Low back pain is quite common. It can be caused by both common fatigue and serious injuries and pathologies. If the pain is severe or does not go away after rest, it is important to see a doctor to rule out dangerous conditions.
What can pain in the lower back be like?
Pain in the lower back can be sharp or aching, appear suddenly or gradually increase, appear with loads or certain movements (for example, bending), or persist regardless of what the person is doing.
The pain may be punctual or radiating (that is, spreading to other areas). In this case, the person feels pain not only in the back, lower back, but also in other parts of the body, such as the lower abdomen, perineum, leg or buttock.
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 their back straight, or maintaining posture when walking.
If the pain is caused by a muscle spasm or a pinched nerve, it can be unbearable and even disabling. This pain forces you to stay in bed until you receive 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, pinches, inflammation. They are often found in men who work with their hands, athletes and young mothers.
In addition, discomfort in the lower back can be a sign of acute or chronic diseases of internal organs. This occurs due to the fact that painful impulses are able to be transmitted along nerve fibers to neighboring regions. In this case, the pain is said to "radiate" to the lower back.
Diseases of the musculoskeletal system that cause pain in the lower back
Most often, low back pain is caused by injuries and pathologies of the musculoskeletal system - muscle and ligament sprains, spinal injuries, hernia and protrusion of intervertebral discs, inflammation of the joints, bone diseases.
Deformations and sprains of muscles and ligaments
Such injuries can occur due to clumsy movements if a person lifts something too heavy or does not follow safety precautions when handling bulky objects. You can also get injured while playing sports or simply sneezing unsuccessfully.
Lower back pain may occur if you lift heavy objects without following safety precautions.
In sprains and strains, the pain intensifies during movement and muscle spasms may appear. It may be painful for a person to walk, lean forward, or keep their back straight.
Diagnosis of deformation and sprain of muscles and ligaments is based on data from physical examination and instrumental studies - ultrasound, x-ray, MRI of the lumbar region. If you suspect a sprain or deformation of muscles or ligaments, contact an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms through ice packs, analgesics and medications to relieve muscle spasms (muscle relaxants). It is important to give the damaged area rest to allow the tissue to recover - this usually takes around 2 weeks. After that, it is important to start rehabilitation: physiotherapeutic exercises are recommended to restore muscle function.
Without treatment, strains and sprains lead to limited mobility: by 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.
Spine 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), this damage can be caused by even minor exposures.
Treatment of spinal injuries consists of preventing additional displacements and deformations of the spinal discs. If the damage is not severe, 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 spinal discs can cause stenosis (narrowing) of the spinal canal, neurological disorders including sciatica - compressed nerve fibers extending from the spinal column.
Intervertebral disc pathologies
Intervertebral discs are fibrocartilaginous plates with gelatinous content located between the vertebrae. They act as shock-absorbing cushions for the vertebrae, ensuring their mobility. Discs can become dislodged (bulge) or rupture (herniate), causing severe pain and limiting spinal mobility.
Hernias and intervertebral protrusions can occur in people with weak muscles and overweight, 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 an intervertebral disc into the spinal canal
Treatment consists of relieving pain and inflammation – rest, analgesics, ointments and compresses on the inflamed area are recommended. Your doctor may prescribe physical therapy or exercise therapy. With moderate damage, the disc can recover if the cause of the hernia or protrusion is excluded - for example, by strengthening the muscular corset, reducing weight and not placing excessive stress on the spine.
If your lower back pain is so severe that it interferes with daily activities, does not subside within 1 to 1. 5 months, or if your symptoms worsen, you should contact your doctor again. In some cases, steroid therapy or even surgery may be necessary. With age, it is possible to develop degenerative diseases of the intervertebral discs - they become flatter and perform a worse shock-absorbing 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 spine to the right or left in relation to the vertical axis. The pathology leads to increased pressure in certain areas of the intervertebral discs and vertebrae, as well as compression of tissues and nerve fibers. Scoliosis can cause severe pain in the right or left lower back – where most stress is placed – and severely limit spinal mobility.
Scoliosis (curvature) of the spine can cause severe pain in the lower back, where a lot of stress is placed.
Scoliosis can occur due to weakening of the muscular 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 form.
Treatment involves the introduction of balanced physical activity (physiotherapy, swimming), massage and manual therapy, physiotherapeutic procedures for muscle strengthening, such as electrical stimulation. For serious injuries, it is recommended to wear a corset, which helps maintain the correct position of the spine.
Arthritis and arthrosis
Inflammation and degenerative processes in the joints of the spine can also cause severe lower back pain. 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.
Treatment of arthritis, depending on its form, may include the use of non-steroidal and steroidal anti-inflammatory drugs and analgesics, physiotherapeutic procedures (magnetic therapy, electrophoresis), therapeutic massage and physiotherapy.
Physiotherapeutic procedures help relieve pain due to joint pathologies
Spondylolisthesis
Displacement of a vertebra in relation to the spine (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 bone density disorder). Spondylolisthesis can cause severe pain in the lower back, buttocks, and legs, as well as cause leg cramps or weakness.
Treatment involves relieving pain and inflammation that occurs due to compression of neighboring 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 used.
In traumatic and non-infectious pathologies of the musculoskeletal system, pain in the lower back usually decreases or subsides when a person takes a comfortable position.
