Why do even young people have back pain? When you need to see a doctor urgently

Lower back pain occurs quite often. Patients say “my lower back hurts”, “my lower back is pinched”, “shot in the lower back”. If the pain is not acute, they may say “lower back hurts,” “lower back pulls,” “lower back ache.” Sometimes the pain is described as a burning sensation in the lower back.

Lower back

called the lower back - from the place where the ribs end to the tailbone. Perhaps a separate word for the lower back was needed just to indicate the place where it hurts. After all, if your back hurts, then in most cases it is your lower back that hurts.

What can low back pain look like?

Most often, lower back pain occurs suddenly, sharply and is acute. In this case they talk about lumbago

(outdated popular name -
lumbago
). The pain is described as sharp, “shooting.” Movements are constrained, sometimes it is even impossible to straighten your back. With any movement the pain intensifies.

An attack of pain can last a couple of minutes, or it can last for a longer period of time (up to several days). It may be that the attack will pass and the pain will no longer remind itself, but often the pain returns and the person gets used to the fact that his lower back can hurt.

Lower back pain can not only be acute (sharp), it can be nagging and chronic. Mild but constant pain in the lower back, sometimes worsening, for example, during physical activity, an infectious disease, hypothermia, etc., is called lumbodynia

. Sometimes there is no direct pain, but stiffness remains in the lower back, and the patient experiences discomfort.

Causes of lower back pain

Lower back pain can be caused by various reasons, but the statistics are as follows:

• in 90% of cases the pain is caused by problems with the spine and back muscles;
• in 6% the cause of pain is kidney disease;
• 4% - diseases of other internal organs (genitourinary system, intestines).

The spine accounts for the majority of all cases of low back pain, and this is no coincidence. In humans, the center of gravity of the body is located exactly at the level of the lower back, and when walking, the entire load falls almost entirely on the lumbar spine (animals that move on four legs do not have this problem). And when a person sits down, the vertebrae of the lower back and sacrum experience the same force of pressure with which a 170-meter layer of water presses on a diver. Naturally, this area is particularly vulnerable.

Diseases of the musculoskeletal system that cause lower back pain:

• pinched sciatic nerve. The nerve roots extending from the spinal cord are compressed by neighboring vertebrae. In this case, a sharp, shooting pain occurs. As a rule, pinched roots become possible due to degenerative changes in the spine (osteochondrosis): the intervertebral discs separating the vertebrae from each other are destroyed, the gap between the vertebrae narrows and sudden movement (tilting, turning) can lead to pinching of the nerve branch;
• sciatica (lumbosacral radiculitis). Pinched nerve roots can become inflamed. Inflammation of the nerve roots is called radiculitis (from the Latin radicula - “root”); To indicate inflammation of the sciatic nerve, a special name is sometimes used - sciatica. If the sciatic nerve is damaged, lumbar ischialgia may be observed - pain in the lower back, also spreading to the buttock and leg along the sciatic nerve;
• intervertebral disc herniation – protrusion of a fragment of the intervertebral disc into the spinal canal. Occurs as a result of injury or degenerative changes in the spine (osteochondrosis);
• myositis of the lumbar muscles. Myositis is an inflammation of skeletal muscles. The cause of myositis of the lumbar muscles can be hypothermia or sudden tension.

Also, lower back pain can be caused by diseases such as multiple sclerosis, degenerative sacroiliitis, osteoporosis.

Features of fatigue and other symptoms of cervical osteochondrosis

Osteochondrosis of the cervical spine can cause not only increased fatigue, but also drowsiness, muscle weakness, apathy, and even chronic fatigue syndrome, in which the patient may not find the strength to simply get out of bed. This is especially evident during an exacerbation of the disease. During this period, patients experience debilitating pain, aggravated by almost any movement of the neck or head, and suffer from sleep problems. This cannot pass without a trace and invariably leaves an imprint on the emotional state, making patients with cervical osteochondrosis irritable, overly vulnerable, grumpy, as fatigue and pain are exhausting and lead to nervous strain.

