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Pain in the lumbar region

Low back pain is the most common pain syndrome in outpatient practice.30-60% of the population in developed countries suffer from recurrent back pain, and up to 80% of all back pain cases occur in the lumbar (lumbar) region.People of all ages can experience back pain, but the highest incidence occurs between the ages of 30 and 60.

back pain in the lumbar region

Low back pain due to illness

Lower back pain is a non-specific symptom and can have many causes.Doctors distinguish between primary and secondary low back pain syndrome.Most pain in the lumbar region is based on changes in musculoskeletal morphology (primary low back pain syndrome).These are mainly degenerative-dystrophic lesions of the spine:

Possible causes of secondary low back pain syndrome:

  • Primary and metastatic tumors in the vertebrae, spinal cord, and retroperitoneal space.
  • Fractured vertebrae.
  • Infectious lesions of the vertebrae and intervertebral discs (tuberculosis, brucellosis, epidural abscess).
  • Non-infectious inflammatory diseases (ankylosing spondylitis, Reiter syndrome, rheumatoid arthritis).
  • Damage to bone metabolism (osteoporosis, osteomalacia).
  • Increasing pain (scoliosis).
  • Acute spinal circulatory disorders (stroke).
  • Gastrointestinal diseases (atypical acute appendicitis, intestinal obstruction).
  • Pain is mentioned in diseases of the pelvic organs (including abdominal pain, infectious gynecological diseases, such as chlamydia, gonorrhea, trichomoniasis, ureaplasmosis, adnexitis).

Pain in the lumbar region can also be acute or chronic, caused by damage to the spine or nerve roots.Pain can be transferred from deeper structures:

  • kidney;
  • pancreas;
  • colon;
  • pelvic organs;
  • retroperitoneal tumor.

Acute pain in the lumbar region

Acute sprain.The pain is localized in the long back muscles during spasm, causing limited movement.There is no migration of pain to the groin or lower extremities.

Fractured vertebrae.Most often, this is a consequence of injury when bending or falling to the leg, but the same result is possible without injury or minimal injury if the patient has an affected skeletal system, osteoporosis, Cushing's syndrome, hyperparathyroidism, myeloma, malignant tumor metastases in the bones, Paget's disease.

Displacement of intervertebral discs in the lumbar region.Symptoms of this disease include pain in the lumbar region, forced body posture, and limited mobility.Involvement of nerve roots in the pathological process is manifested by: nerve root pain, usually unilateral;Sensitivity disorders (paraesthesia, hyperesthesia or hypoesthesia);reduced or absent Achilles or knee reflexes.

Facial syndrome.Compression of the roots at the exit from the spinal canal causes nerve root pain that is not due to disc damage.Unilateral joint syndrome, most commonly involving the L5 root, occurs when the superior and inferior surfaces of the intervertebral joints become enlarged, with consequent narrowing of the intervertebral canal or foramen.

Epidural abscess.Most commonly seen in the thoracic spine, it may be accompanied by acute pain in the back when palpating or touching the affected area.Require prompt diagnosis and initiation of treatment measures, including surgery, if there are signs of spinal cord compression.Pathological processes in the hip joint can be accompanied by pain that radiates to the buttocks and lower limbs to the level of the knee joint.

Chronic lower back pain

Degenerative spinal deformity.Spondylosis is degenerative changes in the lumbar vertebrae with the formation of bone spurs that narrow the spinal canal and put pressure on the roots.If lumbosacral pain appears accompanied by neurological symptoms when walking (loss of sensation, sensory disturbances or weakness in both lower extremities), then suspect claudication syndrome involving the spine and arising from spinal stenosis.Diagnosis is confirmed by examination.

Ankylosing spondylitis.It should be suspected in young people with low back pain that moves down to the hips.First, there is limited mobility and stiffness in the morning, reduced respiratory movements of the chest and progressive curvature and curvature of the thoracic spine.X-ray signs: destruction and restructuring of the sacroiliac joints, forming the so-called “bamboo” spine.Similar symptoms with limited movement in the lower spine may occur with:

  • psoriatic arthritis;
  • Reiter's syndrome;
  • chronic colitis.

Tumors and their metastasis, metabolic diseases.Using X-ray and myelography methods, it is necessary to rule out the following pathological conditions: metastatic carcinoma (breast, lung, prostate, thyroid, kidney, gastrointestinal tract), myeloma, lymphoma.

Osteomyelitis.Caused by pyogenic bacteria (usually staphylococcus) or Mycobacteria tuberculosis;This possibility of infection must be confirmed or excluded by ESR determination, bone X-ray, and tuberculin skin testing.

Tumors in the dura mater:

  • neurofibromatosis;
  • meningioma;
  • lipoma

These tumors can cause chronic pain even before other neurological symptoms appear.Lumbar pain due to internal organ diseases.When the pelvic organs are affected, the pain passes to the sacrum, the organs of the lower abdominal cavity - to the lumbar segment, the upper abdominal cavity - to the lower thoracic and upper lumbar segments.There were no local symptoms or stiffness in the back;Full back movement does not increase pain.

Treatment

When suffering from lumbar spondylosis, the patient feels pain in the lumbar region when walking, sitting, lifting heavy objects, coughing, and sneezing.Lower back pain sometimes spreads to the legs.In this case, you need to urgently contact a neurologist.

Don't delay seeing your doctor if:

  • have severe back pain for more than 3 days;
  • pain that occurs after injury;
  • At the same time, you feel pain in the lower back, legs and feet;
  • lower back pain combined with numbness in the buttocks, thighs, legs, feet and groin area.

Lower back pain is a fairly common symptom, especially in older people.Rheumatism, osteoarthritis of the lumbar region and radiculitis - all these diseases cause acute pain in the lumbar region.Only a proper examination of the body can give results and give a clear answer about the cause of lower back pain.