Back pain in the lumbar region

causes of back pain in the lumbar region

Back pain in the lumbar region is experienced by most people, mostly middle-aged and older, and men and women suffer equally. Pain can occur after physical exertion, hypothermia, lifting and holding a weight, or as a result of prolonged immobility. "Entered the back" - this is how patients often characterize back pain.

Reasons

It should be noted that grief of varying intensity is experienced mainly by people of active age who are not more than 60 years old. This is due to the constant work of the muscles that support the spine and its natural curves. Since the person is more often in a vertical position, the muscles hardly relax.

The sensitivity of the lumbar spine is due to the presence of its weak points: the Petit triangle and the Grunfeld-Lesgaft (rhombus) quadrilateral. The Petit triangle has a poorly expressed muscle layer and is a small gap between the end edges of the latissimus and the oblique outer muscle. The Grunfeld-Lesgaft rhombus does not cover the oblique abdominal muscles from above, it is weakly strengthened, therefore it is prone to the formation of lumbar hernias.

Psoas is the deepest muscle in the body. Affects the flexibility, strength, range of motion and mobility of the joints and the work of internal organs. It is this muscle that is responsible for maintaining a person’s vertical position and takes an active part in raising the legs when walking.

Proper psoas function provides support for the entire upper body and provides a platform for the internal organs of the abdomen. With frequent contractions due to stress or overload, this muscle begins to contract, which can lead to lower back pain, compression of nerve endings, deformity of the vertebrae, and the development of degenerative processes in the joints. Chronic spasm of the psoas muscle has an extremely negative effect on posture, depth of breathing and condition of vital organs.

Low back pain as a symptom

The lower back can be damaged due to problems with the spine or due to systemic diseases. Clinically, several forms of pain syndrome are distinguished: local, projection, reflected, radicular (radicular) and caused by muscle spasms.

Local pain syndrome in the lumbar region is permanent, its intensity depends on the position of the body. In addition, grief increases with the movement and touch of a particular area. With this form of pain, mobility of the trunk and lower limbs can be limited.

Projection pain syndrome is caused by damage to the vertebral and paravertebral (paravertebral) structures. It can be diffuse or local in nature and arises from the compression of nerve endings that transmit signals to the right part of the brain. At the same time, the painful sensations spread along the affected nerve and increase with the twists and turns of the body. During heavy work or physical exercise, pulsating pain is observed, the origin of which is accompanied by axial load on the spine.

Radicular pain syndrome is characterized by suddenness and pronounced intensity: this is what patients mean when they say their back is "caught". The pain is so acute that a person can not direct and is often forced to stay in the position in which he passed a radicular lumbago.

In the absence of movement, the radicular pain syndrome also does not disappear and takes on a painful character. However, attempts to move are accompanied by violent spasms and sharp and fiery shots. In the vast majority of cases, it shoots not only the lower back, but also the entire leg at the ankle. The distinguishing features of radicular pain are its intensification when you turn sideways, bend and straighten your legs straight from a prone position.

Reflected pain syndrome indicates damage to internal organs. This is due to the fact that the lumbar spine and tissues close to the pathological focus are innervated by the same nerve. Since the pain goes from the inside of the body to the surface of the back, the pain is vague, vague, continues with movement, and does not increase with pressure.

Low back pain can be acute or chronic. If this symptom does not bother you for more than three months, they talk about an acute form. If during this time the damaged tissue does not recover, it becomes chronic.

Classification

Low back pain is classified by the mechanism of occurrence and can be nociceptive, neuropathic and psychogenic. The nociceptive type occurs when pain receptors - nociceptors - are irritated and caused by tissue damage due to mechanical damage or local inflammation (spasm, bruising).

why it hurts back in the lumbar region and what to do

Hernia is one of the consequences of osteochondrosis, it is manifested by the elongation of the intervertebral disc between the vertebral bodies.

Neuropathic pain accompanies the scratching of the nerve roots of the intervertebral hernia. They differ in radiation (attraction) in the lower extremities and are combined with numbness and some stiffness of movements. Such pain does not go away on its own and is, as a rule, chronic.

Psychogenic type is a rare phenomenon, which can be caused by a traumatic situation or impaired functioning of the nervous system.

This classification is conditional, as most often all three types cause pain to one degree or another. To define pain, doctors use several terms: lumbago, lumbodynia, and lumboischialgia.

Lumbago is a sudden onset of pain, the onset of which is described by patients as "rupture", "shock" and is compared to a lightning or electric shock. Lumbodinia begins gradually and is characterized by excruciating pain mainly in the lower back, at the end of the spine.

With lumbodynia, the spine does not hurt constantly; pain occurs after a long stay in a stationary position or bending of the trunk. Patiently difficult for patients to bend over and perform even simple activities such as brushing, brushing teeth or ironing clothes. They are looking for the most beneficial posture to relieve tension in the psoas and alleviate their condition.

Lumboischialgia is a pain syndrome that affects the lumbar region, buttocks and back-outer part of one or both legs. It gets worse with every movement, including coughing or sneezing.

Possible pathologies

Most often, the lower back hurts due to muscle strain, especially when you train very intensively or when you do unusual physical work. In this case, the provocateur of pain is the rupture of the connecting fibers at the points of connection of the muscles.

