Pain in the lower back is quite common. It can be caused by ordinary fatigue and serious injuries and pathologies. If the pain is severe or does not disappear after rest, it is important to consult a doctor to rule out dangerous conditions.
What can lower back pain be like?
Lower back pain can be sharp or aching, come on suddenly or gradually increase, occur with loads or certain movements (for example, bending over), or persist regardless of what the person does.
The pain can be point-like or radiating (that is, it spreads to other areas). In this case, the person has pain not only in the back in the lumbar region, but also in other parts of the body, such as the lower abdomen, perineum, leg or buttocks.
Lower back pain may include stiffness of movement or muscle spasms. The person may have difficulty bending over or rising from a lying position, standing with a straight back, or maintaining posture when walking.
If the pain is caused by a muscle spasm or a pinched nerve, it can be excruciating and even disabling. Such pain forces you to stay in bed until you get medical help.
Why does my lower back hurt?
The most common cause of pain in the lower back is one or another pathology of the musculoskeletal system: sprains, pinching, inflammation. They are often found in men who work with their hands, athletes and young mothers.
Also, discomfort in the lower back can be a sign of acute or chronic diseases of the internal organs. This happens due to the fact that pain impulses can be transmitted along nerve fibers to neighboring regions. In this case, they say that the pain "radiates" to the lower back.
Diseases of the musculoskeletal system that cause pain in the lower back
Most often, pain in the lower back is caused by injuries and pathologies of the musculoskeletal system - muscle and ligament sprains, spinal injuries, hernias and protrusions of intervertebral discs, joint inflammation, bone diseases.
Deformations and stretching of muscles and ligaments
Such injuries can occur due to awkward movement if a person lifts something very heavy or does not observe precautions when handling bulky objects. You can also injure yourself while playing sports or if you simply sneeze unsuccessfully.
Lower back pain can occur if you lift heavy objects without following safety precautions.
In the case of sprains and strains, the pain intensifies during movement, and muscle spasms may also occur. It may be painful for a person to walk, bend forward, or keep their back straight.
The diagnosis of deformations and stretching of muscles and ligaments is based on the data of physical examination and instrumental studies - ultrasound, X-ray, magnetic resonance of the lumbar region. If you suspect a sprain or deformation of muscles or ligaments, consult an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms using ice packs, pain relievers, and muscle spasm relievers (muscle relaxants). It is important to rest the damaged area to allow the tissue to heal - this usually takes about 2 weeks. After that, it is important to start rehabilitation: physical therapy exercises aimed at restoring muscle function are indicated.
Without treatment, sprains and strains lead to limited mobility: trying not to injure the damaged area, the person reduces activity, which can lead to weight gain, decreased bone strength and loss of muscle mass.
Spinal injuries
Damage (usually a fracture) to one or more vertebrae occurs as a result of falls, accidents, sports or household injuries. In people with bone density disorders (such as osteoporosis), such damage can be caused by even minor exposures.
The treatment of spinal injuries is to prevent displacement and further deformation of the spinal discs. If the damage is not serious, it is recommended to sleep on a hard surface and limit physical activity. If the damage is significant, surgical methods are used for fixation.
Without treatment, damage to the spinal discs can cause stenosis (narrowing) of the spinal canal, neurological disorders, including sciatica - compression of the nerve fibers that extend from the spine.
Intervertebral disc pathologies
Intervertebral discs are fibrocartilaginous plates with jelly-like contents located between the vertebrae. They act as shock-absorbing cushions for the vertebrae, ensuring their mobility. Discs can become displaced (bulging) or ruptured (herniated), causing severe pain and limiting spinal mobility.
Intervertebral hernias and protrusions can appear in people with weak muscles and excess weight, in those who lead a sedentary lifestyle or lift heavy objects. People who smoke are more susceptible to intervertebral disc pathologies.
Intervertebral hernia - protrusion of the intervertebral disc into the spinal canal
Treatment consists of alleviating pain and inflammation - rest, painkillers, ointments and compresses on the inflamed area are recommended. A doctor may prescribe physical therapy or exercise therapy. With moderate damage, the disc can recover if the cause of the herniation or protrusion is ruled out - for example, strengthening the muscle corset, reducing weight and not overloading the spine.
If the lower back pain is so severe that it interferes with daily activities, does not go away within 1-1. 5 months, or if the symptoms worsen, you should consult your doctor again. In some cases, steroid therapy or even surgery may be required. With age, it is possible to develop a degenerative disease of the intervertebral discs - they become flatter and have a weaker cushioning function, which can also cause pain. In this case, treatment includes pain relief and general improvement of the body.
