Lower back pain: causes, types and treatments

Types of lower back pain

Understanding the nature of the pain is very important, because this will help the doctor immediately make an assumption about the diagnosis and prescribe a more accurate diagnosis.

Pain happens:

• acute (occurs due to recent damage, lasts up to 1.5 months);
• aching;
• blunt;
• strong and long lasting;
• subacute (lasts 6-12 weeks);
• variable (transitory);
• chronic (lasts more than 12 weeks).

Low back pain is also divided into primary and secondary.

Primary

associated with chronic changes in the tissues of the spine and muscles. Sometimes the spinal roots are involved in the process.

Secondary

pain indicates another disease. This could be arthrosis, arthritis, or some pathology of the internal organs.

What can be done to relieve a child's pain?

There are many things parents can do to relieve their child's stomach pain. Often something as simple as gently rubbing the belly with your hand or distracting the child's attention can help relieve the condition. You can also offer the child a drink of water or sit the baby on the potty or toilet. If this does not help, the child can be given paracetamol in the dosage recommended for the appropriate age and weight. Children should not be given aspirin because it can cause a rare but serious condition called Reye's syndrome.

Which doctor should I consult for pain in the lumbar region?

Usually, you first need to contact a therapist, who will already give a referral to a specialist - a neurologist, traumatologist, rheumatologist, or osteopath.

If you are sure that you know exactly the origin of the pain, you can contact a specific doctor directly. For example, if you recently had a bad fall, then you need to see a traumatologist.

Our clinic has a manual therapy department in St. Petersburg, where you can make an appointment with the right doctor for consultation or treatment.

How is diagnosis and examination done by a doctor?

First of all, the doctor must exclude conditions that are life-threatening. For this purpose, clinical and biochemical blood tests are performed. They make it possible to detect inflammatory processes and excess calcium, which is typical for cancer that has metastasized to the bones. Tests also detect multiple myeloma and many other pathologies.

A man over 50 years old may have a prostate-specific antigen test to rule out prostate cancer.

X-rays are required to determine the height of the intervertebral discs and identify osteophytes, if any. The latter are bone tissue growths that appear due to improperly distributed load on the vertebrae and changes in their shape.

MRI and CT are needed to determine whether there is a bulging intervertebral disc, calcifications, or spinal stenosis. Similar changes can be seen on ultrasound, which is increasingly being prescribed instead of CT, as it does not provide radiation exposure.

The patient must consult a neurologist and, if necessary, a chiropractor.

When the examination is completed, the doctor can accurately diagnose and determine treatment tactics. The success of therapy increases tenfold with early treatment.

Our clinic address: St. Petersburg, st. Bolshaya Raznochinnaya, 27 metro station Chkalovskaya

How to cure lower back pain: basic treatment methods

Treatment for the lower back depends on the cause of the pain. What helps in one case may not be effective in another. Let's look at the main types of therapy and ways to relieve pain at home.

Conservative treatment

Conservative therapy is rarely prescribed independently. Usually it complements medication.

Conservative methods primarily include physiotherapy. This can be manual therapy, classical or therapeutic massage, acupuncture. To relieve muscle spasms and restore blood flow, cupping massage with bloodletting at certain trigger points is often prescribed.

Sometimes doctors prescribe herbal treatment that improves blood circulation in the spine where spasms occur.

Kinesitherapy is becoming more and more popular. This is a special gymnastics that needs to be done on decompression machines. Such devices allow you to relieve overstrained muscles and form correct motor stereotypes in a person.

Medications

In most cases, back pain is not health threatening and can be overcome by taking certain medications and using ointments.

First of all, patients are shown non-steroidal anti-inflammatory tablets - Ibuprofen, Ketoprofen, Piroxicam, Nimesulide, Diclofenac. These are good pain relievers that also relieve inflammation.

You can also give injections for pain. One of the effective drugs for pain relief is Baralgin. This is a proven and good remedy to quickly relieve pain caused by spasms. The drug is available in ampoules, is a non-narcotic pain reliever and can relieve even very severe pain.

Where is Baralgin injected?

In a hospital setting, the drug can be administered intravenously. This is how it works faster and more efficiently.

