Back pain is known to almost everyone. It is hard to find someone who has not 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 middle region of the spine. But this is not a serious problem, but simply a consequence of being in an uncomfortable position for a long time.
But severe back pain almost always has specific reasons and is a reason to go to the doctor. Diagnosis will not always be expected because osteochondrosis is just one of the possible problems, back pain.
Why lower back pain and what to do in such a situation is not hard to guess. The 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 number in the tens, 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 may affect the lumbar region.
Primary back pain syndrome occurs as a result of musculoskeletal changes of a morphofunctional nature. Silent is the one that is the cause of the vast majority of cases of back pain in the lumbar region. The most significant reasons are the degenerative-dystrophic changes that occur in different 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.
- spondyloarthritis is a form of osteoarthritis in which the disease affects the intervertebral joints, which are responsible for the mobility of the spine, or synovial joints.
Secondary pain syndrome has many different 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 syndrome;
- a tumor located in the vertebrae, in the spinal cord itself or in the retroperitoneal space, whether it is primary or caused by metastases;
- fracture of one or more dorsal vertebrae. This is probably one of the most serious causes of back pain;
- various infectious diseases leading 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 of a reflected 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, andexitis - all of these diseases cause reflected back pain).
What are acute and chronic pains
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 noticed - 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, even though in fact the problem is in a completely different part of the body. But more often, pain from the pelvic organs, pancreas, kidneys, colon or tumors located behind the peritoneum is predicted in the lumbar region.
Usually people do not know what to do if their back hurts. But it is clear what not to do - it is self-medication. The causes of pain are different, only a specialist can make the correct diagnosis and continued use of pain medication (which many consider as treatment) can do even more harm.
The specialist, on the other hand, makes a diagnosis based on the data obtained as a result of additional examinations, for example, MRI diagnosis of the spine.
Causes of acute pain
Before deciding what to do when your lower back hurts a lot, any serious doctor will first determine the cause of the pain that has appeared. The reasons may be different, but most of them are somewhat related to the spine.
One of the simplest and most harmless causes of pain is acute muscle strain. In this case, long spasmodic muscles are the source of pain. With this problem, the pain rarely "radiates" to other parts of the body, but instead severely restricts 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 vertebral compression fractures. Most often this happens with unsuccessful falls and other back injuries. But if a person is sick with hyperparathyroidism, osteoporosis, Paget's disease or has tumors in the vertebral region, then a fracture can occur and go unnoticed by the patient, as they say "out of the sky". Moreover, a person will not even realize when this fracture occurred.
An equally uncomfortable situation, in which an acute pain appears in the lower back, is the displacement of the intervertebral discs in the lumbar spine. The symptoms of this problem are severe and sharp pains in the lower back, which severely restrict mobility. Most often, the pain occurs due to compression of the nerve roots. The signs of such compression are:
- sensitivity disorders;
- disappearance or significant reduction of the Achilles reflex;
- lack or decrease in the intensity of the knee reflex;
- unilateral radicular pain.
One of the unpleasant tendencies of this problem is that such a displacement can cause lower vertebral pathology. As a result, pain appears below the lumbar region and the functions of the rectum and bladder may be impaired. Localization of pain above the lower back is also possible in some cases.
Acute back pain can also occur as a result of facet syndrome. In this case, the cause of the pain is compression of the root at the exit from the spinal canal, while the intervertebral disc itself remains intact. This syndrome usually results from enlargement of the upper and lower parts of the intervertebral node, resulting in narrowing of the intervertebral foramen.
An epidural abscess is one of the most serious diseases that causes severe back pain. This disease requires urgent diagnosis and immediate treatment, and any very effective measure is recommended, until surgery, the main thing is to quickly eliminate spinal cord compression.
Hip joint diseases are also often the cause of acute back pain. They are characterized by pain radiating to the lower back, legs up to knee level.
Causes of chronic low back pain
One of the causes of chronic pain is spondylosis deformans. With this disease, a dystrophic change occurs in the lumbar spine, the ligament apparatus weakens and bone growth occurs. As a result, the spinal canal narrows and the bony outlets begin to press on the nerve roots. Painful pain may be associated with numbness and weakness in the legs, as well as other neurological symptoms. In any case, a thorough examination will be necessary, according to the results of which the final diagnosis will be made.
Bechterew's disease, also called ankylosing spondylitis, can also cause chronic pain. It is manifested by the withdrawal of pain in the lower back, appears and rapidly develops a curvature of the spine in the chest region. The first symptoms are limited mobility and decreased chest movement during breathing.
Cancer and metabolic disorders often cause pain in the lower back. But even benign tumors can cause chronic pain that will not be associated with neurological symptoms.
Osteomyelitis can also cause lower back pain, which can be very long lasting.
cONcluSiON
As you can see, back pain can occur as a result of many diseases. At the same time, quite often a person does not even expect that the problem will not be where it hurts. So, even if your lower back hurts not constantly, but occasionally - do not pull it, consult a doctor. It is easier to cope with any illness at an early stage, and not when it is in a neglected state and will attract many complications along with it.