Scoliosis of the lumbar spine
Scoliosis (curvature) of the spine is a displacement of the spinal column to the right or left in relation to the vertical axis. Pathology leads to increased pressure on certain areas of the intervertebral discs and vertebrae, as well as pinching of tissues and nerve fibers. Scoliosis can cause severe pain in the lower back on the right or left side - where most of the stress is - and severely limit the mobility of the spine.
Scoliosis (curvature) of the spine can cause severe pain in the area of the lower back where it is under a lot of stress
Scoliosis can occur due to the weakening of the muscle corset in the absence of sufficient physical activity, a sedentary lifestyle (in schoolchildren, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and curvatures are formed.
Treatment includes the introduction of balanced physical activity (physical therapy, swimming), massage and manual therapy, physiotherapeutic procedures for muscle strengthening, such as electrical stimulation. For severe injuries, wearing a corset is recommended to help maintain the correct position of the spine.
Arthritis and arthrosis
Inflammation and degenerative processes in the joints of the spine can also cause severe pain in the lower back. There are many forms of arthritis, including osteoarthritis (damage to cartilage and adjacent tissues), ankylosing spondylitis (ankylosing spondylitis - damage to the joints of the spine, which leads to fusion of the vertebrae).
Arthritis can be caused by natural aging, genetic predisposition or autoimmune diseases.
Arthritis treatment, depending on its form, may include the use of non-steroidal and steroidal anti-inflammatory and painkillers, physiotherapeutic procedures (magnetotherapy, electrophoresis), therapeutic massage and physical therapy.
Physiotherapy procedures help relieve pain due to joint pathologies
Spondylolisthesis
Displacement of the vertebra in relation to the spinal column (spondylolisthesis) occurs as a result of injury or degenerative processes in the spine. Pathology occurs in athletes, elderly people or people with a hereditary predisposition to bone diseases (for example, osteoporosis - a disorder of bone density). Spondylolisthesis can lead to severe pain in the lower back, buttocks and legs, and cause leg cramps or weakness.
Treatment involves relieving pain and inflammation caused by compression of adjacent tissues by the vertebra. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal painkillers in tablets or corticosteroid injections. At the same time, physiotherapeutic procedures and exercise therapy are prescribed to strengthen the muscles and restore the position of the vertebrae. If spondylolisthesis is accompanied by very severe pain, surgical treatment is applied.
In traumatic and non-infectious pathologies of the musculoskeletal system, pain in the lower back usually subsides or decreases when a person takes a comfortable position.
If spondylolisthesis is accompanied by severe pain, the doctor may prescribe corticosteroid injections.
Infectious diseases of the spine
Inflammation of the bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe pain in the lower back. These pathologies are, as a rule, secondary in nature, that is, they arise as a complication of inflammation of other organs (the infection enters the tissues through the bloodstream).
Treatment involves hospitalization, lasts up to 1 month, and then requires rehabilitation that lasts from 6 to 12 months.
Tumor diseases of the spinal column
Neoplasms can develop under the influence of hereditary or external factors (for example, radiation), but most often occur as repeated foci (metastases) in cancers of other organs - lungs, mammary glands, prostate, thyroid gland, kidneys.
One of the most characteristic symptoms of tumor pathologies is pain that does not subside when changing position or after resting. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sudden increase in body temperature with chills are also possible. Without treatment, symptoms worsen.
Treatment is prescribed depending on the type of tumor, its location and symptoms, and may include chemotherapy, radiotherapy and surgical removal of the tumor. Pain relief is carried out with non-hormonal or steroid drugs. To stabilize the spine, your doctor may prescribe wearing a corset.
Orthopedic corset helps to stabilize the spine
Diseases of internal organs that cause pain in the lower back
Pain in the lower back can occur in diseases that are not related to pathologies of the spine and adjacent tissues. Acute or painful, it can accompany inflammation of internal organs: pyelonephritis, urolithiasis, aneurysm of the abdominal aorta. In women, lower back pain can develop due to gynecological pathologies.
Urolithiasis disease
A disease in which stones are formed in the kidneys and bladder - hard formations from the sediment of the chemical components of urine. Pain in the lower back is one of the main signs of pathology. Depending on the size and location, a kidney stone can cause a dull aching pain that comes and goes, or a very sharp pain that does not go away on its own and requires immediate medical attention.