Moreover, such symptoms can occur not only during an exacerbation of the disease, but also be present even during remission. But in this case, they are less pronounced, although increased fatigue, drowsiness and muscle weakness may persist.

Often, cervical osteochondrosis and the vertebral artery syndrome that results from it become the cause of the development of complete apathy, that is, loss of interest in life, or panic attacks. Both conditions are extremely dangerous, as they can lead to severe depression and suicidal thoughts.

But, in addition to increased fatigue and deterioration in performance, cervical osteochondrosis may be accompanied by other symptoms, especially with the development of its complications. This:

• crunching sound that occurs when you move your neck;
• muscle tension in the neck and collar area on one or both sides;
• sharp, dull or aching pain that intensifies with movement and as the disease progresses;
• stiffness of movements;
• pain radiating to the arms and shoulders;
• sleep disorders;
• cochleovestibular disorders (dizziness, instability when walking);
• headaches of various types, including migraines;
• visual impairment;
• panic attacks, anxiety;
• noise in ears.

The nature of the manifestations of diseases depends on the severity of pathological changes in the intervertebral discs, the level of damage, and individual characteristics.

Often, cervical osteochondrosis leads to the development of radicular syndrome. The appearance of its signs should be regarded as a very alarming bell, indicating the progression of the underlying disease and a sharp increase in the risk of complications. By radicular syndrome is meant a complex of neurological disorders that arise as a result of compression by the vertebrae, protrusion, or hernia of the spinal root passing at their level. They branch off in pairs from the spinal cord at the level of each vertebra, and each pair is responsible for the innervation of certain organs or parts of the body. Therefore, when they are compressed, a complex of neurological disorders characteristic of a specific level of damage is observed in the form of:

• sensitivity disorders (numbness, goose bumps sensation, disturbances in the perception of cold and body, loss of pain sensitivity, etc.);
• movement disorders, in severe cases reaching paralysis;
• disturbances in the functioning of the relevant organs (spinal roots passing through the cervical vertebrae are responsible for the innervation of the eyes, tongue, ENT organs, thyroid gland, etc.).

This can also cause weakness, but of a different kind. Due to decreased muscle tone or disruption of their innervation, it may be difficult for the patient to perform everyday activities, which will also be perceived by him as weakness.

Prevention of low back pain

The occurrence of lower back pain is often provoked by a careless attitude towards one’s own health. Pain may be caused by:

• staying in the same position for a long time (for example, during sedentary work);
• incorrect posture;
• low mobility;
• excessive physical activity.

All these factors contribute to the development of diseases manifested by lower back pain. The risk of pain can be reduced by following the following advice from doctors:

• watch your posture;
• Avoid uncomfortable postures when working while sitting. It is advisable that the knees are slightly higher than the hip joints. To do this, use a low chair or footrest. Place a small pillow between your lower back and the back of the seat;
• When working sedentarily, you need to get up from time to time to move around. Take five-minute breaks every hour; how to lift weights correctly
• It is advisable to sleep on an orthopedic mattress (elastic and quite hard);
• You need to lift weights by bending your knee joints, not your back. That is, you need to squat down, bending your knees, and then straighten them, while maintaining a straight line of your back;
• When carrying a load, it must be evenly distributed between both hands; you cannot carry the entire load in one hand (one heavy bag);
• Every day you should do a set of exercises aimed at strengthening the abdominal and back muscles.

