoresis), therapeutic massage and physiotherapy.
Physiotherapeutic procedures help relieve pain due to joint pathologies
Spondylolisthesis
The displacement of a vertebra relative to the spine (spondylolisthesis) occurs as a result of injury or degenerative processes in the spine. Pathology occurs in athletes, elderly people or people with a hereditary predisposition to bone diseases (for example, osteoporosis - a bone density disorder). Spondylolisthesis can cause severe pain in the lower back, buttocks and legs, and cause cramps or weakness in the legs.
Treatment consists of relieving pain and inflammation due to compression of neighboring tissues by the vertebra. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal pain relievers in the form of corticosteroid tablets or 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 intense pain, surgical treatment is used.
In traumatic and non-infectious pathologies of the musculoskeletal system, pain in the lower back usually subsides 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 lower back pain. These pathologies are usually secondary in nature, that is, they arise as a complication of inflammation of other organs (the infection enters the tissues through the bloodstream).
Treatment involves hospitalization, lasts up to 1 month, then requires rehabilitation, which lasts 6 to 12 months.
Tumor diseases of the spine
Neoplasms can develop under the influence of hereditary or external factors (for example, radiation), but most often they appear in the form of repeated foci (metastases) in cancer of other organs - lungs, mammary glands, prostate, thyroid gland, kidneys.
One of the most characteristic symptoms of tumor pathologies is pain that does not subside when changing position or after rest. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sharp increase in body temperature accompanied by chills are also possible. Without treatment, symptoms get worse.
Treatment is prescribed depending on the type of tumor, its location and its symptoms and may include chemotherapy, radiotherapy and surgical removal of tumors. Pain relief is carried out with non-hormonal or steroidal drugs. To stabilize the spine, your doctor may prescribe you to wear a corset.
The orthopedic corset helps stabilize the spine
Internal organ diseases causing lower back pain
Lower back pain can occur with diseases not associated with pathologies of the spine and adjacent tissues. Acute or painful, it can accompany inflammation of the internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. In women, lower back pain can develop due to gynecological pathologies.
Urolithiasis disease
A disease in which stones form in the kidneys and bladder - hard formations from the sediment of chemical components of urine. Lower back pain is one of the main signs of pathology. Depending on their size and location, kidney stones can cause a dull, aching pain that comes on and subsides periodically, or a very sharp pain that does not go away on its own and requires emergency medical attention.
Urolithiasis - 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, CT scan, including with the use of a contrast agent) to make a diagnosis and choose a treatment tactic.
Treatment is prescribed taking into account the size, nature, location of the stones and other factors. If the stone is small (5-10 mm) and there are no other indications for its surgical removal, drug treatment is used. If there is no positive dynamics after a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
A weakening of the walls of the abdominal aorta (aneurysm) can lead to life-threatening conditions such as aortic rupture and intra-abdominal bleeding. As a rule, pathology occurs in older people: the risk group includes men over 65 years old and women over 70 years old, including smokers, people suffering from vascular diseases (high blood pressure), havingever had aneurysms or having a hereditary predisposition to them.
Lower back pain due to an abdominal aortic aneurysm does not improve over time and may be accompanied by pain in the abdomen and legs.
If an aneurysm is suspected, an abdominal ultrasound and CT scan are prescribed.
Treatment depends on the size of the aneurysm. Small changes require monitoring with an instrumental examination twice a year and lifestyle adjustments. Large indications (more than 5 cm, with a high risk of rupture) are an indication for abdominal or minimally invasive surgery.
How to prevent lower back pain
Since lower back pain is most often caused by traumatic injuries to the muscles, fascia, joints or bones, the main recommendation for prevention is to follow safety precautions, maintain a strong muscular corset as well ashealthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet including the vitamins and minerals necessary to maintain healthy bone, muscle and joint tissues;
- maintain a healthy weight;
- regular physical activity: Exercises to prevent lower back pain should include strength exercises to build muscle structure, 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 classes in the gym must be supervised by a qualified trainer;
- observance of safety precautions at home - many injuries can be avoided if you wear comfortable shoes, hang on to the railings on the stairs, take your time when it is 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 (do not reach for it), and when lifting objects from the floor, bendyour legs rather than tilting your body.
Yoga and Pilates classes help relieve lower back spasms and tension
Smoking impairs blood circulation and tissue nutrition, increasing the risk of damage and injury.
What to do if you have lower back pain
If you have lower back pain, the reasons may be different, which means that the treatment tactics will also be different.
In case of severe physical fatigue, the back needs 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 after 1 to 2 days or if it is very severe, you should consult a doctor. While waiting for a doctor, you can try to relieve acute pain with painkillers.
During the appointment, the doctor will conduct an examination, determine the cause of the pain and give treatment recommendations. This will help eliminate dangerous conditions and prevent the development of complications.
Warming (lumbar pepper patch, hot water bottle, sauna) is contraindicated in cases of inflammation, but can relieve acute lower back pain if caused by muscle fatigue or a pinched nerve. These methods can only be used after consulting a doctor.
Which doctor should I contact in case of lower back pain?
If you suspect a pathology of the musculoskeletal system, you should contact a neurologist and an orthopedic traumatologist.
Diagnosis is made during a physical examination and using instrumental methods: magnetic resonance therapy, computed tomography, radiography 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 and muscle fibers.
If you suspect kidney disease, you should contact a urologist, nephrologist or therapist. The doctor will analyze the complaints and conduct a physical examination, 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 to visualize the organs, determine the cause ofpain and choose the most effective treatment. tactical.
If the cause of lower back pain is unclear, you should see a GP 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 functioning of internal organs.
A general blood test helps identify the inflammatory process.
If necessary, the doctor will refer you to instrumental studies (ultrasound, X-ray, MRI) or recommend contacting a specialist for further diagnosis and treatment.