Pelvic pain is pain that is localized below the navel and above the beginning of the thighs. They can be associated with different conditions. Sometimes pelvic pain does not pose any danger and goes away on its own after some time, sometimes it indicates certain diseases, and in some cases it signals that you need to urgently go to the hospital.
Sexually transmitted infections
Characteristic signs of sexually transmitted infections (STIs): pain during urination, vaginal discharge, vaginal bleeding between periods. The most common types of STIs are gonorrhea and chlamydia. The final diagnosis can be made by a doctor after laboratory tests. If you are diagnosed with a sexually transmitted disease, your partner should also be tested.
Symptoms of pyelonephritis in men and women
The structural features of the urinary system affect the course of pyelonephritis. Since women have a shorter urethra, it is easier for infection to reach the kidneys; pyelonephritis is often a consequence of untreated cystitis. Women more often suffer from kidney inflammation; the symptoms of pyelonephritis are more pronounced in them:
- rise in body temperature above 38 °C;
- characteristic features of general intoxication;
- change in the color of urine - up to a dirty yellow or darker color, and in case of urolithiasis and renal colic, there may be blood impurities in it.
Symptoms of pyelonephritis in men are often more subtle:
- thirst and dry mouth;
- general malaise;
- pain in the lumbar region.
Ovarian cyst
The ovaries contain follicles - sacs in which eggs mature. A mature follicle ruptures during ovulation and releases an egg. If this does not happen, it turns into a cyst. Such ovarian cysts are usually harmless and can go away on their own, but they can cause pain and an enlarged abdomen. When the cyst is torsioned, a threatening condition occurs - severe acute pain should force you to immediately consult a doctor. Ovarian cysts are detected during a gynecological examination and ultrasound.
Diseases
Lower back pain can be a symptom of various diseases of the musculoskeletal system and internal organs. The main task of the doctor is to find out what exactly caused the deterioration of the condition and take the necessary measures.
Here are the most common pathologies.
Ankylosing spondylitis (ankylosing spondylitis)
This is a systemic inflammatory disease in which individual vertebrae fuse into a single conglomerate. At the same time, calcium is deposited in the ligaments that stabilize the spine, causing the affected area to almost completely lose mobility.
Distinctive features of low back pain due to ankylosing spondylitis include:
- an increase in intensity at rest, especially with prolonged exposure to a horizontal position;
- stiffness of movements in the lumbar region;
Osteochondrosis of the lumbar spine
This is a very common disease in which the intervertebral discs, which act as shock absorbers, become thinner. The result is irritation of the nerve roots and spasms of the surrounding muscles, causing severe pain. At a late stage of the disease, a herniated disc forms, which can put pressure on the spinal cord, increasing pain.
With osteochondrosis, the pain intensifies:
- when rising from a sitting or horizontal position;
- when trying to lie on your stomach;
- when bending over.
If the disease has caused the formation of a massive hernia, pain in the lower back is often accompanied by numbness and or weakness of one or both legs.
Curvature of the spine in the lumbar region (kyphosis, scoliosis)
Pain in this pathology occurs in the middle and late stages of the disease. Discomfort usually occurs towards the end of the day and is often accompanied by fatigue of the back muscles. The pain is most often caused by spasm of the spinal muscles, and spasm of muscles at a distance (gluteal, periarticular muscles of the upper and lower extremities) is also possible.
Spondyloarthrosis
This is a degenerative-dystrophic disease of the cartilage tissue covering the intervertebral discs. It gradually becomes thinner and destroyed, and bone growths (osteophytes) appear around the affected area. As a result of the reduction in the distance between the vertebrae, the spinal canal narrows, irritation of the nerve roots and spinal cord occurs.
Pain with this pathology:
- intensifies after exercise (prolonged standing, walking) and goes away after rest;
- accompanied by stiffness of movement, first in the morning, then constant;
- can radiate to the thigh and hip joint area.
The muscles in the affected area spasm and are constantly in tension, which also increases pain.
