So let's look at the causes of pain syndrome in the lumbar region in order:
- Diseases of the spine. Bechterew's disease is one of the rarest but serious pathologies that cause back pain. In this disease, the vertebrae fuse together, calcium deposits in the ligaments, and the affected back loses mobility. Characteristic features of pain in this pathology - pain increases at rest, with long lying down; movements of the lumbar region are limited. This disease begins more often at a young age and may have a hereditary tendency.
- The curvature of the spine. Kyphoscoliosis and asymmetric scoliosis (two types of curvature) cause spasms in the deep muscles of the spine. Most often, the pain syndrome is felt in the middle and late stages of the disease, and by the end of the day, it manifests itself more acutely in addition to fatigue. This pathology begins in childhood and can be a hereditary tendency.
- Osteoporosis is a decrease in bone mineral density, which leads to bone fragility and frequent fractures.
- Osteochondrosis - the thinning of the intervertebral discs, which leads to protrusions and herniation of the intervertebral discs in the late stages - is the most common cause of back pain. Moreover, the pain intensifies when you change position: you get up from a sitting position, you try to lie on your stomach, turn over, bend over.
- Spine injuries, sprains and bruises, fractures.
- Spondylolisthesis - that is, displacement of the lumbar vertebra relative to the vertebra below it. The pain is located in the middle of the back, is felt in the legs, and is accompanied by numbness and/or weakness, which is aggravated by standing up or bending backwards.
- Fibromyalgia is a pathology that causes pain in the muscles, ligaments and tendons. There is pain and stiffness in different parts of the body, the pain increases when you touch it. The patient often complains of poor sleep. It occurs most often in women aged 20-50.
- Injuries of soft tissues and kidneys. Severe sharp pain from the patient's kidney is characteristic of urolithiasis. Pain can occur in any position of a person. Another disease that causes discomfort in the lower back is pyelonephritis.
- Infections or infestations of the spine and spinal cord, e. g. osteomyelitis, discitis, spinal epidural abscess. The pain caused by this cause is progressive and does not depend on the patient's position or activity. Sometimes fever or night sweats occur.
- Local inflammatory processes, such as appendicitis or cholecystitis.
Lower back pain can be divided into three types: local, radiating and reflected. Local pain can be felt in the same place where the cause is, this type of pain occurs most often in lumbar syndromes. In this case, the most common cause is osteochondrosis of the spine, degeneration of the intervertebral disc, stretching or spasm of the deep muscles of the spine.
The radiating pain is dull and aching, most often radiating to the leg, sometimes reaching all the way to the foot. This can accompany osteochondrosis with disc herniation, osteoarthritis or degeneration of the deep muscles of the spine, with hemodynamic disturbances along the sciatic nerve.
Referred pain usually means that the cause of the syndrome is in the internal organs. For example, heart disease can cause pain in the arms, back, and shoulder blades. The pain is reflected from the internal organs to the lower back and hurts deeply, independent of movements.
Lower back pain in men and women
In women, back pain can be the result of gynecological diseases. In this case, the discomfort is dull and pulling. Among such diseases in women - adnexitis, ovarian cyst torsion, salpingo-oophoritis, uterine fibroids and endometritis can be expressed as pain in the lower back. Pregnancy often causes back pain due to the increased load on the spine and the increase in body weight, and these are also possible during menopause. In case of an ectopic pregnancy, back pain can also occur - in this case it is unbearable.
In men, the causes of lower back pain are often excessive exercise, heavy lifting, spinal injuries, but they can also refer to exclusively male diseases - prostatitis or epididymitis. The pathology of the prostate is characterized by a pulling, aching pain, and the patient often has impaired urination.
Diagnosis and treatment of low back pain
Depending on the causes of back pain, different specialists are involved in its treatment. If it is a pathology of the spine, then you should contact a kinesitherapist, if it is a pathology of internal organs, then a therapist, gastroenterologist, gynecologist, urologist, If the pathology is of rheumatic origin, then a rheumatologist, in cases of neoplasm at the lower level of the body, then an oncologist.
First of all, to make a diagnosis, the doctor asks the patient, recognizing the nature of the pain: acute or dull, pulling, dependent on movement, activity, body position, and other symptoms. or not. After the oral examination, the doctor examines the patient, feels the lumbar region, the muscles of the spine and the limbs. Further examination, laboratory tests, X-ray, MRI, tissue biopsy, electromyography may be necessary.
Various tools are used for treatment, depending on the disease. In the case of osteochondrosis, scoliosis, spondyloarthrosis and other factors that cause spasm and inflammation in the deep muscles of the spine, painkillers and anti-inflammatory drugs are most often used, but they do not directly affect the cause of the pain syndrome, they eliminate it. it has only its manifestation and many side effects. To eliminate the cause of back pain, we recommend the following:
- strength and stretching decompression exercises to alleviate the spasm of the deep muscles of the spine and eliminate pain,
- therapeutic massage to relieve tension in the muscles of the pathological area,
- cryotherapy for local pain reduction,
- physiotherapy methods, such as shock wave therapy, acupuncture, device massage, balneotherapy (mud treatment, contrast treatment, etc. ),
Prevention of back pain
The main prevention of various diseases of the skeletal and muscular system is the prevention of the development of dystrophy, namely the weakening of the deep muscles of the spine, the condition of which depends on the nutrition of the vertebrae and intervertebral discs. Strengthening the muscles of the spine should be regular, the most modern way to do this is the author's method, that is, the use of power and decompression type simulators. But the exercises can be done without a simulator, there are many of them. It is important to take a break during gymnastics at work, especially if it is sedentary, i. e. take at least 15 minutes every 3-4 hours, just walk for 1. 5-2 hours a couple of times a week, and do this during your morning workout.
According to the method, in order to prevent back pain, it is recommended to perform several simple exercises regularly:
- relaxation of the back (the well-known "Cat") exercise: breathe in on all fours - raise your head, bend your back; exhale - lower your head, round your back;
- stretching step (in yoga, this exercise is called "pigeon pose"): in a four-legged position, one knee must be moved forward, the foot inward, the other leg must be laid back, it must be laid on your stomach, on your thighs, palms under your shoulders. The most effective stretchingto move your arms diagonally to the side and lower your head, holding for 5-10 seconds. Return to the starting position and repeat on the other side.
- raising the pelvis in a supine position with legs bent at the knees;
- pressure: in a lying position, bend your knees and arms at the elbows, holding the back of the head, when exhaling, press your chin to your chest, raise your shoulder blades;
- knee press: in a prone position, we alternately pull our knees to our chest, while exhaling, we press our hands to our body or hang them.
All these exercises are very simple, it is enough to perform 10-15 repetitions of each exercise. With regular practice, they bring incalculable benefits!
Other tips include a comfortable mattress to help your back muscles relax at night. If you spend a lot of time in a car or working on a computer, pay attention to the correct posture. The car seat should be height-adjustable and close to the steering wheel, and the backrest should be soft enough to absorb the impact of rough roads.
When working or studying at a desk, the elbows should be at right angles. The chair must have a back to support the lower back, and the appearance (along with it and the neck) should be straight or slightly up, but not down. The light falls properly on the work surface of the table.
Remember, prevention is more important than cure!