Lows painDisplays an illness or damage to the spine, nerve structures, soft tissue and inner organs are observed with feverish conditions of different genesis.It is acute, stupid, constant, periodic, burning, shooting, bursting.Sometimes it is associated with physical activity, changes in the weather.Pathologies that are manifested by pain in the lower back of the back are diagnosed on the basis of symptoms, anamnesis, examination data and additional studies: radiography, MRI, ct.Peace is necessary before diagnosis, sometimes it is permitted to use ointments and take analgesics.
Why does the lower back hurt
Spinal diseases
A common cause of back pain is congenital anomalies and acquired diseases of the spine.The nature of pain syndrome varies.Pain caused directly by the pathological process, often regularly, locally, painful or pulled, remain in an unpleasant position with weather, physical activity.
Due to the cramp of the muscles, Lumbago (lateral) occurs in a sharp pain, accompanied by the restriction of movements.In many pathologies of the spine, lumboyshialgia is observed - pain, burning or burning and beaming on the back of the thigh.Painful sensations are often found in radicular syndrome.Can be recognized in the following diseases of the spine:
- Degenerative pathologies: Osteochondrosis, lead of the intervertebral disc, Schwandebral hernia, spondylosis, spondylo arthrosis.
- Congenital anomalies: Sacralization, lumbarization.
- Polyetiological conditions: Spondylolis, spondylolist.
- Vascular diseases: Violations of the spine circuit.
- Other diseases: Pre -unit.
- Secondary lesions of nerve structures: Lumbosacral radiculitis, plexitis lumbosacral, myelopathy of various origins.
Craumatic of the spine
For all types of curvature of the spine, minor or moderate painful pain is found, which are associated with a non -violeological redistribution of the load, overvoltage of the muscles and ligaments of the back.Pain appears due to an unpleasant body position, sleep on too hard or too soft bed.The symptom is accompanied by:
- Lordosis;
- Kyphosis;
- Scoliosis;
- Kyphoscoliosis;
- Flat Back syndrome.
osteoporosis
Pulling or painful painful sensations in the lumbar and thoracic spine is the only symptom of osteoporosis for a long time.Pain syndrome is expressly expressly expressed and reinforced after the load before the weather conditions are changed.The symptom is observed in the following varieties of osteoporosis:
- Postmenopausal;
- Youthful;
- idiopathic;
- Senile.
Similar pain is found in patients with secondary forms of pathology due to genetic diseases, endocrine disorders, chronic poisoning and taking medication.Secondary osteoporosis can also occur against the background of the malabsorption syndrome, liver diseases, KHPN, rheumatoid arthritis, well.
Strengthening the pain, increasing the pain duration can be associated with the development of a pathological fracture.Other signs of trauma are often not expressed, so that the fracture often does not remain diagnosed.
Spine injuries
The most common damage is the bruise of the spine.In mild cases, the pathology manifests itself through moderate pain in the lower back, which intensifies during movements, local edema and sometimes hematoma and bleeding.In heavy blue spots, neurological disorders are added to the listed symptoms.
The compression fracture of the lumbar spine occurs due to violent body flexion.It is characterized by sharp pain and breathing at the time of the injury.Then an increase in the pain in corps curves is determined, soft tissue edema is determined.Palpation of the specialist process is painful.Other possible fractures include damage to arches, transverse processes, specialist processes.
In addition, patients with traumatic spondylolistise and subluxation of the vertebrae can be found in patients with traumatic spondylolistish.Painful sensations are paroxysmal, resemble lumbago, supplemented by a feeling of severe and deafness of the lower extremities.
Injuries to soft tissues and kidneys
The violation of soft tissues is accompanied by insignificant or moderate, quickly follow -up local pain, small edema.Bleeding are possible.There is no blood in the urine.The kidney needles manifest themselves through pain and insignificant short -term hematuria.In the case of kidney injuries, the painful syndrome is intense, pain radiates on the lower abdomen, the groin area and genitals.A hematoma is visible in the lumbar region.In severe cases, severe pain and longer macrohematuria are observed.The state of shock is developing.