Urolithiasis disease
An attack of urolithiasis is characterized by severe lumbar pain from the affected kidney. At the same time, the sensations do not change depending on the posture; a person cannot find a position in which they weaken even a little. The attack is often accompanied by a decrease in the amount of urine and a change in its color to reddish.
Lower back pain can also be a consequence of:
- algomenorrhea (painful periods);
- pregnancy;
- inflammation of the pancreas;
- osteomyelitis;
- intestinal obstruction;
- appendicitis, etc.
Pelvic organ prolapse
With age or during pregnancy and childbirth, the pelvic floor muscles may weaken, causing the uterus, vagina and bladder to move downwards. This is not a dangerous condition, but it leads to a feeling of discomfort and makes sexual intercourse painful. Special Kegel exercises help strengthen the pelvic floor muscles.
Varicose veins of the pelvic veins
Varicose veins can occur not only on the legs. Dilatation of the pelvic veins leads to pain, which intensifies when the woman sits or stands. When lying down, symptoms decrease or disappear. Varicose veins of the pelvic veins are treated surgically.
Pain in various parts of the back
The location of pain can tell a lot about its cause. Pain in the upper lumbar region may be due to:
- diseases of the spine;
- injuries;
- muscle spasms due to their overstrain;
- cardiovascular diseases;
- tumors;
- diseases of the gastrointestinal tract.
If the epicenter is in the lower back, the list of probable causes includes, in addition to spinal diseases:
- kidney pathology (pyelonephritis, urolithiasis);
- intestinal dysfunction (constipation, flatulence);
- spasms or inflammation in the pelvic organs (salpingo-oophoritis, endometritis);
- physiological reasons, in particular pregnancy;
- pinched sciatic nerve.
A shift of pain to the right or left may indicate damage to the corresponding spinal cord root or kidney.
Myofascial pain syndrome (MPS)
Quite often, the source of pelvic pain is the muscles and ligaments. This condition is called myofascial pain syndrome and has the following causes:
- muscle and ligament sprains;
- bruises;
- frequent minor muscle injuries, for example, during heavy physical work or sports;
- overstrain of the pelvic muscles, when you have to maintain an uncomfortable position for a long time;
- Sometimes the cause is hypothermia and frequent stress.
There can be many causes of pelvic pain. Sometimes it is difficult for a doctor to determine the cause of this condition without additional examinations. If you are worried about pelvic pain, make an appointment with a gynecologist at ProfMedLab, our phone number: +7 (495) 120-08-07.
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The main reasons why your lower back may hurt
Discomfort in the sacral area can be associated with injuries and repeated microtraumas, for example, due to improper organization of sports training. Without appropriate treatment, back injuries can cause the development of arthrosis or osteochondrosis, the formation of protrusions and hernias.
With arthrosis, the intervertebral discs suffer significantly, and over time they begin to be “replaced” by growing bone tissue – osteophytes. These formations cause the spine to “ossify” and reduce mobility. They also damage blood vessels and nerves, causing intense pain.
With osteochondrosis, the intervertebral discs are also primarily affected. They become thinner, and the spine begins to “sag,” which causes pathological muscle tension, circulatory problems and pinched nerve roots. As a result, not only back pain appears, but also numbness and unruliness of the legs. They can cause pain and deformation of the spine: lordosis, scoliosis and other diseases. It should be taken into account that disturbances in the anatomy of the spine can lead to displacement of internal organs, for example, prolapse of the kidney, which will also cause pain. Almost all diseases of the spinal column are progressive in nature. Injuries and degenerative-dystrophic pathologies without treatment lead to decreased mobility, the formation of intervertebral hernias and damage to the spinal cord, so ignoring pain in the lower spine or sacrum is dangerous for health, and sometimes even life.
