Low back pain is one of the most common reasons that force patients to seek help from a neurologist or therapist. Lumbosacral pain can cause permanent disability, making exercise and self-care impossible. Acute low back pain also often affects men and women. The incidence is higher in middle-aged and elderly people, and low back pain often occurs in teenagers and young people. This is caused by rapid growth, weak muscles in the lower back, and injuries. Therefore, lumbosacral pain is the most pressing problem that anyone can face.
Possible causes of low back pain
Lumbosacral pain may be related to the spine itself and processes occurring outside the spine. . . Consider that the main pathological conditions of acute low back pain can be observed.
- The most common cause of problems and pain is lumbosacral osteochondrosis. . . It is caused by age-related changes in spinal involution, malnutrition (malnutrition) of the corresponding segments of the spine and cartilage, and decreased vertebral height. These pathological processes lead to bone growth and nerve root invasion in the stenosis. As a result, severe pain in the lumbosacral (spine). Osteochondrosis of the lumbosacral region is more common in obese people and patients with long-term physical exertion, causing wear and tear of all vertebral structures. Frequent injuries, lying on the back, weight bearing and accompanying osteoporosis can aggravate the condition and course of the disease. Lumbosacral pain is also related to the involvement of paraspinal muscle fibers (causing muscle tension) and ligaments.
- A herniated disc is an equally rare cause, The clinical manifestation is lumbosacral pain. The intervertebral disc (nucleus pulposus) will lose its elastic properties and elasticity with prolonged trauma exposure and aging. With continuous exposure (overweight, trauma, progressive osteoporosis), the fibrous annulus of the intervertebral disc becomes thinner and forms defects in it. Through these weak points in the annulus, the nucleus pulposus of the intervertebral disc can move or even protrude.
When the annulus fibrosus ruptures and the nucleus pulposus compresses the components of the nerve roots leaving the spinal cord, a herniated disc is formed. Compression causes the waist pain to become extremely severe and sometimes unbearable. The pain of a herniated lumbosacral disc may be accompanied by sensory disturbances and various types of numbness in the corresponding decompression (compression) segments. Pain in the lower back radiates (gives) the lower limbs, causing muscle tension due to spasm. As the course of the disease increases, herniated discs can cause chronic pain in the lumbosacral area. Tension of the back muscles continues, further exacerbating the pain syndrome, making it a chronic disease.
- Spinal stenosis (narrowing)-Lumbosacral pain is related to prolonged walking or physical exertion. Acute low back pain may be accompanied by symptoms of leg weakness, waist, and gluteal muscle cramps. When severely damaged, sensory dysfunction may occur.
- Tumor lesions of the lumbosacral spine segmentUsually manifested as varying degrees of pain in the waist. Usually, as the process progresses, low back pain tends to get worse. The nature of tumor lesions can be benign (vertebral cysts) and malignant (spinal tumors, or metastatic lesions of distant tumors). According to its morphological properties, the tumor can be osteosarcoma, hemangioma or develop from myeloma. Pain in the lumbosacral region with this pathology usually afflicts the patient during the day and night (continuous, no light gap), and is exacerbated by rest, shaking, or knocking. Low back pain is accompanied by muscle tension, cramps, sensory disturbances, weight loss, and blood changes (anemia).
- Osteoporosis (bone loss)-Usually it is the cause of bone pain in different parts. Osteoporosis develops due to the accelerated excretion of calcium in the bones, so all bones become fragile and fracture easily (usually of a family nature) with little mechanical stress. The lumbosacral pain of osteoporosis is combined with other pain in the bones to have an average degree of pain syndrome. Lumbar pain can cause muscle tension and cramps, usually accompanied by a decrease in the patient's height. The most common type of osteoporosis is postmenopausal, which occurs in women after the loss of ovarian function.
- Ankylosing spondylitisIt is usually accompanied by soreness throughout the spine, characterized by pain in the lumbar and sacral joints. Over time, the disease can cause spinal stiffness and cause other peripheral joints to participate in the chronic process.
In addition to these conditions, lumbar pain may be caused by the following reasons not related to vertebral defects:
- Kidney and renal pelvis disease(Exacerbation of chronic pyelonephritis), renal urolithiasis, renal tumor disease and tumor metastasis to the kidney. At the same time, the pain in the waist is higher locally (in the projection position of the kidney), and the pain in the lumbosacral region is not very typical. Pain is accompanied by other characteristic changes (frequent urination, dysuria, changes in urinalysis, temperature response);
- Upper gastrointestinal diseases(Peptic ulcer, pancreatic inflammation, pancreatic cancer) sometimes manifests as lumbosacral pain in a certain area. But back pain has nothing to do with exercise, it can be combined with other discomforts (vomiting, stool disorder, nausea, burning pain in the esophagus);
- In some cases, acute back pain may occurUsed for various inflammatory diseases of female genital area(Annexitis, endometriosis), cancer (uterine cancer), fibroids, abdominal tumors. Women's low back pain sometimes occurs during menstruation, or just before menstrual cramps. During pregnancy, the waist and sacrum may also feel heavy and painful;
- Hip osteoarthritis(Hip joint disease), especially as the process worsens, in addition to gait disorder and difficulty walking, it can also be painful in the lumbosacral area, the hip muscle area on the corresponding side of the lesion, and the lower back and hip muscles are tight.
Acute low back pain: what to do?
If the patient has acute back pain in the waist, he must immediately seek the help of a qualified specialist to diagnose the cause of the pain that has already occurred. More commonly, the patient goes to see a neurologist, where after proper diagnosis (X-ray, computed tomography, MRI) and neurological examination, he is diagnosed with spinal disease.
If there is no convincing spinal pathology data (osteochondrosis, disc herniation), other methods (visceral ultrasound imaging, densitometry, pelvic ultrasound) and related experts (oncologists, gynecologists, endocrinologists) may be neededConsultation.
Treatment of back pain
Acute low back pain, in accordance with the doctor's prescription, through non-steroidal anti-inflammatory drugs (in the form of tablets or injections), appointment of muscle relaxants, rest, bed rest, application of anti-inflammatory ointments, application of compression. Treatment in the acute phase can be carried out in a fixed place or a polyclinic.
Prescribe drugs to improve microcirculation, acute back pain, and use blockers. Sometimes, because other types of treatment are ineffective, they resort to surgery (compression of nerve roots). When combined with osteoarthritis, chondroprotective agents are used for a long time in osteoporosis-calcium and vitamin D3 preparations. Physiotherapy effect (provided that there are no contraindications), physiotherapy exercises, in the rehabilitation phase-follow-up treatment in nursing homes can be used.