Back pain in the lumbar region: lumbar osteochondrosis?

Back pain

Back pain- one of the most common complaints of various diseases. Almost every person has experienced pain at least once in their life, which is most often located in the sacral spine or between the lower edge of the XII pair of ribs and the buttocks, i. e.low back pain(BNS).

Low back pain is usually accompanied by muscle tension, often the presence of painful spots. It can radiate (give) to other parts of the body, such as the legs, buttocks, stomach, pelvic region, and so on.

Acute low back pain often occurs suddenly and can last from a few minutes to several weeks. Generally, in 90% of cases, the lower back pain goes away on its own within 3-4 weeks, but in the remaining 10% of cases it becomes chronic and can last for years, sometimes worsening and then receding. Most often, the real cause of low back pain cannot be determined.

Back pain in the lumbar region - causes

Various diseases can cause back pain in the lumbar region.Low back pain(BNS) is actually just a symptom that occurs with the development of a number of pathological processes in the organs of the chest and abdominal cavity, the small pelvis, and the structures of the spine; it can also be psychogenic.

Pain in the lower back

Back pain can occur with a stomach ulcer and 12 duodenal ulcers. Reflective pain is often localized in the lower back or slightly higher, less commonly in the upper quarter of the body.

In pancreatitis and cholecystitis, pain is often seen in the projection zone of the sixth to eighth intercostal space.

In the pathology of the genitourinary sphere, reflected pain is often localized in the lumbar and lower chest levels of the spine.

Lower back pain, right or left

Right or left low back pain is most often a sign of kidney stones. In kidney stones, the stone growing in the kidney pushes the fine parenchyma of the kidney from the inside, sometimes causing severe pain in the lower left or right lower back in the kidney where the stone is located.

The lower back pain radiates toward the foot

When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, legs, abdominal cavity, and genitals. Very often, back pain radiating to the legs can be a signrenal colicwith urolithiasis of the kidneys.

In addition, lumbar pain radiates to the leg with lumboishalgia. Ishalgia appears as pain in the legs, especially during healing.

Side and low back pain

Lower back pain radiates to the left and right in acute or chronic kidney inflammation. Kidney pain lasting several days in a row with fever, chills, dysuricus (urinary disorders)acute pyelonephritis. . .

Back pain in the back

Pelvic processes (uterus, appendages, bladder, intestines) cause pain in the lumbosacral region. However, there are often secondary muscle tone syndromes (reflex disorders in the small and middle pharyngeal muscle, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) combined with lumbar spine pathology, chronic processes in the small pelvis. Such patients need the collegial treatment of a neurologist-neurosurgeon, urologist, gynecologist, proctologist.

Low back pain

Tumors of the pelvic bones, especially at the onset of the disease, can mimic lumboischialgia, and in the presence of a concomitant vertebrogenic process, patients sometimes undergo neurosurgery for a lower lumbar hernia. This is a cause for concernchondrosarcomas, Ewing sarcomas, reticulosarcomas, osteoblastomasand some others. Mandatory X-ray examination usually solves the diagnostic problem. It should be borne in mind that the general somatic and hematological condition of the patient may determine the oncological aspect of the disease.

Low back and pelvic pain

Difficulties in differential diagnosis are seen in the latent course of pelvic bone tuberculosis when temperature and ESR do not rise, and pain may mimic the lumbar ischialic syndrome of lumbar osteochondrosis. The process can be secretly continued from childhood and adolescence and can manifest itself in the form of sacroiliitis in an adult. In recent years, the problem of tuberculosis has become urgent again, and the physician must remember these manifestations of the disease.

Thus, pain in the lumbar region and lower back often has nothing to do with any disease of the spine and is an alarming symptom of completely different diseases of the internal organs. Therefore, a comprehensive examination is required for back pain.

Low back pain in women - causes

Pull the back pain

Low back pain in womenit is often associated with premenstrual syndrome. Such pains are usually pulling in nature, appear a few days before menstruation, and last for 2-3 days after it begins, and disappear on their own.

Back and abdominal pain in women

Back and abdominal pain with premenstrual syndrome, which can be accompanied by lower abdominal cramps and painful periods with heavy bleeding, can be symptoms of severe reproductive disease, such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)more.

Abdominal pain radiates to the lower back

In women, abdominal pain can radiate to the lower back, lower abdomen, vagina, and external genitals.

It should be recalled that abdominal and low back pain in women may be a symptom of dangerous disorders of the pelvic area, such as: uterine fibroids, proliferationendometrioid tissueoutside the uterus, the development of adhesions, cancer of the reproductive organs, etc.

In addition, in women, severe pain in the lower back and lower abdomen (especially on the right or left side) may be a rupture of the ovarian cyst or a symptom of an ectopic pregnancy.

Low back pain during pregnancy

In women, back and abdominal pain often indicates natural physiological changes that are accompanied by an increase in uterine size during the development of a normal pregnancy.

Low back pain during pregnancyit causes additional stress on the spine, is normal and does not require special treatment. However, pregnant women with severe back pain should always consult a doctor who is pregnant.

Low back pain in men - causes

In men, back pain is most often associated with degenerative diseases of the spine, especially with heavy physical exertion, work involving weight lifting. In addition, lower back pain may be associated with various diseases of the internal organs.

