Back pain in the waist area is familiar to everyone. According to statistics, she is responsible for 25% of all medical needs. Its appearance can cause many different factors, from ordinary fatigue to quite serious illness. Therefore, you should not ignore the problem, especially if the discomfort occurs frequently and will get worse over time. In this case, you should contact the therapist as soon as possible, or go directly to the neurologist and receive a full examination.
In this way, the disease can be diagnosed at an early stage and timely measures can be taken to prevent its development. However, if you are injured or fail to fall on the eve of the onset of pain, you need to immediately apply to the surgeon or spine surgeon for consultation.
Characteristics of low back pain and related symptoms
Back pain may have different nature and severity. They can be strong, shoot, grumble, pull, etc. They can increase strength during physical exertion, when sitting or standing for a long time, and when at rest or not. All of these are important diagnostic factors that allow doctors to make a correct diagnosis and find the real cause of the patient's condition.
When making a diagnosis, the most important thing is whether the pain will spread to the buttocks, hips, knees, feet, if it is spread, and where. Again, the point is that there are limitations in spinal mobility, regardless of whether the patient can bend freely, turns the body or reduces the range of motion.
Spinal pain is called low back pain. If it spreads to the legs, it is called low back pain.
Acute pain refers to pain that lasts less than 3 months; otherwise, they are called chronic pain. In the latter case, the disease usually progresses as the condition worsens and resolves.
Lower back pain rarely occurs alone. In most cases, there is also the complexity of other diseases, and patients themselves are rarely connected with each other. Usually, low back pain is combined with the following symptoms:
- Feeling crawling on the back and/or legs, numb;
- Muscle weakness;
- Pain in hip and knee joints;
- Rupture of pelvic organs (irregular menstruation, performance problems, uncontrolled urination, defecation);
- Leg numbness.
Similar signs indicate pathology of the spine.
However, since they not only arouse the appearance of back pain, there is another group of symptoms that may accompany lower back pain and indicate the pathological condition of internal organs or cancer. Therefore, you need to pay special attention to your status:
- Quick and unnecessary weight loss;
- Relieve pain in the groin and perineum;
- Increased urination, soreness;
- Body temperature rises, chills;
- Skin color changes in the epicenter of the pain;
- Irregular menstruation, abnormal discharge.
If lower back pain is related to one or more of the above symptoms, you should seek medical attention immediately. When the first group develops symptoms, they need to consult a neurologist, and the second group needs the help of a urologist, gynecologist, endocrinologist or other stenosis specialist. The therapist will help you know exactly which doctor to contact.
Cause of occurrence
All causes of low back pain can be divided into two categories: spinal disease and internal organ pathology, especially gynecological diseases, kidney pathology, gastrointestinal organs, and endocrine disorders. However, in most cases, they are the result of the development of changes in the spine and surrounding muscles. The most common causes of back pain are:- Osteochondrosis;
- Spondylopathy;
- Inflammatory diseases of the spine;
- Myofascial syndrome;
- Ankylosing spondylitis;
- Scoliosis;
- Injured.
However, lower back pain may also be the result of overwork or certain physiological changes. In this case, they do not need special treatment, but only a reduction in exercise and day care.
Osteochondrosis and intervertebral disc hernia
Osteochondrosis is the most common spinal disease. Its development is usually related to inevitable age-related changes, because almost every elderly person has more or less symptoms.
Osteochondrosis is the price humans pay for the ability to walk straight. It is characterized by gradually destroying the intervertebral disc, making it thinner, and decreasing its elasticity and firmness. As a result, they no longer cope with pressure and may bulge. Therefore, an intervertebral hernia is formed.
Most commonly, osteochondrosis affects the intervertebral discs of the lumbar spine. When they extend into the spinal canal or intervertebral foramen, the nerves are almost inevitably damaged, causing acute pain in the lower back and radiating to the legs and buttocks.
Spondylopathy
Spondylosis is a complication of advanced osteochondrosis, in which the intervertebral disc is almost completely destroyed, and due to the ongoing degeneration process and the increase in the load on the spine, bony processes called osteophytes are formed at the edges of the vertebrae.
Therefore, there is a high risk of compression and injury to nearby nerves. This can cause severe pain and radiation to the legs.
Spondylitis
Inflammatory diseases of the spine are most common in young people, mainly men. They can cause severe pain and even trouble at night. This is their special difference. As the disease progresses, without timely treatment, the pain will become more severe and plague people more frequently.
It is not uncommon to seek medical help years after the first symptoms appear. Because the spine inflammatory process is so long, irreversible changes may occur, which may eventually lead to immobility and disability.
Sometimes, in addition to lower back pain, there is discomfort in the joints of the legs and arms. In this case, the cause of discomfort may be arthritis, osteomyelitis.
Myofascial Syndrome
Myofascial syndrome is a common pathology in which pain occurs after staying in an uncomfortable position for a long time or performing manual labor. Myofascial syndrome is more common in women. Using it, lower back pain may occur after accidental exercise or fatigue. Its distinguishing feature is the presence of so-called trigger points on the spasmodic muscles in the waist area and buttocks. Pressing the trigger points can cause sudden pain episodes. Myofascial syndrome significantly reduces people's quality of life, but it does not pose a serious threat.
Bechterew disease
Ankylosing spondylitis or ankylosing spondylitis is a chronic joint disease in which the joint, spinal joints and surrounding soft tissues are mainly affected. For this disease, people worry about back pain, bone pain, and stiffness in movement, but the symptoms usually disappear without a trace in the afternoon and evening.
In addition, physical exercise has a beneficial effect on the health of patients and helps eliminate pain syndrome. A fairly specific symptom of ankylosing spondylitis is bending of the waist, curved spine and limited progressive movement.
Scoliosis
Scoliosis is the lateral curvature of the spine. Its severity may vary, directly affecting the intensity of back pain and other symptoms. Since the deformation of the spine causes the displacement of all anatomical structures, the nerves are usually squeezed, causing severe pain. In addition, other neurological symptoms may occur, including numbness and paresis.
Compression fracture
In elderly people with osteoporosis and trauma, lower back pain may be the result of an undiscovered spinal compression fracture. As a result, the vertebrae flatten and occupy abnormal positions, which leads to incorrect spinal load distribution, disc degeneration, and pain.
Physiological causes of low back pain
During hard physical work, strenuous exercise training will increase the load on the muscles. As a result, lactic acid will accumulate in the muscles and cause pain. It is not uncommon to have back pain when wearing uncomfortable shoes (especially high heels) for a long time.
Moreover, lower back pain is often observed during pregnancy. In this case, they are due to a shift in the center of gravity and an increase in pressure on the spine.
Diagnosis
To determine the cause of back pain in the lumbar region, it is recommended to consult a neurologist. Initially, you can consult a therapist, but most likely, the doctor will still refer the patient to a neurologist.
At the reception, the specialist will conduct a thorough investigation of the patient to find out what he is worried about, what his lifestyle is, and so on. In addition, an examination is required during which the doctor evaluates the severity of the reflex, performs neurological examinations and evaluates the patient’s mobility. Based on the results obtained, the doctor can make a preliminary diagnosis and understand which violations caused the back and lower back pain.
In order to confirm the existing hypothesis and accurately find out the cause of the pain, a comprehensive examination of the patient was carried out, which may include:
- Routine and biochemical blood tests-with their help, changes in the blood can be detected, indicating that there is an inflammatory process, infection or tumor in the body;
- General urinalysis-used to distinguish kidney diseases that are the cause of pain in the waist area;
- CT is a modern method of radiological diagnosis. It allows you to visualize all bone structures very clearly and detect the smallest deviations from the norm.
- MRI-Provides comprehensive information about soft tissue and cartilage conditions (including intervertebral discs). MRI can diagnose intervertebral hernias, vascular changes, and tumors of any size.
Low back pain treatment
Strictly choose the method of treating back pain individually. At the same time, it is always complicated, including symptomatic treatment, lifestyle changes, and treatments that aim to eliminate the cause of low back pain. Therefore, if the first two components of the treatment are generally common and prescribed to all patients, then taking into account the existing diseases, the compliance treatment will be strictly developed separately.
In most cases, patients will be initially provided with conservative treatment, the main component of which is medication. In more difficult situations, physical therapy, manual therapy and exercise therapy are also recommended.
But anyway, all patients with low back pain should:
- Give up the exhausted exercise of lifting heavy objects;
- Reduce weight in the case of obesity;
- If a person is forced to sit for long periods of time, take regular breaks to warm up.
- Increase the level of physical exercise, but avoid overwork and hard work (walking every day, morning exercises, special exercise therapy, swimming);
- The use of support bandages can reduce the burden on the lower back, thereby providing favorable conditions for the early rehabilitation of the spine.
According to the source of the pain, it is recommended that patients stay in bed for a few days, or on the contrary, increase their physical activity level, but within a reasonable range. For example, pain caused by nerve compression requires you to rest for a few days. On the contrary, in other diseases, moderate physical exercise is one of the mandatory components of treatment. It helps to increase the effectiveness of medications, reduce the risk of complications and prevent disability.
Unfortunately, conservative therapy cannot always be used to treat low back pain. In some cases, it proved to be ineffective, even after unswervingly adhering to medical advice for months without any results. In other cases, the examination results indicate that there is a pathology that cannot be eliminated by any non-surgical method. In this case, it is recommended that the patient consult a neurosurgeon and perform appropriate surgical procedures to restore the normal anatomy of the spine.
Medications
In order to improve the patient’s condition and quickly relieve pain, the following is prescribed:
- NSAIDs in the form of tablets, injections and topical preparations have analgesic and anti-inflammatory properties;
- Corticosteroids-short-term administration to control severe inflammation;
- Muscle relaxants-muscle cramps necessary to relieve muscle cramps, usually the body's reflex response to pain, aggravating the pain;
- B vitamins-improve nerve conduction by normalizing the nutrition of nerve fibers and increasing the transmission speed of nerve impulses.
For severe pain that cannot be tolerated, it can be blocked. This procedure involves injecting anesthetic directly into the area where pain or nerve fibers pass. Therefore, it is possible to completely stop the pain syndrome within a period of time and improve the patient's health.
However, the blockade is only temporary and can only be implemented in medical institutions, because it is usually necessary to inject drugs to a point near the spine that is next to a large number of nerves. Therefore, blind execution of this procedure may lead to serious or even fatal consequences.
In addition to the drugs listed above, a group of other drugs have been prescribed that can help eliminate the underlying diseases that cause pain syndrome. Therefore, antibiotics, chondroprotective agents, immunomodulators and other drugs can also be prescribed for patients.
Physical Therapy
Patients with spinal diseases usually require physical therapy. Thanks to the correct selection of physical influence methods and program frequency, it is possible to achieve significant anti-inflammatory and analgesic effects, and improve microcirculation, accelerate the elimination of local edema, muscle spasms, etc. Physiotherapy significantly improves the effectiveness of other treatments, but treatment is only used after acute treatment is eliminated.
In most cases, patients need to prescribe:
- Electrophoresis;
- UHF;
- Ultrasound therapy;
- Magnetic therapy;
- Reflexology;
- Seepage current, etc.
Generally, the process includes 8-10 sessions, which are executed at a certain frequency.
Manual therapy
For osteochondrosis, scoliosis and many other diseases, manual treatment can have a truly amazing effect on the condition of the spine. However, only qualified chiropractors can perform manual treatment competently, benefiting the patient, not harming it.
The use of special manual exposure techniques can not only improve microcirculation, relax over-tuned muscles and overly relaxed muscles, but also increase the distance between the vertebrae and normalize their positions. A qualified chiropractor can find the location where the nerve is squeezed and relieve the pressure on the anatomical structure.
Literally, after the first treatment, most patients notice an improvement in their well-being and a significant reduction in the severity of the pain syndrome until it is completely eliminated. However, in order to consolidate the results obtained, it is recommended to take a complete manual therapy course and attend an auxiliary course in the future.
Exercise therapy
Physiotherapy can help the body cope with stress. For each disease, a set of special exercises has been developed, which can be performed regularly to solve the most important tasks in the current situation. Therefore, it is possible to make the back muscles normal intonation and strengthening with the help of the correct choice of complex physiotherapy exercises. Therefore, the pressure on the spine will be reduced, which will effectively prevent the progression of the disease and create favorable conditions for the recovery of the disease.
