Low back pain is familiar to almost everyone. It's hard to find someone who has never experienced this extremely unpleasant symptom at least once. Sometimes it is enough to sit in an uncomfortable position for a while to cause discomfort in the lumbar region of the spine. But this is not a serious problem, but simply a consequence of being in an uncomfortable position for a long time.
But severe back pain almost always has specific reasons and is a reason to see a doctor. The diagnosis will not always be expected, because osteochondrosis is only one of the possible problems, back pain.
It is not difficult to guess why the lower back hurts and what to do in such a situation. The doctor will diagnose and identify the cause of the pain, after which treatment will need to begin.
Pain syndrome: primary and secondary
Understanding why the lower back hurts, we must not forget that the causes of such pain number in the dozens, and a layman will never be able to determine the true source of the problems.
In general, the medical classification separates the 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 he who is the cause of the vast majority of cases of back pain in the lumbar region. The most important of the reasons are degenerative-dystrophic changes that occur in various parts of the spine:
- Osteochondrosis, which is a lesion of bone and cartilage tissue, this disease has a dystrophic nature. When it affects the intervertebral disc and adjacent vertebrae, spondylosis begins to develop.
- Spondyloarthrosis is a form of osteoarthritis, in which the disease affects the intervertebral joints, which are responsible for the mobility of the spine 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;
- a tumor located in the vertebrae, in the spinal cord itself or in the retroperitoneal space, regardless of whether it is primary or caused by metastasis;
- fracture of one or more dorsal vertebrae. This is perhaps one of the most serious causes of back pain;
- various infectious diseases that cause damage to 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 that your lower back hurts;
- diseases of the gastrointestinal tract. For example, acute appendicitis with an atypical course, intestinal obstruction;
- back pain is often mirrored in nature. A similar problem can occur with some diseases of organs located in the pelvic region. For example, renal colic, sexually transmitted diseases (gonorrhea, trichomoniasis, chlamydia, ureaplasmosis, andexitis - all these diseases cause reflected back pain).
What are acute and chronic pain?
Low back pain is also divided into acute and chronic, which can be caused by a variety of problems and diseases, both of the nerve endings and of the spine itself.
Displaced pain is also often observed: there is a translation of pain from other organs, which are much deeper. In other words, it seems to a person that their lower back hurts, although in reality the problem is in a completely different part of the body. But most of the time, pain from the pelvic organs, pancreas, kidneys, colon, or tumors behind the peritoneum projects to the lower back.
People often don't know what to do if their lower back hurts. But it is very clear what you should not do: 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 do even more damage.
The specialist, in turn, makes a diagnosis based on the data obtained as a result of additional examinations, for example, MRI diagnostics 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 appeared. The reasons may be different, but most of them are related to the spine in some way.
One of the simplest and most harmless causes of pain is acute muscle strain. 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 rather 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 spinal fracture, 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 sick with hyperparathyroidism, osteoporosis, Paget's disease or there are tumors in the spinal region, then a fracture can occur and go unnoticed by the patient, as they say "out of nowhere. "Also, a person will not even understand when this fracture occurred.
An equally unpleasant situation, in the event that acute pain appears in the lumbar area, is the displacement of the intervertebral discs in the lumbar spine. The symptoms of this problem are a sharp and severe pain in the lower back, which severely restricts mobility. Most often, pain occurs due to compression of the nerve roots. The signs of such compression are:
- sensitivity disorders;
- disappearance or significant decrease of the Achilles reflex;
- absence or decreased intensity of the knee reflex;
- unilateral radicular pain.
One of the unpleasant tendencies of this problem is that such displacement can cause pathology of the lower vertebrae. As a result, pain appears below the lumbar region and the functions of the rectum and bladder may be affected. In some cases, localization of pain above the lower back is also possible.
Acute back pain can also occur as a result of facet syndrome. In this case, the cause of pain is compression of the root 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 a narrowing of the intervertebral foramen.
An epidural abscess is one of the most serious diseases that causes severe back pain. This disease requires urgent diagnosis and immediate treatment, and highly effective measures are recommended, until surgical intervention, the main thing is to quickly remove the compression of the spinal cord.
Diseases of the hip joint are also often the cause of acute low back pain. They are characterized by pain that radiates to the lower part of the lower back, to the legs up to the height of the knees.
Causes of chronic low back pain
One of the causes of chronic pain is deforming spondylosis. With this disease, a dystrophic change occurs 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 outgrowths begin to press on the nerve roots. Painful aches can be accompanied by numbness and weakness in the legs, as well as other neurological symptoms. In any case, a complete examination will be necessary, based on the results of which the final diagnosis will be established.
Bechterew's disease, also called ankylosing spondipoarthrosis, can also cause chronic pain. It manifests itself with pulling pain in the lower back, a curvature of the spine appears in the thoracic region and develops rapidly. The first symptoms are limited mobility and decreased movement of the chest when breathing.
Cancer and metabolic disorders often cause low back pain. But even benign tumors can cause chronic pain that will not be accompanied by neurological symptoms.
Osteomyelitis can also cause low back pain, which can be very long-lasting.
Conclution
As you can see, back pain can occur as a result of many diseases. At the same time, very often a person does not even expect that the problem is not where it hurts. So even if your lower back does not hurt constantly, but from time to time, do not pull, consult a doctor. It is easier to cope with any disease at an early stage, and not when it is in a neglected state and it will bring with it a lot of complications.