Low painIt indicates a disease or damage to the spine, in nerve structures, soft tissues, internal organs, with feverish states of various genesis.It is acute, stupid, constant, periodic, burning, shooting, burst.Sometimes it is associated with physical activity, changes over time.The pathologies, manifested by back pain, are diagnosed on the basis of complaints, anamnesis, exam data and further studies: radiography, magnetic resonance imaging, ct.Before making a diagnosis, peace is necessary, sometimes it is allowed to use ointments, taking analgesics.
Because the lower back is bad
Spinal diseases
A common cause of back pain are the congenital anomalies and the acquired diseases of the spine.The nature of pain syndrome varies.The pain caused directly by the pathological process, often periodic, local, painful or pulled, is associated with time, physical activity, remains in an uncomfortable position.
Due to the spasm of the muscles, lumbago (lateral) occurs, a strong pain accompanied by the restriction of movements.With many pathologies of the spine, lumboyshialgia is observed: painful, burning or burning wood, which radiates on the back of the thigh.Painful sensations are often found in the root syndrome.It can be detected in the following diseases of the spinal column:
- Degenerative diseases: osteochondrosis, protrusion of the intervertebral disc, intervertebral hernia, spondylosis, arthrosis spondyus.
- Congenital anomalies: sacralization, low background.
- Polyziological conditions: spondilolis, spondilolist.
- Vascular diseases: Violations of spinal circulation.
- Other diseases: Thinking of thinking.
- Secondary injuries of nerve structures: lumbosacral root, lumbosacral plexitis, myelopathy of various genesis.
Curvature of the spine
Note mild or moderate pains for all types of curvature of the spinal column, which is associated with non -cowardice redistribution of the load, overtention of the muscles and ligaments of the rear.Pain appears due to a location of the uncomfortable body, sleeping too hard or too soft.The symptom is accompanied by:
- Lordosis;
- Cifosis;
- scoliosis;
- cifosulinosis;
- Flat back syndrome.
Osteoporosis
The painful sensations that pull or sore in the lumbar and chest column for a long time are the only symptom of osteoporosis.Pain syndrome is expressly expressed, it intensifies after the load, before changing the weather conditions.The symptom is observed at the following varieties of osteoporosis:
- Postmenopausal;
- Youth;
- idiopathic;
- senile.
Similar pains are detected in patients with secondary forms of pathology, due to genetic diseases, endocrine disorders, chronic intoxications and drugs of drugs.Secondary osteoporosis can also occur against the background of badbsorption syndrome, liver diseases, Khpn, rheumatoid arthritis, well.
Strengthening pain, increasing the duration of pain can be associated with the development of a pathological fracture.Other trauma signs are often not expressed, so the fracture often remains not diagnosed.
Spinal lesions
The most common damage is the bruise of the spinal column.In slight cases, the pathology occurs from a moderate back pain, intensifies during the movements, the local edema and sometimes hematomas and bleeding.In serious bruises, neurological disorders are added to the listed symptoms.
The fracture of the compression of the lumbar column occurs due to the violent flexion of the body.It is characterized by acute pain, which keeps breathing at the time of the injury.Therefore, an increase in pain is noticed in case of body curves, edema of soft tissues is detected.The palpation of the thorny process is painful.Other possible fractures include damage to arches, transverse processes, thorny processes.
In addition, back pain is found in patients with traumatic spondylolists and subluxation of the vertebrae.The painful sensations are paroxysmal, resemble Lumbago, completed by a sense of gravity and numbness of the lower ends.
Sliding fabric lesions and kidneys
The lesion of the soft tissues is accompanied by a local insignificant or moderate local pain in rapid decrease, small edema.Hemorrhages are possible.There is no blood in the urine.Renal bruises are manifested by short -term insignificant pain and hematuria.In case of kidney lesions, the painful syndrome is intense, the pain radiates to the lower abdomen, the groin and the genitals.A hematoma is visible in the lumbar region.In serious cases, strong pain, prolonged macroemituria is observed.The condition of shock develops.
