Back pain in the lumbar region

Back pain in the lumbar region is common to everyone. According to statistics, he is the cause of 25% of all requests for medical treatment. Its appearance can give rise to many different factors from superficial fatigue to quite serious illness. Therefore, you can not ignore the problem, especially if the discomfort often appears, and even more so over time. In such a situation, you should contact a therapist as soon as possible or go directly to a neurologist and undergo a thorough examination.This will allow the diagnosis of the disease in the early stages of development and take timely steps to stop its development. But if at the onset of pain there is an unsuccessful injury or fall, you should immediately register to consult a traumatologist or spine surgeon.

Characteristics of back pain and accompanying symptoms

Back pain can have different properties and severity. They can be loud, shooting, sore, pulling, and more. They can become stronger while doing physical exercise, sitting or standing for long periods of time, and passing while resting or not. All of these are important diagnostic factors that allow the doctor to make a correct diagnosis and find the real cause of the patient’s condition.

What is important in making a diagnosis is whether the pain is radiating to the hips, back, knees, legs, and if so, where and how. Also, the weight point is the presence of restriction of spinal mobility movement, whether the patient can tilt the body freely, rotate the body, or the distance of movement is reduced.

Pain in the spine is called lumbodynia. If it spreads to the feet, it is called lumboischialgia.

Acute pain is pain that persists for less than 3 months; otherwise, it talks about chronic pain. In the latter case, the disease often persists with periods of deterioration and remission.

Low back pain is rare separately. In most cases, there are other complexes of the disorder, in which the patients themselves rarely associate with each other. Often, back pain is combined with:

• feeling of crawling on the back and / or legs, numbness;
• muscle weakness;
• pain in hips, knee joints;
• pelvic organ disorders (menstrual irregularities, problems with potential, loss of urinary control, defecation);
• paralyzed.

Similar signs indicate spinal pathology.But because not only can they provoke the appearance of back pain, there are a bunch of other symptoms that can accompany lower back pain and indicate pathology of internal organs or cancer. Therefore, you need to be careful with your own situation when it appears:

• rapid and unnecessary weight loss;
• sores and pain in the groin, perineum;
• increased urination, pain;
• rising body temperature, chills;
• skin discoloration in the pain center area;
• menstrual irregularities, unusual discharge

If lower back pain is associated with one or more of the above symptoms, you must see a doctor immediately. When symptoms appear from the first group, consultation with a neurologist is required, from the second, the help of a urologist, gynecologist, endocrinologist or other narrow specialist is needed. The therapist will help you understand exactly which doctor to contact.

Cause

All causes of back pain in the lumbar region can be divided into 2 groups: diseases of the spine and pathology of internal organs, in particular, gynecological diseases, renal pathology, organs of the gastrointestinal tract, endocrine disorders. But still, it is often the result of the development of changes in the spine and surrounding muscles. The most common causes of back pain are:

• osteochondrosis;
• spondylosis;
• inflammatory diseases of the spine;
• myofascial syndrome;
• ankylosing spondylitis;
• scoliosis;
• injury.

However, lower back pain can also be caused by overwork or certain physiological changes. In such situations, they do not require special treatment, but only a decrease in physical activity and a more frugal day regimen.

Osteochondrosis and intervertebral hernia

Osteochondrosis is the most common spinal disease. Its development is often associated with inevitable age-related changes, as almost every parent has symptoms that are greater or lesser.

Osteochondrosis is the human price to pay for the ability to walk straight. It is characterized by gradual destruction of the intervertebral disc, its thinning, decreased elasticity and stiffness. As a result, they stop overcoming stress and may increase. Thus, an intervertebral hernia is formed.

Often, osteochondrosis affects the intervertebral disc of the lumbar spine. When they protrude into the spinal canal or foraminal foramen, nerves are almost inevitable, leading to the appearance of acute pain in the lower back and its irradiation to the legs and back.

Spondylosis

Spondylosis is a complication of advanced osteochondrosis, in which the intervertebral disc is almost completely destroyed, and due to the ongoing degenerative process and increased load on the spine, bone protrusions called osteophytes form along the edges of the vertebrae.Therefore, there is a high risk of crushing and injury to nearby nerves. This causes severe pain that can radiate to the feet.

