Back pain in the lumbar region - causes and treatment

Various diseases can cause back pain in the lumbar region.

The main diseases causing 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 injury 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 joint, or internal organs near the lower back.

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

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

Also, pain in the lower back can appear due to a muscle strain 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 playing sports.

Osteochondrosis of the lumbosacral spine

With 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;
• diseases of the genital organs;
• rectal problems.

Most often, back pain with osteochondrosis is:

• aching;
• bursting;
• pulling;
• at times the pain is burning.

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

Causes of back pain with 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, 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;
• having 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 who suffer from rheumatoid arthritis, ankylosing spondylitis and other inflammatory diseases of the joints often fall ill with osteochondrosis of the lumbosacral spine.

Treatment of osteochondrosis

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

To do this, apply:

• 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);
• 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, since they have a lot of contraindications and side effects.

There are several more methods for treating osteochondrosis:

1. Manual therapy helps to restore the functions of the lumbar spine and its anatomical structure. Massage for osteochondrosis 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 drugs. The most useful for osteochondrosis will be: electrophoresis, paraffin therapy, phonophoresis and magnetotherapy. To achieve a tangible effect, it is recommended to carry out 3 courses of 10 physiotherapy procedures with a two-week break 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 doctor and, preferably, under the supervision of a specialist. A set of exercises designed specifically for the treatment of lumbosacral osteochondrosis will help strengthen the muscles of the back, 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, this will lead to the development of the disease and soon the back pain will become so severe that you still have 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 playing sports, care must be taken not to overextend your back and damage the spine.

Back pain with intervertebral hernia

A 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

Often, back pain in the lumbar region occurs with lumbago.

Lumbago is the sudden appearance of acute lower back pain at the time of physical exertion, lifting weights.

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

A reflex is triggered, as a result of which the tone of the lumbar muscles is greatly increased. The patient freezes in a monotonous position, cannot straighten his back and turn.

This manifestation of herniated discs of the lumbar spine is most often found 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 leg.

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

Symptoms of back pain with intervertebral hernia

Table - Symptoms for herniated discs

The main symptoms	Peculiarities
Long-term pain in the lumbar region.	Can last up to several months. They wear an aching, pulling, burning character.
Dysfunction of the pelvic organs.	Incontinence or urinary retention. Violation of defecation. In men, a hernia can affect potency.
Weakness of the leg muscles, a decrease in their tone, a decrease in 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 damage to the spinal cord.
Pale skin, increased sweating, white or red spots.	Compression of the nerves in the spinal roots, which regulate blood vessels, sweat glands and other autonomic functions.

With intervertebral hernia, in most cases, pathological changes develop in the lumbar spine.

Identification of herniated discs

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

A herniated disc develops due to:

1. Degenerative changes in the vertebrae and intervertebral discs. Herniated disc is often a complication of osteochondrosis.
2. Postponed injuries of the spinal column: compression fractures of the vertebrae, subluxation.
3. Increased loads on the spinal column: with constant work sitting or standing in a monotonous posture, improper carrying of weights, excessive physical exertion, overtraining in 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. Most often this is due to industrial hazards. Under the influence of vibration, the structure of the intervertebral disc is disturbed, it becomes weakened.
9. Poor posture, scoliosis.

Herniated disc treatment

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

The body is able to spontaneously recover after 24 weeks. Therefore, there are not always indications for surgical intervention.

Medication for herniated discs is aimed at relieving back pain.

Hernia is mainly treated with the following drugs:

• non-steroidal pain relievers;
• steroid hormones.

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

There are other methods of treatment of intervertebral hernias without surgery:

1. Manual therapy. The chiropractor is trying to eliminate the herniated disc with his hands.
2. Kinesitherapy. This is a kind of physiotherapy exercises. It normalizes muscle tone, restores blood circulation, and increases tissue regeneration.
3. Hirudotherapy.
4. Cryotherapy. This is a low temperature treatment technique. Liquid nitrogen is placed on 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 the ongoing conservative treatment;
• severe neurological disorders: decreased sensitivity, muscle tone and strength, paralysis and paresis;
• urinary incontinence, impotence in men (if it is caused by compression of a hernia of the spinal cord).

Back pain treatment with blockade

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

The block is performed by injecting anesthetics.

The therapeutic effect of the blockade is characterized by:

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

Contraindications for blockade:

• an infectious lesion of the spine;
• fever;
• mental illness;
• cardiovascular failure stage 2-3;
• weakness;
• blood clotting disorders;
• renal and hepatic impairment;
• tendency to seizures;
• pregnancy.

Diagnostics 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 spinal examinations with the help of:

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

An examination and palpation of the lumbar region and spine is mandatory. Consultation of a neurologist or vertebrologist is required.

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