At home you can inject it intramuscularly - into the buttock. Visually divide the buttock into four segments by drawing two lines - horizontally and vertically in the middle. The injection should be given in the upper right part (for the right buttock). With one confident movement, you need to insert the needle to its entire length and then inject the drug by pressing the syringe. The medicine should be administered moderately quickly. Before the injection, be sure to disinfect the skin, and afterward, apply a cotton swab soaked in antiseptic for about 5 minutes.

Important!

We do not recommend self-medication. Before using any medications, be sure to consult your doctor!

Let's return to drug treatment methods. In some cases, hormonal medications are prescribed to reduce swelling and pain. They act faster than non-steroidal anti-inflammatory drugs. They are administered under medical supervision or strictly according to the prescribed regimen. At home, you can give intramuscular injections or take the prescribed drug in tablets. In the hospital, IVs are usually placed.

Hormonal drugs are also used for therapeutic blockades, that is, they are injected directly into the source of pain. The main drugs in this group are Prednisolone and Dexamethasone.

Many commercials position ointments and gels as the most effective means of combating pain. However, in fact, this method of introducing the active substance into the body is considered the most ineffective, because most of the drug does not even pass through the skin.

Alarm signals:

• Increased frequency and intensification of pain;
• Weight loss;
• Vomiting blood or coffee grounds.

In the treatment of gastritis and peptic ulcers, regular nutrition without overeating, the exclusion of irritating foods, the use of boiled, baked or lightly fried low-fat second courses, light dinners at least 2-3 hours before bedtime, the exclusion of sour juices and sweets are of great importance. The doctor prescribes an examination, diet and appropriate medications.

Diseases of the biliary system. Diseases of the biliary system in children, as a rule, are of microbial origin. Predisposing factors are a violation of the outflow of bile, which develops with dyskinesia of the biliary system.

Dyskenesia may be associated with dysfunction of the sphincter apparatus, blockage of the ducts or their compression. Subsequently, the presence of an inflammatory process in the ducts may be accompanied by a violation of the outflow of bile.

The contractility of the gallbladder is important.

The pain syndrome is usually accompanied by dyspeptic disorders (nausea, belching, unstable stool, constipation). An important symptom is liver enlargement associated with stagnation of bile.

There are no symptoms of chronic intoxication and changes in other organs. Physical development corresponds to age. In some children, the main symptoms of the disease are liver enlargement without pain.

A good effect for improving well-being is provided by excluding too fatty, spicy, fried foods from the diet. The same applies to baked goods. Vegetable oil, on the contrary, increases bile secretion and is recommended to be consumed more often. If, in addition to the specified diet, you increase physical activity, this is often enough for recovery and well-being.

If diet and lifestyle changes are not enough, choleretic agents are used. Your doctor should recommend specific medications.

Enteritis, colitis (enterocolitis) is an inflammatory disease of the wall of the small and large intestines, characterized by abdominal pain and diarrhea syndrome.

Chronic colitis and enterocolitis are most often associated with acute infections. In this case, the pathogen that caused the disease has already lost its significance, and the dysfunction of the intestine is supported by those morphological changes that remain after the infection.

The main clinical symptoms are abdominal pain, bloating and rumbling, impaired intestinal motility (constipation, diarrhea, or diarrhea alternating with constipation). Pain may be absent during the period of remission of the disease, but dysfunction of the intestines remains, which requires restorative treatment.

In addition, increased irritability, tearfulness, depressed mood, vascular dystonia syndrome, and a tendency to smooth muscle spasms are typical for these patients.

Rehabilitation consists of organizing nutrition according to the ability to absorb food, psychotherapy, the use of physiotherapeutic influences, and the use of astringents, enveloping, and absorbent agents. Recommendations on nutrition, daily routine, and medications can only be given by a doctor.

How to quickly get rid of pain without drugs and at home

You won’t be able to get rid of pain in a minute, but in 5-10 it’s quite possible. To do this, you need to do an exercise aimed at relieving muscle spasm and relaxing the lumbar region.

We offer two options:

Exercise one

• Starting position: kneeling.
• The right leg should be bent at a right angle, it should stand in front. With your left foot, place your knee on the floor.
• In this position you need to find balance and fixate.
• When you succeed, reach back with your left hand and grab your left foot.
• After this, pull your left leg by the heel to the pelvis. The thigh muscles should be well stretched. You can enhance the effect by squeezing your left buttock.
• Stay in this position for half a minute, then slowly and carefully lower your left leg, returning to the starting position.
• After this, do the exercise for your right leg.