Treatment of pain in the lower back and sacral spine
If you are unable to consult a doctor immediately, it is acceptable to take pain medication as an emergency measure. For mild pain, conventional analgesics are sufficient, but for severe signs of musculoskeletal disease, it is better to use one of the non-steroidal anti-inflammatory drugs. These medications eliminate not only pain, but also swelling and inflammation, and lower the temperature. Please note: non-steroidal anti-inflammatory drugs have significantly more contraindications for use than simple analgesics, so be sure to read the list of contraindications in the instructions for the drug. It should be remembered that the use of painkillers only numbs the pain, but does not help get rid of its causes, so self-administration of these medications does not replace medical care. In the early stages, all spinal diseases are treated conservatively. Advanced pathological conditions often require surgical intervention, which is why it is so important to consult a doctor immediately when the first signs of illness appear. Comprehensive therapeutic care allows you to:
- restore healthy spinal anatomy;
- normalize blood circulation;
- improve tissue nutrition;
- eliminate compression of the nerve roots;
- strengthen the muscle corset;
- remove displacement of organs;
- normalize mobility;
- eliminate inflammation and swelling;
- restore damaged tissue;
- eliminate pain.
To achieve these results, a combination of three main treatment methods is necessary: physiotherapy, exercise therapy and medications (anti-inflammatory, chondroprotectors and others). Manual therapy, acupuncture and massage are used as auxiliary methods to speed up recovery. Network of clinics “Hello!” deals with the treatment of pathologies of the joints and spine. Modern diagnostic equipment is used to determine the causes of back pain and identify complications. For treatment, classical and proven new treatment methods are used. The high level of qualifications of doctors and nursing staff helps to achieve complete recovery or stable remission in the vast majority of patients.
We specialize in the treatment of the musculoskeletal system, even in severe stages of disease. We have been helping thousands of patients avoid surgery for 10 years!
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This is the strongest team of experts who teach at the RUDN Department. We are the clinical base of leading universities, where the best doctors in Moscow, unique specialists from Russia and abroad are trained.
Ways to identify the causes of girdle pain
Modern diagnostic methods make it possible to determine the cause of pain localized in the back and under the ribs. When patients who have experienced back pain come to the Yusupov Hospital, the existing symptoms are studied, after which an examination is prescribed.
The main diagnostic measures for back pain are:
- urine and blood tests. The Yusupov Hospital has its own laboratory, so the results are delivered to the attending physician in the shortest possible time;
- Ultrasound of internal organs to detect pathological changes;
- examination of substances discharged from the lungs to exclude diseases of the respiratory system;
- X-ray of the upper limbs and lungs;
- gastroscopy.
Patients may be referred for additional consultation to other specialists at the Yusupov Hospital, a cardiologist, a neurologist, or a rheumatologist. Self-medication for back pain can provoke serious consequences, since without special equipment and knowledge it is impossible to accurately identify the cause of the disease and its manifestations.
Types of back pain depending on the cause
Pain sensations are primary and secondary; each of these types can be caused by a wide range of conditions and diseases.
In this article we will try to consider only the most basic ones. 1. Nonspecific (primary). This type of pain has a direct connection with problems in the spine and surrounding tissues.
Causes of back pain associated with the spine:
- Scoliosis. Poor posture, leading to gradual curvature of the spine, displacement of the vertebrae and muscle strain.
- Osteochondrosis. The cause of the development of the disease is a decrease in the shock-absorbing capacity of the spine: damage to the intervertebral discs, rupture of the fibrous ring and, as a consequence, infringement of the disc nucleus. Pain sensations are localized in the area of the spine in which there are pathological changes. So, with osteochondrosis of the thoracic spine, back pain is localized in the thoracic region (the back hurts between the shoulder blades and under the ribs); with osteochondrosis of the lumbar spine, a person experiences pain in the lumbar region.
- Intervertebral hernia. Due to damage to the intervertebral disc, protrusion of the soft structures of the vertebrae occurs with the possibility of strangulation (regular and strangulated hernia). The pain is localized at the site of the hernia.
- Ankylosing spondylitis. It is characterized by back pain and limited mobility in the spine, which leads to a forced “leaning forward” posture in the patient.
- Osteomyelitis. The cause of the disease is an infectious process that has developed in the spinal column. The patient feels that the pain affects not only the spine, but also the back muscles.