Among the pathologies that cause this symptom, the following should be noted:

  • intervertebral hernia.The main signs are sharp pain that appears suddenly, a feeling of stiffness, stiffness in the back, weakness in the lower extremities;
  • spinal compression fracture. Occurs with injuries, osteoporosis and tumors;
  • cauda equina syndrome.This complex of symptoms is caused by the compression of a massive nerve bundle located between the first lumbar vertebra and the coccyx. Manifested as severe pain in the right or left behind, at waist level and below. Pain syndrome radiates to one or both limbs and the groin area. Progression of the disease leads to palpable impaired sensitivity and severe weakness in the legs. If left untreated, serious complications develop, including disability;
  • Acute abdominal aortic aneurysm.Pain and heaviness in the lower back are often the only symptoms of this condition. It is most often diagnosed in older people suffering from atherosclerosis and complaining of pain at night sutures;
  • infectious lesions.Drawing and dull pain in the lower back provoke chronic bacterial infections of the skin, urogenital and respiratory systems, impaired immune system function, taking hormonal medications. In addition to pain, there is discomfort in the areas of the abdomen and hips, behind the sternum;
  • neoplasm.The pain bothers both day and night, gradually increasing. As a rule, there is a sharp weight loss for no apparent reason. Tumors are most often diagnosed in people over the age of 50 with a history of cancer.

With gastrointestinal tract pathologies, generational pain may occur. The feeling that pulls the lower back, often accompanies gynecological diseases. Congenital skeletal defects and metabolic disorders can also cause pain in the lower back.

Attention:if the lower back is severely sore, and the pain is excruciating, unbearable, we can assume a worsening of urolithiasis when the stone formed moves along the urinary tract.

Treatment

Treating low back pain of any origin is one of the most challenging medical fields. All modern studies on this topic say one thing: acute pain in the lower back and lower extremities should be eliminated as soon as possible. If you do not relieve the pain in time and allow the chronicity of the pain syndrome, then the preconditions for the development of psychogenic disorders will be created. By setting in clinical symptoms, they slow down the healing process and weaken its outcome. Therefore, first of all, they relieve pain, regardless of their intensity.

Nonsteroidal anti-inflammatory drugs and analgesics are needed to relieve pain. In severe cases, when it is very painful for a person to walk and lower back pain is used, therapeutic blockades.

how to treat low back pain

Analgesic drugs are weak, moderate and strong. The latter allow you to quickly relieve pain, but they have many side effects. Their use is justified in case of severe damage to the intervertebral discs and compression of the nerve endings.

Modern pharmacology offers therapeutic patches with various ingredients - anti-inflammatory, warming, chondroprotective and herbal supplements.

If the pain is mild or moderate, your doctor will prescribe analgesics. In case of damage to the paravertebral structures, non-steroidal anti-inflammatory drugs - NSAIDs with triple effect are most often used. They not only relieve pain, but also suppress inflammation, low body temperature.

NSAIDs are used in tablets or injections, and in the form of oils or gels.

Using plasters shows good results. B vitamins, which doctors prescribe in injections or pills, help to cure low back pain.

Muscle spasms often provoke severe pain syndrome, which helps muscle relaxants. Severe pain and beatings caused by inflammation are controlled by hormonal medications.

Healing blocks

Sometimes the only remedy for pain relief is blockage. An injection turns off one of the links of the pathological chain, as a result of which the pain impulse does not reach the spine, legs and internal organs. Blocks can be used for diagnostic purposes to determine the true cause of pain.

After the injection, the pain goes away in a few minutes, the procedure itself is like getting a puncture. The indications for its implementation are as follows:

  • osteochondrosis and its complications - protrusion and herniated discs;
  • mioziti;
  • neuralgia
  • ;
  • spondyloarthritis (calcification of the vertebral joints).

Attention:blockades are only performed in a sterile hospital setting. This is due to the fact that the spinal cord is vulnerable to the penetration of various pathogenic microorganisms. When infected with a virus, a fatal outcome is not ruled out.

Medical blockades are performed no more than four times a year, if necessary, a course of 10 injections or more may be prescribed. Among them, you definitely need a 5-7-day break. Solutions for blockade injections contain several ingredients, the main ones being pain relievers. Corticosteroids are added to relieve inflammation. Ingredients for injection may also include vitamins, thrombolytics, enzymes. To normalize nerve impulse transmission, ATP is introduced into the solution.

Physiotherapy

What to do after the relief of acute symptoms depends on the type and severity of the disease. Patients may be assigned massage, exercise therapy, and physiotherapy.

Most effective for low back pain:

  • electrophoresis with special preparation;
  • mud wrappers;
  • paraffin and ozokerite applications;
  • turpentine and pearl baths;
  • amplipulse therapy;
  • electrical muscle stimulation;
  • acupuncture.

To stabilize the vertebrae and reduce the load on the muscles of the lower back, doctors recommend the use of orthopedic corsets. They are especially effective for chronic pain caused by damage to vertebral structures. The use of applicants allows acceleration of recovery.

The positive impact of these products is as follows:

  • pain syndrome is eliminated or significantly reduced;
  • the state of the nervous system is normalized;
  • increases vitality and efficiency;
  • metabolic processes in the body are accelerated;
  • Spasmodic muscles relax.

Therapeutic exercises can only be done during the remission period, with minimal or complete absence of pain. A strong muscular corset is an excellent prevention of most diseases of the musculoskeletal system.

Caution:High power loads, sharp luggage turns, jumping, running and rocking legs are prohibited.

Thus, back pain is a signal of a problem in the spine or internal organs. To prevent the chronology of the pathological process and to prevent possible complications, it is necessary to consult a specialist.