In the people, acute pain in the lower back is called “lumbago”. In medicine, the term lumbago is used to refer to this phenomenon. Pathology should be distinguished from lumbalgia, which is characterized by persistent aching pain in the lower back (BPM). It is a case of acute back pain if it lasts no more than three weeks.
Lumbago often occurs in people with degenerative changes in the lumbosacral spine. The appearance of pain can also provoke injuries, heavy physical work, hypothermia. Much less often lumbago develops on the background of serious diseases of internal organs.
An acute back pain that spreads to the leg is called sciatica. Pathology occurs due to pinching or inflammation of the spinal roots involved in the formation of the sciatic nerve. In some sources, sciatica is called lumbosacral radiculitis.
Specific and non-specific pain
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According to statistics, in 85% of patients with lumbago doctors do not detect any serious diseases. In this case, we are talking about the so-called non-specific BNPs. They develop on the background of lumbosacral osteochondrosis and occur in the form of musculoskeletal pain syndrome. In the international classification of diseases (ICD-10) pathology assigned code
Causes of acute specific lower back pain are malignant neoplasms, diseases of internal organs, damage to the central nervous system, inflammatory diseases or injuries of the spine.
Symptoms that make it possible to suspect a specific BPHS:
- the appearance of painful sensations at the age of less than 15 or more than 50 years;
- the non-mechanical nature of the pain (lack of relief after resting or changing the position of the body);
- gradual increase in pain over time;
- concomitant increase in body temperature;
- causeless weight loss;
- feeling of stiffness in the back in the morning;
- impaired urination;
- previous oncological diseases;
- the presence of pathological changes in the blood or urine;
- symptoms of spinal cord injury (sensitivity disorders, muscle paresis, or paralysis).
Specific BJVS usually indicate infectious, rheumatic, oncologic, vascular, hematologic diseases, can appear in case of diseases of internal organs (stomach, pancreas) or organs of the genitourinary system (kidney). In older people, specific pains may indicate the development of osteoporosis.
Specific BHFS cause lumbago in only 8-10% of cases. Even less often (3-5%), pain and lumbago in the lower back occur on the background of compression radiculopathy – pinching and damage to the lumbosacral nerve roots.
Types of pain
Depending on the developmental mechanism, nociceptive, neuropathic and psychogenic back pains are distinguished. The first ones arise as a result of irritation of nociceptors – sensory nerve endings, which are located in certain structures of the vertebral column and some internal organs.
Types of nociceptive pain:
- local. Usually has a diffuse, aching character. It is localized directly in the spinal region. The intensity of the painful sensation varies with the position of the person’s body;
- reflected. It does not have a clear localization and does not weaken when the position of the body changes. Occurs with diseases of internal organs (stomach, kidney, pancreas).
Table 1. Localization of nociceptors and causes of their irritation
Cause of pain
Neuropathic pains develop as a result of damage (pinching, inflammation, demyelinating diseases) of the spinal roots or nerves of the lumbosacral plexus. They are shooting and often radiate to the lower limb.
Psychialgia is most often caused by stress, depression, neurosis, hysterical disorders, post-traumatic syndrome, and vascular dystonia. Psychogenic pains may have different nature and intensity.
Unilateral acute back pain, which is located to the left or to the right, usually has a neuropathic nature and indicates neuralgia, sciatica or radiculopathy.
Factors provoking the emergence of lumbago
Acute pain in the lumbar region most often occurs on the background of degenerative-dystrophic diseases of the spine. The intervertebral discs and facet joints are first involved in the pathological process, then the ligaments, muscles, tendons and fasciae.
Painful sensations arising on the background of diseases of the musculoskeletal system, usually have a mechanical nature. This means that the pain is aggravated by overstressing the structures of the spinal column.
Factors that can cause acute sharp back pain:
- back injuries;
- sudden movements made without proper training;
- lifting heavy loads;
- long stay in an uncomfortable position.
