Acute lower back pain, causes, symptoms, diagnosis, treatment

In some cases, the patient can be difficult to stand up straight in a standing position. Acute back pain can last from several days to several weeks.

back pain

Causes of acute lower back pain

Most people at least once in their life has experienced back pain. Although pain or discomfort may appear at any level, most often it affected the lumbar region. This is because the lower back is forced to bear the weight of the entire body and head.

Back pain is the second most frequent reason for seeking medical attention, second only to colds and flu.

Typically, the first acute lower back pain occurs after lifting a heavy object, sudden movements, injury, or long sitting in one position.

Acute back pain often is the result of sudden trauma to the muscles and ligaments of the back, herniated disc of the lumbar spine. Pain, in such cases, it may be caused by muscle spasm, sprain or torn muscles and ligaments.

Causes of sharp pain in the back include:

  • vertebral compression fractures due to trauma or osteoporosis;
  • muscle spasm (excessive muscle tension);
  • hernia;
  • sciatica;
  • stenosis (narrowing) of the spinal canal);
  • curvature of the spine (eg scoliosis or kyphosis) including disease Chairman Mau;
  • stretching/tearing of muscles or ligaments of the back;
  • spondylosis;
  • spondylolisthesis;
  • infection of the spine (discitis, abscess.

Acute back pain can also cause the following systemic diseases:

  • diffuse disease of connective tissue;
  • Bechterew's disease;
  • a malignant tumor in the spine;
  • rheumatoid arthritis.

Causes sharp pains not related to problems in the spine or tissues of the back:

  • abdominal aortic aneurysm;
  • diseases of the gastro-intestinal tract: pancreatitis, stomach ulcer, cholecystitis;
  • herpes zoster;
  • disease of pelvic organs: endometriosis, prostatitis, pelvic inflammatory disease;
  • diseases of the retroperitoneal space: renal colic, pyelonephritis;
  • pregnancy.

Symptoms

Symptoms of acute lower back pain vary greatly depending on its cause. You may feel numbness, tingling type of pain may be different, as well as the severity of pain from mild discomfort to pain that you can barely tolerate. In addition, lower back pain is often combined with pain in the leg, hip, and foot. In some cases it may be weakness in the leg.

Here are some examples of symptoms characteristic of various diseases and conditions:

  • in case of intervertebral hernia: lower back pain, often in the leg, and leg pain stronger than back pain and aggravated by sitting or after sleeping. The pain may radiate to the buttock, thigh and down the leg until the foot. There may be tingling, numbness in the foot and toes, in rare cases, muscle weakness of the legs;
  • stretching the muscles of the lower back: diffuse lower back pain that does not give in the leg or buttocks; increases with movement and is attenuated at rest;
  • when spinal stenosis: back pain and foot and leg pain stronger than back pain as spinal stenosis is often accompanied by the development of intervertebral hernias; aggravated by standing and walking, is attenuated at rest and when bent back. The pain may be unilateral, bilateral;
  • in diffuse connective tissue disease: pain in several joints, fever, weight loss, weakness;
  • osteomyelitis: persistent pain, often temperature is normal; blood count normal, increase of erythrocyte sedimentation rate (ESR) and/or C-reactive protein level.

Diagnosis

On consultation, the doctor will hold a conversation with the patient, asking questions about the nature and severity of pain and other symptoms, gather information about medical history and conduct a medical examination. Based on the data in conversation and examination, the doctor can make a diagnosis, or preliminary diagnosis, which will need to be confirmed and/or clarified with the help of medical tests. Medical tests can be different, starting with blood and ending with studies of nerve conduction. The most popular examinations include:

X-rays

x-ray

Radiography is conducted in order to assess the bone status of the patient. Diagnoses that can be put with x-rays, include osteoporosis, compression fracture and bony growths (osteophytes);

Magnetic resonance imaging (MRI)

The advantage of MRI over other studies is that by MRI to obtain high-quality detailed images of not only bone but also soft tissues: muscles, ligaments, blood vessels, nerves, intervertebral discs, spinal cord, etc.

The most common diagnoses on the MRI findings:

  • disc herniation;
  • narrowing (stenosis) of the spinal canal;
  • spondylitis.

Other diagnoses that can be put through an MRI:

  • ankylosing spondylitis (type of arthritis);
  • infection of the bone;
  • cauda equina syndrome;
  • compression fractures;
  • discitis (inflammation of the intervertebral disc);
  • abscess of the spinal cord;
  • damage to the spinal cord;
  • a tumor in the spine.

Computed tomography (CT)

Computed tomography also allows to image not only bone but also soft tissues, however, the picture quality is inferior to the quality of the images obtained by MRI, so CT is recommended if MRI for some reason it is impossible or difficult, for example, in the presence of a pacemaker or structures in the body.

Treatment

What you can do at home for acute back pain?

  • restriction of physical activity for 1-2 days. This will help to relieve the symptoms and reduce the inflammation in the painful area;
  • applying hot-water bottles or bladder with ice to the painful area;
  • receiving over-the-counter painkillers. Do not take these drugs in larger quantities than indicated in the instructions to take drugs you need not more than 3 days. If the pain persists, you need to consult a doctor.

During sleep it is better to take the position of the embryo and put a pillow between the legs. If You are accustomed to sleeping on your back, placed under the knees pillow or rolled up towel to relieve the strain on the back.

If the cause of lower back pain more serious, then the patient requires a specific treatment, depending on the disease or condition is causing pain, then it is impossible to do without the help of professionals.

One of the most common causes of acute lower back pain that needs special treatment is intervertebral hernia. The treatment of intervertebral hernia is usually conservative, only occasionally doctors have to use surgical methods. There are a large number of conservative methods of treatment of intervertebral hernia. Here are some of them:

  • Medication. Drug treatment involves administration of painkillers and anti-inflammatory drugs.
  • Traction of the spine. This extension does not lead to complications in comparison with the exhaust on the tables with a vector load or cargo. Traction of the spine allows to partially restore power and as a result, the condition of intervertebral discs and reduces the size of the intervertebral hernias;
  • Therapeutic massage. Types of therapeutic massages are different. In General, this method is aimed at achieving relaxation of the back muscles, relieve muscle spasms that often accompany lower back pain;
  • Physiotherapy. Therapeutic exercises aimed at strengthening the small muscles of the back;
  • Hirudotherapy
    Leech therapy reduces inflammation around the hernia reduces pain. Is an alternative to pain medication.
  • Surgical treatment. Surgical treatment of intervertebral hernia is recommended only for patients who are not responding to the treatment by conservative means, provided that this treatment was carried out regularly and systematically, as well as patients who started treatment already with the symptoms of severe neurological deficit: weakness in leg, paresis, paralysis of the legs, numbness in the groin area, impaired control over the functions of urination and/or defecation. All of the above symptoms are indications for urgent surgery on the spine.
21.09.2018