Pain in the lumbar region is familiar to every person; there are few who have not encountered it. Sometimes sitting for a long time is enough to cause lower back pain. According to statistics, 60-90% of people experience pain in the lumbar region. Low back pain is in second place after acute respiratory diseases and is a common cause of temporary disability.

In 80% of cases, pain in the lumbar region is associated with pathology of the spine, the remaining 20% ​​are associated with concomitant diseases of the internal organs. Pain in the lower back can be an innocent functional disorder that disappears without a trace, or it can indicate serious problems with the spine or internal organs. Therefore, it is important to consult a doctor in time, diagnose the problem and avoid serious complications.

Causes of pain in the lumbar region

The causes of pain in the lumbar region are varied. They can be primary, associated with pathology of the spinal column, and secondary, associated with diseases of the internal organs. Along with the causes, it is necessary to take into account predisposing factors that can provoke or intensify pain. These factors include:

  • Features of professional activity (heavy physical activity, for example, loaders, builders or athletes who lift weights, etc.).
  • Sitting for a long time, especially every day.
  • Sedentary lifestyle.
  • Overweight.
  • Unbalanced diet (lack of calcium, phosphorus, protein, vitamins in the body).
  • Bad habits – drinking alcohol and drinking alcohol.

By reducing or eliminating the above-described factors affecting the body, this is already a huge step towards improving the overall health and condition of the spine, and as a result, eliminating or reducing back pain.

Having dealt with the predisposing factors, let’s move directly to the causes of pain in the lumbar region.

The primary causative factors of back pain are associated with degenerative processes in the spine, these include:

  • Osteochondrosis is degenerative-dystrophic changes in intervertebral discs and cartilage, which leads to disc deformation and hernia.
  • Spondylosis is a degenerative process in which the formation of bone growths on the vertebrae (i.e., the growth of bone tissue) occurs as a compensatory reaction to excessive loads. The growth of bone tissue leads to spasms of the muscles around the spine, limits its mobility, and possible injury to the radicular nerves in the lumbosacral region and the membranes of the spinal cord.
  • Spondyloarthrosis is a progressive degeneration of the articular surface of the lumbosacral vertebrae with the involvement of ligaments, muscles, articular capsule in the pathological process and the proliferation of marginal osteophytes. This process leads to deformation of the intervertebral discs, the joint space decreases, the mobility of the spine is limited, and pain and tension in the muscles around the spine are noted. Spinal roots may become compressed over time.
  • Spondylolisthesis is characterized by displacement of the vertebrae relative to each other, as a result of which the lumen of the spinal canal changes and the spinal roots are injured.
  • Herniated intervertebral discs.

    • Secondary causative factors arising as a result of concomitant pathology in the body include:

  • Metabolic disorders, lack of micro- and macroelements in the body, as a result of which the bone skeleton changes (for example, osteomalacia, osteoporosis, hemochromatosis, alkaptonuria).
  • Curvature of the spinal column (lordosis, kyphosis, scoliosis).
  • A malignant neoplasm located near the spinal column or its metastasis to the spine.
    • Metastases to the vertebrae or epidurals.
    • Lymphogranulomatosis, lymphoma or multiple myeloma.
  • Infectious diseases:
    • Epidurit (spinal epidural abscess).
    • Spondylitis (osteomyelitis of the spine).
    • Sweating disease (tuberculous spondylitis).
    • Purulent discitis.
  • Injuries to the spinal column (for example, vertebral fractures).
  • Autoimmune diseases:
    • Rheumatoid arthritis.
    • Reiter’s syndrome (simultaneous damage to the joints, urinary system and conjunctiva of the eyes).
    • Ankylosing spondylitis (ankylosing spondylitis).
  • Back pain of a psychogenic nature (mental disorders), as well as after a stroke.
  • Diseases of the gastrointestinal tract (for example, intestinal obstruction, appendicitis).
  • Specific and nonspecific diseases of the pelvic organs (renal colic, inflammation of the ovaries, sexually transmitted diseases).
  • Lower back pain during physiological processes in women (during menstruation and pregnancy).

    • How does pain in the lumbar region manifest?

    How does pain in the lumbar region manifest, you ask? Differently. Lower back pain can occur depending on the degree of its severity:

    • Acute, shooting in nature, quite strong, sudden (lumbago).
    • Chronic, lasting more than three months. This pain is often dull, aching in nature (lumbodynia or lumboishalgia).

    In addition, pain in the lumbar region can take a recurrent course and make itself felt from time to time.

    The occurrence of lower back pain is associated with pinched nerve roots, spasms, swelling and irritation of the muscles, ligaments, vertebrae and intervertebral discs of the lumbosacral region.