Spinal spine infections and spinal cord
The osteomyelitis of the spine can be hematogenic, post -traumatic, contact, postoperative.The acute form of the disease manifests itself quickly increasing the lower part of the back, combined with chills, fever, poisoning syndrome and deterioration in general conditions.The pain that contracts, bursting, so intense as to prevent any movements, force the patient to freeze in bed.In chronic osteomielite, the manifestations are smooth, a fistula path with separate purulent is formed.
The tuberculosis of the spinal column develops gradually.Initially, periodic deep pains are observed, improved after loading, the increase in the sensitivity of the skin in the projection of the interested vertebrae.The rigidity of the pace is formed.Against the background of the significant destruction of the bone structures, the nature of pain changes, since it is caused by the compression of the nerve roots.The pain burns, radiates towards the legs, completed by the paresthesia, numbness.
In patients with spinal epidural abscess, the pain is serious, deep, poured, combined with chills, hyperthermia, muscle tension.Taping on the thorny processes of the vertebrae is painful.With the progression of the pathology, rooster syndrome occurs, therefore the paresis develops the disorders of the pelvic organs.
Local inflammatory processes
The purulent processes in the surface tissues and the fiber near the ground are accompanied by intense back pain.The possible causes of pain syndrome are bubbles, charcoal and parranefrite.
In the first two cases, the abscess is formed in the skin, it looks like a limited and severely painful seal with a diameter of 1 cm of crimes or blue crimes with one or more rods in the center.Pain intensifies quickly, becomes contraction, button, sleep loss.There are general hyperthermia, insignificant or moderate violation of the general state.
With Paranefrite, at the beginning a pronounced fever occurs.Pain syndrome develops after 2-3 days.The pains are very intense, they can be administered to the stomach or hypochondrium, they intensify when walking, movements, deep breathing.In some forms of Paranefrite due to pain, the patient takes a forced position.The lumbar muscles are tense.Edema, local hyperemia, hyperthermia are detected.The condition is serious.
Infectious diseases
The painful pain spread in the lower back, causing the desire to change the position of the body, are characteristic of acute infections, accompanied by an increase in temperature and intoxication syndrome.In most cases, they are due to myosite, often combined with pain in the muscles of the limbs.Observed with flu, tonsillitis, acute respiratory viral infections.Sometimes the pain is caused by renal damage.Infectious diseases accompanied by pain in the lower back include:
- hemorrhagic fever;
- Encephalitis from Japanese mosquitoes;
- Ebola fever;
- disease and mouth disease;
- Severe form of coronavirus infection;
- Generalized forms of bacterial infections, mushrooms, virals.
In a number of patients, back pain is observed with a cytokine storm - an inflammatory reaction that develops against the background of serious infectious diseases.Epidemiological myalgia is accompanied by intense paroxysmal pains up to 10 minutes, which appear not only in the lower back of the back, but also in other parts of the rear part, in the area of the abdominal wall, the chest, the limbs.I repeat with a 30-60 minutes interval.Combined with rhinitis, conjunctivitis, severe hyperthermia.
Other muscle injuries
Fouring pain in the muscles of the lumbar region is determined after intense physical effort: the performance of the force exercises for the muscles of the back, a long stay in a forced position with a low part of the tense back.Mialgia mitigates to rest, intensifies during the movements, weakens after heating, the clean heat, disappears after a few days.
The myosites develop not only with infectious diseases, but also after hypothermia or overload, against the background of exogenous intoxication, metabolic disorders.Accompanied by long -term painful pain.There are also special forms of myosite:
- Specific infectious myosite for syphilis and tuberculosis;
- Idiopathic, youthful dermatomosite and polychexitis;
- Polympiosite and dermatomosite for oncological pathologies, systemic diseases of the connective tissue.
Chronic widespread pains are observed throughout the body, including the lower back of the back, with fibromyalgia.They are combined with sleep disorders, asthenia, neurotic disorders.
Other diseases
In addition to the pathologies listed in the lower back, they can worry about conditions such as:
- Spinal spine cancer, spinal cord: sarcoma, emangioma, metastases, intramidullary and non -tracious neoplasms of the spinal cord.
