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 injuries to the joints of the spine or hips.

Most often, this symptom is due to lumbosacral spine disease.

The lumbar spine is mobile, which causes more frequent injuries in this 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 joint or internal organs near the lower back.

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

• pain may occur as a result of osteochondrosis of the lumbosacral spine;
• painful sensations may be due to 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 hip joints.

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

• making sharp bends;
• 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 bladder disease;
• diseases of the genital organs;
• rectal problems.

Most often, back pain with osteochondrosis is:

• sick;
• shooting;
• withdrawal;
• sometimes the pain burns.

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

Causes of back pain in lumbosacral osteochondrosis

The lumbar spine is characterized by great mobility and can withstand heavy loads on a daily basis.

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

The group at high risk of developing lumbosacral osteochondrosis includes:

• overweight people;
• leading an inactive lifestyle;
• has improper posture.

Also, this disease can develop with excessive exertion 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 joint diseases often suffer from osteochondrosis of the lumbosacral spine.

Treatment of osteochondrosis

Treatment of osteochondrosis of the sacro-lumbar spine is aimed at slowing down the process of destroying intervertebral discs, restoring nerve root function and eliminating pain.

To do this, log in:

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

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

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

Nonsteroidal anti-inflammatory drugs and steroid hormones should be used with great care, as they have many contraindications and side effects.

There are several other methods for 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 the acute period of the disease has been stopped with the help of medication. The most useful for osteochondrosis will be: electrophoresis, paraffin therapy, phonophoresis and magnetotherapy. To achieve a tangible effect, it is recommended to conduct 3 courses of 10 physiotherapy procedures with a break of two weeks between them.
3. One of the most effective methods of treating osteochondrosis is physiotherapy exercises. Physical education should be carried out after appropriate consultation with a physician and, if possible, under the supervision of a specialist. A set of exercises designed specifically to treat lumbosacral osteochondrosis will help strengthen the back muscles, which will relieve some of the load from the intervertebral discs.
4. Spa treatment (radon baths, therapeutic mud, etc. ) has a good effect on osteochondrosis.

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

Prevention of osteochondrosis

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

When carrying weights and playing sports, you must be careful not to stretch your back or damage your spine.

Back pain with intervertebral hernia

Spinal hernia or intervertebral hernia is a disease in which the intervertebral disc is deformed, the outer part of the disc is ruptured simultaneously with the protrusion of the inner part of the disc outside the vertebral body.

Lumbago

Lumbar back pain often occurs in the lumbar region.

Lumbago is the sudden onset of acute lower back pain during physical exertion, weight lifting.

Back pain in this case has the character of tearing, stabbing, shooting. It is associated with acute prolapse of the intervertebral disc and irritation of nerve endings located in the annulus fibrosus.

A reflex is triggered, causing the lumbar muscle tone to increase greatly. The patient freezes in a monotonous position, cannot straighten his back and turn around.

This manifestation of lumbar disc herniation 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 to the back of the leg.

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

Symptoms of back pain with intervertebral hernia

Table - Symptoms of disc herniation

Main symptoms	Special features
Prolonged pain in the lumbar region.	It can take up to several months. They carry a character that hurts, pulls, burns.
Pelvic dysfunction.	Urinary incontinence or retention. Violation of defecation. In men, hernias can affect potency.
Weakness of leg muscles, reduction of their tone, reduction of reflexes.	Compression of motor nerves in spinal roots.
Paralysis (complete lack of movement) or paresis (partial lack of movement) in the legs.	Spinal cord compression and damage.
Pale skin, increased sweating, white or red spots.	Compression of nerves in the spinal roots, which regulate blood vessels, sweat glands and other autonomic functions.

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

Identification of disc herniation

Statistics for the detection of intervertebral hernias:

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

Reasons for the development of intervertebral hernia

Disc herniation occurs due to:

1. Degenerative changes in the vertebrae and intervertebral discs. Herniated disc is often a complication of osteochondrosis.
2. Delayed spinal injuries: compression fractures of the vertebrae, subluxation.
3. Increased loads on the spine: with constant work, sitting or standing in a monotonous position, improper weight bearing, excessive physical exertion, overtraining of athletes.
4. Sedentary lifestyle.
5. Infectious diseases in which the spinal column is affected.
6. Overweight.
7. Congenital malformations of the spine.
8. Vibration action. This is most often 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 can recover spontaneously after 24 weeks. Therefore, there are not always indications for surgery.

Disc herniation medications aim to relieve back pain.

Hernia is mainly treated with the following drugs:

• nonsteroidal pain medications;
• steroid hormones.

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

There are other methods of treating intervertebral hernias without surgery:

1. Manual therapy. The chiropractor tries to remove 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 low temperature treatment technique. Liquid nitrogen is applied to the affected area. This improves blood circulation in the tissues.

Herniated disc surgery

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

• severe back pain in the lumbar region that does not go away for a long time, 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 cord hernia).

Treatment of back pain by blockade

Hernia repair is a procedure that aims to numb the affected area and alleviate muscle spasm.

The blockade is performed by injecting an anesthetic.

The therapeutic effect of the blockade is characterized by:

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

Contraindications to the blockade:

• infectious lesion of the spine;
• fever;
• mental illness;
• cardiovascular insufficiency stage 2-3;
• weakness;
• blood clotting disorders;
• kidney and liver damage;
• propensity to attack;
• pregnancy.

Diagnosis of back pain disease

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

The doctor can prescribe spinal examinations with the help of:

• computed tomography;
• X-ray of the lumbosacral spine;
• M. R. I;
• 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.