Backache

Low back pain

Low back pain is often referred to as low back pain or low back pain. Low back pain or "back pain" is an episode of acute low back pain, usually related to hypothermia and fatigue. Low back pain occurs in many people and is usually the cause of temporary disability. Usually, sports injuries or sprains may be the cause of low back pain, but sometimes the factors that cause the pain are still unknown. Low back pain is characterized by pain that does not radiate to the legs. Low back pain (low back pain) can appear sharply throughout the day and gradually get worse. Stiffness usually develops in the morning and gradually becomes a pain syndrome. Muscle spasms can also cause curvature of the spine (analgesic scoliosis). The pain itself may be caused by muscle spasms, and muscle spasms are related to other causes. This may be overload or sprain, sports injury, herniated disc, spondyloarthropathy (spondylopathies), kidney disease (infection or kidney stones). Sometimes patients will accurately judge the causal relationship between the appearance of discomfort and fatigue and hypothermia, but they often experience pain for no reason. Sometimes, even after sneezing, bending over or putting on shoes, back pain can occur. This can be promoted by the deformation of spinal diseases, such as scoliosis.

Unlike low back pain, the term low back pain does not refer to acute pain, but subacute or chronic pain. Usually, low back pain will gradually appear within a few days. Pain may also occur in the morning and may decrease with physical activity. Lumbodynia is characterized by increased pain under prolonged static load (sitting, uncomfortable body posture). Another feature of low back pain is to relieve the pain by lying down in a certain position. Due to muscle cramps, it is difficult for patients with low back pain to perform daily activities, such as washing clothes or wearing shoes. Due to this disease, the amount of trunk movement is reduced (leaning forward or, to a lesser extent, tilting or stretching to the side). Due to pain syndrome, patients often have to change positions when they need to sit or stand. Unlike low back pain, muscle cramps are less pronounced, usually do not cover the entire lower back, and there are usually signs of cramping on one side.

Causes of low back pain

Back pain is a symptom. The most common cause of back pain is diseases (injuries) of the muscles, bones, and intervertebral discs. sometimesBackacheIt can be caused by diseases of the abdominal cavity, small pelvis, and chest. This pain is called reflex pain. Abdominal diseases (such as appendicitis), aortic aneurysms, kidney diseases (urolithiasis, kidney infections, bladder infections), pelvic organ infections, ovaries-all these diseases can be manifestedBackache. . . Even a normal pregnancy can cause low back pain due to sprains in the pelvic area, muscle spasms caused by pressure, and nerve stimulation.

oftenBackacheIt is related to the following diseases:

  • Compression of nerve roots causes sciatica symptoms. The most common cause is a herniated disc. Usually, when the nerve root is compressed, the pain is severe, and there is radiation and sensitivity damage in the innervated area of the nerve root. Disc herniation is mainly caused by degeneration of the intervertebral disc. The gel-like part of the intervertebral disc protrudes from the central cavity and exerts pressure on the nerve root. The degenerative process of the intervertebral disc begins at the age of 30 years and older. But the presence of hernias does not always affect the nerve structure.
  • Spondylopathy-Degenerative changes in the vertebrae themselves, bone growth (osteophytes) occur, which affect nearby nerves and cause pain.
  • Degenerative changes in the spine (spondylopathies and osteochondrosis) can cause spinal stenosis. Patients with lumbar spinal stenosis may experience low back pain radiating to both legs. Low back pain may occur when standing or walking.
  • Cauda equina syndrome. This is a medical emergency. Cauda equina syndrome occurs when components of the cauda equina (the end part of the spinal cord) are compressed. People with cauda equina syndrome may experience pain and impaired bowel and bladder function (urinary incontinence and fatigue). This syndrome requires emergency surgery.
  • Pain syndromes, such as myofascial pain syndrome or fibromyalgia. Myofascial pain syndrome is characterized by pain and soreness at certain points (trigger points), and reduced muscle movement in the painful area. By relaxing the muscles located in the painful area, the pain syndrome can be reduced. With fibromyalgia, pain and aches all over the body. Fibromyalgia is not characterized by tightness and muscle pain.
  • Bone infections of the spine (osteomyelitis) are rarely the cause of the disease.
  • Non-infectious inflammatory diseases of the spine (ankylosing spondylitis) can cause stiffness and pain in the spine (including the lower back), especially when you wake up in the morning.
  • Tumors, most commonly cancer metastases, may be the source of waist discomfort.
  • Nerve inflammation and the corresponding pain (in the chest or waist) may be caused by damage to the nerve itself (for example, shingles)
  • In view of the various causes of symptoms, such as acute or subacute low back pain, it is important to fully evaluate the patient and perform all necessary diagnostic procedures.

symptom

Lumbosacral pain is the main symptom of low back pain, low back pain, and low back pain.

