Low back pain is known to almost everyone. It's hard to find someone who has never experienced this extremely unpleasant symptom at least once. Sometimes, sitting in an uncomfortable position for a while is enough to cause discomfort in the lower back of the spine. But this is not a serious problem, but simply a consequence of being in an uncomfortable position for too long.
But severe back pain almost always has specific reasons and is a reason to go to the doctor. Diagnosis will not always be expected, as osteochondrosis is just one of the possible problems, back pain.
Why the lower back hurts and what to do in such a situation is not hard to guess. The doctor will diagnose and identify the cause of the pain, after which you will need to start treatment.
Pain syndrome - primary and secondary
Understanding why the lower back hurts, we must not forget that the causes of this pain are dozens, and a layperson will never be able to determine the true source of the problems.
In general, medical classification separates primary and secondary pain syndromes that can affect the lower back.
Primary low back pain syndrome occurs as a result of musculoskeletal changes of a morphofunctional nature. It is the cause of the vast majority of cases of back pain in the lower back. The most significant of the reasons are the degenerative dystrophic changes that occur in various parts of the spine:
- Osteochondrosis, which is a lesion of the bone and cartilaginous tissue, is a disease of dystrophic nature. When it affects the intervertebral disc and adjacent vertebrae, spondylosis begins to develop.
- Spondyloarthrosis is a form of osteoarthrosis, in which the disease affects the intervertebral joints, responsible for spinal mobility, or synovial joints.
Secondary pain syndrome has much more varied causes of pain:
- scoliosis, which is a curvature of the spine, as well as some other growth disorders;
- various inflammations of a non-infectious nature. For example, rheumatoid arthritis, Reiter's syndrome;
- tumor located in the vertebrae, in the spinal cord itself, or in the retroperitoneal space, regardless of whether it is primary or caused by metastases;
- fracture of one or more dorsal vertebrae. This is perhaps one of the most serious causes of back pain;
- various infectious diseases that damage the vertebrae and intervertebral discs (tuberculosis, brucellosis, epidural abscess);
- Stroke conditions in which there is a serious violation of the blood supply to the spinal cord. In this case, there may also be a feeling of pain in the lower back;
- diseases of the gastrointestinal tract. For example, acute appendicitis with an atypical course, intestinal obstruction;
- often, back pain is of a reflected nature. A similar problem can occur with some organ diseases located in the pelvic region. For example, renal colic, sexually transmitted diseases (gonorrhea, trichomoniasis, chlamydia, ureaplasmosis and exis - all these diseases cause reflected back pain).
What are acute and chronic pain<2_img_rightxx>
Low back pain is also divided into acute and chronic, which can be caused by a variety of problems and diseases, both in the nerve endings and in the spine itself.
Displaced pain is also frequently observed - there is a translation of pain from other organs, which are located much more deeply. In other words, to a person it feels like the lower back hurts, even though the problem is actually in a completely different part of the body. But most of the time, pain from Organs pelvic organs, pancreas, kidneys, colon, or tumors located behind the peritoneum is projected into the lower back.
Usually people don't know what to do if their lower back hurts. But it's pretty clear what you shouldn't do - it's self-medication. The causes of pain are varied, only a specialist can make the correct diagnosis, and the constant use of painkillers (which many consider a treatment) can cause even more damage.
The specialist, in turn, makes a diagnosis based on data obtained from complementary exams, for example, MRI diagnoses of the spine.
Causes of acute pain
Before deciding what to do when the lower back hurts a lot, any serious doctor will first determine the cause of the pain that has arisen. The reasons may be different, but most of them are somehow related to the spine.
One of the simplest and most harmless causes of pain is acute muscle tension. In this case, the spasmodic long muscles are the source of the pain. With this problem, the pain rarely "radiates" to other parts of the body, but it severely restricts a person's mobility. This reason is very common, often faced by athletes and people whose work is associated with various physical activities.
Another common but much more serious source of pain is a fractured spine, especially when it comes to compression fractures of the vertebrae. Most of the time, this happens with unsuccessful falls and other back injuries. But if a person is ill with hyperparathyroidism, osteoporosis, Paget's disease or there are tumors in the vertebral region, then a fracture can occur and go unnoticed by the patient, as they say "out of the blue". Furthermore, the person will not even understand when this fracture occurred.
An equally unpleasant situation in which acute pain arises in the lower back is dislocation of the intervertebral discs in the lumbar spine. The symptoms of this problem are severe, sharp pain in the lower back, which severely restricts mobility. Most of the time, the pain is due to the compression of the nerve roots. The signs of such compression are:
- sensitivity disorders;
- disappearance or significant decrease of the Achilles reflex;
- absence or decrease in knee reflex intensity;
- unilateral radicular pain.
One of the unpleasant tendencies of this problem is that this dislocation can cause pathology in the lower vertebrae. As a result, pain appears below the lower back and rectum and bladder functions may be impaired. Locating the pain above the lower back is also possible in some cases.
Acute back pain can also occur as a result of facet syndrome. In this case, the cause of pain is root compression at the exit of the spinal canal, while the intervertebral disc itself remains intact. This syndrome usually results from enlargement of the upper and lower facets of the intervertebral joint, resulting in narrowing of the intervertebral foramen.
An epidural abscess is one of the most serious diseases that cause severe back pain. This disease requires urgent diagnosis and immediate treatment, with any highly effective measures being recommended, until surgical intervention, the main one being to quickly eliminate the compression of the spinal cord.
Hip joint disease is also often the cause of acute back pain. They are characterized by pain that radiates down the lower back, from the legs to the level of the knees.
Causes of Chronic Low Back Pain
One of the causes of chronic pain is spondylosis deformans. With this disease, there is a dystrophic change in the vertebrae of the lumbar spine, the ligamentous apparatus weakens and bone growth occurs. As a result, the spinal canal narrows and the bony bulges begin to press on the nerve roots. Sore pain may be accompanied by numbness and weakness in the legs, as well as other neurological symptoms. In any case, a complete examination will be necessary, according to the results of which the final diagnosis will be established.
Bechterew's disease, also called ankylosing spondipoarthrosis, can also cause chronic pain. It manifests as a pulling pain in the lower back, a curvature of the spine in the thoracic region appears and develops rapidly. The first symptoms are difficulty in walking and decreased chest movement when breathing.
Cancer and metabolic disorders often cause lower back pain. But even benign tumors can cause chronic pain that will not be accompanied by neurological symptoms.
Osteomyelitis can also cause lower back pain, which can be very long-lasting.
As you can see, back pain can occur as a result of many illnesses. At the same time, the person often doesn't even expect the problem not to be where it hurts. So even if the lower back doesn't hurt constantly, but from time to time - don't pull, see a doctor. It is easier to deal with any illness at an early stage rather than when it is in a neglected state and will bring with it many complications.