BACK PAIN: painful muscle spasms and its treatment with muscle relaxants

Back pain is one of the most common complaints that patients present in general medical practice. They are often caused by spinal osteochondrosis - a degenerative lesion of the intervertebral disc cartilage and reactive changes in the adjacent vertebral bodies. Damage to the intervertebral disc develops as a result of repeated injuries (heavy lifting, excessive static and dynamic load, falls, etc.) and age-related degenerative changes. The nucleus pulposus, the central part of the disc, dries out and partially loses its shock-absorbing function. The fibrous ring, located along the periphery of the disc, becomes thinner, cracks form in it, towards which the nucleus pulposus moves, forming a protrusion (prolapse), and if the fibrous ring ruptures, a hernia. Currently, drugs have been created that have a structure-modifying effect on cartilage tissue (the old name is chondroprotectors). A typical representative of the group is the drug chondro, prescribed in a course of 4 months (the effect lasts 2 months after discontinuation). In the affected spinal segment, relative instability of the spine occurs, osteophytes of the vertebral bodies develop (spondylosis), and ligaments and intervertebral joints are damaged (spondyloarthrosis). Herniated intervertebral discs are most often observed in the lower lumbar discs, less often in the lower cervical and upper lumbar discs, and extremely rarely in the thoracic discs. Disc herniations into the vertebral body (Schmorl's hernias) are not clinically significant; disc herniations in the posterior and posterolateral direction can cause compression of the spinal root (radiculopathy), spinal cord (myelopathy at the cervical level) or their vessels.

In addition to compression syndromes, reflex (muscular-tonic) syndromes are possible, which are caused by impulses from receptors in response to changes in the discs, ligaments and joints of the spine - painful muscle spasm. Reflex muscle tension initially has a protective nature, since it leads to immobilization of the affected segment, but later this factor becomes the cause of pain. Unlike compression syndromes of spinal osteochondrosis, which are relatively rare, painful muscle spasms occur during the life of almost every second person.

A classic example of a painful muscle spasm is lumbago (lumbago), which is characterized by a sharp, shooting pain in the lower back, usually developing during physical activity (lifting heavy objects, etc.) or awkward movement. The patient often freezes in an uncomfortable position, and an attempt to move leads to increased pain. The examination reveals tension in the back muscles, usually scoliosis, flattening of the lumbar lordosis or kyphosis.

Lumbodynia - back pain - and lumboischialgia - pain in the back and along the back of the leg - develop more often after physical activity, awkward movement or hypothermia, less often - without any reason. The pain is aching in nature and intensifies with movements in the spine, certain postures, and walking. Lumboischialgia is characterized by pain in the buttock, in the posterior parts of the leg, not reaching the toes. The examination reveals pain, tension in the muscles of the back and posterior group of leg muscles, limited mobility of the spine, often scoliosis, and symptoms of tension (Lasegue, Wasserman, etc.).

At the cervical level, reflex muscular-tonic syndromes may occur: cervicalgia and cervicobrachialgia, which often develop after physical activity or awkward neck movement. Cervicalgia is pain in the cervical region, which often spreads to the back of the head (cervicocranialgia). Cervicobrachialgia is pain in the cervical region spreading to the arm. Characteristically, the pain intensifies with movements in the neck or, conversely, with a prolonged static position (at the movies, after sleeping on a thick, high pillow, etc.). During the examination, tension in the cervical muscles is revealed, restriction of movements in the cervical spine, and pain on palpation of the spinous processes and intervertebral joints on the side of pain are often observed.

When a nerve root is compressed (radiculopathy), in addition to painful muscle spasms and limitations in mobility in the spine and limbs, sensory, reflex and (or) motor disturbances are detected in the area of ​​the affected root. At the lumbar level, the fifth lumbar (L5) and first sacral (S1) roots are most often affected, less often - the fourth lumbar root and very rarely - the upper lumbar roots. Radiculopathies of the lower cervical roots are much less common.

