Low painIndicates a disease or damage to the spine of the spine, nerve structures, soft tissues, internal organs, is observed with feverish states of various genesis.It is sharp, stupid, constant, periodic, burning, throwing, bursting.Sometimes it is associated with physical activity, climate changes.Pathologies, manifested by lumbar pain, are diagnosed based on complaints, anamnesis, examination data and additional studies: radiography, magnetic resonance imaging, CT.Before making a diagnosis, peace is necessary, sometimes it is allowed to use ointments, taking painkillers.
Why the lower back hurt
Spine diseases
A common cause of lower back pain are congenital anomalies and acquired diseases of the spine of the spine.The nature of pain syndrome varies.The pain caused directly by the pathological process, usually periodic, local, painful or pulled, is associated with climate, physical activity, remain in an uncomfortable position.
Due to the spasm of the muscles, lumbago (lateral) occurs-a marked pain accompanied by the restriction of movements.With many pathologies from the spine, lumboyshialgia - pain, burning or wood is observed, radiating on the back of the thigh.Painful sensations are often found in root syndrome.Can be detected in the following spinal spinal diseases:
- Degenerative pathologies: Osteochondrosis, intervertebral disc protrusion, intervertebral hernia, spondylosis, spondyle arthrosis.
- Congenital anomalies: Sacralization, Lombalization.
- Polyetiological conditions: SPONDYLOLIS, SPANDLONIST.
- Vascular diseases: Violations of spinal circulation.
- Other diseases: Inauguration disease.
- Secondary lesions of nerve structures: Lumbosacra radiculitis, plexite lumbosacra, myelopathy of various genesis.
Spine curvature
Smaller or moderate pain are observed for all types of spine curvature of the spine, which is associated with non -violeological redistribution of the load, muscle overtellation and back ligaments.The pain appears as a result of an uncomfortable body position, sleep in the bed very hard or very soft.The symptom is accompanied by:
- Lordosis;
- kyphosis;
- scoliosis;
- ciposcoliosis;
- Flat back syndrome.
Osteoporosis
Pulling or painful painful sensations in the lumbar and thoracic spine for a long time are the only symptom of osteoporosis.Pain syndrome is expressly expressed, intensifies after load before changing the weather conditions.The symptom is observed in the following varieties of osteoporosis:
- post -feedback;
- Youth;
- idiopathic;
- senile.
Similar pains are detected in patients with secondary forms of pathology due to genetic diseases, endocrine disorders, chronic poisoning and take some medications.Secondary osteoporosis can also occur against the bottom of malabsorption syndrome, liver disease, kHpn, rheumatoid arthritis, well.
Strengthening pain, increasing pain duration may be associated with the development of a pathological fracture.Other signs of trauma are usually not expressed, so fracture usually remains without diagnosis.
Spine lesions
The most common damage is the bruise of the spine of the spine.In light cases, the pathology manifests itself by moderate lower back pain, intensifying during movements, local edema and sometimes bruises and bleeding.In severe hematomas, neurological disorders are added to listed symptoms.
Lumbar spine compression fracture occurs due to violent body flexion.It is characterized by acute pain, maintaining breathing at the time of injury.Then an increase in pain in case of body shifts is observed, soft tissue edema is detected.The palpation of the spinous process is painful.Other possible fractures include damage to arcs, transverse processes, thorny processes.
In addition, lumbar pain is found in patients with traumatic spondylolistisia and vertebra subluxation.The painful sensations are paroxysmal, remember lumbago, complemented by a sense of gravity and numbness of the lower extremities.
Soft and kidney tissue injuries
Soft tissue injury is accompanied by insignificant or moderate that quickly diminish local pain, small edema.Bleeding are possible.There is no blood in the urine.Renal bruises are manifested by short -term insignificant pain and hematuria.In the case of kidney lesions, painful syndrome is intense, pain radiates to the lower abdomen, groin and genitals.A hematoma is visible in the lower back.In severe cases, intense pain, prolonged macrohematuria are observed.The shock condition develops.