Exercise two (you will need a massage roller)

• Lie on your back with a massage roller under your sacrum. Important: do not place the roller under your spine under any circumstances.
• Gently pull your right knee toward your chest. The left heel should touch the floor. At this moment, you will feel the anterior thigh muscle stretch.
• To increase muscle tension, place your left hand behind your head and turn your bent knee slightly to the right.
• Hold this position for half a minute.
• Repeat the exercise for the other leg.

Other home remedies for lower back pain

If the pain is caused by swelling, a dry cold compress can help. Take ice or something frozen from the freezer, put it in a bag and wrap it in a cloth. Apply to the lower back for 20 minutes for two days. You can repeat every two hours.

If the pain does not go away from the cold, then after two days you can try warm compresses. They increase blood circulation in the lower back and relieve pain by interrupting pain signals from nerve endings to the brain. It is best to use an electric heating pad for this. If you don't have it, a regular one will do. You can also simply take a warm bath.

What diseases may cause lower back pain?

Ankylosing spondylitis

This disease develops gradually. At first, mild pain appears in the lower back, then it intensifies and spreads to other parts of the spine. The pain may occur sporadically, but most often it is constant and decreases only as long as the pain medication is in effect.

Features of the nature of pain:

• worsens at rest, especially in the morning and in the second half of the night in a horizontal position;
• accompanied by stiffness of movements;
• goes away or decreases after charging;
• goes away quickly after taking a non-steroidal anti-inflammatory drug.

Sometimes the pain is very weak or not at all, and the only symptom is a decrease in the mobility of the spine, which spreads from the bottom up. Some patients also have pain in their shoulders and their mobility is limited. It happens that the joints of the legs and arms swell and hurt.

Hernia and osteochondrosis

These diseases have similar symptoms and depend on each other, so we will look at them together.

With lumbar osteochondrosis, the pain is severe because the nerve roots are mechanically irritated. In addition, when the membranes and septa of the intervertebral disc rupture, substances enter the bloodstream that irritate pain receptors.

At the late stage of osteochondrosis, the intervertebral discs bulge and a hernia forms. The lower back is most often affected because the openings between the fourth and fifth lumbar vertebrae and between the fifth vertebra and the sacrum are the narrowest, but the nerve roots that pass through them are the most massive. The patient feels severe pain, similar to radiculitis. If the hernia is massive, it begins to put pressure on the spinal cord, which leads to decreased sensitivity in the legs and even paralysis.

Characteristic signs of a hernia:

• it is impossible to stand up without leaning on a chair or knee, because the load on the disc responds with a severe attack of pain;
• You can’t lie on your stomach just like that, but only with a pillow;
• It is impossible to bend down to pick something up from the floor, but to do this you need to carefully squat.

Kyphosis and scoliosis

In the early stages there is no pain. You may feel very tired in your back muscles, and in the evening you really want to go to bed as soon as possible. At the second stage, neurological disorders appear:

• hands go numb;
• shoulders and forearms weaken;
• My back starts to hurt a lot.

Spondyloarthrosis

At the same time, spondylosis develops. When it occurs, the cartilage of the intervertebral disc is destroyed, and bone protrusions grow around the altered disc. This can lead to a narrowing of the spinal canal and compression of the spinal cord, which causes the legs to go numb or even paralyzed, and the function of the pelvic organs is disrupted.

Main symptoms:

• lower back pain, which in rare cases radiates to the thigh closer to the hip joint;
• reduction of pain after rest or cessation of exercise;
• soreness and tension in the lower back muscles;
• limitation of spinal mobility.

The pain intensifies while standing and walking, there is a feeling of heaviness and stiffness in the lower back in the morning. Usually, stiffness and heaviness go away after morning exercises.

The pain is moderate and can become chronic. This is due to constant irritation of the nerve roots and nerves.

Protrusions

Protrusions occur where mobility, and therefore wear, is highest. Therefore, the lower back is most often affected.

