The lower back is called the lower back - from the area where the ribs end to the tailbone (the lowest protruding vertebra).Most often, when a person has “back pain,” we are talking about the lower back.And if 20 years ago, pain in the lower back bothered mainly older people, now even quite young patients turn to specialists for help with their backs.
Why does the lower back suffer so often?The fact is that the center of gravity of the human body is located precisely at the level of the lumbar spine, and it bears almost the entire load when walking.This is one of the disadvantages of upright walking - vertebrates that move on 4 limbs do not have such ailments.
Causes of lower back pain – what you need to know
Statistical studies tell us the following about the frequency of causative factors for lower back pain:
- 91% of calls are problems with the spinal column and the muscular frame of the back.
- 5% of complaints are related to diseases of the urinary system.
- 4% - pathologies of other organs (reproductive system, gastrointestinal tract).
Types of lower back pain
Often, back problems arise unexpectedly - like a bolt from the blue.Such acute pain in the lower back is called “lumbago,” and previously one could hear the term “lumbago.”The name itself speaks of the sharp, shooting nature of the sensations.During an attack of lumbago, any movement only intensifies the torment, and the patient involuntarily finds himself in a constrained position, freezing in one position.Lumbago lasts for several minutes and then subsides.
If the pain is prolonged and aching in nature, then we are talking about lumbodynia.These are low-intensity but constant painful sensations in the lumbar region, which intensify during physical activity or during hypothermia.
And there is a condition when there is no back pain itself, but a person feels stiffness and discomfort.In this case, additional diagnostics from specialists is also required.Depending on how lower back pain manifests itself, approaches to treating it vary.
Low back pain as a symptom of disease?
Back pain itself can signal very different pathological conditions, and often understanding the true cause is not so easy.
For example, there is such a thing as displaced pain.It denotes a situation where the back hurts on the right, left or lower back - and the person thinks that the cause of his torment lies in the spine.However, after research it turns out that one of the internal organs (kidneys, intestines or organs of the reproductive system) is to blame.The human body is very complex and confusing.Let's look at some possible root causes of discomfort in the lumbar back.
Musculoskeletal disorders causing lower back pain
The connection between spinal column diseases and lower back pain is direct and unambiguous.It was previously mentioned that spinal pathologies are the most common cause of back pain and account for more than 90% of all visits.
Protrusions and herniated intervertebral discs are rightfully in first place in terms of prevalence.With such destructive pathologies, the intervertebral disc initially moves slightly outward, prolapses (disc protrusion), and as the disease progresses, the integrity of the disc is disrupted in such a way that the inner part (nucleus pulposus) comes out of the surrounding fibrous ring.
Protrusions most often occur due to traumatic damage to the disc or osteochondrosis.
Another painful consequence of osteochondrosis is compression and pinching of the sciatic nerve.The pain is sharp and shooting - lumbago.
As a result of this compression, the nerve can become inflamed.The general name of such an ailment is radiculitis, and if the inflammation concerns the sciatic nerve, then it is designated by the more specific term “sciatica.”Pain with sciatica is concentrated in the lumbar region and spreads to the buttock and thigh along the sciatic nerve.
Now about the disease that leads to the development of all of the above - osteochondrosis.Pain in the lower back with osteochondrosis is a sharp shooting or dull aching character.With the development of the disease (2nd and 3rd degree), neurological symptoms appear - numbness, a feeling of pins and needles in the lower extremities.In the morning, a person is bothered by a feeling of stiffness.The functioning of the gastrointestinal tract, kidneys, and reproductive system is disrupted.
The main goal in the treatment of osteochondrosis is to relieve pain and stop the destruction of the vertebrae and intervertebral discs.It is important to understand that the earlier treatment is started, the better the prognosis.
Kidney, urinary tract and lower back pain
You might have heard.that lower back pain is due to diseased kidneys.In some cases this is indeed true.We recommend consulting a urologist if you are concerned about the following symptoms:
- Frequent painful urination, change in urine color.
- Deterioration of health, indifference to life.
- Hyperthermia is an elevated temperature.
- Decreased appetite, feeling of nausea.
- Arterial hypertension.
Pain varies.For example, with an exacerbation of chronic pyelonephritis, the pain seems to pull and surround the lower back, and renal colic is acute and short-term.
It is characteristic that pain in kidney pathology is concentrated on one side - since one kidney is involved in the inflammatory process.This is how a renal calculus (stone) appears in the kidney or ureter.
Another important diagnostic criterion is that in nephropathies, the intensity of pain does not change with changes in body position.However, as you understand, it is better to leave the right to make an accurate diagnosis to a specialist.
