Low back pain is the most common pain syndrome seen in outpatient clinics.30-60% of the population in developed countries suffer from recurrent back pain, and up to 80% of back pain occurs in the lumbar region (low back).People of all ages can suffer from low back pain, but the peak incidence occurs between the ages of 30 and 60.
Lower back pain caused by disease
Low back pain is a non-specific symptom that can be caused by a variety of causes.Doctors distinguish between primary and secondary low back pain syndromes.Most low back pain is caused by changes in musculoskeletal morphology and function (primary low back pain syndrome).These are mainly degenerative dystrophic lesions of the spine:
Possible causes of secondary low back pain syndrome:
- Primary and metastatic tumors of the vertebrae, spinal cord, and retroperitoneal space.
- Vertebral fractures.
- Infectious lesions of the vertebrae and intervertebral discs (tuberculosis, brucellosis, epidural abscess).
- Non-infectious inflammatory diseases (ankylosing spondylitis, Reiter's syndrome, rheumatoid arthritis).
- Metabolic bone pathologies (osteoporosis, osteomalacia).
- Growing pains (scoliosis).
- Acute spinal cord circulatory disorder (stroke).
- Gastrointestinal disorders (acute appendicitis, atypical course of intestinal obstruction).
- Pain caused by diseases of the pelvic organs (including renal colic, infectious gynecological diseases such as chlamydia, gonorrhea, trichomoniasis, ureaplasmosis, adnexitis).
Lower back pain can also be acute or chronic and is caused by damage to the spine or nerve roots.May divert pain away from deeper structures:
- kidney;
- pancreas;
- colon;
- Pelvic organs;
- Retroperitoneal tumors.
severe pain in lower back
Acute sprain.The pain is concentrated in the area where the long muscles of the back spasm, resulting in limited movement.There was no pain transfer to the groin area or lower extremities.
Vertebral fractures.Usually this is the result of an injury when bending the leg or falling, but the same result can be obtained without injury or minor trauma if the patient's skeletal system is affected, osteoporosis, Cushing's syndrome, hyperparathyroidism, myeloma, metastasis of malignant tumors in the bones, Paget's disease.
Lumbar disc displacement.Symptoms of this disorder include lower back pain, forced body postures, and limited movement.The manifestations of the involvement of nerve roots in pathological processes are: radicular pain, usually on one side; sensitivity disorders (paresthesia, hyperesthesia or hypoalgesia); weakening or disappearance of the Achilles tendon or knee reflexes.
Facet syndrome.Compression of the tooth root at the exit of the spinal canal can cause radicular pain, but this pain is not caused by disc damage.Unilateral facet syndrome is most commonly associated with the L5 root and occurs when the upper and lower facet joints of the intervertebral joints enlarge, which can lead to narrowing of the spinal canal or intervertebral foramen.
Epidural abscess.Most commonly found in the thoracic spine, acute pain in the back may be associated with palpation or percussion of the affected area.If signs of spinal cord compression occur, rapid diagnosis and initiation of treatment, including surgery, are needed.Pathological processes in the hip joint can be accompanied by pain that radiates to the hip area and the lower limbs to the level of the knee joint.
chronic low back pain
Spondylosis deformans.Spondylosis deformans is a degenerative change in the lumbar spine in which bone spurs form, narrowing the spinal canal and putting pressure on the roots.If lumbosacral pain occurs when walking and is accompanied by neurologic symptoms (loss of sensation, dysesthesia, or weakness in both lower extremities), spinal-related intermittent claudication syndrome, caused by spinal stenosis, is suspected.Diagnosis can be made through examination.
Ankylosing spondylitis.This disorder should be suspected in young people with lower back pain that spreads to the buttocks.First, there is limited mobility, morning stiffness, reduced respiratory movement of the chest, and gradual bending and flexion of the thoracic spine.X-ray signs: The sacroiliac joints are destroyed and reorganized, forming a so-called "bamboo" spine.Similar symptoms of limited lower spine movement may occur in:
- psoriatic arthritis;
- Wright syndrome;
- Chronic colitis.
Tumors and their metastasis, metabolic diseases.Using radiography and myelography, it is necessary to exclude the following pathological conditions: metastatic cancer (breast, lung, prostate, thyroid, kidney, gastrointestinal tract), myeloma, lymphoma.
osteomyelitis.Caused by pyogenic bacteria (usually Staphylococcus aureus) or Mycobacterium tuberculosis; the possibility of these infections must be confirmed or excluded by determination of ESR, bone X-ray, and tuberculin skin test.
Intracranial tumors:
- Neurofibromatosis;
- Meningioma;
- Lipoma
These tumors may cause chronic pain even before other neurological symptoms develop.Moving pain in the lower back due to visceral disease.When the pelvic organs are affected, the pain is transferred to the sacral area, the organs of the lower abdominal cavity - the lumbar segment, the upper abdominal cavity - the lower thoracic spine and the upper lumbar segment.No local symptoms or back stiffness; full back movement without increased pain.
treat
Patients with lumbar osteochondrosis may experience lower back pain when walking, sitting, lifting heavy objects, coughing, or sneezing.Lower back pain sometimes radiates into the legs.In this case, you urgently need to contact a neurologist.
Don't delay seeing your doctor if:
- Severe low back pain for more than 3 days;
- Pain after injury;
- You also experience pain in your lower back, calves, and feet;
- Lower back pain is accompanied by numbness in the buttocks, thighs, calves, feet, and groin area.
Lower back pain is a fairly common symptom, especially among older adults.Rheumatism, lumbar osteochondrosis and radiculitis - all these diseases can cause acute pain in the lower back.Only a proper examination of the body can yield results and give a clear answer to the cause of back pain.