Main causes of back and leg pain
The spinal nerves form nerve trunks. The largest of them is the paired sciatic nerve, which leaves through the gluteal region into the lower extremities. With osteochondrosis, hernia or protrusion of the intervertebral disc, spondylosis and other diseases, the spinal cord roots that form the sciatic nerve may be pinched. The result is swelling, inflammation, poor circulation and lack of oxygen in the pinched spinal nerves, which causes sharp and severe pain in the back and legs
along the course of the sciatic nerve.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Radicular syndromes
The described phenomena in medicine are called radicular syndrome (radiculopathy) - this is a complex of neurological symptoms that occurs when the spinal nerves are pinched or irritated. Pain in the back and limbs
often occurs with intervertebral hernia, protrusions, and other diseases of the spine.
With radicular syndrome, pain is accompanied by various neurological symptoms. In addition to pain, sensitivity disorders are possible - patients complain of numbness, tingling, burning sensation on the skin. Reduced pain sensitivity. The skin is cold even on the hottest day. With advanced radicular syndrome, atrophy and weakness of the muscles of the lower extremities may be observed. But the most striking symptom remains pain along the nerves, the intensity of which varies from mild aching to unbearable.
Let us consider the variants of radicular syndromes and the causes of their occurrence separately.
Sciatica (sciatica)
Sciatica is called chronic pain in the lower extremities, most often arising from protrusion/hernia of the 5th lumbar/1-2 sacral vertebrae. The nature of pain in the acute period is described by patients as burning, shooting, boring, pulling. The pain spreads along the sciatic nerve, through the buttock, the outer surface of the thigh and lower leg, to the back of the foot. Increased pain is provoked by turning, bending the body, lifting weights, being forced to stand for a long time, and cold weather. With sciatica, there may be no pain in the spine itself.
The intensity of pain depends on the location of the intervertebral hernia, and to a lesser extent on its size. A characteristic sign is that pain occurs on one side, less often on both sides.
Shooting pain in the lower back (lumbago, lumbodynia)
Lumbago is an acute, sudden pain in the lower back. Most often, the cause of lumbodynia is osteochondrosis or protrusion/hernia of the intervertebral disc. Unlike sciatica, pain is localized at one point, in the projection of the affected segment of the spine. The provoking factor is lifting weights, physical activity, and a draft blowing through the lower back, especially after hard work.
A characteristic symptom is a forced position; attempts to straighten the lower back lead to increased pain. The reason is a sharp spasm of the back muscles that occurs in response to severe pain. The duration of an attack of pain with lumbodynia can vary from several minutes to days and even weeks. Rest and a firm bed may relieve pain in some patients.
Lumbalization and sacralization
Lumbarization and sacralization are anomalies in the development of vertebrae in the lumbosacral spine. During lumbarization, the first and/or second vertebra of the sacral spine in the process of development takes on the shape characteristic of the lumbar vertebrae, while maintaining mobility (normally, the vertebrae of the sacral spine completely fuse by the age of 18, forming the sacrum or sacrum). With sacralization, the 5th and/or 4th lumbar vertebrae in the process of development take on the characteristics of the vertebrae of the sacral spine and fuse with it into one whole.
Both anomalies lead to disruption of the biomechanics of the spine and improper distribution of loads. Often sacralization and lumbarization are accompanied by other anomalies (split vertebral arches, flattening of vertebral bodies). All this leads to the development of spinal osteochondrosis, provokes the formation of hernias and protrusions, which in turn cause lumbago and sciatica.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Pinched sciatic nerve (lumboischialgia)
Infringement of the spinal nerves forming the sciatic nerve, as mentioned above, is a consequence of osteochondrosis, hernias and protrusions of the intervertebral discs. And most often this condition is accompanied by both acute pain in the lower back (lumbago) and sharp, nagging pain along the sciatic nerve in the legs (sciatica). This condition is called lumboischialgia.
Treatment of tendinitis
It is important that treatment for this disease is prescribed by a doctor. The first step is to remove excess stress on the joint whose tendons are inflamed. It is not necessary to completely immobilize an arm or leg. You can simply “take care” of your limbs and not put unnecessary strain on them physically. In order to reduce mobility, elastic bandages, bandages, and bandages are useful. Exercise therapy may be prescribed, which should be carried out by an experienced rehabilitation therapist. Properly selected exercises will not only relieve muscle tension, but also strengthen them.
To relieve the pain that always accompanies tendonitis, doctors prescribe non-steroidal anti-inflammatory drugs. They are available in the form of ointments and creams, as well as tablets for oral administration.
In some cases, treatment with glucocorticoid injections will be effective, but it should be remembered that such injections can provoke tendon rupture. Physiotherapy, which is used in combination with drug treatment, will also be useful. If a large amount of calcifications and salt deposits were found in the inflamed area, then shock wave therapy will help break them up.
If the sciatic nerve is pinched due to inflammation of the hip joint, the doctor may prescribe surgery to eliminate the underlying problem. In this case, drug treatment will be ineffective, since it can only eliminate the symptoms, but not cure the disease.
One of the most popular drugs today that helps heal inflamed joints and tendons is Artracam. It has a positive effect on the metabolism in cartilage tissues and also stimulates biosynthesis.
The main active ingredient of Artracam is glucosamine sulfate. It has a pronounced analgesic and anti-inflammatory effect, and also increases the amount of hyaluronic acid in the synovial fluid. Degenerative processes in the joints are slowed down, and joint function is restored. The pain becomes less pronounced even in the acute period.
