Back pain in the lumbar region - causes and treatment

Various diseases can cause back pain in the lumbar region.

The main diseases that cause back pain are joint injuries in the spine or hip joint.

Most often this symptom is due to diseases of the lumbosacral spine.

The lumbar spine is mobile, which causes more frequent injuries to this particular area.

Causes of back pain in the lumbar region

Back pain is a signal that there is a problem in the body with the spine, hip or internal organs near the lower back.

If your back hurts in the lumbar region, the reasons may be the following:

• pain may occur as a result of osteochondrosis of the lumbosacral spine;
• painful sensations may be due to an intervertebral hernia;
• ankylosing spondylitis;
• vertebral displacement;
• rheumatism;
• inflammation of the back muscles (myositis);
• inflammation of the sciatic nerve;
• spinal fracture;
• osteoarthritis of the hip and other diseases of the spine and hips.

Also, lower back pain can occur due to muscle tension or muscle spasm. Muscle spasm can occur if you make sudden movements with a load on the lower back:

• making sharp turns;
• sudden weight lifting;
• when you play sports.

Osteochondrosis of the lumbosacral spine

In lumbosacral osteochondrosis, back pain in the lumbar region can be combined with symptoms such as:

• increased urination;
• urinary incontinence;
• chronic and often exacerbated diseases of the bladder;
• genital diseases;
• rectal problems.

The most common back pain with osteochondrosis is:

• pain;
• bursting;
• pulling;
• sometimes the pain is burning.

Often the pain in the lumbar region in this case disappears when standing or lying down and intensifies when sitting, especially on a hard surface, coughing and exercise.

Causes of back pain in lumbosacral osteochondrosis

The lumbar spine is characterized by great mobility and withstands heavy loads daily.

This is the main reason for the development of lumbar osteochondrosis, manifested by dystrophy and deformity of the intervertebral discs.

The group at high risk of developing lumbosacral osteochondrosis includes:

• overweight people;
• leading an inactive lifestyle;
• with incorrect posture.

Also, this disease can develop with overwork in professional athletes and even with improper exercise at home.

Frequent stress and lack of sleep can contribute to the development of osteochondrosis.

People suffering from rheumatoid arthritis, ankylosing spondylitis and other inflammatory diseases of the joints often suffer from osteochondrosis of the lumbosacral spine.

Treatment of osteochondrosis

The treatment of osteochondrosis of the sacro-lumbar spine is aimed at slowing down the process of destruction of the intervertebral discs, restoring the functions of nerve roots and eliminating pain.

To do this, attach:

• medicines;
• manual therapy;
• physiotherapeutic methods;
• physiotherapy;
• surgical methods.

In the treatment of osteochondrosis of lumbar-sacral osteochondrosis are used such drugs as:

• chondroprotectors (to restore cartilage tissue);
• non-steroidal anti-inflammatory drugs;
• immunomodulators;
• steroid hormones;
• vitamin complexes.

It is necessary to use non-steroidal anti-inflammatory drugs and steroid hormones with great care, as they have many contraindications and side effects.

There are several other methods of treating osteochondrosis:

1. Manual therapy helps to restore the functions of the lumbar spine and its anatomical structure. Osteochondrosis massage helps to strengthen the muscles of the lower back and improve metabolic processes in the tissues.
2. Physiotherapy is carried out after stopping the acute period of the disease with the help of drugs. The most useful for osteochondrosis will be: electrophoresis, paraffin therapy, phonophoresis and magnetic therapy. To achieve a tangible effect, it is recommended to conduct 3 courses of 10 physiotherapy procedures with a two-week break in between.
3. One of the most effective methods of treating osteochondrosis is physiotherapy. Physical education should be performed after appropriate consultation with a physician and preferably under the supervision of a specialist. A set of exercises designed specifically to treat lumbosacral osteochondrosis will help strengthen the muscles of the back, which will relieve some of the load on the intervertebral discs.
4. Spa treatment (radon baths, healing mud, etc. ) has a good effect on osteochondrosis.

If you ignore the symptoms of osteochondrosis and do not seek medical help, this will lead to the development of the disease and soon the back pain will become so severe that you still need to consult a doctor for help.

Prevention of osteochondrosis

For the health of the spine you need to eat right, monitor your posture and lead an active lifestyle.

When carrying weights and exercising, be careful not to stretch your back too much or damage your spine.

Back pain with intervertebral hernia

Spinal hernia or intervertebral hernia is a disease in which the intervertebral disc deforms, the outer part of the disc ruptures simultaneously with the protrusion of the inner part of the disc outside the body of the spine.

Lumbago

Lumbar back pain often occurs in lumbago.

Lumbago is a sudden onset of acute low back pain during exercise, lifting weights.

Back pain in this case has a tearing, piercing, shooting nature. It is associated with a sharp prolapse of the intervertebral disc and irritation of the nerve endings that are located in the fibrous ring.