  • The pain may radiate to the front, side, or back of the leg (lower sciatica), or it may be limited to the waist (lower back pain, low back pain).
  • The feeling of pain in the lower back will worsen after fatigue.
  • Sometimes the pain gets worse at night or when sitting for long periods of time, such as during a long bus trip.
  • Numbness and weakness may appear in the leg in the area innervated by the compressed nerve.

For timely diagnosis and treatment, some criteria (symptoms) deserve special attention:

  • A recent history of injury, such as a fall from a height, a traffic accident, or similar incidents.
  • Patients over 50 years of age have minor injuries (for example, falling from a low place due to slipping and landing on the buttocks).
  • A history of long-term use of steroids (for example, these are patients with bronchial asthma or rheumatism).
  • Anyone suffering from osteoporosis (mainly elderly women).
  • Any patient over 70 years of age: At this age, there is a high risk of cancer, infection, and abdominal organ diseases, which can cause low back pain.
  • Oncology history
  • The presence of recent infectious diseases
  • The temperature exceeds 100F (37. 7 C)
  • Drug use: Drug use increases the risk of infectious diseases.
  • Low back pain worsens during rest: usually, the nature of this pain is related to tumors or infections, and this pain may also be related to ankylosing spondylitis (ankylosing spondylitis).
  • Significant weight loss (for no apparent reason).
  • The existence of any acute neurological dysfunction is a signal that urgent medical assistance is needed. For example, this is a behavior that violates walking and foot dysfunction, and is usually a symptom of acute nerve injury or compression. In some cases, such symptoms may require urgent neurosurgery.
  • Bowel or bladder dysfunction (incontinence and urinary retention) may be a sign of a medical emergency.
  • Failure of recommended treatment or increased pain may also require medical attention.

The presence of any of the above factors (symptoms) is a signal for seeking medical help within 24 hours.

diagnosis

Medical history is important to make an accurate diagnosis, because various conditions can cause low back pain. The time of the onset of pain, the relationship with physical exertion, whether there are other symptoms, such as cough, increased body temperature, bladder or intestinal dysfunction, seizures, etc. Perform physical examination: determine pain points, whether there is muscle cramps, and conduct neurological status studies. If a disease of the abdominal or pelvic organs is suspected, an examination (ultrasound of the abdominal organs, ultrasound of the pelvis and pelvic organs, blood urine test) is performed.

If the physical origin of low back pain is ruled out, instrumental research methods such as radiography, CT, or MRI can be specified.

X-rays are the initial examination method, allowing you to determine whether there are changes in bone tissue and indirect signs of changes in the intervertebral disc.

CT allows you to see the presence of various changes in bone tissue and soft stones (especially in contrast).

MRI is the most informative research method and can diagnose morphological changes in various tissues.

Densitometry is required when osteoporosis is suspected (usually women over 50)

EMG (ENMG) is used to determine conduction violations along nerve fibers.

Prescribing laboratory tests (blood tests, urine tests, blood biochemistry) is mainly to rule out the inflammatory process in the body.

Pain treatment

Back pain exercises

After diagnosis and confirmation of the origin of the vertebral body of low back pain and low back pain, certain low back pain treatment methods are prescribed.

In acute pain, you need to rest for 1-2 days. Bed rest can reduce muscle strain and muscle spasms. In most cases, when the pain syndrome is caused by muscle cramps, the pain syndrome will be relieved within a few days without the use of drugs, just due to rest.

drug. For pain syndromes, drugs from the non-steroidal anti-inflammatory drug group are used. COX-2 inhibitors have fewer side effects, but long-term use of these drugs also has certain risks. Given that all drugs in this group have many side effects, the drugs in this group should be short-term and taken under the compulsory supervision of a doctor.

Muscle relaxants can be used to relieve cramps. However, the use of these drugs is only effective when cramps occur.

Steroids can be used to treat pain, especially when symptoms of sciatica are present. However, due to the obvious side effects, the use of steroids should be selective and short-lived.

Manipulative therapy. This technique is very effective in the presence of muscle block or facet joint subluxation. Mobilizing motion segments can reduce muscle cramps and low back pain.

physiotherapy. There are many modern physiotherapy procedures that can relieve pain and inflammation and improve microcirculation (for example, electrophoresis, cryotherapy, laser therapy, etc. ).

Exercise therapy. Exercise is not recommended for acute low back pain. After alleviating the pain syndrome, exercise therapy can be combined. In the presence of chronic pain, exercise can be very effective in strengthening muscle corsets and improving the biomechanics of the spine. Exercise can only be selected with an exercise therapist, because independent exercise usually leads to increased pain performance. Systematic exercise therapy, especially in the case of degenerative changes in the spine (osteochondrosis, spondylopathy), can maintain the function of the spine and significantly reduce the risk of pain syndrome.