Painful muscle spasm also occurs with another fairly common cause of pain in the back and limbs - myofascial pain caused by the formation of so-called trigger zones in the muscles and (or) associated fascia. Myofascial pain is manifested by muscle tension and the presence of trigger points in them, which are identified through manual examination of the muscles. An active trigger point is a constant source of pain that increases with palpation in the muscle; a latent trigger point causes pain only when palpated. For each muscle there is an independent myofascial syndrome with a characteristic localization of pain when the trigger zone is irritated, spreading beyond the projection of the muscle to the skin surface. There are no focal neurological disorders, except in cases where tense muscles compress the nerve trunk.

It is important to remember that back pain may be the only symptom of a spinal cord tumor, syringomyelia and other spinal cord diseases. Pain occurs with destruction of the vertebrae and damage to the nerve roots due to infectious processes (tuberculous spondylitis, spinal epidural abscess), neoplasms (primary and metastatic tumors of the spine, myeloma), dysmetabolic disorders (osteoporosis, hyperparathyroidism, Paget's disease). Back pain can be a consequence of a spinal fracture, congenital or acquired deformities (scoliosis, etc.), spinal stenosis, spondylolisthesis, ankylosing spondylitis.

It is possible for various somatic diseases (heart, stomach, pancreas, kidneys, pelvic organs, etc.) through the mechanism of referred pain.

The examination of a patient with back pain requires careful consideration. Any back pain cannot be attributed to “osteochondrosis” - a condition that is detected by X-ray examination in most middle-aged and elderly people. Neurological manifestations of spinal osteochondrosis and myofascial pain are characterized by painful muscle spasms and limited mobility of the spine.

The diagnosis of reflex and compression complications of osteochondrosis is based on clinical data and requires the exclusion of other possible causes of back pain. X-rays of the spine are used mainly to exclude congenital anomalies and deformities, inflammatory diseases (spondylitis), primary and metastatic tumors. X-ray CT or MRI can identify a disc herniation, determine its size and location, and also detect spinal stenosis and a spinal cord tumor.

The diagnosis of myofascial pain is based on clinical findings (identification of painful muscle tension in one or more muscles) and requires the exclusion of other possible causes of pain; differential diagnosis with reflex syndromes (muscular-tonic syndromes) due to spinal osteochondrosis often causes difficulties; a combination of these diseases is possible.

Treatment of reflex syndromes and radiculopathy due to osteochondrosis is based in the acute period on ensuring rest - the patient is advised to avoid sharp bends and painful positions. Prescribed bed rest for several days until the sharp pain subsides, a hard bed (a shield under the mattress), taking centrally acting muscle relaxants, and, if necessary, additional analgesics and non-steroidal anti-inflammatory drugs. To facilitate movement during this period, you should wear a neck or lumbar corset (fixing belt). You can use physiotherapeutic analgesic procedures, rubbing in pain-relieving ointments, compresses with a 30-50% solution of dimexide and novocaine, novocaine and hydrocortisone blockades. As pain subsides, a gradual increase in physical activity and muscle strengthening exercises are recommended.

In the chronic course of reflex syndromes and radiculopathies, manual therapy, reflexology, physiotherapeutic treatment, and sanatorium-resort treatment can be effective. Surgical treatment (removal of a herniated disc) is necessary in those rare cases when compression of the spinal cord or cauda equina roots occurs. Surgical treatment is also indicated for discogenic radiculopathy, accompanied by severe paresis, and in case of long-term (more than three to four months) lack of effect from conservative treatment and the presence of a large disc herniation. To prevent exacerbations of osteochondrosis, it is recommended to avoid provoking factors (lifting large loads, carrying a heavy bag in one hand, hypothermia, etc.), and regularly engage in therapeutic exercises.

For myofascial pain, it is necessary to keep the muscle at rest for several days. As treatment, you can prescribe muscle stretching exercises (post-isometric relaxation), physiotherapy, reflexology or local injection of anesthetics into trigger zones, compresses with dimexide and anesthetics.