- Spinal injuries. In this case, the cause of back pain is injury and its accompanying complications. The intensity of pain and its location are directly related to the type of injury and the affected part of the spinal column.
In 40–50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3–5% of severe back pain is associated with damage to the roots of the spinal cord (radicular pain).
Back pain associated with pathological changes in muscles:
- Fibromyalgia. The inflammatory process develops in the muscles surrounding the spine, is characterized by symmetry and can be chronic. In this case, the back muscles along the entire spine hurt. The important point is that peak pain occurs when certain areas are pressed.
- Polymyositis. Hypothermia can trigger the disease. As a result of the development of the disease, the patient experiences muscle weakness and pain, which intensifies when trying to make a turn.
- Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that lower immunity can serve as a trigger. It manifests itself as pain that increases as the disease progresses and can cover all areas of the back. Severe back pain impairs mobility to such an extent that the patient is unable to move independently. A clear asymmetry is visualized in the back.
- Charcot's disease. Symptoms are caused by inflammation in the peripheral nerves along the spinal column. As a result of the pathological process, in addition to fairly intense pain, there is a change in the person’s gait.
In 50–60% of cases of nonspecific back pain, their localization is in the muscles.
2. Specific (secondary pain). This type of pain, despite its localization in the back, is often not directly related to diseases of the spinal column or the surrounding muscular skeleton. The causes of specific pain are extremely varied, but the most dangerous are cancer. Thus, pain radiating to the back can be caused by a malignant neoplasm in the area of the mammary glands, lungs or prostate, which provokes metastasis of the spine.
Diseases that cause specific pain include:
- Pinched nerve roots in the chest. Most often this leads to the development of intercostal neuralgia. The pain in this case is localized at the pinched site. Thus, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinching occurred). Soreness has varying degrees - from aching to sharp, shooting. Most often, pain occurs when moving or pressing on the affected area. This fact is the main difference between intercostal neuralgia and diseases of the heart and lungs, which can also manifest as pain under the left (or right) shoulder blade from the back.
- Diseases of the gastrointestinal tract. Pain is most often provoked on the right side; in some cases, it can spread to the left side of the body. For the most part, pain is localized in the lumbar and sacrolumbar regions. Quite strong pain is characteristic of pathologies associated with manifestations of diseases of the pancreas, colon diverticulum, intestinal obstruction, retrocecal appendicitis, etc.
- Ulcerative lesions. Ulcerative lesions of the organs of the upper abdominal cavity (peptic ulcer of the duodenum and stomach) can manifest themselves in the form of pain in the thoracic and lower lumbar back. If the lower part of the abdominal cavity is affected (ulcerative colitis), pain is localized in the lumbar region. The severity of pain may vary, but most often reaches its peak at night.
- Appendicitis. In acute appendicitis, in cases where the vermiform appendix (appendix) is located behind the cecum, the back hurts in the lumbar region. The pain is alternating in nature and can vary from aching, mild to acute, intense.
- Kidney diseases. Quite often they manifest themselves as pain in the lumbar region. This type of manifestation is characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies that have a direct connection with the spinal column occurs based on the analysis of other clinical manifestations and research results.
- Urolithiasis disease. With renal colic, the back hurts in the lumbar region. The pain is pronounced, intense, occurs suddenly and does not depend on the position of the body. Back pain in the lower back and with coral nephrolithiasis. Manifestations of the pain syndrome are low-intensity, the pain is rather aching in nature.
- Diseases of the female reproductive system and menstrual pain. In these cases, the pain is most often localized in the lower back.
- Neoplasms in the pulmonary system. In this case, pain appears at the stage when the lungs undergo germination of peripheral tumor elements (metastases) into the pleural area and chest wall. The nature of the pain is intense and debilitating.
- Cardiovascular diseases. The most common causes of pain localized in the thoracic back are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
- Inflammatory processes in the joints. Infectious arthritis can cause pain to radiate from the affected joint to nearby areas, including back pain.
For the most part, the causes of pain in the back are identical for representatives of both sexes, but it is necessary to identify a number of diseases that differ in gender predisposition.