Excessive exercise and lower back pain
Our spine is adapted to physical activity.Therefore, the appearance of pain in your back after going to the gym should alert you.Normally, soreness in the back muscles due to the accumulation of lactic acid goes away within 1-2 hours and, if this does not happen, pathology should be suspected.
The cause of pain in the spine after playing sports can be old injuries or hidden problems with the intervertebral discs - for example, disc protrusion.In this case, eliminating physical exercise will not lead to healing, but will only hide the course of a destructive spinal disease.
In addition, back pain after exercise is characteristic of myofascial syndrome.It is not a threat to life, but significantly reduces its quality.
At the same time, physical activity can also contribute to the disappearance of back pain - for example, an overweight patient is more likely to get rid of back pain as a result of losing weight.
Remember that constant and periodic pain in the lower back after physical activity should be a reason to consult a doctor.
Hypothermia and lower back pain
Prolonged exposure to cold air and wind can lead to hypothermia.If the lower back was not protected from harmful environmental factors, an uncomfortable condition such as myositis may occur.This is the name for inflammation of skeletal muscles.The pain is aching in nature, and upon palpation (palpation) there is a tightening of the back muscles.
Features of lower back pain in women and the mechanism of their occurrence
It’s no secret that women’s well-being is closely related to their hormonal levels, which undergo dramatic changes not only throughout their lives, but also every month.Therefore, every month at a certain phase of the menstrual cycle, women may experience nagging pain in the lower back.Alas, this is a variant of the physiological norm.
And during pregnancy, discomfort in the lower back is considered normal - if it goes away after rest.After all, significant hormonal changes occur in a woman’s body during this period, the uterus expands - which changes the deflection in the lower back and shifts the center of gravity.In addition, a pregnant woman’s weight naturally increases, which also puts increased stress on the spine.
If we talk about other causes of pain in the lumbar region in women, back pain may indicate approaching menopause.This is due to a decrease in estrogen levels and changes in a number of other sex hormones.
Therefore, diagnosis of the causes of lower back pain in women should be carried out especially carefully so as not to miss important symptoms of serious diseases and not to write off the pathological causes of lower back pain in women.Indeed, among such formidable diseases there may be a cyst, apoplexy or inflammation of the ovary, and even cervical tumors.Ignoring and untimely diagnosis of such conditions can lead to infertility and critical complications.
What diseases may cause lower back pain?
Symptoms, nature of pain |
Presumable diagnosis by MRI |
| Lower back pain when coughing, sneezing, bending over. | Protrusion (bulging) of the intervertebral disc of the L1/L2 (L2/L3, L3/L4, L4/L5) vertebra |
| Numbness, tingling not only in the back, but also in the buttocks and lower extremities. | Symmetrical dorsal (posterior) protrusion of the discs of the L1/L2 (L2/L3, L3/L4, L4/L5) vertebra |
| Weakness in the leg muscles, motor reflexes worsen. | Dorsal (posterior) median protrusion of discs of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, shooting pains; the patient cannot even straighten up during an attack. | Circular protrusions of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Staying in one position for a long time causes aching pain. | Diffuse protrusions of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Symptoms may be absent for a long time and are discovered by chance. | Median disc protrusion of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Sharp, stabbing pain in the lower back - also called "lumbago". | Herniated discs of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| Pain in the leg extending below the knee, a sensation of “pins and needles” in the leg. | Dorsal disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| It is often asymptomatic, with patients reporting only mild discomfort. | Schmorl's hernia of L1, L2, L3, L4, L5 vertebrae |
| The functioning of the intestines, bladder, and reproductive system is disrupted. | Paramedian disc herniation of L1/L2, L2/L3, L3/L4, L4/L5 vertebrae |
| In the early stages, the course is asymptomatic.Pain occurs when the tumor spreads beyond the disc. | Hemangiolipoma and hemangioma in the L1 vertebral body (L2, L3, L4, L5) |
| The pain depends on the degree of displacement of the vertebra.If changes occur in the joints, movement disorders are noted. | Retrolisthesis and antelisthesis of L1 vertebra (L2, L3, L4, L5) |
| The pain is periodic at first, then becomes constant.Increased by physical activity. | Ventral wedge-shaped deformity of the L1 vertebral body (L2, L3, L4, L5) |
| Aching pain in the lower back, left or right, along the spine.Numbness, feeling of "pins and needles".Muscle tension. | MRI picture, signs of degenerative-dystrophic changes (osteochondrosis) of the lumbar spine |
| Rsharp pain from exertion or careless movement.Changes in gait, dysfunction of the genitourinary system. | Osteochondrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
| Pain in the buttocks and legs, discomfort from sitting on a chair for a long time and walking for a long time. | Spondyloarthrosis of the lumbar spine, 1st degree (2nd degree, 3rd degree) |
What to do if you have lower back pain?
If pain symptoms in the back in the lumbar region do not go away or decrease within 3 days, you should consult a doctor.What to do before visiting a doctor?
What you can do yourself for lower back pain
If the cause of the pain is unknown:
- take your temperature to detect inflammation in the body.
- determine accompanying symptoms (vomiting, diarrhea, or other)
- call a doctor at home or go to the emergency room.
If the cause of the pain is known (bruise, sprain or lower back injury):
- take a non-steroidal anti-inflammatory drug (NSAID) - diclofenac, ibuprofen or another.
- applying cold locally will help reduce swelling and dull the pain.
- tightly tighten the lumbar area with a towel or orthopedic belt to fix the injured area in one position.
- Consult a doctor for a full diagnosis and determine further treatment tactics.
What not to do for lower back pain
- Under no circumstances should you heat a painful area of your back!Heat will increase blood flow and, if there is inflammation, will worsen the situation: it will increase pain and lead to the spread of the infectious process.For the same reason, you should avoid visiting bathhouses and saunas.
- You cannot relieve pain for a long time if you have persistent and unexplained back problems.Ignoring the root cause can only aggravate the course of the disease and lead to serious complications.
- You cannot try to straighten the vertebrae on your own or roughly massage your back.Without diagnosis, such actions can cause vertebral displacement and cause unnecessary additional injury.
Which doctor should I consult for pain in the lumbar region?
It happens that a person would be glad to go to a specialist, but does not know which doctor to contact with a complaint of lower back pain.Let's bring a little clarity to this issue.
First of all, you should make an appointment with a general practitioner.He will conduct a differential diagnosis and determine which doctor you should continue treatment with.It could be:
- Neurologist – for neurological symptoms and involvement of nerves in the process.
- Urologist – if diseases of the urinary system (kidneys) are suspected.
- Gynecologist – for the treatment of diseases of the female reproductive system.
According to indications, a complete blood count (CBC) and a general urinalysis (UCA), an X-ray examination of the spine (in particular, MRI), ultrasound of the pelvic organs, kidneys and other studies may be prescribed.
It is important to remember that self-medication and other home remedies for lower back pain are a waste of money and time.Moreover, by delaying a visit to a specialist, you risk acquiring an advanced form of the disease, thereby dooming yourself to long-term, expensive, and often less successful (than in the early stages) treatment.
How to cure lower back pain: basic treatment methods
You may naturally have a question: if self-medication is not effective, then how to cure lower back pain?A competent specialist has many techniques in his arsenal, including both conservative and surgical treatment.
Conservative treatment consists of the following points:
- Taking anti-inflammatory (NSAIDs) and painkillers orally and locally.
- Physiotherapy (shock wave therapy, acupuncture).
- Kinesiotherapy.
- Therapeutic massage.
- Therapeutic exercise and gymnastics.
Physiotherapeutic procedures and massage must be carried out after the acute phase of the disease, when the pain syndrome has been relieved.
Surgical treatment is indicated in advanced cases of spinal diseases, when conservative methods fail to achieve any significant result.However, with timely diagnosis and correctly prescribed treatment, the need for surgical interventions can be delayed or completely avoided.
Prevention of low back pain
As a rule, painful sensations in the back and lower back arise due to a careless attitude towards one’s health.After all, a sedentary lifestyle, burdened by sedentary work and forced prolonged stay in one position, is typical for many of us.Excessive physical activity without preparation (stretching) and lifting weights with an incorrect back position are no less harmful.It's no wonder that the majority of the world's population experiences lower back pain.
Doctors' advice for preventing back pain:
- Watch your posture, keep your back straight.
- Avoid awkward postures in the workplace.You can place a small pillow under your lower back to support your back.Try it!
- When sitting at a desk for a long time, it is recommended to get up from time to time (every hour), ideally doing a joint warm-up, or you can just walk.
- It is advisable to sleep on an orthopedic mattress; it is quite hard and, at the same time, elastic.
- Start the day with exercises to strengthen your back and core muscles.
How to lift weights correctly?
If you need to pick up and carry something heavy, you should do this by bending your knees, not your back.That is, you first need to sit down, take the load, and then straighten your knees, leaving the back line straight.
Lower back pain: what to do?
Now that you have read about the most common causes of lower back pain, you know what you need to know and what to do, the question arises - where to turn?Definitely, when choosing a clinic, preference should be given to a medical center where you can be consistently examined by different specialists.That is, you will not need to go to the other end of the city for additional diagnostics, and a full-fledged comprehensive treatment plan for back pain in the lumbar region will be drawn up in one place.
The qualifications of doctors and the availability of appropriate equipment play an equally important role.After all, lower back pain due to osteochondrosis and myositis require different approaches to therapy.