As already noted, for both acute pain and chronic pain syndromes, the treatment of painful muscle spasms is of great importance. Tonic muscle tension can not only cause pain in itself, but can also cause deformation and limit the mobility of the spine, as well as cause compression of the nerve trunks and vessels passing nearby. For its treatment, in addition to non-steroidal anti-inflammatory drugs, analgesics (for example, nimulide in the form of a transdermal gel for local therapy or in the form of lingual tablets for acute pain syndrome), physiotherapy and therapeutic exercises, muscle relaxants are used as first-line drugs - drugs that can break the “vicious circle" of pain syndrome [2].

To treat painful muscle spasms, muscle relaxants are used orally or parenterally. By reducing reflex muscle tension, muscle relaxants reduce pain, improve motor functions and facilitate physical therapy. Treatment with muscle relaxants begins with the usual therapeutic dose and continues as long as the pain syndrome persists; As a rule, the course of treatment lasts several weeks. A number of studies have proven that in the case of painful muscle spasms, adding muscle relaxants to standard therapy (non-steroidal anti-inflammatory drugs, analgesics, physiotherapy, therapeutic exercises) leads to a more rapid regression of pain, muscle tension and improved spinal mobility.

Mydocalm, baclofen and sirdalud are used as muscle relaxants. Muscle relaxants are usually not combined with each other. To relieve painful muscle spasms, you can also use diazepam (Seduxen, Relanium) in an individually selected dose.

Baclofen has a muscle relaxant effect mainly at the spinal level. The drug is close in structure to γ-aminobutyric acid (GABA); it binds to presynaptic GABA receptors, leading to a decrease in the release of excitatory amino acids (glutamate, aspratate) and suppression of mono- and polysynaptic activity at the spinal level, which causes a decrease in muscle tone; baclofen also has a moderate central analgesic effect. It is well absorbed from the gastrointestinal tract, the maximum concentration in the blood is reached 2-3 hours after administration. The initial dose is 15 mg per day (in three doses), then the dose is increased by 5 mg every day until the desired effect is obtained, the drug is taken with meals. Usual doses for the treatment of painful muscle spasms are 20-30 mg. The maximum dose of baclofen for adults is 60-75 mg per day. Side effects often include drowsiness and dizziness. Sometimes nausea, constipation, diarrhea, and arterial hypotension occur; Caution is required when treating elderly patients.

Sirdalud (tizanidine) is an α-2 adrenergic receptor agonist. The drug reduces muscle tone due to suppression of polysynaptic reflexes at the level of the spinal cord, which can be caused by inhibition of the release of excitatory amino acids and activation of glycine, which reduces the excitability of spinal cord interneurons; Sirdalud also has a moderate central analgesic effect. When taken orally, the maximum concentration of sirdalud in the blood is reached within an hour; food intake does not affect its pharmacokinetics. The initial dose of the drug is 6 mg per day in three doses, the average therapeutic dose is 12-24 mg per day, the maximum dose is 36 mg per day. Side effects include drowsiness, dizziness, and a slight decrease in blood pressure; Caution is required when taking the drug in elderly patients.

Mydocalm (tolperisone) has been widely used for a long time in the treatment of reflex and compression complications of degenerative changes in the spine (osteochondrosis, spondylosis, spondyloarthrosis) and myofascial pain [3]. Mydocalm has a predominantly central muscle relaxant effect. A decrease in muscle tone when taking the drug is associated with a depressive effect on the caudal part of the reticular pharmacy and suppression of spinal reflex activity. The drug has a moderate central analgesic effect and a slight vasodilator effect. Mydocalm intake begins with 150 mg per day three times a day, gradually increasing the dose until the effect is obtained, in adults usually up to 300-450 mg per day. For a quick effect, the drug is administered intramuscularly at 1 ml (100 mg) twice a day or intravenously at 1 ml once a day.