Inflammatory diseases of the spine

Often, inflammatory diseases of the spine occur in young people, and especially in men. They cause disturbing pain even at night, which is their specific difference. As it progresses, if there is no timely treatment, the pain becomes more intense and bothers the person more often.

It is not uncommon for patients to seek medical help several years after the first symptoms appear. As a result of prolonged inflammatory processes in the spine, irreversible changes can occur, which can eventually lead to helplessness and disability.

Sometimes, in addition to lower back pain, there is discomfort in the joints of the legs and arms. In such cases, the cause of discomfort may be arthritis, osteomyelitis.

Myofascial Syndrome

Myofascial syndrome is a common pathology in which pain occurs after prolonged stay in an uncomfortable position or after physical exercise. Slightly more often, myofascial syndrome occurs in women. Thus, back pain occurs after careless movement or physical exercise. The distinguishing feature is the presence of the so-called trigger points on the spasmodic muscles in the lumbar and back areas, pressing which causes a sudden onset of pain. Myofascial syndrome significantly reduces the quality of human life, but does not pose a serious threat.

Bechterew's disease

Ankylosing spondylitis or ankylosing spondylitis is a chronic joint disease in which the sacroiliac joint, spinal joint and surrounding soft tissues are particularly affected. With this disease, people worry about back pain and sacrum pain as well as stiffness of movement, but symptoms usually disappear without a trace in the evening and at night.

In addition, physical activity has a beneficial effect on the well-being of the patient and contributes to the elimination of pain syndrome. Specific symptoms of ankylosing spondylitis are swelling, arcuate curvature of the spine and progressive mobility limitations.

Scoliosis

Scoliosis is the lateral curvature of the spine. This can be of varying severity, which directly affects the intensity of back pain and other symptoms. Because spinal deformities cause the displacement of all anatomical structures, nerves are often pinched, causing severe pain. In addition, other neurological signs may be present, including numbness and paresis.

Compression fractures

In the elderly who suffer from osteoporosis and trauma, lower back pain may be caused by an undetectable spinal fracture. As a result, the vertebrae are flattened and occupy an abnormal position, resulting in improper load distribution on the spine, degenerative processes on the intervertebral disc and the appearance of pain.

Physiology causes lower back pain

Doing hard physical work, intense sports training causes an increase in load on the muscles, as a result of which lactic acid accumulates in it, which causes pain. Back pain is not uncommon with wearing uncomfortable shoes for long periods of time, especially with heels.

Also, lower back pain is often observed during pregnancy. In such situations, it is caused by a shift in the center of gravity and an increase in pressure on the spine.

Diagnostics

To find out the causes of back pain in the lumbar region, it is recommended to see a neurologist. Initially, you can get a consultation from a therapist, but, most likely, the doctor will still refer the patient to a neurologist.

During the appointment, the specialist will conduct a thorough survey of the patient, find out what worries him, the lifestyle he leads, and more. Further, an examination is required, in which the doctor assesses the severity of the reflex, performs a neurological test and assesses the patient's mobility. Based on the results obtained, the doctor can make an initial diagnosis and understand the type of violation that causes the onset of back and back pain.

To confirm the existing assumptions, to determine the exact cause of the pain, a thorough examination of the patient is performed, which includes:

• General and biochemical blood tests - with its help, changes in the blood are detected, indicating inflammatory processes in the body, the presence of infections or tumors;
• general urinalysis - used to differentiate kidney disease as a cause of pain in the lumbar region;
• X-rays - show changes in spinal structure, signs of fractures, provide information on bone density and allow you to diagnose major spinal diseases, as well as osteoporosis (detection of spinal pathology is a reason for more thorough examination usingCT or MRI);

• CT is a modern radiation diagnostic method, which allows you to clearly describe all bone structures and detect slight deviations from the norm;
• MRI - provides comprehensive information on the condition of soft tissues and cartilage, including intervertebral discs, using MRI, you can diagnose intervertebral hernias in various measurements, changes in blood vessels, tumors.

Treatment of low back pain

Back pain treatment is chosen individually. At the same time, it is always complex and includes symptomatic therapies, lifestyle changes and treatments aimed at eliminating the causes of back pain found. Therefore, if the first 2 components of therapy are usually universal and prescribed to all patients, then etiotropic therapy is developed strictly individually, taking into account existing diseases.