Spine and spinal cord infections
Osteomyelitis of the spine can be hematogenic, post -traumatic, contact, postoperative.The acute form of the disease manifests itself through rapidly increasing pain in the lower back, combined with chills, fever, inxication syndrome and a deterioration in the general condition.The pain twitches, bursts and so intensely that they prevent movements, force the patient to freeze in bed.In chronic osteomyelitis, manifestations are smoothed, a fistula course with purulent separate course is formed.
The tuberculosis of the spine gradually develops.First, periodic deep pain is observed and reinforced after the stress, the increased sensitivity of the skin in the projection of the affected vertebrae.The stiffness of the passage is formed.Against the background of the significant destruction of bone structures, the type of pain changes because it is caused by the compression of the nerve roots.The pain burns, shines on the legs, supplemented by paraesthesia, numbness.
In patients with epidural abscess with spine, the pain is heavy, deep, cast, combined with chills, hyperthermia and muscle tension.Taking up the spells' mutual processes is painful.With the progress of the pathology, the Rooster syndrome occurs, then the paresis, then the disorders of the pelvic organs, develop.
Local inflammatory processes
Wearing processes in surface fabrics and almost soil fibers are accompanied by intensive pain in the lower back area.Possible causes of pain syndrome are spring, carbohydrates and paranephritis.
In the first two cases, the abscess is formed in the skin, looks like a limited, sharply painful seal with a diameter of 1 cm purple or purple shadow with one or more rods in the middle.The pain tightens quickly, becomes twitching, pulsating and lose sleep.General hyperthermia, insignificant or moderate violation of the general state are determined.
In paranephritis, a pronounced fever initially occurs.Pain syndrome develops after 2-3 days.The pain is very intense, can be given to the stomach or hypochondrium, increases when walking, movements, deep breathing.In some forms of paranephritis due to pain, the patient occupies a forced position.The lumbar muscles are tense.Edema, local hyperemia, hyperthermia are determined.The condition is serious.
Infectious diseases
Diffuse painful pain in the lower back, which causes the desire to change the position of the body, are characteristic of acute infections, accompanied by an increase in temperature and inxication syndrome.In most cases, they are due to myositis, which are often combined with pain in the muscles of the limbs.Observed with influenza, tonsillitis, acute breathing virus infections.Sometimes pain is provoked by kidney damage.The infectious diseases accompanied by pain in the lower back area include:
- Hemorrhagic fever;
- Japanese mosquito dephalitis;
- Ebola fever;
- Correspondence and mouth disease;
- severe form of a coronavirus infection;
- Generalized forms of bacterial, mushrooms, viral infections.
In a number of patients, the pain in the lower back in a cytokine storm is observed - an inflammatory reaction that develops against the background of serious infectious diseases.Epidemiological myalgia is accompanied by intensive paroxysmal pain of up to 10 minutes, which occurs not only in the lower back, but also in other parts of the back in the area of the abdominal wall, chest and limbs.Repeated with an interval of 30-60 minutes.In combination with rhinitis, conjunctivitis, severe hyperthermia.
Other muscle lesions
The painful pain in the muscles of the lumbar spine is determined after intensive physical exertion - the performance of strength exercises for the muscles of the back, a long stay in a forced position with a tense lower back.Myalgia refuses in peace, increases during the movements, weakens after warming, properly warm up, disappears after a few days.
Myosites not only develop with infectious diseases, but also after hypothermia or overload against the background of exogenous poisoning and metabolic disorders.Accompanied by long -term painful pain.There are also special forms of myositis:
- specific infectious myositis for syphilis and tuberculosis;
- Idiopathic, juvenile dermatomyositis and polymiositis;
- Polymiositis and dermatomyositis for oncological pathologies, systemic diseases of the connective tissue.
Chronic diffuse pain throughout the body, including the lower back, is observed with fibromyalgia.They are combined with sleep disorders, asthenia and neurotic disorders.
Other diseases
In addition to the listed pathologies of the lower back, you can deal with such conditions as:
- Tumor of the spine, spinal cord: Sarcoma, hemangioma, metastases, intramedullary and extra -rehearsal -neoplasms of the spinal cord.