In injuries, the occurrence of lumbago is usually caused by mechanical damage to the structures of the spinal column. Prolonged sitting in an uncomfortable position can cause muscle spasm or pinching of the nerves, which lead to the appearance of painful sensations. Weight lifting provokes the formation of hernias of intervertebral discs, hypothermia leads to neuralgia or inflammation of the nerves that form the sciatic nerve.
Some people complain: bent down and can not straighten because of acute pain in the lower back. A similar phenomenon indicates lumbosacral sciatica or the formation of a herniated intervertebral disk. Acute back pain occurs when leaning forward or lifting weights. Subsequently, it increases with active leg movements, coughing, sneezing, straining.
Causes of acute lower back pain
Painful sensations in the back, not related to physical activity, indicate inflammatory diseases of the internal organs, malignant neoplasms or their metastases. But acute back pain, aggravated by movement, usually speaks of diseases of the spine, pinching of the spinal roots, or damage to the peripheral nerves.
You do not know what to do in case of acute low back pain and how to deal with it at home? It is possible to arrest pain syndrome with the help of ointments and dry heat. However, after feeling better, you need to go to the doctor. Having examined you, a specialist will diagnose and prescribe treatment.
Myofascial pain syndrome
The reason for the development of pathology is muscular overstrain due to severe physical exertion, psycho-emotional disorders, long sitting or lying in one position. Painful sensations arise from the irritation of muscle nociceptors with lactic acid, cytokines, prostaglandins, biogenic amines, neurokinins, etc.
The development of myofascial muscle syndromes is not associated with spinal osteochondrosis.
Typical signs of pathology:
- nociceptive nature of pain;
- spastic contraction of the back muscles;
- limiting the amount of movement in the spine;
- the presence of trigger zones – seals in the muscles, the pressure on which leads to increased pain;
- pain on palpation in the paravertebral points;
- no neurological symptoms.
For myofascial pain syndromes characteristic aching or sharp acute back pain. It is enhanced by the extension of the spine, turning the back, prolonged standing and lying on the stomach. Prolonged muscular tension can cause reflex curvature of the spine, followed by the development of degenerative-dystrophic changes in it.
Myofascial pain syndromes can manifest both acute and chronic pain.
Muscle tonic pain syndrome
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Most often it develops as a result of irritation of nociceptors located in the region of the facet joints of the spine. Less commonly, the source of pain is the dura mater, the cases of the spinal roots, the posterior or anterior longitudinal ligaments. Muscle-tonic pain syndrome usually occurs on the background of osteochondrosis or spondylarthrosis of the lumbosacral spine.
Painful sensations in the back cause reflex muscle spasm. Subsequently, the spasmodic muscles themselves become a source of pain. Because of this, mobility in the lower back is deteriorating.
Musculo-tonic syndrome can be distinguished according to one characteristic feature. In people with this pathology, acute back pain in the lumbar region decreases in the supine position with bent lower limbs.
Occurs due to damage to one or more spinal roots. It is manifested by shooting or burning pains in the lower back. The patient’s sensitivity is disturbed and paresthesias occur in the zone that is innervated by the affected root. Less commonly, a person is disturbed by movement disorders.
Causes of Radicular Pain:
- compression of the nerve root due to acute protrusion of the disc into the central canal of the spinal column;
- degenerative changes of the spine (spondylosis, spondylarthrosis, hypertrophy of the yellow ligament, spondylolisthesis);
- acute herniated disk (substances that come out of the gelatinous nucleus, cause aseptic inflammation, swelling and ischemia of the spinal root).
Pain syndrome with compression radiculopathy is usually mixed. It includes signs of nociceptive and neuropathic pain. This is explained by the fact that on the background of radiculopathy reflex muscular-tonic pain syndrome almost always develops.
If the spinal roots are damaged, doctors identify the positive symptom of Lasegue in humans. Straight lower limb can not be raised more than 30-50 degrees.
In pathology, the fifth lumbar (L5) or the first sacral (S1) spinal root is most often damaged.
