Lower back pain is known to almost everyone. It is difficult to find someone who has not experienced this extremely unpleasant symptom at least once. Sometimes it is enough to sit in an awkward position for a while to cause discomfort in the lumbar spine. But this is not a serious problem, but simply a consequence of a long stay in an awkward position.
But severe back pain almost always has special reasons and is a reason to go to the doctor. A diagnosis will not always be expected, as osteochondrosis is just one of the possible problems, back pain.
Why the lower back hurts and what to do in such a situation is not hard to guess. The doctor will diagnose and identify the cause of the pain, after which you will need to start treatment.
Pain syndrome - primary and secondary
Understanding why the lower back hurts, we must not forget that the causes of such pain are numbered in the dozens, and the layman will never be able to determine the true source of the problem.
In general, medical classification separates primary and secondary pain syndromes that may affect the lumbar region.
The primary back pain syndrome occurs as a consequence of musculoskeletal changes of a morphofunctional nature. It 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 different 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.
- spondyloarthritis 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 many different causes of pain:
- scoliosis, which is a curvature of the spine, as well as some other growth diseases;
- various inflammations of a non-infectious nature. For example, rheumatoid arthritis, Reiter's syndrome;
- a tumor located on the vertebrae, in the spinal cord itself, or in the retroperitoneal space, regardless of whether it is primary or caused by metastases;
- fracture of one or more dorsal vertebrae. This is perhaps one of the most serious causes of back pain;
- various infectious diseases that lead to damage to the spine and intervertebral discs (tuberculosis, brucellosis, epidural abscess);
- stroke conditions in which there is a serious disruption of the spinal cord blood supply. In this case, there may also be a feeling that your lower back is hurting;
- diseases of the gastrointestinal tract. For example, acute appendicitis with atypical course, intestinal obstruction;
- often back pain is of a reflected 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 and excitis - all of these diseases cause reflected back pain).
What are acute and chronic pain
Lower back pain is also divided into acute and chronic, which can be caused by various problems and diseases, both nerve endings and the spine itself.
Displaced pain is also often noticed - there is a translation of pain from other organs, which are much deeper. In other words, the person seems to have lower back pain, even though the problem is actually in a completely different part of the body. But most often, pain from the pelvic organs, pancreas, kidneys, colon, or tumors located behind the peritoneum is projected into the lumbar region.
Usually people do not know what to do if their lower back hurts. But it is quite clear what you should not do - it is self-medication. The causes of pain are different, only a specialist can make a correct diagnosis, and the constant use of pain medications (which many consider to be a cure) can cause even more damage.
The specialist in turn makes the 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 badly, any serious doctor will first determine the cause of the pain that has occurred. The reasons may be different, but most of them are somehow related to the spine.
One of the simplest and safest causes of pain is acute muscle strain. In this case, spasmodic long muscles are the source of pain. With this problem, the pain rarely "radiates" to other parts of the body, but severely limits a person’s mobility. This reason is very common, they often meet 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 spine. This most often happens with failed 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 that the patient will notice, as they say "out of the blue". Moreover, the person will not even understand when this fracture occurred.
An equally embarrassing situation, in case of acute lower back pain, is the displacement of the intervertebral discs in the lumbar spine. The symptoms of this problem are strong, sharp pains in the lower back, which severely limit mobility. Most often the pain occurs due to compression of the nerve roots. Signs of such compression are:
- sensitivity disorders;
- disappearance or significant reduction of the Achilles reflex;
- absence or decrease in the 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 area, and the functions of the rectum and bladder may be impaired. Localization of pain above the lower back is also possible in some cases.
Acute back pain can also occur as a result of facet syndrome. In this case, the cause of the pain is the compression of the root at the exit of the spinal canal, while the intervertebral disc itself remains intact. This syndrome usually occurs by enlargement of the upper and lower sides of the intervertebral joint, which results in narrowing of the intervertebral foramen.
Epidural abscess is one of the most severe diseases that causes severe back pain. This disease requires urgent diagnosis and urgent treatment, and all highly effective measures are recommended, until surgery, the main thing is to quickly remove the compression of the spinal cord.
Hip joint diseases are also often the cause of acute lower back pain. They are characterized by pain radiating to the lower back, from the legs to the level of the knees.
Causes of chronic back pain
One of the causes of chronic pain is spondylosis deformans. With this disease there is a dystrophic change in the vertebrae of the lumbar spine, the ligament 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 pain may be accompanied by numbness and weakness of the legs, as well as other neurological symptoms. In any case, a complete examination will be required, according to the results of which a final diagnosis will be made.
Bechterew's disease, also called ankylosing spondylitis, can also cause chronic pain. It is manifested by dragging pain in the lower back, a curvature of the spine in the thoracic region, and it develops rapidly. The first symptoms are limited mobility and reduced chest movements when breathing.
Cancer and metabolic disorders often cause lower back pain. But even benign tumors can cause chronic pain that will not be accompanied by neurological symptoms.
Osteomyelitis can also cause lower back pain, which can be very long lasting.
Conclusion
As you can see, back pain can occur as a result of many diseases. At the same time, often a person does not even expect that the problem will not be where it hurts. So, even if your lower back does not hurt constantly, but from time to time - do not pull, see a doctor. It is easier to deal with any disease at an early stage rather than when it is in a neglected state and will entail many complications.