According to statistics, 70-80% of our population at least once in my life encountered back pain in the lower back, or medically speaking, pain in the lower back. Its prevalence in the UK is 59% in Denmark and 70% in Finland to 75%. Among all granted "sick leave" in our country the third in the cases of back pain.
Causes of lower back pain can be very diverse — from psychogenic factors to metastasis of cancer. Fortunately, serious pathology is not more than 5% of cases pain in the lower back, its main cause is overexertion or muscle spasm and other problems of locomotor apparatus.
Back pain, like any other organ, are diverse. More 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 back pain can be:
For the duration of the pain may be:
Typical clinical manifestations will depend on the source of pain.
Muscular-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 muscle load is distributed unevenly. Some of them are becoming increasingly congested, which, on the contrary, do not receive the required load. As a result, in the individual muscle begins to spasm, causing pain. There are so-called trigger points, the impact of which increases the spasm and pain. Characteristic features of pain:
It is on this kind of pain well are ointments that are warm or popular devices. However, the effect of them is short, after all, the reason that causes a muscle spasm, they do not resolve. More reliable method — the injection of pain medication directly into the trigger point, as well as kinesiotherapy, physiotherapy, manual therapy.
Caused by compression or stretching of the spinal 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 tissues. It sharply increases with sneezing, coughing, strain on the spine. It is this pain felt like a classic "cross" radiating along the nerve root.
Caused due to disc herniation, protrusion (bulging) of part of it in the spinal canal or the appearance of sequestration — a detached part of the disk. Anyway compressed by the entity called "pony tail" — the roots of the lowest spinal nerves innervating the lower limbs. The pain extends along the course of nerve roots from the waist to the foot, and there alone, and walking, increases with extension of the spine and decreases when tilted forward.
Is caused by pathology of the small intervertebral (facet) joints. The pain may be local, but also radiate to (give) in the groin, tailbone, back of the thigh. Is worse when bending and rotating at the waist.
All these types of pain syndrome appear acutely, sometimes the patient can even tell what day post exposure (something lifted up, not turned, etc.). Pain worse towards evening and after exercise, decrease after the holidays. Often this kind of pain is typical for people in middle and old age.
Caused by inflammatory lesions of the joints of the spine — the various kinds of arthritis: rheumatoid, Reiter's disease, ankylosing spondylitis, etc., Inflammatory pain often occurs in relatively young people, develops gradually. It is maximum in the early afternoon and decreases in the evening 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. Since many conditions can manifest in similar ways, at least in terms of pain, it is better not to do the diagnostics yourself, and consult a doctor.
Immediate specialist consultation is required if:
These signs can be symptoms of serious diseases that require immediate treatment.
For pain in the back and lumbar region doctor first just to rule out life-threatening condition — fortunately they are quite rare.
General and biochemical blood analysis allows to reveal the inflammatory changes, to detect elevated levels of calcium, characteristic of a metastasis of malignant tumors to bone structures, changes in the number of blood cells in multiple myeloma and so on. Men can assign analysis on prostate specific antigen to exclude a possible prostate cancer.
X-ray examination will reveal a change in the height of intervertebral disks, osteophytes possible — growth of bone tissue, caused by an incorrectly distributed load on a vertebrae, the changing shape of the vertebrae themselves.
CT and MRI will show bulging of the intervertebral disc, calcification (areas of calcification), spinal stenosis.
Today these two studies is gradually coming ultrasound of the spine to detect similar changes, without exposing the patient to excessive radiation load.
Obligatory consultation of the neurologist, according to testimony — chiropractor.
After a complete examination, it becomes clear treatment strategy. As a rule, to cope with the pain in the lumbar possible therapeutic methods, surgery is indicated is relatively rare.
In 95% of cases the patient has no need to worry — usually the back pain does not pose a threat to health and can be curable. Myofascial syndrome is adjusted faster to eliminate radicular pain may require several months. Anyway, in most cases it is necessary medical therapy. Use of non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce swelling, drugs to maintain the intervertebral cartilage. Sometimes to reduce the pain and swelling and is prescribed hormonal medications — they act faster non-steroidal anti-inflammatory, they are administered in the form of closures and droppers under control of the doctor.
Drugs can be in the form of ointments and gels — this method of treating back pain popular commercials. But as a method of introduction into the organism of the active substance, the use of external means is the most ineffective, it is possible to predict, because most of the funds do not even penetrate through the skin.
Another popular method is oral medication, or, more simply, pills and capsules. To take a pill is easy, the effect occurs quite quickly, usually within half an hour-hours, but 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 blockade. Their only drawback is the strict requirement for high qualification of the doctor who will carry out this manipulation.
Typically, medicinal treatment is non-drug methods. What physiotherapy will 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 on a special decompression equipment that help to relieve tense muscles, to form new movement patterns, thus removing the cause of back pain.
So, the best option therapy for back pain — the combination of medical methods and non-pharmacological approach. Such a complex work in several directions allows faster to cope with the disease, to get rid of pain or to gain lasting effect.