The effectiveness and safety of the use of mydocalm for painful muscle spasms was proven in a double-blind, placebo-controlled study [4]. In eight study centers, 110 patients aged 20 to 75 years were randomized to receive mydocalm 300 mg per day or placebo in combination with physical therapy and rehabilitation for 21 days. The pain threshold of pressure, measured using a special device (Pressure Tolerance Meter) at 16 symmetrical points of the torso and limbs, is considered as an objective criterion for the effectiveness of treatment. In addition, patients subjectively assessed their condition based on the intensity of pain, the feeling of muscle tension and spinal mobility; the doctor also assessed muscle tension and spinal mobility. Before the start of treatment and after its completion, a detailed clinical and laboratory examination was carried out, including an ECG, blood pressure measurement, and a biochemical blood test for 16 indicators.

According to research results, the use of mydocalm significantly reduces painful muscle spasms, measured objectively by instrumental methods. The difference between the treatment and placebo groups, which was observed as early as the fourth day, gradually increased and became statistically significant on the 10th and 21st days of treatment, which were chosen as endpoints for evidence-based comparison. An analysis of the subjective assessment of treatment results given by doctors and patients after its completion (21 days) showed that in the group of patients receiving Mydocalm, the treatment results were significantly more often assessed as very good, while in the placebo group there was no effect significantly more often. According to the subjective assessment of the results of treatment given by patients after its completion (after 21 days), no significant differences were identified regarding the tolerability of mydocalm and placebo. The vast majority of patients had good tolerability of mydocalm. ECG results, biochemical and hematological parameters in the group of patients taking both mydocalm and placebo also did not differ.

It is important to note that more than half (62%) of the patients included in the study were receiving other types of therapy before the study began, and most of them (68%) did not experience improvement. This demonstrates the effectiveness of Mydocalm in the treatment of painful muscle spasms that are resistant to other types of therapy.

Parenteral administration of mydocalm can quickly relieve pain and reduce muscle tension. In vertebrogenic muscular-tonic syndrome, intramuscular administration of 100 mg mydocalm relieves pain after 1.5 hours, and treatment with mydocalm for a week at 200 mg/day intramuscularly, and then for two weeks at 450 mg/day orally has a significant advantage over standard therapy; At the same time, therapy with mydocalm not only reduces pain, but also relieves anxiety and increases mental performance [1].

For painful muscle spasms, the advantages of mydocalm, in addition to its effective muscle relaxant and analgesic effect, are the absence of side effects and good interaction with non-steroidal anti-inflammatory drugs, which in many cases makes it possible to reduce the dose of the latter and, as a result, weaken or even completely eliminate their side effects without reducing the effectiveness of treatment.

An important advantage of mydocalm over other muscle relaxants is the absence of sedation and muscle weakness when taking it. This benefit was proven in a double-blind, placebo-controlled study [5]. The study included 72 healthy volunteers aged 19 to 27 years (mean age 21.7 years). The study was carried out over eight days, during which time volunteers randomized to receive 150 or 450 mg of mydocalm per day in three divided doses or placebo, also in three divided doses. Neuropsychological studies are carried out in the morning on the first and last (eighth) days of the study before and after taking mydocalm after 1.5, 4 and 6 hours or placebo. The results of the study did not show any significant differences in the speed of sensorimotor reactions and the speed of performing various psychological tests 1.5, 4 and 6 hours after taking mydocalm at a dose of 50 or 150 mg or placebo. Similar studies conducted on the eighth day from the start of taking mydocalm also did not show significant differences compared to the placebo group. This indicates the good tolerability of mydocalm and the possibility of prescribing it in cases where the patient’s occupation requires maintaining quick reactions and the ability to concentrate, including when driving a car.

Thus, painful muscle spasm is one of the most common causes of back pain (due to reflex syndromes of osteochondrosis or myofascial pain). In such cases, it is recommended to use muscle relaxants in combination with various medications, physiotherapy and therapeutic exercises. In recent years, the effectiveness and safety of the muscle relaxant mydocalm has been proven, which does not cause a sedative effect and is available in a form for parenteral administration to quickly relieve pain.