- Nephropathy: Pyelonefrite, glomerulonefrite, urolitiasis, kidney heart attack, thrombosis of kidney veins, kidney cysts, kidney carcinoma, purulent processes.
- Hereditary diseases: Hereditary cerebellar atassia Pierre-Marie.
- Exogenous intoxications: abuse of phenylpropanolamine.
- Pathologies of the heart and blood vessels: Endocarditis leffler, abdominal aorta aneurysm.
- Emergency conditions: Shock Emotransfusion.
For the diseases of the pelvis, the irradiation of pain in the lower back is sometimes noticed.The appearance of a symptom is possible with a series of female diseases, prostate cancer, projection, sigmoid.
Diagnostics
Primary diagnostics is carried out by an orthopedic traumatologist.In the presence of patient neurological symptoms, the neurologist examines.The doctor interviews the patient, performs an objective exam.According to the testimony, consultations of a surgeon, rheumatologist, urologist and other specialists are appointed.The diagnostic program may include:
- Neurological examination.In the research process, the specialist evaluates reflections, muscle strength, coordination of movements, profound and superficial sensitivity.
- X -raggi.On the radiographs of the lumbar department, fractures, a decrease in the height of the intervertebral discs, other degenerative changes, volumetric formations, signs of inflammatory processes and spondylolists are visible.If necessary, standard radiographs are integrated by functional studies.
- Other Neuroimaging methods.To clarify the radiography data, CT and MRI are used.During computerized tomography, the structure of solid structures is studied in detail, the state of intervertebral ligaments and discs is examined on magnetic resonance imaging.To exclude stenosis, myelography is performed.
- Functional research.The condition of the muscles and nervous conductivity is assessed using electromyography, electroneorography and studies on potentials caused.
- Laboratory test.To confirm the infectious nature of the disease, the determination of the pathogen makes blood tests and microbiological examination.To detect neurinance, serological reactions are used.
According to the testimony, an ultrasound of the kidneys, prostate, pelvic organs, urine tests, abdominal aorta, other studies and other studies are conducted.
Treatment of pain in line
Help in the preospedaliera phase
With traumatic damage to the spine, it is necessary to lay the patient on the shield and immediately deliver to the medical institution.In case of non -human pain, it is necessary to reduce the load on the back, optimize the position of the body during work and rest.Acute pain syndrome is an indication to consult a neurologist.
Before the examination of experts, a single intake of analgesics is possible.In Lumbago, lumbar -the angry caused by degenerative diseases previously diagnosed with the spine, the use of heating and pain relievers of local acts is allowed.If there is the suspicion of the presence of an infectious process, local funds are not shown.
Conservative therapy
The basis of treatment are physiotherapy measures and drug therapy.The patient is prescribed a protective regime.Apply the following methods:
- Fans.Effective in acute and chronic muscles and in the spine.Used in the form of tablets, local products.
- Neurotropic vitamins.Patients are introduced by vitamins B, which improve the effect of drugs of other groups, help reduce pain.
- Local anesthetics.With stubborn and acute pains, therapeutic blocks with anesthetics are performed.To improve the result of the treatment, painkillers are combined with glucocorticosteroids.
- Fisalization.Apply ultrasound, magnetotherapy, percutaneous electrical stimulation, laser therapy, pharmacological electrophoresis.It is possible to prescribe massage, manual therapy, acupuncture.
Surgical treatment
Given the characteristics of the pathology, the following surgical interventions are performed:
- Instability: Spondilodesi between -Core, transpected fixation, fixation with plates.
- Tumors, osteoporosis, osteomyelitis, tuberculosis: sequestratraltomy, vertebroplasty, cifoplasty, company.
- Internvertebral hernias: discontomy, micro -prowex, nucleoplasty.
- Put the spinal channel: Laminectomy, facetectomy, decompression of the punctuation of the disc.
In the postoperative period analgesics, antibiotics are prescribed.Rehabilitation measures include exercise therapy, massage, physiotherapy.