- Kidney disease: Pyelonephritis, glomerulonephritis, urolithiasis, Kidney heart -hearted, kidney vein -thrombosis, kidney cyst, kidney cancer, astructed processes.
- Hereditary diseases: hereditary cerebellar pierre-marie.
- Exogenous poisoning: Misuse of phenylpropanolamine.
- Pathologies of heart and blood vessels: Endocarditis Leffler, aneurysm of the abdominal aorta.
- Emergency conditions: Hemotransfusion shock.
In the case of diseases of the pelvis, the radiation of pain in the lower back is sometimes noted.The occurrence of a symptom is possible with a number of female diseases, prostate cancer, projection and sigmoid.
Diagnosis
Primary diagnostics are carried out by an orthopedic traumatologist.In the presence of neurological symptoms of the patient, the neurologist examines.The doctor interviews the patient and carries out an objective examination.According to statements, the consultations of a surgeon, rheumatologist, urologist and other specialists are appointed.The diagnostic program can include:
- Neurological examination.In the research process, the specialist evaluates reflexes, muscle strength, coordination of movements, depth and superficial sensitivity.
- X -Ray.In the X -rays of the lumbar department, fractures, a decrease in the height of the intervertebral discs, other degenerative changes, volumetric formations, signs of inflammatory processes and spondylolisthesis are visible.If necessary, standard X -rays are supplemented by functional studies.
- Other neuroimaging methods.To clarify the data of radiography, CT and MRI are used.During computer tomography, the structure of solid structures is examined in detail, the condition of the ligaments and the intervertebral discs are examined on the MRI.In order to rule out stenosis, myelography is carried out.
- Functional research.The condition of the muscles and the nervous conductivity is evaluated using electromyography, electronography and studies on potential.
- Laboratory tests.In order to confirm the infectious nature of the disease, the determination of the pathogen conducts blood tests and microbiological examinations.Serological reactions are used to prove neuro -infections.
According to the certificate, an ultrasound of the kidneys, prostates, pelvic organs, urine tests, abdominal aorta, other studies and other studies are carried out.
Line pain treatment
Help in the pre -clinical phase
With traumatic damage to the spine, it is necessary to put the patient on the sign and immediately deliver to the medical facility.In the case of non -human pain, it is necessary to reduce the load on the back, to optimize the position of the body during work and calm.Acute pain syndrome is an indication of the advice of a neurologist.
Before the expert examination, a single analgesic recording is possible.In Lumbago is Lumbal -Ilgie, which is caused by previously diagnosed degenerative diseases of the spine, the use of warming and pain relief.If there is an infectious process of the presence, local funds are not displayed.
Conservative therapy
The basis of the treatment is physiotherapy measures and drug therapy.A protective regime is prescribed to the patient.Use the following methods:
- NSAID.Effective in acute and chronic muscles and spine.Is used in the form of tablets, local products.
- Neurotrope vitamins.The patients are introduced by B vitamins that improve the effects of drugs from other groups and reduce the pain.
- Local anesthetics.Therapeutic blockages with anesthetics are carried out with stubborn and acute pain.To improve the result of treatment, pain relievers are combined with glucocorticosteroids.
- Physoization.Use ultrasound, magnetotherapy, percutaneous electrical stimulation, laser therapy, drug electrophoresis.It is possible to prescribe massage, manual therapy, acupuncture.
Surgical treatment
In view of the characteristics of the pathology, the following surgical interventions are carried out:
- Instability: Inter -core spondylodesis, transedicular fixation, fixation with plates.
- Tumors, osteoporosis, osteomyelitis, tuberculosis: sequestralktomie, vertebroplasty, kyphoplasty, company.
- Intermediate vertebrae: diskomy, microdiseis, nucleoplasty.
- Set the spine canal: laminectomy, facetectomy, hard disk decompression.
In the postoperative period, analgesics are prescribed antibiotics.The rehabilitation measures include practice therapy, massage, physiotherapy.