Severe back pain

Sharp pain in the lumbar spine can cause discomfort, improper load distribution, etc. This pain is usually accompanied by muscle cramps or dislocation of the vertebral discs. Pain can also be caused by muscle fixation at the roots of the nerve endings in the spine.

Back pain and lumbar pain

Pain in the lumbar region of men, prostate adenoma radiating to the lower back, testicular torsion, oncology, urological diseases, etc.

Classification of back pain

The classification prevalent in many countries, which aims to optimize LPS medical care, distinguishesspecific, radical and non-specific BNS. . .

Specific back paina symptom of a certain disease, often severe and even life-threatening (cancer, including spinal metastases; infectious - tuberculosis, spinal osteomyelitis, epidural abscess, etc. ; inflammatory - such as ankylosing spondylitis and other spondyloarthritis; traumatic and osteoporosis of the vertebrae; , gynecological, urological and renal diseases, spinal stenosis and cauda equina syndrome, etc. ).

Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the physician to suspect the patient’s severe pathology and purposefully examine (preferably with the appropriate specialist) to determine the correct diagnosis and treatment.

Radicular (radical) pain in the lower back, including sciatica syndrome, is a consequence of spinal cord compression.

The treatment of patients with radical LNS is the prerogative of the neurologist, with the participation of neurosurgeons with special indications. In practice, such patients often seek the help of chiropractors.

The following can be distinguished from radical pain in the lower back:

  • lumbago,obsessionlumbago;
  • lumbodynia- prolonged pain in the lower back only;
  • lumboishalgia- radiant back pain in the leg.

Non-specific back pain- the most common, not associated with visceral disease, severe pathology of the spine, spinal cord and roots. This can be caused by overloading the lumbar spine, especially with heavy lifting, uncomfortable sleeping or prolonged working positions, and so on.

Therefore, it is entirely reasonable that the planned spinal X-ray is not included in the recommendations for the examination of patients with non-specific lower back pain (NLP) syndrome. Such patients do not need a mandatory consultation with a neurologist, but are treated by a GP, district therapist, or GP.

Low back pain and "lumbar osteochondrosis"

Lumbar osteochondrosis(Lumbar Spine Osteochondrosis)- the most common diagnosis used in patients complaining of lumbar spine pain. However, it is impossible to identify individual cases of lower back pain episodes in which a patient often has a "degenerative-dystrophic" lesion with a "normal" diagnosis."Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .

For pain in the lower back or lower back, the diagnosis is often made, for example:"Dorsopathy. Lumbar spine osteochondrosis. Sciatica. Lumbarization". . . Although the correct diagnosis in this case sounds like this:"Lumbago with sciatica in the background of osteochondrosis of the lumbar spine. Lumbarization. (code 544. 4) ".

It should be noted that there is no nosological unit in the foreign classification of degenerative-dystrophic diseases. "spinal osteocondritis". . . Moreover, not the term"Osteochondrosis", and other terms describing dystrophic changes in the spine should not be used as a synonym for clinical diagnosis.

Chondrosisdystrophic changes in the cartilage of the disc,osteochondrosis- dystrophic changes of the disc and adjacent vertebral bodies. However, both radiologists and clinicians are unaware of signs of spinal dystrophic changes(recording of chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, hyperostosis, etc. )leads to overdiagnosis: these types of pathologies are found where they do not exist.

Often referred to as osteochondrosis are all the degenerative changes listed because of the unknown differences between them. Misunderstanding includes osteochondrosisdisc herniation, which is the result of rupture and is usually a normal disc and does not alter the dystrophic process. Although the designation of a disc herniation as osteochondrosis is as incorrect as a meniscus rupture of the knee joint - osteoarthritis.

The International Association of Vertebro-Neurologists recommends the use of the general term "vertebral dysfunction" (which, incidentally, is also not included in the ICD-10 disease classification) when appropriate clinical symptoms appear.

Many modern, mostly foreign authors emphasize that there is no correlation between radiological signs of degenerative spinal lesions on the one hand and the appearance or intensity of low back pain on the other, as only 1 in 10 patients with radiological signs of degenerative spinal lesions is a clinical manifestation.

Treating back pain at home

In the case of low back pain with muscle tension and muscle tension, ointments for low back pain can significantly relieve symptoms and help relieve muscle tension.

Low back pain ointment and pills

Ointments and creams are used to treat the lower back. Alternatively, you can take tablets that contain non-steroidal anti-inflammatory drugs (NSAIDs).

However, it should be recalled that self-treatment of home low back pain with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease that causes such diseases and very sad consequences. Self-healing of the lower back is particularly dangerous for kidney diseases, such asacute pyelonephritisobsessionrenal colicrequires emergency qualified medical care.

Prevention of lumbar pain

Persons affected by the disease, especially before stable remission develops, must follow certain prevention instructions:

  • Do not tilt your body without holding your arm; pick up objects from the ground with your knees bent.
  • Change your posture more often, don’t stand for long, don’t sit.
  • Work at a table or workplace, keep it upright because you place one leg on your knees and place it in front of the other.
  • Be sure to perform certain yoga exercises, aerobics, without the advice of a physical education physician or vertebrologist.
  • Beware of hypothermia, drafts, and prolonged heating in a hot bath, as muscle relaxation will deprive the muscle ligament of immobilizing protection for a while.