Most people, mostly middle-aged and older, experience back pain in the lumbar region, and both men and women suffer equally. Pain can occur after physical exertion, hypothermia, lifting and carrying a weight, or as a result of prolonged immobility. "Entered the back" - this is how patients often characterize back pain.
It should be noted that soreness of varying intensity is experienced mainly by people of active age who are no 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 most often in an upright position, the muscles hardly rest.
The vulnerability of the lumbar spine is due to the presence of its weak points: the Petit triangle and the Grunfeld-Lesgaft quadrangle (rhombus). The Petit triangle has a weakly expressed muscle layer and is a small gap between the end edges of the latissimus and the external oblique muscle. The Grunfeld-Lesgaft rhombus does not cover the oblique abdominal muscles from above, it is poorly strengthened, therefore it is prone to the formation of lumbar hernias.
The psoas is the deepest muscle in the body. It affects flexibility, strength, range of motion and mobility of joints, and the work of internal organs. It is this muscle that is responsible for maintaining the vertical position of a person and takes an active part in lifting the legs when walking.
Proper psoas function provides support for the entire upper body and provides a platform for the viscera of the abdomen. With frequent contraction due to stress or overexertion, this muscle begins to shorten, which can lead to lower back pain, compression of nerve endings, deformation 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 the state of vital organs.
Low back pain as a symptom
The lower back may hurt 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 spasm.
Local pain syndrome in the lumbar region is permanent, its intensity depends on the position of the body. In addition, soreness increases with movement and palpation of a specific area. With this form of pain, the mobility of the trunk and lower extremities 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 occurs as a result of compression of nerve endings that transmit signals to the appropriate part of the brain. At the same time, painful sensations spread along the affected nerve and increase with turns and tilts of the body. During hard work or exercise, throbbing pain is noted, the origin of which is associated with axial load on the spinal column.
Radicular pain syndrome is characterized by suddenness and pronounced intensity: this is what patients mean when they say that their back is "grabbed". The pain is so acute that a person cannot straighten out and is often forced to remain in the position in which the radicular lumbago overtook him.
In the absence of movement, the radicular pain syndrome also does not go away and acquires an aching character. However, attempts to move are accompanied by severe spasms and sharp, burning lumbago. In the overwhelming majority of cases, it shoots not only in the lower back, but also in the entire leg to the ankle. Distinctive features of radicular pain is its intensification when turning to the side, bending and lifting straight legs from a prone position.
Reflected pain syndrome indicates damage to internal organs. This is due to the fact that the lumbar spine and tissues near 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 indistinct, blurred, persists with movement and does not increase with pressure.
Lower back pain can be acute or chronic. If this symptom bothers no more than three months, they speak of an acute form. If during this time the damaged tissue is not restored, it becomes chronic.
Low back pain is classified by mechanism of occurrence and can be nociceptive, neuropathic and psychogenic. The nociceptive type appears when pain receptors - nociceptors are irritated and is caused by tissue damage due to mechanical injury or local inflammation (sprains, bruises).
Hernia is one of the consequences of osteochondrosis, it is manifested by the protrusion of the intervertebral disc between the vertebral bodies.
Neuropathic pain accompanies the pinching of the nerve roots of the intervertebral hernia. They differ in irradiation (recoil) to 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.
The psychogenic type is a rare phenomenon that can be caused by a traumatic situation or impaired functioning of the nervous system.
This classification is conditional, since most often all three types cause pain to one degree or another. To define painfulness, 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 likened to a lightning or electric shock. Lumbodynia begins gradually and is characterized by aching pains mainly in the lower part of the lower back, at the end of the spine.
With lumbodynia, the back does not constantly hurt; pain occurs after a long stay in a motionless position or bending of the trunk. It is difficult for patients to bend over and perform even simple activities such as washing, brushing teeth or ironing clothes. They are looking for the most beneficial position to relieve tension in the psoas and ease their condition.
Lumboischialgia is a pain syndrome that affects the lumbar region, buttocks, and the posterior-outer part of one or both legs. It gets worse with any movement, including coughing or sneezing.
Most often, the lower back hurts due to muscle strain, especially when training too intensely or performing unusual physical work. In this case, the provocateur of pain is the rupture of the connective fibers in the places of muscle attachment.