The symptoms are mild for a long time, so people do not even suspect that this is not ordinary fatigue, but a serious diagnosis. However, then the manifestations intensify:

• discomfort in the lower back gradually turns into pain, which becomes stronger and occurs more often, it hurts a person to move, the pain radiates to the legs and eventually spreads to them;
• pain in the legs spreads to the buttocks, numbness, tingling, and cramps may occur;
• I'm worried about lumbago in the lower back;
• constant sharp or aching pain appears;
• in the final stages, without treatment, the leg muscles weaken and motor activity decreases;
• pain occurs in the right and/or left hypochondrium.

Arthritis

The symptoms of lumbar osteoarthritis are similar to those of osteochondrosis. With this disease, the nutrition of the intervertebral discs is disrupted and the joints become inflamed. In later stages, limited mobility and even paralysis are possible.

Arthritis is a chronic disease, so you need to follow all doctor’s instructions for life to maintain a normal quality of life.

Main symptoms:

• aching dull pain in the lower back;
• lumbago in the lower back due to hypothermia;
• impaired sensitivity in different parts of the body;
• the inability to move due to pain after a person has been in one position for a long time.

Osteomyelitis

With this disease, there is constant aching pain in the lower back, which intensifies with movement and does not go away with rest. The pain may be worse at night and can be relieved with a dry, warm compress.

Other symptoms are also present:

• signs of general intoxication of the body - sweating, chills, weight loss, slight increase in body temperature;
• local abscess, as a result of which the nerve roots are compressed and the functions of the organs innervated by them are disrupted;
• paresis and paralysis (in severe cases).

Pancreatitis

If only the head of the pancreas is affected, then the pain occurs in the right hypochondrium, if its body - “in the pit of the stomach”, if the tail - in the left hypochondrium.

If the entire gland is inflamed, the pain is girdling in nature and radiates to the back, under the left shoulder blade.

In some cases, the pain radiates to the left thigh, groin, tailbone, and perineum.

The nature of the pain can be different - acute, nagging, periodic. Usually it starts to hurt 2-3 hours after eating, but sometimes almost immediately - after 10-15 minutes. During physical activity, the capsule of the gland is stretched, which also causes pain.

Spinal stenosis

Occurs due to hernia, protrusion or sequestration. Compresses the lower spinal nerves that innervate the lower extremities. The pain spreads along the affected nerve root, from the lower back to the foot, bothers you when walking and at rest, intensifies when a person tries to straighten the spine, and subsides when bending forward.

Facet syndrome

This is a disease of the intervertebral joints, which are called “facet joints”. The pain can be localized only at the site of the lesion or radiate to the tailbone, groin, and back of the thigh. Unpleasant sensations intensify when rotating in the lower back and bending, after physical activity and in the evening.

What does the doctor pay attention to when examining a child?

As with any child being examined by a doctor, the first thing to determine is how severe the child's condition is. To determine this, doctors look at a number of factors, including the baby's general appearance, vital signs such as heart rate, breathing rate, temperature, and any information the parents have given them.

Then the doctor examines the tummy. Simply placing your hand on your stomach can give your doctor a lot of useful information. If the tummy is soft when pressed and does not hurt much, then a serious cause for the pain is much less likely. If there is pressure on the child’s abdomen and he experiences severe discomfort, you should immediately think about hospitalization. Unfortunately, children are poor at localizing pain. Thus, pain caused by a cause outside the abdominal cavity (eg, basal pneumonia, testicular torsion) can also manifest as abdominal pain. Conversely, intra-abdominal problems may result in pain elsewhere (for example, kidney problems may present as testicular pain, and subdiaphragmatic problems may cause shoulder pain).

Simple tests are often done, such as checking the child's urine for infection or checking the child's blood sugar levels. After collecting all the information, the doctor will try to find out the cause of the child’s abdominal pain. In an unhealthy child it is important to find the cause, but often in a healthy child such a cause cannot be found.

Causes of lower back pain

Let's consider the main causes of lower back pain, taking into account their localization.

Pain above the lower back, but below the shoulder blades

The main reasons why it hurts in this area:

• diseases of the spine (primary pain);
• injury - from a fall, an incorrectly performed exercise, or a blow;
• muscle strain, spasm;
• cardiovascular diseases;
• tumors, including malignant ones;
• gastrointestinal diseases.

Pain below the waist

Pain in the lower back occurs due to diseases of the spine or internal organs. In the second case, the pain is called “referred”. Most often, pain occurs after a long walk, prolonged sitting, bruises and injuries, infectious diseases, or heavy lifting.