Exercise therapy also helps to improve blood circulation in the affected area, thereby accelerating the inflammatory process and more likely leading to a complete recovery. In many cases, correct exercise can help relieve lower back pain and reduce its frequency.
The training plan 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 accompanying diseases, the patient's physical fitness level, his age and other factors. Only experts can correctly choose the most effective and safe exercises.
Held the first class under his supervision. In their process, patients learn to perform each recommended exercise correctly, which is beneficial. Gradually increase the load to reach the optimal level. However, it is not recommended that you increase the number of repetitions or complicate the exercise yourself. Any changes to the physiotherapy practice program can only be introduced by experts.
Patients only need to strictly follow their own recommendations and practice daily in a comfortable environment. All exercises are performed at a slow speed. No sudden movement is allowed. However, if pain occurs during class, you should stop exercising immediately and consult a doctor as soon as possible.
Low back pain surgery
In most cases, disc herniation requires the help of a spine surgeon. The formation of herniated disc leads to the development of spinal root invasion and nerve root pain. If the bump has already formed, it is impossible to pull it back by modern non-invasive methods. The only way to eliminate it and at the same time eliminate lower back pain is to remove the intervertebral hernia through surgery.
There are several types of surgery for intervertebral hernia. The specific strategy of surgical intervention depends on the type, location and size of the hernia:
- Nucleoplasty and edemaplasty are percutaneous surgery methods that can remove part of the nucleus pulposus by puncturing a tissue with a diameter of several centimeters and reduce the size of the hernia.
- Microdiscectomy is a fundamental method to solve intervertebral disc herniation, that is, the intervertebral disc or the entire intervertebral disc is removed through an incision up to 3 cm long, but unlike other methods, it can eliminate hernias of any size, no matter where it isWhat is the position and release in the spinal canal? Even in the most difficult part of the spine, there is nerve compression.
- Endoscopic surgery-involves the use of a special device with a camera to remove a herniated disc through a puncture that does not exceed 1 cm in diameter. It can be used to remove hernias of any size, but this technique cannot be used to remove tumors in anatomically difficult areas.
In addition, scoliosis requires the help of a spine surgeon. In this case, all forces are directed to restore the normal axis of the spine. In the past, this required a large incision, almost running through the entire back. But today, the deformity of the spine can be corrected with minimally invasive incisions.
Various types of metal structures are used to restore the normal axis of the spine, but their essence is roughly the same. Use special screws to fix the structure on the vertebrae, and by correcting its tension at different positions, the displaced vertebrae can be put back in place and fixed in the correct position. Over time, modern types of metal structures can improve the initial results of surgery without the need to re-intervene the human body. This can be achieved by using special screws to correct the position of the mounting structure.
If a spinal fracture occurs, surgical intervention cannot be avoided. In this case, only by restoring the normal shape, size and position of the vertebrae, you can get rid of low back pain. Recently, kyphoplasty and vertebroplasty have been performed for this purpose. The essence of the two operations comes down to the fact that a special bone cement is injected into the vertebrae damaged by the injury through a thin puncture needle.
It will fill up all available space and harden after 10 minutes. However, in severe compression fractures, kyphoplasty is preferred because it can also help restore the normal shape of the vertebrae, which will ensure the correct distribution of the spinal load in the future and reduce the risk of complications. This operation involves pre-introducing a special balloon into the damaged vertebrae and then gradually expanding them to restore the vertebrae to their original appearance. Afterwards, the balloon is lowered and removed, and the formed cavity is filled with bone cement.
Therefore, back pain may be a physiological change, a common symptom of muscle fatigue or severe disease of the spine or internal organs. Therefore, if they occur regularly, especially in the context of the same factors, you should not hesitate and ignore the problem. Please contact a qualified expert to make the treatment as quick and easy as possible. Moreover, if the disease cannot be identified in the early stages of the disease, modern neurosurgery techniques will be able to eliminate it through surgery, thereby minimizing the risk of complications.