Lower back pain is quite common. It can be caused by both simple fatigue and serious injuries and pathologies. If the pain is severe or does not go away after rest, it is important to consult a doctor to rule out dangerous conditions.
What can lower back pain be?
Lower back pain can be sharp or aching, come on suddenly or increase gradually, occur with exercise or certain movements (for example, bending over), or continue regardless of what the person does.
The pain may be localized or radiating (ie spread to other areas). In this case, a 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, legs or buttocks.
Lower back pain may include stiffness of movement or muscle spasms. The person may have difficulty bending over or standing up from a lying position, standing with their back straight, or maintaining a walking posture.
If the pain is caused by a muscle spasm or a pinched nerve, it can be excruciating and even debilitating. 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, pinches, 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 internal organs. This is 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" in the lower back.
Diseases of the musculoskeletal system causing 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, herniated and bulging intervertebral discs, joint inflammation, bone diseases.
Deformations and sprains of muscles and ligaments
Such injuries can occur due to awkward movement if a person lifts something very heavy or does not follow safety measures when working with bulky objects. You can also injure yourself while exercising or if you simply sneeze unsuccessfully.
Lower back pain can occur if you lift heavy objects without following precautions.
With sprains and strains, the pain increases during movement and muscle spasms may occur. It may be painful for the person to walk, bend forward, or keep their back straight.
The diagnosis of deformation and dislocation of muscles and ligaments is based on data from a physical examination and instrumental studies - ultrasound, X-ray, MRI of the lumbar region. If you suspect a sprain or deformation of muscles or ligaments, you should contact an orthopedic traumatologist.
Treatment consists of relieving acute pain and muscle spasms with the help of ice packs, pain relievers and drugs to relieve muscle spasms (muscle relaxants). It is important to rest the damaged area to allow the tissue to recover - this usually takes about 2 weeks. After that, it is important to start rehabilitation: physiotherapy exercises aimed at restoring muscle function are indicated.
Without treatment, sprains and strains lead to limited mobility: trying not to injure the injured area, a person reduces activity, which can lead to weight gain, reduced 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 domestic 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 injury is not severe, it is recommended to sleep on a hard surface and limit physical activity. If the damage is significant, surgical methods of fixation are used.
Without treatment, damage to the spinal discs can cause stenosis (narrowing) of the spinal canal, neurological disorders, including sciatica - pinched nerve fibers exiting the spine.
Pathologies of the intervertebral discs
Intervertebral discs are fibrocartilaginous plates with jelly-like contents located between the vertebrae. They act as cushions for the vertebrae, ensuring their mobility. Discs can become displaced (bulging) or ruptured (herniated), causing severe pain and limiting the mobility of the spine.
Intervertebral hernias and 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 pathologies of the intervertebral discs.
Intervertebral hernia - protrusion of the intervertebral disc in the spinal canal
Treatment consists of relieving pain and inflammation - rest, painkillers, ointments and compresses on the inflamed area are recommended. The doctor may prescribe physical therapy or exercise. With moderate damage, the disc can be restored if the cause of the herniation or protrusion is ruled out - for example, strengthening the muscle corset, reducing weight and without excessive strain on the spine.
If the pain in the lower back is so severe that it interferes with daily activities, does not subside within 1-1. 5 months, or if the 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 a degenerative disease of the intervertebral discs - they become flatter and perform a worse 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 spine to the right or left relative to the vertical axis. The 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 placed - and severely limits the mobility of the spine.
Scoliosis (curvature) of the spine can cause severe pain in the lower back area where a lot of stress is placed
Scoliosis can occur due to a weakening of the muscle corset in the absence of sufficient physical activity, a sedentary lifestyle (in students, office workers). In this case, it is difficult for the muscles to maintain the physiological position of the back and distortions are formed.
Treatment includes the introduction of balanced physical activity (physical therapy, swimming), massage and manual therapy, physiotherapy procedures to strengthen muscles, such as electrical stimulation. In severe 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 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, resulting in 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 and pain-relieving drugs, physiotherapeutic procedures (magnetic therapy, electrophoresis), therapeutic massage and physiotherapy.
Physiotherapy procedures help relieve pain due to joint pathologies
Spondylolisthesis
Displacement of a vertebra relative to the spine (spondylolisthesis) occurs as a result of injury or degenerative processes in the spine. The pathology occurs in athletes, the elderly or people with a hereditary predisposition to bone diseases (for example, osteoporosis - a disorder of bone density). Spondylolisthesis can cause severe pain in the lower back, buttocks and legs and cause leg cramps or weakness.
