According to statistics, 70-80% of our population, at least once in my life suffered back pain in the lower back, or medically speaking, pain in the lower back. Its prevalence in the UK is a 59% in Denmark and 70% in Finland to 75%. Between all granted "the low" in our country, the third in the cases of back pain.
Causes of lower back pain, can be very diverse, from psychogenic factors of the metastasis of the cancer. Fortunately, serious pathology is not more than 5% of cases of pain in the low back, the main cause is overexertion or muscle spasm and other problems of the musculoskeletal system.
Types of back pain in the lumbar region
Back pain, like any other organ, are different. Most often it is the character of the pain is the first sign that the doctor can make an assumption about the nature of the disease.
The origin of the back pain may be:
- primary — caused by a chronic functional or degenerative changes in the tissues of the spine and the muscles, sometimes with involvement of adjacent structures — the cord and the nerve roots.
- secondary — caused by trauma, inflammation, arthritis or osteoarthritis of the intervertebral joints, injuries of internal organs.
For the duration of the pain can be:
- acute — occurs because of a new injury or emerging pathological condition, inseparably connected with it, has a duration up to 6 weeks;
- subacute — lasts 6 to 12 weeks;
- chronic duration of more than 12 weeks.
Typical clinical manifestations depend on the source of pain.
Muscle-tonic and other pain syndromes
Hypothermia, constant uncomfortable posture during work or rest, improper movement patterns, degenerative diseases of the spine, changing the height and elasticity of intervertebral discs, lead to the fact that the muscle load is distributed in an unequal manner. Some of them are becoming more congested, which, however, do not receive the necessary load. As a result, in the person of the muscle begins to spasm, causing pain. Are the so-called trigger points, the impact of which increases the spasm and pain. Characteristics the characteristics of the pain:
- clearly limited the area (local pain);
- it is the deep sense of the muscle layer;
- the muscle felt tight a tight area, or strand, within which is located a particular painful spot;
- when exposed to these points the pain increases sharply, causing the patient to shiver (a symptom of the jump);
- the limitation;
- if you can stretch the muscle pain decreases.
It is in this kind of pain are ointments that are warm or popular devices. However, the effect of them is short, after all, the reason that causes a muscle spasm, which do not resolve. The most reliable method — the injection of pain medication directly into the trigger points, as well as kinesiotherapy, physiotherapy, manual therapy.
Compressive radiculopathy
Caused by compression or stretching of the cord and the nerve roots due to disc herniation or decrease its height and, as a consequence, the distance between the vertebrae. This pain often feels like a shallow, extending rather in the skin than in the deep tissue. - Increases sharply with sneezing, coughing, pressure on the spine. Is this pain felt like a classic "cross" of radiation in the course of the nerve root.
Stenosis spinal
Caused by the herniated disc, protrusion (bulging) of part of it in the spinal canal or the appearance of the kidnapping — a detachment of part of the disk. Anyway tablet for the entity called "tail of horse" — the roots of the lower spinal nerves innervating the lower limbs. The pain extends along the course of nerve roots from the waist to the foot, and there is no sun, and walking, increases with the extension of the spine and decreases when leaned forward.
Special syndrome
It is caused by pathology of the small intervertebral (facet) joints. The pain may be local, but also radiate to (give) to the groin, tailbone, back of the thigh. It is worse when bending and rotation at the waist.
All of these types of pain syndrome appear sharp, sometimes, the patient can even say what day post exposure (something lifted up, not turned, etc.). Pain worse towards evening and after exercise, decrease after the holidays. Often, this type of pain is typical for people of middle and old age.
Inflammatory pain
Caused by inflammatory lesions of the joints of the spine — the different types of arthritis: rheumatoid arthritis, disease, Reiter, ankylosing spondylitis, etc., Inflammatory pain often occurs in relatively young people, develops gradually. It is maximum in the first hour of the afternoon and decreases at night or after physical exertion. Often accompanied by morning stiffness.
Other possible causes of lower back pain — pathology of internal organs, for example kidney disease or inflammation of appendages in women. From many diseases can manifest in a similar way, at least in terms of pain, it is best not to diagnose yourself, and consult a doctor.
Immediate specialist consultation is necessary if:
- the pain came after the injury, especially in women over age;
- in the history of cancer;
- the pain is accompanied by the increase of temperature;
- suddenly, and without any apparent reason loss of weight;
- the motion changes or subtract feet;
- there are difficulties with urination and defecation.
These signs can be symptoms of serious diseases that require immediate treatment.
Diagnosis of the pathology
For pain in the back and lumbar region doctor just to rule out life-threatening condition — fortunately these are very rare.
General and biochemical blood analysis allows to reveal changes in inflammatory, to detect elevated levels of calcium, characteristic of a metastasis of malignant tumors of bone structures, changes in the number of blood cells in multiple myeloma and so on. Men can assign analysis of prostate antigen specific to rule out a possible prostate cancer.
X-ray examination reveals a change in the height of intervertebral disks, osteophytes possible the growth of bone tissue, caused by an incorrectly distributed load on a vertebrae, the change of the form of the vertebrae themselves.
The CT and the MRI shows the bulging of the intervertebral disc, calcification (areas of calcification), stenosis cord.
Today these two studies is gradual ultrasound of the spine in order to detect similar changes, without exposing the patient to excessive load of radiation.
Mandatory consultation of the neurologist, according to testimony — chiropractor.
After a complete examination, it becomes obvious treatment strategy. As a general rule, to deal with the pain in the lumbar region of possible therapeutic methods, surgery is indicated is relatively rare.
Medication for back pain back
In 95% of cases, the patient has no need to worry — usually the back pain do not represent a threat to the health and can be curable. Myofascial syndrome is adjusted more quickly to eliminate the pain root may require several months. Anyway, in the majority of cases it is necessary medical therapy. Use of non-steroidal anti-inflammatory drugs (Nsaids) to relieve pain and reduce the inflammation, drugs to maintain the intervertebral cartilage. Sometimes to reduce the pain and inflammation and is prescribed medications hormonal — act faster non-steroidal anti-inflammatory, that are administered in the form of closures and droppers under control of the doctor.
The drugs may be in the form of ointments and gels — this method of treatment for back pain popular ads. But as a method of introduction in the organism of the active substance, the use of external media is more inefficient, it is possible to predict, because most of the funds do not even penetrate through the skin.
Another popular method is the oral medication, or, more simply, pills and capsules. By taking a pill is easy, the effect is occurs very quickly, usually within half an hour-hours, but in the long-term use of medication can affect the gastrointestinal tract.
Therefore, the quickest and most effective way to relieve the pain of injections directly into the muscle or area of the affected nerve root, the so-called lock. Its only drawback is the strict requirement for the high qualification of the doctor that will carry out this manipulation.
Non-drug therapy
Typically, medicinal treatment non-drug methods. Which physiotherapy need, solves a doctor. This can be a classic massage or chiropractic, and osteopathic treatments, and acupuncture. Gaining popularity and physiotherapy — special exercises in the form of classes, in special decompression equipment that helps to relieve muscle tension, to form new movement patterns, thus removing the cause of back pain.
Therefore, the best therapeutic option for back pain — the combination of medical methods and non-pharmacological approach. This complex work in several directions, allows faster to deal with the disease, to get rid of the pain or to gain lasting effect.