If spondylolisthesis is accompanied by severe pain, your doctor may prescribe corticosteroid injections.
Infectious diseases of the spine
Inflammation of bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe lower back pain. These pathologies, as a rule, are of a secondary 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, which takes 6 to 12 months.
Tumor diseases of the spine
Neoplasms can develop under the influence of hereditary or external factors (for example, radiation), but most often they appear as repeated foci (metastases) in cancer of other organs - lungs, mammary glands, prostate, thyroid gland, kidneys.
One of the most characteristic symptoms of tumor pathologies is pain that does not decrease with a change in position or after rest. Symptoms such as numbness, partial paralysis, uncontrolled urination and a sharp 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 tumors. Pain relief is achieved with non-hormonal or steroid medications. To stabilize the spine, your doctor may prescribe the use of a corset.
Orthopedic corset helps stabilize the spine
Diseases of internal organs that cause pain in the lower back
Low back pain can occur with diseases not associated with pathologies of the spine and adjacent tissues. Acute or painful, it may accompany inflammation of internal organs: pyelonephritis, urolithiasis, abdominal aortic aneurysm. In women, pain in the lower back can occur due to gynecological pathologies.
Urolithiasis disease
A disease in which stones form in the kidneys and bladder - hard formations from the sediment of chemical components in urine. Low back pain is one of the main signs of pathology. Depending on the size and location, kidney stones can cause a dull, aching pain that occurs and subsides periodically, or a very sharp pain that does not go away on its own and requires emergency medical care.
Urolithiasis - formation of stones in the kidneys and bladder
If you suspect kidney stones, contact a urologist or nephrologist. The doctor will prescribe examinations and instrumental studies (ultrasound, X-ray examination, computed tomography, including the use of a contrast agent) to make a diagnosis and choose treatment tactics.
Treatment is prescribed taking into account the size, nature, location of the 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 is no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
A weakening of the walls of the abdominal aorta (aneurysm) can lead to potentially fatal conditions such as aortic rupture and intra-abdominal bleeding. As a rule, the pathology occurs in elderly people: the risk group includes men over 65 years old and women over 70 years old, including smokers, people with vascular diseases (high blood pressure), who have already had aneurysms or who have a predisposition hereditary for them.
Pain in the lower back due to an abdominal aortic aneurysm does not decrease over time and may be accompanied by pain in the abdomen and legs.
If an aneurysm is suspected, abdominal ultrasound and computed tomography are prescribed.
Treatment depends on the size of the aneurysm. Small changes require follow-up with instrumental examination twice a year and lifestyle adjustments. Significant (above 5 cm, with a high risk of rupture) are an indication for abdominal or minimally invasive surgery.
How to prevent back pain
Since low 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 muscular corset, as well as healthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet that includes the vitamins and minerals necessary to maintain the health of bone, muscle and joint tissues;
- maintain a healthy weight;
- regular physical activity: exercises to prevent low back pain should include strength exercises to develop muscular structure, stretching to relieve muscle tension and spasms, and cardiovascular training to maintain blood supply and tissue nutrition;
- compliance with safety precautions when practicing sports - for example, the first classes in the gym must be supervised by a qualified trainer;
- compliance with safety precautions at home - many injuries can be avoided if you wear comfortable shoes, hold on to the stair railing, take your time when it is slippery outside;
- observing safety precautions when lifting heavy objects - the load on the spine will be less if you approach the object as close as possible (do not reach for it), and when lifting objects from the floor, bend your legs instead of tilting your body.
Yoga and Pilates classes help relieve spasms and tension in the lower back
Smoking impairs blood circulation and impairs tissue nutrition, increasing the risk of damage and injury.
What to do if your lower back hurts
If the lower back hurts, the reasons may be different, which means that the treatment tactics will also be different.
In case of severe physical fatigue, it is necessary to rest your back - perhaps this will be enough for the muscles to recover and the mobility of the spine to return.
If the pain does not go away within 1-2 days or is very severe, see a doctor. While waiting to see a doctor, you can try to relieve acute pain with pain relievers.
At the consultation, the doctor will perform an examination, determine the cause of the pain and give treatment recommendations. This will help eliminate dangerous conditions and prevent complications from developing.
Warming (lumbar pepper patch, hot water bottle, sauna) is contraindicated for inflammation, but can relieve acute lower back pain if it is caused by muscle fatigue or a pinched nerve. These methods can only be used after consulting a doctor.
Which doctor should I contact with a complaint of low back pain?
If you suspect pathology of the musculoskeletal system, contact a neurologist and orthopedic traumatologist.
The diagnosis is made during physical examination and using instrumental methods: magnetic resonance imaging, computed tomography, X-ray and ultrasound. It is also possible to prescribe myelogram (radiography or computed tomography 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, contact a urologist, nephrologist or therapist. The doctor will analyze the complaints and perform a physical examination, and 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 to visualize the organs, determine the cause of the pain and choose the most effective treatment. tactics.
If the source of lower back pain is unclear, see a general practitioner or therapist.
The doctor will take an anamnesis (medical history), analyze hereditary risks, perform a physical examination and prescribe tests that will identify inflammatory processes or disturbances in the functioning 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 contacting a specialist for further diagnosis and treatment.