A reflex is triggered, as a result of which the tone of the lumbar muscles increases significantly. The patient freezes in a monotonous position, unable to straighten his back and turn around.

This manifestation of disc herniation of the lumbar spine is most common in men aged 30-40 years.

sciatica

Sciatica (sciatica) - irritation of the sciatic nerve due to pinching of the hernial protrusion of the spinal roots.

Sciatica causes pain, burning, tingling and numbness that spreads from the lower back down the back of the legs.

These symptoms usually occur on one side, depending on the position of the herniated disc.

Symptoms of back pain with intervertebral hernia

Table - Symptoms of disc herniation

The main symptoms	Features
Long-term pain in the lumbar region.	It can last up to several months. They are painful, pulling, burning.
Pelvic dysfunction.	Incontinence or urinary retention. Violation of defecation. In men, hernias can affect potency.
Weakness of the leg muscles, decreased their tone, decreased reflexes.	Compression of the motor nerves in the spinal roots.
Paralysis (complete lack of movement) or paresis (partial lack of movement) in the legs.	Compression and spinal cord injury.
Pale skin, increased sweating, white or red spots.	Compression of nerves in the spinal roots that regulate blood vessels, sweat glands and other autonomic functions.

In most cases, intervertebral hernias develop pathological changes in the lumbar spine.

Identification of disc herniation

Statistics for the detection of intervertebral hernias:

• 48% of disc herniations occur between the last lumbar vertebra (heel) and the sacrum.
• 46% are between the fourth and fifth lumbar vertebrae.

Reasons for the development of intervertebral hernia

Disc herniation develops due to:

1. Degenerative changes in the vertebrae and intervertebral discs. Disc herniation is often a complication of osteochondrosis.
2. Delayed spinal injuries: compression fractures of the vertebrae, subluxation.
3. Increased loads on the spine: when working constantly sitting or standing in a monotonous position, improper weightlifting, excessive physical activity, overtraining in athletes.
4. Sedentary way of life.
5. Infectious diseases in which the spine is affected.
6. Overweight.
7. Congenital malformations of the spine.
8. Vibration action. Most often this is due to industrial hazards. Under the influence of vibrations the structure of the intervertebral disc is disturbed, it becomes weakened.
9. Poor posture, scoliosis.

Treatment of disc herniation

According to statistics, in most cases with an intervertebral hernia, all symptoms disappear 6 weeks after the first attack and remission occurs.

The body is able to recover spontaneously after 24 weeks. Therefore, there is not always an indication for surgery.

Disc herniation medication is aimed at relieving back pain.

Hernia is mainly treated with the following drugs:

• non-steroidal analgesics;
• steroid hormones.

Physiotherapy for intervertebral hernias is used as directed by a physician.

There are other methods for treating intervertebral hernias without surgery:

1. Manual therapy. The chiropractor tries to eliminate the herniated disc with his hands.
2. Kinesitherapy. This is a type of physiotherapy exercise. Normalizes muscle tone, restores blood circulation and increases tissue regeneration.
3. Hirudotherapy.
4. Cryotherapy. This is a technique for treating low fever. Liquid nitrogen is applied to the affected area. This improves blood circulation in the tissues.

Disc herniation surgery

Surgical treatment of intervertebral hernia is prescribed in the presence of:

• severe back pain in the lumbar region, which does not last long, despite ongoing conservative treatment;
• severe neurological disorders: decreased sensitivity, muscle tone and strength, paralysis and paresis;
• urinary incontinence, impotence in men (if caused by compression of the spinal hernia).

Treatment of back pain with blockade

Hernia repair is a procedure that aims to relieve pain in the affected area and relieve muscle spasm.

Blocking is done by injecting anesthetics.

The therapeutic effect of the blockade is characterized by:

• quick pain relief - relief comes in 1-2 minutes;
• elimination of muscle spasm, which intensifies the painful sensations;
• relief of inflammation, especially with corticosteroids;
• reduction of soft tissue swelling, which causes pinching of nerve fibers.

Contraindications to blockade:

• infectious lesion of the spine;
• fever;
• mental illness;
• cardiovascular failure 2-3 stage;
• weakness;
• coagulation disorders;
• kidney and liver damage;
• propensity to seizures;
• pregnancy.

Diagnosis of the disease for back pain

If your back hurts in the lumbar region, then the first step is to consult a doctor and undergo an examination.

The doctor may prescribe tests for the spine using:

• CT;
• X-ray of the lumbosacral spine;
• magnetic resonance;
• electroneuromyography;
• vascular dopplerography, etc.

Examination and palpation of the lumbar region and spine are mandatory. A consultation with a neurologist or vertebrologist is required.

Thus, almost always the cause of lower back pain is vertebral displacement, muscle spasm or intercostal neuralgia.