Spine and spinal cord infections
The osteomyelitis of the spine can be hematogenic, post -traumatic, contact, postoperative.The acute form of the disease is manifested by rapidly increasing lower back pain, combined with chills, fever, intoxication syndrome and general deterioration.The pain twists, bursting, so intense that they prevent any movements, force the patient to freeze in the bed.In chronic osteomyelitis, the manifestations are softened, a fistulous course with purulent separate.
Spinal spine tuberculosis develops gradually.At first, periodic deep aches are observed, improved after load, increased skin sensitivity in the projection of affected vertebrae.The rigidity of the march is formed.In the context of the significant destruction of bone structures, the nature of pain changes, as it is caused by compression of nerve roots.The pain burns, radiates to the legs, complemented by paraesthesia, numbness.
In patients with spinal epidural abscess, pain is severe, deep, spilled, combined with chills, hyperthermia, muscle tension.The recording in the thorny processes of the vertebrae is painful.With the progression of the pathology, the rooster syndrome occurs and then paresis, the disorders of the pelvic organs develop.
Local inflammatory processes
Purulent processes in surface tissues and nearby soil fiber are accompanied by intense lower back pain.Possible causes of pain syndrome are boils, carbunks and paranephritis.
In the first two cases, the abscess is formed on the skin, it looks like a limited and painful seal, with a diameter of 1 cm of precious shadow or red blue with one or more stresses in the center.The pain intensifies rapidly, writhing, pulsating, losing sleep.General hyperthermia, insignificant or moderate violation of the general state are observed.
With paranephritis, there is a pronounced fever at first.Pain syndrome develops after 2-3 days.The pains are very intense, they can be given to the stomach or hypocondrium, intensify when walking, movements, deep breathing.In some forms of paranephritis due to pain, the patient assumes a forced position.The lumbar muscles are tense.Edema, local hyperemia, hyperthermia are detected.The condition is severe.
Infectious diseases
Diffuse painful pain in the lower back, causing a desire to change the position of the body, is characteristic of acute infections, accompanied by an increase in temperature and intoxication syndrome.In most cases, they are due to myositis, usually combined with pain in the limb muscles.Observed with influenza, tonsillitis, acute respiratory viral infections.Sometimes pain is caused by kidney damage.Infectious diseases accompanied by pain in the lower back include:
- Hemorrhagic fever;
- Japanese mosquito encephalitis;
- Ebola fever;
- foot and mouth disease;
- severe form of coronavirus infection;
- Generalized forms of bacterial, fungal and viral infections.
In several patients, lower back pain is observed with a cytokine storm - an inflammatory reaction that develops in the bottom of serious infectious diseases.Epidemiological myalgia is accompanied by intense paroxysmal pain of up to 10 minutes, which appear not only in the lower back, but also in other parts of the back, in the area of the abdominal wall, chest, limbs.Repeated with a 30 to 60 minute interval.Combined with rhinitis, conjunctivitis, severe hyperthermia.
Other muscle injuries
Painful pain in the muscles of the lower back is determined after intense physical effort - the performance of strength exercises to the back muscles, a long stay in a forced position with a tense back.Myalgia decreases at rest, intensifies during movements, weakens after heating, heater, disappears after a few days.
Myiosites develop not only with infectious diseases, but also after hypothermia or overload, against the exogenous intoxication background, metabolic disorders.Accompanied by painful pain in the long run.There are also special forms of myositis:
- Infectious myositis specific to syphilis and tuberculosis;
- Idiopathic and juvenile dermatomyositis and polymiciositis;
- Polymicositis and dermatomyositis for cancer pathologies, systemic diseases of connective tissue.
Chronic diffuse pain throughout the body, including the lower back, are observed with fibromyalgia.They are combined with sleep disorders, astenia, neurotic disorders.
Other diseases
In addition to the pathologies listed from the lower back, they can worry about the conditions such as:
- Spine tumor, spinal cord: Sarcoma, hemangioma, metastases, intramedular and extra -sagraul neoplasms of the spinal cord.