In most cases, patients are initially offered conservative treatment, the main component of which is drug treatment. In more difficult cases, it is recommended to perform physiotherapy procedures, manual therapy and exercise therapy.

But in any case, all patients with back pain should:

• stop lifting heavy objects and tiring sports;
• to lose weight in the event of obesity;
• rest for a while to warm up if one has to sit for a long time;
• increase the level of physical activity, but avoid excessive work and hard work (daily walking, morning exercise, doing special exercise therapy complexes, swimming);
• to use a support bandage, which will relieve the load on the lower back and thus provide favorable conditions for early recovery of the spine.

Depending on the source of the pain, patients may be advised to stay in bed for a few days or, conversely, increase their level of physical activity, but within reasonable limits. For example, pain caused by nerve stress requires you to rest your back for a few days. In other diseases, on the other hand, moderate physical activity is one of the components of mandatory therapy. It helps to increase the effectiveness of drug treatment, reduce the risk of complications and prevent disability.

Unfortunately, conservative therapy cannot always be used to treat back pain. In some cases, it turns out to be ineffective and does not give results even after several months of adhering to medical recommendations. In other situations, the results of examination indicate the presence of pathology that can no longer be eliminated by non-surgical methods. In such situations, patients are advised to consult a neurosurgeon and perform appropriate surgical interventions to restore normal spinal anatomy.

Drug therapy

To improve the patient's condition and get rid of pain quickly, here are the following:

• NSAIDs in the form of tablets, injections and topical preparations - have analgesic and anti-inflammatory properties;
• corticosteroids - given in a short course to control severe inflammation;
• muscle relaxation - needed to relieve muscle spasms, which is often the body's reflex reaction to pain and worsening it;
• Vitamin B - improves nerve conduction by normalizing nerve fiber nutrition and increasing the speed of nerve impulse transmission.

For severe intolerable pain, blockage may occur. This procedure involves the injection of anesthetic solution directly into the sore area or nerve fibers. Therefore, it is possible to temporarily stop the pain syndrome completely and improve the well-being of the patient.

But the restriction has only a temporary effect, and its implementation is only possible in medical institutions, as it is most often necessary to inject the drug into points located around the spine, where nerve mass passes. Thus, the implementation of illiterate procedures can result in severe and sometimes fatal consequences.

In addition to the medications listed above, another set of medications is prescribed, which helps eliminate the underlying disease that causes the pain syndrome. Therefore, patients can also be given antibiotics, chondroprotectors, immunomodulators and other group drugs.

Physiotherapy

Physiotherapy treatment is often prescribed for patients with spinal disorders. Thanks to the method of physical impact and frequency of properly selected procedures, it is possible to achieve anti-inflammatory effects, clear analgesics, as well as improve microcirculation, accelerate the elimination of local edema, muscle spasms, and others. Physiotherapy significantly increases the effectiveness of other treatment methods, but is used only after removal of the acute process.

Often, patients are prescribed:

• electrophoresis;
• UHF;
• ultrasound therapy;
• magnetic therapy;
• reflexology;
• diadynamic currents, etc.

As a rule, the procedure consists of 8-10 sessions, which are carried out at a certain frequency.

Manual therapy

With osteochondrosis, scoliosis and a number of other diseases, manual therapy sessions can have a profound effect on the condition of the spine. But only a qualified chiropractor can perform a manual therapy session competently and benefit the patient, not the danger.

The use of special techniques of manual exposure makes it possible to achieve not only an increase in microcirculation, relaxation of muscles that are too tight and too relaxed, but also an increase in distance between the vertebrae, as well as the normalization of their position. A qualified chiropractor can find the place where the nerve is pinched and relieve the pressure of the anatomical structure on it.

Literally, after the first session, the majority of patients saw an increase in their well-being and a significant decrease in the severity of the pain syndrome until it was completely eliminated. But to combine the results obtained, it is recommended to undergo a complete manual therapy course, and in the future to take a support course.

exercise therapy

Physical therapy helps the body cope with the stress. For each disease, a special set of exercises has been developed, its regular implementation enabling the completion of the most important tasks in the current situation. Therefore, with the help of properly chosen physiotherapy exercises, it is possible to restore the muscles to a normal tone and strengthen them. Thanks to this, the spine will experience less stress, which will be an effective prevention of disease progression and create favorable conditions for its recovery.

