Low back pain is familiar to almost everyone. It is difficult 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 awkward position for a long time.
But severe back pain almost always has specific reasons and is a reason to go to the doctor. The diagnosis will not always be predicted, because osteochondrosis is only one of the possible problems, back pain.
Why the lower back hurts and what to do in such a situation is not difficult to guess. Your 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 counted by the dozen, and a layman will never be able to determine the true source of the problems.
In general, the medical classification separates primary and secondary pain syndromes that can affect the lumbar region.
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 significant of the reasons are the 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, 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 diseases;
- various inflammations of a non-infectious nature. For example, rheumatoid arthritis, Reiter's syndrome;
- a tumor localized 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 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 the lower back hurts;
- diseases of the gastrointestinal tract. For example, acute appendicitis with atypical course, intestinal obstruction;
- often, back pain is reflex 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 and exite - all these diseases cause reflex 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 located much deeper. In other words, it seems to a person that the lower back hurts, although in reality the problem is in a completely different part of the body. But very often, pain from the pelvic organs, pancreas, kidneys, colon or tumors that are behind the peritoneum is projected into the lumbar region.
People usually don't know what to do if their lower back hurts. But it's clear what you shouldn't do: it's self-medication. The causes of pain are many, only a specialist can make the correct diagnosis and the constant use of painkillers (which many consider a treatment) can hurt even more.
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, 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 fatigue. In this case, the 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, 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 often 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 vertebral region, then a fracture can occur and unnoticed by the patient, as they say "out of the blue". Moreover, a person will not even understand when this fracture occurred.
An equally unpleasant situation, in the event that acute pain appears in the lower back, is the displacement of the intervertebral discs in the lumbar spine. Symptoms of this problem are severe sharp pain in the lower back, which severely limits mobility. Most often, pain occurs due to compression of the nerve roots. The signs of this compression are:
- sensitivity disorders;
- disappearance or significant decrease of the Achilles reflex;
- absence or decrease in the intensity of the knee reflex;
- unilateral root pain.
One of the unpleasant tendencies of this problem is that such a 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 can be impaired. In some cases, localization of pain above the lower back is also possible.
Acute back pain can also occur due to facet syndrome. In this case, the cause of pain is compression of the root as it exits the spinal canal, while the intervertebral disc itself remains intact. This syndrome usually results from widening of the upper and lower facets of the intervertebral joint, resulting in narrowing of the intervertebral foramen.
An epidural abscess is one of the most serious diseases that cause severe back pain. This disease requires urgent diagnosis and immediate treatment, and highly effective measures are recommended, up to surgery, the main thing is to quickly eliminate the compression of the spinal cord.
Diseases of the hip joint are also often the cause of acute lower back pain. They are characterized by pain that radiates to the lower part of the lower back, legs to the knee.
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 ligament apparatus weakens and bone growth occurs. As a result, the spinal canal narrows and the bone growths begin to press on the nerve roots. Aching pains can be accompanied by numbness and weakness in the legs, as well as other neurological symptoms. In any case, a comprehensive examination will be required, based on the results of which the final diagnosis will be established.
Bechterew's disease, also called ankylosing spondhyarthrosis, can also cause chronic pain. It is manifested by 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 back pain. But even benign tumors can cause chronic pain that will not be accompanied by neurological symptoms.
Osteomyelitis can also cause aching lower back pain, which can be very long-lasting.
Conclusion
As you can see, back pain can occur due to 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 the 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 will bring many complications with it.