    Pain in the lumbar region can be:

    • Mechanical, which usually occurs or increases in the afternoon, after physical activity and decreases or goes away after rest. The occurrence of such pain is caused by degenerative-dystrophic or functional disorders of the structures of the back. It is observed in middle-aged or elderly people.
    • Inflammatory – occurs or intensifies in the first half of the day, decreases with physical activity and when taking non-steroidal anti-inflammatory drugs, morning stiffness is characteristic. The cause of this pain is inflammatory spondylopathies. The onset of the disease is noted at a young age.

    Depending on which structures are damaged, the following types of pain in the lumbar region are distinguished:

  • Local (local) pain in the lumbar region. It occurs due to damage and irritation of the structures of the lumbar region (joints, musculoskeletal system, ligaments). This pain is clearly localized, constant, and usually not severe. May vary depending on body position.
  • Reflex (referred) pain in the lumbar region.
    • Pain that radiates to the lumbar spine due to diseases of the internal organs (pelvic and abdominal organs). This pain can radiate to the buttocks and thighs. Such pain is deep, pulling and aching, and does not go away with rest.
    • Pain that occurs due to damage to the sacrum. It can radiate to the groin and buttocks, thighs, and even the feet. The pain is long-lasting, dull, and diffuse.
  • Radicular pain in the lumbar region. Occurs due to irritation of the spinal nerve roots. Radicular pain is more intense than reflex pain and radiates from the spine to the periphery. This pain is located in the area of ​​innervation of the spinal root and can radiate to the lower extremities to the toes. Coughing, sneezing or other straining increases radicular pain.
  • Muscle pain (fibromyalgia) is pain that occurs due to protective muscle spasm. It occurs most often and occurs in many diseases of the spine. Prolonged, chronic muscle tension causes aching, sometimes cramping pain.

    • Dull and aching pain in the lumbar region

    Dull and aching pain in the lumbar region can be a manifestation of a wide variety of diseases of the spine and internal organs (osteochondrosis, intervertebral hernia, infections, tumors, etc.). Pain of this nature usually occurs gradually. But depending on the severity of the pathological process, dull and aching pain can progress and transform into acute pain. More often, dull and aching pain in the lumbar region occurs in women during menstruation, during pregnancy and with infections of the genitourinary system (for example, pyelonephritis). In order to correctly determine the causative factor of dull pain in the lumbar region, you need to seek help from a specialist who will conduct a differential diagnosis and prescribe optimal therapy.

    Acute back pain in the lumbar region

    Acute pain in the lumbar region occurs suddenly, is quite painful and brings severe discomfort, significantly limiting motor activity. It can occur as a result of sudden movements – turning the body, bending, lifting heavy objects, abruptly rising from a sitting position. Acute pain in the lumbar region may indicate serious diseases of the spine or internal organs. Causes of acute lower back pain can be:

    • spinal injury (for example, fracture),
    • severe stretching of the back muscles,
    • displacement of intervertebral discs,
    • lumbar intervertebral hernia,
    • arthrosis of the intervertebral joints (facet syndrome),
    • arthrosis of the hip joints (coxarthrosis),
    • epiduritis,
    • infections of the genitourinary system.

    In case of acute pain in the lumbar region, bed rest is necessary (take the most comfortable position in which the pain is least noticeable) and call a doctor. It is better not to self-medicate, because… this can lead to serious complications, including disability.

    Diagnosis of back pain in the lumbar region

    Diagnosis of pain in the lumbar region is carried out by a neurologist or vertebrologist and is based on the following measures.

    • Collecting an anamnesis (medical history) by a doctor. Causal and predisposing factors are determined (possible injuries, concomitant diseases, characteristics of professional activity, etc.).
    • Examination (including palpation), which is used to assess the general condition, orthopedic and neurological status (assess the mobility of the lower back, sensitivity in the lumbar region, etc.).
    • Additional examination methods:
      • X-ray examination of the lumbosacral spine,
      • computed tomography of the spine (the condition of the vertebrae, intervertebral discs, soft tissues, blood vessels, etc. is assessed),
      • magnetic resonance imaging of the spine,
      • if necessary, myelography is prescribed (x-ray contrast study of the spinal cord pathways – a contrast agent is injected into the spinal canal, an x-ray is taken and thus its patency is determined, which may be impaired due to tumors, hernias, stenoses),
      • Bone scintigraphy (radionuclide study) is prescribed if previous X-ray examination methods are not informative. It can be used to identify tumors, arthritis, etc.
      • general clinical examinations (general blood and urine analysis, biochemical blood test)
    • Consultation with narrow specialists (if necessary):
      • surgeon,
      • orthopedist,
      • urologist or nephrologist,
      • gynecologist,
      • infectious disease
      • proctologist,
      • cardiologist,
      • gastroenterologist,
      • oncologist.