Literature.

1. Avakyan G.N., Chukanova E.I., Nikonov A.A. The use of mydocalm in the relief of vertebrogenic pain syndromes // Journal. neurol. and psychiatrist. 2000. No. 5. P. 26-31.
2. Parfenov V. A., Yakhno N. N. Neurology in general medical practice. - M., 2001.
3. Parfenov V. A. Mydocalm in neurological practice // Treatment of nervous diseases. 2002. No. 2. P. 10-12.
4. Pratzel HG, Alken RG, Ramm S. Efficacy and tolerance of repeated doses of tolperisone hydrochloride in the treatment of painful reflex muscle spasm: results of a prospective placebo-controlled double-blind trial // Pain. 1996. Vol. 67.- P. 417-425.
5. Dulin J., Kovacs L., Ramm S. et al. Evaluation of sedative effects of single and repeated doses of 50 mg and 150 mg tolperisone hydrochloride. Results of a prospective, randomized, double-blind, placebo-controlled trial // Pharmacopsychiat. 1998. Vol. 31. P. 137-142.

V. A. Parfenov, Doctor of Medical Sciences, Professor of MMA named after. I. M. Sechenova T. T. Batysheva, Candidate of Medical Sciences Polyclinic for Rehabilitation No. 7 of Moscow

Lower back pain due to kidney disease

For lower back pain, it is important to determine what is causing it - pathologies of the musculoskeletal system or kidney disease (as well as other internal organs). Diagnosis must be carried out by a doctor. However, there are signs to suggest that the pain may be due to problems with the kidneys and/or other organs of the genitourinary system. If these symptoms occur, it is advisable to immediately contact a urologist. Kidney disease (or more broadly, the genitourinary system) can be suspected if lower back pain is accompanied by:

• general deterioration in health (lethargy, drowsiness, weakness, increased fatigue);
• swelling of the eyelids and face. Swelling is especially pronounced in the morning, after waking up, and subsides in the evening;
• increased body temperature, chills, sweating;
• loss of appetite, nausea, vomiting;
• frequent or painful urination;
• changes in the characteristics of urine (it may become more concentrated in color or, conversely, colorless, contain mucus or blood);
• increased blood pressure.

Also an important sign that lower back pain is caused by problems of the internal organs, and not the musculoskeletal system, is its independence from the position of the body: the pain does not increase or decrease from changes in the position of the body and limbs. However, with prolonged standing in a standing position due to check pathology, the pain may intensify. The location of the pain also matters. With kidney disease, pain is most often observed on one side (since usually only one kidney is affected). Kidney pain may not be limited to the lower back, but may spread along the ureter, to the groin, to the external genitalia, to the inner thighs.

Contact the experts for help

“EL Clinic” is a medical center that employs such qualified specialists as an orthopedist, manualist, and osteopath. Patients are provided with real help in the fight against developing pathologies in the musculoskeletal system. Timely seeking medical help is an excellent opportunity to prevent complications during development and illness and get rid of it quickly and without surgical intervention by surgeons.

Patients of the clinic can make an initial appointment, which will be followed by a comprehensive examination of the body, drawing up an individual treatment plan that is effective in a particular case. Physical therapy is often prescribed: classes are aimed at consolidating the results achieved during treatment for a long period of time. The clinic also offers massage and myostimulation. All procedures are carried out by experienced specialists. In addition, patients may present with pathologies such as autonomic disorders, arthrosis, and poor posture.

Making an appointment with a specialist is quite simple: you can make an appointment by calling the specified phone number, filling out a feedback form or sending a request via email. The clinic manager will independently contact the patient and select a convenient date and time for the visit.

Lower back pain: what to do?