Among the pathologies that cause this symptom, the following should be noted:
- intervertebral hernia.The main signs are sharp pain that appears unexpectedly, a feeling of stiffness, stiffness in the back, weakness in the lower extremities;
- compression fracture of the spine. Occurs with injuries, osteoporosis and tumors;
- cauda equina syndrome.This complex of symptoms is caused by compression of a massive nerve bundle located between the first lumbar vertebra and the coccyx. It manifests itself as severe pain on the right or left behind, at the waist level and below. Pain syndrome radiates to one or both limbs and the groin area. The progress of the disease leads to impaired tactile sensitivity and severe weakness in the legs. If untreated, severe complications develop, including disability;
- acute abdominal aortic aneurysm.Pain and heaviness in the lower back is often the only symptom of this condition. Most often diagnosed in elderly people suffering from atherosclerosis and complaining of night stitching pains;
- infectious lesions.Pulling and dull pains in the lower back provoke chronic bacterial infections of the skin, urogenital and respiratory systems, impaired functioning of the immune system, taking hormonal drugs. In addition to pain, there is discomfort in the abdominal and groin areas, behind the sternum;
- neoplasms.Soreness disturbs both day and night, gradually increasing. As a rule, there is a sharp weight loss without obvious reasons. Tumors are diagnosed most often in people over 50 years of age with a history of cancer.
Girdle pain may occur with pathologies of the gastrointestinal tract. 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 acutely ill, and the pain is excruciating, unbearable, one can assume an exacerbation of urolithiasis when the formed stone moves along the urinary tract.
The treatment of 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 in the lower extremities must be eliminated as soon as possible. If you do not give anesthesia on time and allow the chronicity of the pain syndrome, then the prerequisites for the development of psychogenic disorders will be created. Layering on clinical symptoms, they slow down the healing process and weaken its result. 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 the lower back aches severely, therapeutic blockades are used.
Analgesic drugs are weak, moderate, and powerful. The latter allow you to quickly relieve pain, but they have many side effects. Their use is justified in cases of severe damage to the intervertebral discs and compression of nerve endings.
Modern pharmacology offers medicinal patches with different components - anti-inflammatory, warming, chondroprotective and herbal supplements.
If 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 a triple effect are most often used. They not only relieve pain, but also suppress inflammation, lower body temperature.
NSAIDs are used in tablets or injections, and in the form of ointments or gels.
The use of 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 throbbing caused by inflammation are controlled by hormonal drugs.
Sometimes the only remedy for pain relief is with blockages. An injection turns off one of the links of the pathological chain, as a result of which the pain impulse does not reach the back, legs and internal organs. Blocks can be used for diagnostic purposes to establish the true cause of pain.
After the injection, the pain disappears in a matter of minutes, the procedure itself resembles taking a puncture. The indications for its implementation are as follows:
- osteochondrosis and its complications - protrusion and herniated discs;
- spondyloarthrosis (calcification of the vertebral joints).
Attention:blockades are performed only in a sterile hospital environment. 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 lethal outcome is not excluded.
Medical blockades are carried out no more than four times a year, if necessary, a course of 10 injections or more can be prescribed. Between them, you definitely need a 5-7-day break. Solutions for blockade injections contain several components, the main ones being pain relievers. Corticosteroids are added to relieve inflammation. The composition for injections can also include vitamins, thrombolytics, enzymes. To normalize nerve-impulse transmission, ATP is introduced into the solution.
What to do after acute symptom relief depends on the type and severity of the illness. Patients can be assigned massage, exercise therapy and physiotherapy.
Most effective for lumbar pain:
- electrophoresis with special preparations;
- mud wraps;
- paraffin and ozokerite applications;
- turpentine and pearl baths;
- amplipulse therapy;
- muscle electrical stimulation;
To stabilize the vertebrae and reduce the load on the muscles of the lower back, doctors recommend using orthopedic corsets. They are especially effective for chronic pain caused by damage to the vertebral structures. The use of applicators allows to speed up recovery.
The positive impact of these products is as follows:
- pain syndrome is eliminated or noticeably 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 remission, with minimal or no pain. A strong muscular corset is an excellent prevention of most diseases of the musculoskeletal system.
Attention:high power loads, sharp turns of the trunk, jumping, running and swinging legs are prohibited.
Thus, back pain is a signal of trouble in the spinal column or internal organs. In order to prevent chronicity of the pathological process and prevent possible complications, it is necessary to consult a specialist.