Often, pain below the lower back is associated with unhealthy and improper stress on the spine. Less commonly, these may be diseases of the gastrointestinal tract and genitourinary system - cholecystitis, cystitis, pyelonephritis, gastritis, constipation.

Signs of referred pain:

• rare or frequent and painful urination;
• bloating;
• lower abdominal pain;
• increased body temperature;
• nausea, vomiting;
• diarrhea or constipation.

In women, the causes of pain below the lower back can be: pregnancy and its complications, menopause, menstruation.

If there are no other symptoms other than pain, then they say that it is due to problems with the musculoskeletal system. If the pain is localized in the pelvic area, this may be a consequence of a previous disease of the hip joint.

Left lower back pain

The nature of the pain is aching, it does not go away with rest, it occurs when walking, physical activity, running, or after prolonged sitting.

If the pain does not go away after rest, then its causes may be:

• scoliosis;
• osteochondrosis;
• spinal infections;
• circulatory disorders.

If pain occurs when walking and goes away after rest, it could be radiculitis, diabetes mellitus, spinal displacement, or pinched nerve root.

Aching pain above the lower back on the left occurs with a sedentary lifestyle and may indicate the presence of osteochondrosis, recent hypothermia or incorrect posture.

Acute, girdle pain in the side, which radiates to the left shoulder blade, may be one of the symptoms of myocardial infarction. A stomach ulcer radiates to the same area, the pain is sudden, sharp, cutting.

Right lower back pain

• Cramping pain is characteristic of diseases of the genitourinary system.
• Increasing pain indicates an inflammatory process, including an abscess.
• Dagger pain is an emergency condition, that is, internal bleeding, ulcer, rupture of an organ, thromboembolism.
• Shooting is characteristic of diseases of the spine when the spinal roots are involved in the process.
• Constant dull and monotonous pain is characteristic of diseases of parenchymal organs, such as the liver.
• Nagging pain occurs with damage to the musculoskeletal system, including trauma.

Lower back pain when coughing

The most important causes of pain when coughing:

• Hernia – accompanied by loss of sensation in the limbs. Pain also appears when bending forward.
• Stenosis. At the same time, it is difficult to walk, there is weakness in the legs. The examination shows a decrease in the thickness of the discs.
• Facet arthropathy. The lower back hurts when coughing, but the pain goes away if you bend towards the traumatic injury. The muscles on the affected side become overstrained.
• Injury to the fibrous ring. The pain intensifies when bending over, moving, or sitting for long periods of time.
• Osteochondrosis. It reduces the function of the spine.
• Kidney diseases.
• Neuralgia – girdling pain.

Why does my child have a stomach ache?

Abdominal pain is a common symptom in children and can have many possible causes. Some common causes include constipation, viral infection, gastrointestinal and urinary tract infections. Most abdominal pain in children is mild and transient and is caused by minor illnesses (eg, gastroenteritis, viral infection). Mild, intermittent pain in the central abdomen is usually not serious. In young children, it can be difficult to immediately determine the cause of mild abdominal pain. In some cases, the cause of pain may be the psychological state of the child.

There are more serious causes of abdominal pain, but they are less common. These include severe infections and problems requiring surgery, such as appendicitis.

Ways to prevent lower back pain

To prevent lower back pain, you must:

• Provide yourself with adequate exercise - do exercises in the morning, simple exercises to stretch the muscles and spine.
• Periodically take massage courses - classic, cupping on trigger points.
• Do warm-ups or undergo cryotherapy courses as prescribed by your doctor.
• Eat right to avoid gastrointestinal pathologies. It is necessary to maintain a balance of proteins, fats, carbohydrates, and consume enough plant fiber. Alcohol, fatty, fried, salty and spicy foods should be excluded from the diet. Do not overuse smoked and canned foods, fast food. Another important point is the drinking regime: you need to drink 1.5-2 liters of liquid per day (along with soups, tea, etc.).
• At the first signs of illness, you should consult a doctor. In the early stages, almost any disease can be cured quickly and easily, without any consequences. If you are predisposed to lower back problems, you should visit a neurologist for prevention at least once a year.

Our clinic address: St. Petersburg, st. Bolshaya Raznochinnaya, 27 metro station Chkalovskaya