    Treatment of back pain in the lumbar region

    Treatment of pain in the lumbar region depends on the cause of its occurrence, the severity of the process and, as a rule, is conservative (surgical treatment is not excluded).

  • Elimination of the cause that caused lower back pain (treatment of concomitant diseases, osteochondrosis, hernias, etc.).
  • Bed rest, the bed should be hard (usually a shield is placed under the mattress).
  • A balanced diet with sufficient amounts of vitamins, protein, micro- and macroelements (especially calcium and phosphorus).
  • Symptomatic therapy:
    • non-steroidal anti-inflammatory drugs – dikloberl, movalis, ibuprofen – effectively eliminate inflammation and pain,
    • it is possible to use analgesics such as analgin, baralgin,
    • the use of muscle relaxants that reduce muscle spasms and tension (mydocalm, tizanidine),
    • prescribe B vitamins (improve metabolic processes in the cell) and vitamin C (strengthens blood vessels and improves immunity),
    • use of local products (ointments, gels or compresses) – finalgon, fastum – gel, ketonal, indomethacin or orthophen ointment. Compresses with dimexide or novocaine.
    • antiviral drugs and immunomodulators (Anaferon, Echinacea),
  • The use of drugs that reduce degenerative-dystrophic processes in osteochondral tissue (Artrofon, Dona, Structum).
  • It is possible to prescribe therapeutic blockades – the introduction of painkillers (novocaine, lidocaine) to the place where the pain is most pronounced, the so-called trigger points (most often an epidural blockade is performed with the introduction of an analgesic into the epidural space of the spine). A blockade is possible with the combined use of novocaine and a corticosteroid drug (Cortisone, Diprospan).
  • Physiotherapeutic treatment:
    • electrophoresis using calcium, lidase, novocaine.
    • phonophoresis (use of ultrasound) – improves and accelerates the healing process, has an anti-inflammatory and analgesic effect, reduces swelling,
    • electrical stimulation of muscles (relaxes muscles, improves lymph and blood circulation in the muscles around the spine),
    • amplipulse therapy (has an analgesic and vascular-trophic effect),
    • paraffin treatment (restores and improves neuromuscular conduction, metabolic processes, improves lymph and blood circulation),
    • reflexology (acupuncture, electroacupuncture, laser therapy),
    • balneotherapy (use of sulfide, radon, sodium baths, etc.),
    • mud therapy (use of mud applications at low temperatures).
  • Therapeutic gymnastics begins with minimal loads and under the strict supervision of a doctor. It is carried out after the acute pain has been relieved.
  • Therapeutic massage (strengthens the back muscles and helps stabilize the spine), carried out exclusively by a specialist, after an acute period.
  • It is recommended to wear corsets, semi-corsets, bandages, elastic belts, and reclinators. With their help, treatment and prevention of lower back pain is carried out, because they limit the range of motion, reduce pain and muscle spasm.
  • If conservative methods are ineffective and the process progresses, accompanied by dysfunction of internal organs, increased compression of the spinal cord and/or its roots, the issue of surgical treatment (for example, removal of an intervertebral hernia) is considered.
  • In folk medicine, the following are used to treat back pain:
    • horseradish compresses,
    • ointments based on iodine, lemon, birch oil are rubbed in,
    • rubbing with black radish and honey is carried out.

    • A set of therapeutic measures is selected individually by the doctor for each case, depending on the cause of pain in the lumbar region, clinical symptoms, severity of the process, concomitant diseases and age.

    Prevention of lumbar pain

    Prevention of pain in the lower back involves simple measures.

  • Identification and treatment of concomitant pathologies that can lead to lower back pain (various infections, tumors).
  • A balanced diet with sufficient levels of micro- and macroelements (especially calcium and phosphorus), protein, and vitamins.
  • Avoid heavy physical activity and heavy lifting. Distribute the load evenly throughout the body. Avoid making sudden movements whenever possible.
  • Lead an active lifestyle (play sports – swimming, walking, therapeutic exercises).
  • Perform therapeutic massage.
  • If your professional activity involves sitting for a long time, then you need to take a break every hour (walk, do a little exercise).
  • Comfortable bed with orthopedic mattress.
  • To prevent pain in the lumbar region, it is recommended to wear bandages, corsets, posture correctors, and an elastic belt (especially when performing heavy physical activity; bandages and belts are also recommended for pregnant women).
  • Watch your weight, because… Excess weight increases the load on the spine.
  • Eliminate bad habits – smoking, alcohol.
  • Every year undergo a preventive examination of the whole body.

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