Lumbar pain is one of the most common causes forcing a patient to seek help from a neurologist or therapist. Pain in the lumbosacral spine can become permanently disabled, making movement and self-care impossible. Acute low back pain often affects both men and women. Lower back pain is more common in adolescents and young adults with a higher incidence in middle and old age. This is due to rapid growth, weakness of the fragile muscles of the lower back, injuries. Thus, lumbosacral spine pain is the most pressing problem anyone can face.
Possible causes of back pain in the lumbar region
Lumbosacral spine pain may be associated with processes inside and outside the spine. . . Consider the main pathological conditions in which acute low back pain is observed.
- The most common problem and cause of pain is lumbosacral osteochondrosis. . . This is due to age-related changes in the spine, dystrophy (malnutrition) of the corresponding segments of the spine and cartilage, and a decrease in vertebral height. These pathological processes lead to bone growth and damage to the nerve roots at the site of stenosis. As a result, severe pain develops in the lumbosacral back (spine). The lumbosacral region of osteochondrosis is much more common in obese people as well as in patients who have experienced prolonged physical exertion, contributing to the wear and tear of all vertebral structures. Frequent injuries, falls, weight bearing, and associated osteoporosis exacerbate the picture and course of the disease. Pain in the lumbosacral region is also associated with the involvement of paravertebral muscle fibers (causing muscle tension) and ligaments in the process.
- Herniated plate is an equally rare cause, the clinical manifestation of which is lumbosacral back pain. The intervertebral disc (inner nucleus pulposus) loses its elasticity and resilience with prolonged traumatic exposure as it ages. With continuous exposure (overweight, trauma, progressive osteoporosis), the annular fibrosis of the disc becomes thinner and defects occur. Through these weak points in the annulus fibrosus, the pulposus nucleus of the disc can move and even protrude.
The herniated disc is formed when the annulus fibrosus ruptures and the nucleus pulposus compresses the elements of the nerve roots leaving the spinal cord. Compression leads to pain in the lumbar region becoming extremely intense, sometimes unbearable. Pain in the lumbosacral spine with a disc herniation can be accompanied by sensory disturbances and various types of numbness in the corresponding segments of decompression (compression). The lower back pain radiates to the lower limb (ad), causing muscle tension in the spasm. With a prolonged course, the disc herniation causes chronic pain in the lumbosacral region. Back muscle tension in a constant state further increases the pain syndrome, which becomes chronic.
- Spinal stenosis (narrowing)- Lumbosacral back pain is seen with prolonged walking or exercise. Acute low back pain can be accompanied by weakness of the legs, spasmodic symptoms of the lumbar muscles and buttocks. In case of significant damage, sensory disorders may occur.
- Tumor changes in segments of the lumbosacral vertebraeoften manifested in varying degrees of pain in the lumbar region. Typically, lower back pain gets worse as the process progresses. The nature of the tumor lesion can be both benign (vertebral cyst) and malignant (spinal tumor or metastatic lesions of a distant tumor). Due to its morphological nature, the tumor may develop as a result of osteosarcoma, hemangioma, or myeloma. The pain in the lumbosacral region with this pathology often disturbs the patient day and night (continuously, without lack of light), increases at rest, with shaking, knocking. Lower back pain is accompanied by muscle tension, cramps, sensory disturbances, weight loss, blood changes (anemia).
- Osteoporosis (bone loss)- quite often the cause of pain in bones of different localizations. Osteoporosis develops as a result of faster excretion of calcium from bones, as a result of which all bones become brittle, prone to fractures with low mechanical stress (often of a household nature). In osteoporosis, lumbosacral back pain is combined with other bone pain, the pain syndrome is moderate. Pain in the lumbar region can cause muscle tension and cramps, often along with a decrease in the patient's height. The most common type of osteoporosis is menopause, which occurs in women after the extinction of ovarian function.
- Ankylosing spondylitisoften characterized by pain in the lumbar region and ileosacral joint along with pain in the entire spine. Over time, the disease leads to spinal stiffness and involvement of other peripheral joints in the chronic process.
Under these conditions, pain in the lumbar region may be caused by the following non-vertebrogenic defects:
- diseases of the kidneys, pelvic pelvis(exacerbation of chronic pyelonephritis), renal urolithiasis, renal cancer and metastases of renal tumors. However, in the lumbar region, the pain is slightly higher localized (at the site of kidney projection), the pain in the lumbosacral region is not very characteristic. Pain is accompanied by other characteristic changes (frequent urination, dysuria, changes in urine analysis, temperature response);
- diseases of the upper floors of the digestive system(gastric ulcer, pancreatitis, pancreatic cancer) at a certain localization sometimes appear as pain in the lumbosacral region. But back pain is not accompanied by movements, can be combined with other complaints (vomiting, stool disturbances, nausea, burning along the esophagus);
- acute back pain may occur in some casesfor various inflammatory diseases of the female genitals(adnexitis, endometriosis), cancer (uterine cancer), fibroids, abdominal tumors. Women’s back pain sometimes occurs during or immediately before menstruation. During pregnancy, difficulty and pain can also occur in the lumbar region and sacrum;
- deforming hip joint osteoarthritis(coxarthrosis), especially with exacerbation of the process, gait disturbance, gait difficulties may cause pain in the lumbosacral region, in the muscular area of the gluteal region on the appropriate side of the lesion, tension in the lower back and buttock muscles.
Acute low back pain: what to do?
If the patient has acute back pain in the lumbar region, the assistance of a qualified professional should be sought immediately to diagnose the cause of the pain. More often, the patient turns to a neurologist, where he or she is diagnosed with spinal disease after proper diagnosis (X-ray, computed tomography, MRI) and neurological examination.
In the absence of convincing data on spinal pathology (osteochondrosis, disc herniation), additional methods (ultrasound imaging of internal organs, densitometry, pelvic ultrasound) and consultation with related professionals (oncologist, gynecologist, endocrinologist) may be required.
Treatment of back pain in the lumbar region
Acute low back pain prescribed by a doctor, non-steroidal anti-inflammatory drugs (in the form of tablets or injections), muscle relaxants, rest, bed rest, anti-inflammatory ointments, compresses. Treatment in the acute phase can be performed in a standing position or in an outpatient clinic.
Prescribe medications that improve microcirculation, acute back pain, blockade. Sometimes they resort to surgical treatment (by compressing the nerve roots) due to the ineffectiveness of other types of therapeutic effects. In combination with osteoarthritis, chondroprotectors are used for a long time, in osteoporosis - calcium and vitamin D3 preparations. Physiotherapeutic effects (provided there are no contraindications), physiotherapy practices and in the rehabilitation phase - aftercare can be used in sanatoriums.