Urolithiasis - formation of stones in the kidneys and bladder
If you suspect a kidney stone, consult a urologist or nephrologist. The doctor will prescribe tests and instrumental studies (ultrasound, X-ray examination, computerized tomography, including the use of a contrast medium) in order to make a diagnosis and choose treatment tactics.
Treatment is prescribed taking into account the size, nature, location of stones and other factors. If the stone is small (5-10 mm) and there are no other indications for surgical removal, drug treatment is used. If there are no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.
Aneurysm of the abdominal aorta
Weakening of the walls of the abdominal aorta (aneurysm) can lead to life-threatening conditions such as aortic rupture and intra-abdominal bleeding. As a rule, the pathology occurs in the elderly: the risk group includes men over 65 years old and women over 70 years old, including smokers, those suffering from vascular diseases (high blood pressure), who previously had aneurysms or have a hereditary predisposition tothem.
Lower back pain due to an abdominal aortic aneurysm does not stop with time and may be accompanied by abdominal and leg pain.
If an aneurysm is suspected, abdominal ultrasound and computed tomography are prescribed.
Treatment depends on the size of the aneurysm. Small changes require monitoring with an instrumental examination twice a year and lifestyle adjustments. Significant ones (over 5 cm, with a high risk of rupture) are an indication for abdominal or minimally invasive surgery.
How to prevent lower back pain
Since lower back pain is most often caused by traumatic injuries to muscles, fascia, joints or bones, the main recommendation for prevention is to follow safety precautions, maintain a strong muscle corset, as well as healthy bones and joints.
Prevention of sprains and microtrauma of the lower back:
- a varied diet that includes vitamins and minerals necessary for maintaining healthy bone and muscle tissue and joints;
- maintaining a healthy weight;
- regular physical activity: exercises to prevent lower back pain should include strength exercises to develop the muscular frame, stretching to relieve muscle tension and spasms, and cardio to maintain blood supply and tissue nutrition;
- following safety precautions during sports - for example, the first lessons in the gym must be supervised by a qualified trainer;
- following safety precautions at home - many injuries can be avoided if you wear comfortable shoes, hold on to the railings on the stairs, take your time when it's slippery outside;
- following safety precautions when lifting heavy objects - the load on the spine will be less if you get as close to the object as possible (don't reach for it), and when lifting objects from the floor, bend your legs instead of leaning your body.
Yoga and pilates classes help relieve spasms and tension in the lower back
Smoking impairs blood circulation and tissue nutrition, increasing the risk of damage and injury.
What to do if your lower back hurts
If your lower back hurts, the reasons can be different, which means that the treatment tactics will also be different.
In case of severe physical fatigue, the back should be rested - perhaps this will be enough for the muscles to recover and restore the mobility of the spine.
If the pain does not disappear within 1-2 days or if it is very strong, it is necessary to consult a doctor. While you are waiting for the doctor, you can try to relieve the acute pain with painkillers.
During the appointment, the doctor will perform an examination, determine the cause of the pain and give recommendations for treatment. This will help to eliminate dangerous conditions and prevent the development of complications.
Heating (lumbar pepper patch, hot water heater, sauna) is contraindicated in inflammation, but can relieve acute pain in the lower back if it is caused by muscle fatigue or a pinched nerve. These methods can be used only after consulting a doctor.
Which doctor should I contact with a complaint of lower back pain?
If you suspect a pathology of the musculoskeletal system, consult a neurologist and orthopedic traumatologist.
The diagnosis is made by physical examination and instrumental methods: magnetic resonance, computerized tomography, X-ray and ultrasound. It is also possible to prescribe a myelogram (X-ray or CT study with a contrast agent injected into the spinal canal) and electromyography - a study that allows you to assess the state of nerve and muscle fibers.
If you suspect kidney disease, consult a urologist, nephrologist or therapist. The doctor will analyze the complaints and perform a physical examination, then prescribe laboratory and instrumental tests to clarify the diagnosis.
Based on blood and urine tests, the doctor will be able to determine whether there is inflammation in the organs of the urinary system, and ultrasound and X-ray studies will help visualize the organs, determine the cause of the pain and choose the most effective treatment. tactics.
If the origin of lower back pain is unclear, you should consult a general practitioner or therapist.
The doctor will collect medical history, analyze hereditary risks, perform a physical examination and prescribe tests that will determine inflammatory processes or disorders in the work of internal organs.
A general blood test helps to identify the inflammatory process.
If necessary, the doctor will refer you to instrumental studies (ultrasound, X-ray, MRI) or recommend that you consult a specialist for further diagnosis and treatment.