Localization of pain in the back and legs
The localization of pain in the lower back and lower extremities depends on the location of the protrusion or herniation of the intervertebral disc. There are lateral, central (horizontal hernias) and internal (Schmorl's hernia) herniations of the intervertebral disc.
Pain radiates to right leg
Pain radiating to the right leg occurs with a lateral or horizontal herniation of the intervertebral disc that occurs on the right. In this case, the right spinal nerve is pinched, and the pain, accordingly, will radiate to the right leg.
Pain radiates to left leg
Pain radiating to the left leg occurs due to hernias/protrusions of the left half of the intervertebral disc.
Pain in the lower back and lower back
Isolated lower back pain of the lumbago type occurs with a central location of a hernia or protrusion, strictly at 12 o’clock. In this case, the hernial protrusion is directed into the spinal canal; there is no pinching of the spinal nerves in the intervertebral foramen, as occurs with lateral hernias. Because of this, there is no pain radiating to the legs. The source of pain is the posterior longitudinal ligament of the spine stretched by a hernia.
Types of severe back pain that radiates to the legs
The nature of pain during hernias/protrusions of the lumbosacral region greatly depends on the location of the hernia, the individual characteristics of the patient (diameter of the intervertebral foramina, diameter of the spinal canal, age and severity of degenerative changes). The size of the hernia can also affect the severity of pain.
Drawing, burning, shooting pains in the back and legs are characteristic of the acute period of the disease, immediately after the onset of an attack of lumboischialgia. They are poorly relieved by analgesics, and may last 1-2 weeks before improvement.
Aching pain in the back and legs is often chronic and can last for years if the patient neglects a visit to a neurologist or treatment. Periodically, there may be periods of exacerbation associated with physical activity or heavy lifting.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Causes
The causes of ankle arthritis vary. Very often, joint inflammation develops after an injury. Closed injury is accompanied by aseptic inflammation, which can go away on its own.
The cause of the development of purulent arthritis of the ankle and foot is the consequences of coccal infection entering the joint cavity after open injuries, surgical interventions or intra-articular injections. Sometimes the cause of the pathological process is a sexual or intestinal infection suffered some time ago. This kind of arthritis is called reactive, and it has a hereditary predisposition. Another disease that has a genetic basis is rheumatoid arthritis, the development mechanism of which is associated with autoimmune processes (allergy to the patient’s own tissues). Infectious arthritis develops against the background of specific infections: brucellosis, syphilis, gonorrhea, tuberculosis. The ankle is affected relatively rarely, usually with gonorrhea.
Arthritis can also be caused by psoriasis, gout, diseases of the gastrointestinal tract (GIT), connective tissue, etc.
Hereditary pathology is characterized by the presence of trigger factors that give impetus to the onset of the disease. These are previous infections, hypothermia, stress, the presence of foci of infection and concomitant diseases, excess body weight, a sedentary lifestyle, heavy physical activity, and unfavorable living conditions. There are also occupational hazards. The risk of developing ankle arthritis increases in people in such professions as dancers, loaders, weightlifters, military personnel of certain branches of the military, etc.
How is back and leg pain diagnosed?
The first stage of diagnosing the causes of back pain radiating to the legs is a consultation with an experienced neurologist. Radicular syndrome can be diagnosed during a routine neurological examination. A characteristic sign is the positive Lasègue symptom, which consists of increased pain in the leg when it is raised up while lying on the back. It is also called the spinal cord root tension symptom.
A neurological examination also reveals other disorders - decreased sensitivity of the skin to pain, absence or blurred reflexes, atrophic phenomena, weakness of the muscles of the lower extremities. To confirm the diagnosis, it is best to use magnetic resonance imaging of the lumbosacral spine.
How to relieve back and leg pain
A short course (2-3 days) of nonsteroidal anti-inflammatory drugs, or NSAIDs, can be used to relieve back and leg pain. Drugs in this series have the ability to fight inflammation and can relieve pain of various origins. When the sciatic nerve is pinched, they have average effectiveness. It is strictly forbidden to take NSAIDs for more than 5 days due to the high risk of complications such as stomach ulcers and gastric bleeding. Rest and a firm bed may relieve pain in some patients. However, for others, these measures may lead to increased pain. You should try to find the optimal position in which the pain becomes less severe. Wearing an orthopedic corset can also be effective - it relieves pain by unloading the diseased spine, acting as a muscular frame.
Features of the development of tendinitis in children
This disease does not occur as often in children as in adults. The most “popular” place where tendinosis occurs is the knee joint. At the first symptoms of tendonitis in a child, you need to contact a pediatric traumatologist. He will conduct an examination and make an accurate diagnosis. After this, the little patient will be prescribed the necessary medications. Most often, the list includes muscle relaxants and non-steroidal anti-inflammatory drugs, both for oral administration and in the form of ointments.
For a certain period of time, you will have to limit your mobility and remove all physical activity. If the pain is very severe, the joint is immobilized. Treatment includes a variety of physical therapy, including electrophoresis. As soon as the acute phase of the disease has passed, a course of massages is carried out and physical therapy is added.
How to treat back pain that radiates to your legs
During the period of acute pain, it is recommended to rest, take painkillers, as well as drugs that eliminate spasms of the back muscles. After the acute pain subsides, physiotherapy, massage, and therapeutic exercises are prescribed, which are included in the rehabilitation program for all patients with diseases and injuries of the spine.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience