So, let's consider in order the causes of pain syndrome that occurs in the lumbar region:
- Diseases of the spine. Rarer but more serious conditions that cause back pain include Bechterew's disease. With this disease, the vertebrae grow together, calcium is deposited in the ligaments, and the affected back loses mobility. Features of pain in this pathology: pain increases at rest, with a long lie; movements in the lumbar region are limited. This disease most often begins at a young age and can have a hereditary predisposition.
- Curvature of the spine. Kyphoscoliosis and asymmetric scoliosis (two types of curvature) cause spasms of the deep muscles of the spine. Most often, the pain syndrome makes itself felt in the intermediate and late stages of the disease, manifests itself most acutely by the end of the day, along with fatigue. This pathology begins in childhood and can also have a hereditary predisposition.
- Osteoporosis is a decrease in bone mineral density, which leads to bone fragility, frequent fractures.
- Osteochondrosis - thinning of the intervertebral discs, in an advanced stage leading to protrusions and herniated intervertebral discs - the most common cause of back pain. Also, the pain intensifies when changing positions: getting up from a sitting position, trying to lie on your stomach, turning around, bending over.
- Spinal injuries, sprains and bruises, fractures.
- Spondylolisthesis - that is, the displacement of the lumbar vertebra relative to the underlying vertebra. The pain is localized in the middle of the back, is felt along the legs and is accompanied by numbness and / or weakness, aggravated by standing up or bending backwards.
- Fibromyalgia is a condition that causes pain in the muscles, ligaments and tendons. There is pain and stiffness in various parts of the body, the pain is aggravated when touched. Often the patient complains of poor sleep. More common in women between the ages of 20 and 50.
- Soft tissue and kidney injuries. A sharp sharp pain from the diseased kidney is characteristic of urolithiasis. Pain can occur in any position of a person. Another disease that has a symptom of discomfort in the lower back is pyelonephritis.
- Infections or infections of the spine and spinal cord, eg. osteomyelitis, discitis, spinal epidural abscess. The pain caused by this cause progresses, it does not depend on the position or activity of the patient. Sometimes there is a fever or night sweats.
- Local inflammatory processes, such as appendicitis or cholecystitis.
Back pain is divided into three types: local, radiant and reflex. Local pain is felt in the same place where its cause is, this type of pain is more common in lumbar syndromes. In this case, the most common cause is osteochondrosis of the spine, degeneration of the intervertebral disc, elongation or spasm of the deep muscles of the spine.
Radiant pain is dull and aching, most often it radiates to the leg and happens to reach the foot itself. This may accompany osteochondrosis in the herniated disc stage, 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, with heart disease, the arm, back, and shoulder blade can hurt. The pain is reflected from the internal organs to the lower back and has a deeply aching character, it does not depend on movements.
Back pain in men and women
In women, back pain can be the result of gynecological diseases. In this case, the discomfort is dull, pulling. Among these diseases in women - adnexitis, torsion of the ovarian cyst, salpingo-oophoritis, uterine fibroids and endometritis can be expressed as pain in the lower back. Pregnancy, due to the increased load on the spine and the increase in body weight, often causes back pain and is also possible during menopause. Back pain can also occur with an ectopic pregnancy - in this case it is unbearable.
The causes of back pain in men are often caused by excessive exercise, heavy lifting, spinal injuries, but can also indicate exclusively male diseases: prostatitis or epididymitis. The pathology of the prostate is characterized by pulling and aching pain, the patient often has problems with 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, it is necessary to contact kinesitherapists, if it is a pathology of the internal organs, then to a therapist, gastroenterologist, gynecologist, urologist, If the pathology is of rheumatic origin, then to a rheumatologist, in cases of neoplasm in the lower plane of the body, then to an oncologist.
First of all, for the diagnosis, the doctor interviews the patient, recognizing the nature of the pain: if it is acute or deaf, if it is pulling, if it depends on movement, activity, body position, if it is accompanied by other symptoms or not . After a verbal questioning, the doctor examines the patient, palpates the lumbar region, the muscles of the spine and the limbs. Additional examinations, laboratory tests, X-rays, MRI, tissue biopsy, electromyography may be needed.
For treatment, including depending on the disease, various means are used. In cases of osteochondrosis, scoliosis, spondyloarthrosis and other factors that cause spasms and inflammation in the deep muscles of the spine, the most commonly used are painkillers and anti-inflammatory drugs, but they do not directly affect the cause of the pain syndrome, they only eliminate its manifestation and they have many side effects. To address the cause of back pain, the following is suggested:
- power and stretching decompression exercises to relieve spasm of the deep muscles of the spine and eliminate pain,
- therapeutic massage to relieve tension in the muscles of the pathology area,
- cryotherapy to reduce pain locally,
- physiotherapy methods, such as shock wave therapy, acupuncture, apparatus massage, balneotherapy (mud applications, contrast treatments, etc. ),
Back pain prevention
The main prevention of various diseases of the musculoskeletal system is the prevention of the development of dystrophy, namely the weakening of the deep muscles of the spine, on the condition of which the nutrition of the vertebrae and intervertebral discs depends. Strengthening the muscles of the spine should be regular, and the most modern way for this is the author's method, that is, the use of power and decompression simulators. But the exercises can be performed even without simulators, there are a lot of them. It is important to take a break for gymnastics at work, especially if it is of the sedentary type, that is, every 3-4 hours, devote at least 15 minutes to this, just walk a couple of times a week for 1, 5-2 hours and do it at the morning in office.
According to the method, it is recommended to regularly perform several simple exercises to prevent back pain:
- relaxation of the back (the well-known "Cat" exercise): in the position on all fours, inhale - raise your head, bend your back down; exhalation: lowering of the head, rounding of the back;
- stretch step (in yoga, this exercise is called "Pigeon Pose"): in the position on all fours, you have to move one knee forward, the foot inwards and the other leg backwards, lying on your stomach on the thigh, palms under the shoulders. For the most effective stretch, move your arms diagonally to the sides and lower your head, pausing for 5-10 seconds. Return to the starting position and repeat for the other side.
- raise the pelvis to the supine position with the legs bent at the knees;
- press: in the supine position, bend the knees and arms at the elbows, holding the nape, press the chin to the chest as you exhale, raising the shoulder blades;
- knee press: in the prone position, pull your knees in turn towards your chest, pressing your hands to your body as you exhale, or do it while hanging.
All these exercises are very simple, you just need to do 10-15 repetitions for each exercise. With regular practice, they will bring you invaluable benefits!
Among the additional tips, a comfortable mattress can be placed so that the back muscles can relax during the night. If you spend a lot of time driving or working on the computer, take care of the correct body position. The car seat must be adjustable in height and close to the steering wheel and the backrest must be soft enough to withstand the bumps of rough roads.
While working or studying at the table, the elbows should be bent at right angles. The chair must necessarily have a backrest to support the lower back and the gaze (together with it and the neck) must be directed or slightly up, but not down. The light falls correctly on the work surface of the table.
Remember, prevention is more important than cure!