Diseases of internal organs
According to statistics, kidney diseases cause acute back pain in 6% of cases. Less commonly, back pain occurs due to abnormalities of the pancreas, liver, stomach, duodenum or pelvic organs.
Symptoms that indicate damage to internal organs:
- chills, sweating, general weakness and apathy;
- nausea, vomiting, loss of appetite;
- fluctuations in blood pressure;
- appearance of edema on the body;
- impaired urination;
- no connection between pain intensity and body position.
Bilateral back pain usually occurs with pyelonephritis and glomerulonephritis – inflammatory diseases of the kidneys. As a rule, they are stupid, have a nagging character.
Acute pain in the left or right side of the lower back most often indicates renal colic. It radiates along the ureters to the external genital organs and the inner surface of the thigh.
Pancreatitis (inflammation of the pancreas) is characterized by the appearance of surrounding pain, which is more pronounced on the left side.
Acute back pain during pregnancy
The cause of acute back pain in pregnant women is most often an increased load on the spine. Pain does not occur until the fifth month of pregnancy and pass after childbirth. Pain can also occur during Braxton-Hicks false contractions.
You do not know how to treat acute back pain during pregnancy? Ask your gynecologist for advice. He will tell you what means you can use without the risk of harming the baby.
What you need to identify the causes of lumbago
The first thing to do in case of acute back pain is to contact a neuropathologist or a spinal doctor. An experienced doctor will be able to suspect this or that pathology after talking with the patient and his examination. To clarify the diagnosis, he may order additional tests and some tests.
Methods that may be required to verify the diagnosis:
- spine X-ray Informative in the diagnosis of the last stages of osteochondrosis. On radiographs, you can see the change in the distance between the vertebrae and the growth of osteophytes;
- MRI spinal column. The technique makes it possible to identify practically any pathological changes in the vertebrae, intervertebral discs and joints. Magnetic resonance imaging allows to identify osteochondrosis and spondylarthrosis even in the initial stages;
- myelography. The essence of the study lies in the X-ray contrast examination of the spine. The method allows to identify asbestosis, tumors, narrowing of the spinal canal, hernia and ruptures of intervertebral discs;
- general clinical research. Allows you to identify signs of inflammation in the blood or urine. The testing is useful in the diagnosis of diseases of the kidneys, pancreas, etc.
Try to avoid treating acute low back pain at home. If you feel unpleasant sensations in your back, go to the doctor right away. The specialist will determine the cause of lumbodynia and prescribe you the appropriate treatment.
First aid for acute back pain
What to do in case of a sudden lumbago? How to reduce pain and quickly ease well-being? How and what is the best way to relieve acute back pain at home?
First of all, you should abandon heavy physical exertion and prolonged sitting in the same posture. In the early days of the disease is best to adhere to bed rest. The bed should be moderately hard. After improving well-being it is very useful to maintain moderate physical activity. It helps to improve trophism in tissues and speed up recovery.
Drugs from the NSAID group help relieve acute back pain. They have a pronounced anti-inflammatory effect. Medicines are used in the form of ointments or tablets.
Preparations for the relief of pain:
To relieve muscle tension and improve spinal mobility, use muscle relaxants of central action. Numerous studies have confirmed their effectiveness in combating acute back pain. The most popular means of this group are Tolperisone, Baclofen and Tizanidine.
Simultaneous use of NSAIDs and central muscle relaxants is much more effective than using only one of these drugs.
Treatment of acute pain
Therapeutic tactics for lumbago depends on the reason for its appearance. If the pain is caused by diseases of the internal organs, the patient is hospitalized in a therapeutic, nephrological, gastroenterological, surgical or other department. There the patient will be examined and cured.
If back pain is non-specific, the person is prescribed medications and physiotherapy. Of the latter, reflexotherapy, massage, manual therapy have a good effect. In acute back pain, special exercises are helpful. They help to improve the mobility of the spine, relieve muscle spasm and ease a person’s well-being.
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