- Kidney disease: pyelonephritis, glomerulonephritis, uroolithiasis, kidney heart attack, kidney vein thrombosis, kidney cyst, kidney cancer, purulent processes.
- Hereditary diseases: Hereditary cerebellar ataxia Pierre-Marie.
- Exogenous poisoning: Phenylpropanolamine abuse.
- Heart pathologies and blood vessels: Endocarditis leffler, abdominal aortic aneurysm.
- Emergency conditions: Hemotransfusion shock.
For pelvis diseases, pain irradiation in the lower back is sometimes observed.The appearance of a symptom is possible with various female diseases, prostate cancer, projection, sigmoid.
Diagnosis
The primary diagnosis is made by an orthopedic traumatologist.In the presence of patient neurological symptoms, the neurologist examines.The doctor interviews the patient, performs an objective exam.According to the testimony, consultations of a surgeon, rheumatologist, urologist and other experts are appointed.The diagnostic program may include:
- Neurological examination.In the research process, the expert evaluates reflexes, muscle strength, movement coordination, deep and superficial sensitivity.
- X -Ray.Regarding the radiographs of the lower back, fractures, a decrease in intervertebral disc high, other degenerative changes, volumetric formations, signs of inflammatory processes and spondylolists are visible.If necessary, standard radiographs are complemented by functional studies.
- Other methods of neuroimaging.To clarify the radiography data, CT and MRI are used.During computed tomography, the structure of solid structures is studied in detail, the state of ligaments and intervertebral discs is examined in magnetic resonance imaging.To exclude stenosis, myelography is performed.
- Functional research.The condition of the muscles and nervous conductivity is evaluated using electromyography, electroneorography and studies of potential caused.
- Laboratory tests.To confirm the infectious nature of the disease, the determination of the pathogen has blood tests and microbiological examination.To detect neuroinfections, serological reactions are used.
According to the testimony, an ultrasound of the kidneys, prostate, pelvic organs, urine tests, abdominal aorta, other studies and other studies are performed.
Treatment of Line Pain
Help in the pre -hospital internship
With traumatic damage to the spine, it is necessary to place the patient in the shield and immediately deliver to the medical institution.In the case of non -human pain, it is necessary to reduce the load at the rear, optimize body position during work and rest.Acute pain syndrome is an indication for consulting a neurologist.
Prior to the expert examination, analgesic intake is possible.In Lumbago, the lower back -lumbar caused by previously diagnosed degenerative diseases of the spine, the use of heating and analgesics from local acts is allowed.If there is a suspicion of the presence of an infectious process, local funds will not be shown.
Conservative therapy
The basis of treatment are physiotherapeutic measures and drug therapy.The patient receives a protection regime.Apply the following methods:
- Aine.Effective in acute and chronic muscles and spine.Used in the form of tablets, local products.
- Neurotropic vitamins.Patients are introduced by B -complex vitamins, which increase the effect of drugs from other groups, help reduce pain.
- Local anesthetics.With stubborn and acute pain, therapeutic blockages with anesthetics are performed.To improve treatment outcome, painkillers are combined with glucocorticosteroids.
- Fissoalization.Apply ultrasound, magnetotherapy, percutaneous electrical stimulation, laser therapy, medicine electrophoresis.It is possible to prescribe massage, manual therapy, acupuncture.
Surgical treatment
Given the characteristics of the pathology, the following surgical interventions are performed:
- Instability: Inter -core spondylodesis, transpedicular fixation, plates fixation.
- Tumors, osteoporosis, osteomyelitis, tuberculosis: sequestralctomy, vertebroplasty, scoplasty, corporate.
- Intervertebral hernias: dyscoctomy, microdiscectomy, nucleoplasty.
- Placing the spinal canal: laminectomy, facetectomy, disk punctuation decompression.
In the post -operative period, analgesics, antibiotics are prescribed.Rehabilitation measures include exercise, massage, physical therapy.