Treatment involves relieving pain and inflammation that occurs due to compression of adjacent tissues by the vertebra. Depending on the severity of the pain syndrome, the doctor may prescribe non-hormonal pain relievers in tablets or injections of corticosteroid drugs. At the same time, physical therapy 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 disappears or decreases 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 the bone tissue (osteomyelitis) and inflammation of the intervertebral disc (discitis) can cause severe pain in the lower back. 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, after which rehabilitation is required, which takes from 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 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 subside with a change of position or after rest. 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 tumors. Pain relief is done with non-hormonal or steroid drugs. To stabilize the spine, the doctor may prescribe wearing a corset.
An orthopedic corset helps to stabilize the spine
Diseases of internal organs causing 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 the internal organs: pyelonephritis, urolithiasis, aneurysm of the abdominal aorta. In women, pain in the lower back can develop due to gynecological pathologies.
Urolithiasis disease
A disease in which stones form in the kidneys and bladder - hard formations from the precipitate 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, kidney stones can cause a dull aching pain that comes and goes periodically, or a very sharp pain that does not go away on its own and requires emergency medical attention.
Urolithiasis - formation of stones in the kidneys and bladder
If you suspect kidney stones, you should contact a urologist or nephrologist. The doctor will prescribe tests and instrumental studies (ultrasound, X-ray examination, computed tomography, including with 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, medical treatment is used. If there is no positive dynamics within a month, removal by non-invasive or surgical methods is recommended.
Abdominal aortic aneurysm
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 and women over 70, including smokers suffering from vascular diseases (high blood pressure), who previously had aneurysms or have a hereditary predisposition to them.
Lower back pain due to abdominal aortic aneurysm does not go away with time and may be accompanied by abdominal and leg pain.
If 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 correction. 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 damage to muscles, fascia, joints or bones, the main recommendation for prevention is to follow precautions, maintain a strong muscle corset, as well as healthy bones and joints.
Prevention of sprains and microtraumas of the lower back:
- a varied diet that includes vitamins and minerals necessary to maintain 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 muscle frame, stretching to relieve muscle tension and spasms, and cardio training to maintain blood supply and tissue nutrition;
- observance of safety measures during sports - for example, the first classes in the gym must be supervised by a qualified trainer;
- observing safety measures at home - many injuries can be avoided if you wear comfortable shoes, hold on to the railings on the stairs, do not rush when it is slippery outside;
- observing 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, not tiltyour body.
Yoga and Pilates classes help relieve spasms and tension in the lower back
Smoking impairs circulation and impairs tissue nutrition, increasing the risk of damage and injury.
What to do if your back hurts
If your lower back hurts, the causes may be different, which means that the treatment tactics will also be different.
In case of severe physical fatigue, it is necessary to give the back a rest - perhaps this will be enough to restore the muscles and return the mobility of the spine.
If the pain does not disappear within 1-2 days or if it is very strong, you should consult a doctor. While you are waiting for a doctor, you can try to relieve the acute pain with painkillers.
At the appointment, the doctor will conduct an examination, determine the cause of the pain and give recommendations for treatment. This will help eliminate dangerous conditions and prevent the development of complications.
Warming (lumbar pepper, hot water bottle, sauna) is contraindicated in inflammation, but may relieve acute low back pain if caused by muscle fatigue or pinched nerve. These methods can only be used after consulting a doctor.
Which doctor should I consult with a complaint of lower back pain?
If you suspect pathology of the musculoskeletal system, you should contact a neurologist and an orthopedic traumatologist.
The diagnosis is made during a physical examination and with the help of instrumental methods: magnetic resonance therapy, computer tomography, X-rays and ultrasound. It is also possible to prescribe a myelogram (X-ray or computer study with a contrast substance injected into the spinal canal) and electromyography - a study that allows you to assess the condition of nerve and muscle fibers.
If you suspect kidney disease, you should contact a urologist, nephrologist or therapist. The doctor will analyze the complaints and conduct a physical examination, after which he will 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 examinations will help to 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 an anamnesis (medical history), analyze hereditary risks, conduct a physical examination and prescribe tests that will identify inflammatory processes or disorders 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 tests (ultrasound, X-rays, MRI) or recommend contacting a specialist for further diagnosis and treatment.