Low back pain is a symptom of a disease that requires treatment. Therefore, it is necessary to consult a doctor. But in the event of a sudden attack of acute pain (“lumbago”, typical of radiculitis), first of all, it is necessary to relieve the pain syndrome. Doctors advise:

• use gentle heat. Tie a woolen scarf or woolen belt around your lower back;
• take painkillers;
• It is necessary to take a position that allows you to relax your back muscles. It is recommended to lie on your back, on a hard, flat surface (board); The legs should be raised and bent at the knees, for which a rolled blanket or pillow should be placed under them. (It is not advisable to lie on the floor; there may be a draft).

The proposed pose is not a dogma. The patient should feel relief, so other positions are possible; for example, lying on a board, place your legs bent at the knees on it, holding a pillow between them. You can try lying on your stomach and stretching your legs, placing a bolster under your ankle joints. If the severity of the pain has been relieved, this does not mean that a doctor is no longer needed. Without proper treatment, attacks will recur, and the situation as a whole will worsen.

How you can and should sit

The correct position of the back means adopting a posture in which the lower back is as relaxed as possible and relieved of heavy loads. Here are some rules to follow.

1. Avoid chairs and armchairs with straight designs . If you work sitting and spend a lot of time at a desk, give preference to furniture with an ergonomic backrest. It should be identical to the physiological curves of the spine.
2. If you do not have the opportunity to purchase a chair with an orthopedic back, buy a special bolster and place it under your lower back. Before purchasing, it is advisable to conduct several experiments and understand approximately what shape and thickness of the roller will suit you. To do this, at the initial stage, instead of a roller, you can use an ordinary towel folded several times.
3. Adjust the height of the table or choose a new table to suit your height. Your forearms should not hang in the air, but lie on the surface of the table or rest against a special stand or chair armrests.
4. Also take care to adjust the height of the chair . The correct position of the legs should be as follows: the thighs are parallel and the shins are perpendicular to the floor. If an armchair or stool is too high for you, purchase an adjustable footrest or use things like reams of office paper instead.
5. If you have to sit on a chair for a long time, then doctors recommend doing a warm-up at least once an hour . In this case, it is not necessary to do any special exercises; it will be enough to simply change the position of the body. You can go pour some tea, wash the dishes, do pull-ups, walk to the store, or walk around the room a little.
6. For activities related to writing, drawing or sketching, it is advisable to use a table with an inclined surface towards the person sitting. These are the desks that modern schools and kindergartens now offer their students.
7. When sitting at the table, do not lean forward too much . The permissible tilt angle is 2 degrees. Otherwise, you will multiply the load on your spine and by the end of the working day you will feel severe fatigue (or even pain) in your back.
8. If you feel pain or discomfort in your back, immediately change your position . In general, remember that changing your position frequently is one of the main keys to a healthy back. Try changing your body position several times during the working day. For example, work 2 hours while sitting, 2 hours while standing, and 2 hours while lying on the couch. If you frequently change your body position, then there will be no such thing as “wrong position” for you at all.

Which doctor should I contact with a complaint of lower back pain?

If you have lower back pain, it is best to consult a general practitioner, since first of all you need to determine which organ disease is causing the pain. Depending on the results of the examination, consultation with a particular medical specialist may be required. Can be assigned:

• consultation with a neurologist to assess the condition of the spine, back muscles and nervous system;
• consultation with a urologist – in case of suspected urinary system disease;
• consultation with a gynecologist – if chronic diseases of the female reproductive system are suspected or present;
• general blood test and general urinalysis - to confirm or exclude the inflammatory nature of the disease;
• radiography of the spine;
• Ultrasound of the hip joints;
• as well as other studies.

In what cases should you consult a doctor?

If your back hurts severely and for a long time, you should in any case visit a neurologist. But some alarming symptoms scream that a visit to the doctor is simply necessary:

• severe pain after injury; • back pain combined with increased body temperature; • fecal and urinary incontinence; • severe pain that radiates to the arm, leg, accompanied by numbness, tingling and other unpleasant sensations; • severe pain, which always bothers you, does not go away even during rest.