Exercise therapy also helps to improve blood circulation in the affected area, which speeds up the course of the inflammatory process and leads to full recovery. Proper exercise for many conditions can help reduce back pain and reduce the frequency of its occurrence.

The training program is developed individually for each patient. This takes into account not only the type of pathology detected and its severity, but also the presence of concomitant disease, the level of physical fitness of the patient, his age and other factors. Only a specialist can choose the most effective and safe set of exercises correctly.

Under his supervision was held first class. In their journey, patients learn to perform each of the proposed exercises correctly so as to be beneficial. Gradually, the load increases, bringing it to the optimum level. But it is not recommended to increase the number of repetitions of the exercise itself or to complicate it. Any changes to the physical therapy program are only introduced by a specialist.

Patients only need to follow their recommendations and practice every day in a comfortable environment. All exercises are done at a slow pace. Sudden movements are not allowed. But if pain arises during the lesson, training should be stopped immediately and see your doctor as soon as possible.

Surgery for back pain

Often, the help of a spine surgeon is needed for an intervertebral hernia, the formation of which has led to a violation of the roots of the spine and the development of radicular pain. If a bulge is already formed, it is impossible to force it to be pulled back in a non-invasive modern way. The only way to get rid of it and at the same time to get rid of lower back pain is to remove the intervertebral hernia with surgery.

There are several types of surgery used for intervertebral hernias. Specific tactics of surgical intervention are determined by the type, location and size of the hernia:

• Nucleoplasty and hydroplasty are methods of percutaneous surgery that make it possible to remove part of the nucleus pulposus through a puncture of tissue with a diameter of a few centimeters and reduce the size of the hernia.
• Microdisceectomy is a radical method of solving intervertebral hernia problems, which implies the removal of it or the entire disc through a 3 cm incision. But, unlike other methods, it allows you to get rid of a hernia of any size, regardless of its location in the spinal canal, and release the pinched nerve even in the most difficult parts of the spine.
• Endoscopic surgery - involves the removal of a disc herniation through a puncture with a diameter of up to 1 cm using special equipment with a video camera. It can be used to pull hernias of various sizes, but this technique cannot be used to remove neoplasms in anatomically difficult places.

Also, the help of a spine surgeon is needed for scoliosis. In this case, all forces are directed to restore the normal axis of the spine. Previously, this required making large incisions that extended almost the entire back. But today it is possible to correct spinal deformities in a minimally invasive manner through small incisions.

Various types of metal structures are used to restore the normal axis of the spine, but the essence is almost the same. The structure is glued to the vertebrae with special screws and by adjusting its tension at different points it is possible to return the transferred vertebrae to its place and fix it in the correct position. This type of modern metal structure makes it possible, over time, to improve the initial results of operation without re-intervention in the body. This is achieved by correcting the position of the mounted structure using special screws.

Surgical intervention is unavoidable in the event of a spinal fracture. In such cases, removing back and lower back pain can only be done by restoring the normal shape, size and position of the vertebrae. Recently, kyphoplasty and vertebroplasty have been performed for this purpose. The essence of these two operations stems from the fact that through a thin puncture needle, special bone cement is injected into the vertebrae that have been destroyed by injury. It fills all the empty space and hardens after 10 minutes. But in severe compression fractures, priority is given to kyphoplasty, as it can also help restore the normal shape of the vertebrae, which will ensure proper load distribution on the spine in the future and reduce the risk of complications. The operation involves the initial introduction of a special balloon into the shattered vertebrae, which gradually expands, restoring the vertebrae to re-appearance. Afterwards, the balloon is lowered and removed, and the formed cavity is filled with bone cement.

Thus, back pain can occur as a result of physiological changes, normal muscle fatigue, or serious pathological symptoms of the spine or internal organs. Therefore, if it happens periodically and especially against the background of the action of the same factors, you should not hesitate and ignore the problem. Contact a qualified specialist so that treatment is as quick and easy as possible. And if the disease is undetectable in the early stages of its development, modern neuropathic surgery will make it possible to remove it surgically with minimal risk of complications.