Low back pain: lumbar osteochondrosis?

Back pain

Back pain- one of the most common complaints of patients with a wide variety of diseases. Almost everyone has had pain at least once in their life, most often in the sacrum or between the lower edge of the XII. The pair of ribs and the gluteal folds were located; H.Lower back pain(BNS).

Lower back pain is usually accompanied by muscle tension, often painful points. It can radiate into other parts of the body, for example into the leg, into the gluteal muscles, into the abdomen, into the pelvic region, etc.

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

Low back pain - causes

A variety of conditions can cause lower back pain in the lumbar region.Lower back painIn fact, (BNS) is just a symptom that occurs with the development of a wide variety of pathological processes in the organs of the thoracic and abdominal cavity, pelvis and structures of the spine; it can also be psychogenic.

Lower back pain

Back pain above the lower back can occur with gastric and duodenal ulcers. Reflected pain is often located in the lower back or a little higher, less often in the upper quadrant of the body.

Often, with pancreatitis and cholecystitis, pain is noted in the projection zone of the sixth to eighth intercostal space.

In the pathology of the genitourinary area, the reflected pain is often localized in the area of the lumbar and lower thoracic spine.

Lower back pain, right or left

Right or left back pain is most often a sign of kidney stones. With kidney stones, a stone growing in the kidney presses on the delicate parenchyma of the kidney from within and sometimes causes severe pain in the lower back on the left or right of the kidney where the stone is located.

Lower back pain radiates to the leg

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

In addition, lumbar pain with lumboishalgia radiates into the leg. Ishalgia occurs primarily as a pain in the leg during recovery.

Side and lower back pain

Lower back pain radiates to the left and right in acute or chronic kidney infections. Pain in the kidneys that lasts for several days in a row and is accompanied by fever, chills, dysuric phenomena (urinary tract disorders) indicate a diseaseacute pyelonephritis. . .

Back pain in the back

Processes in the pelvic area (uterus, limbs, bladder, intestines) cause pain that is localized in the lumbosacral region. Often, however, there are secondary muscular-tonic syndromes (reflex disorders of the small and medium gluteal muscles, piriformis syndrome, pelvic floor syndrome, symphysosternal syndrome) in combination with a pathology of the lumbar spine with chronic processes in the organs and tissues of the pelvis. Such patients require collegial treatment from a neurologist-neurosurgeon, urologist, gynecologist, proctologist.

Lower back pain

Tumors of the pelvic bones, especially at the onset of the disease, can mimic lumbar sciatica, and with the concomitant vertebrogenic process, patients are sometimes treated neurosurgery for a hernia in the lower lumbar spine. That concernsChondrosarcomas, Ewing sarcomas, reticulosarcomas, osteoblastomasand some others. A mandatory X-ray examination usually solves the diagnostic problem. It should not be forgotten that the general somatic and hematological condition of the patient can determine the oncological aspect of the disease.

Lower back and pelvic pain

Difficulties in differential diagnosis are noted in the latent course of tuberculosis of the pelvic bones, when there is no increase in temperature and ESR and the pain is able to mimic the lumbar ischialgic syndrome of lumbar osteochondrosis. The process can be secret from childhood and adolescence and manifest itself in an adult in the form of sacroiliitis. In recent years, the problem of tuberculosis has again become more urgent, and the doctor needs to remember these manifestations of the disease.

Pain in the lumbar and lower back areas often has nothing to do with a disease of the spine and is alarming symptoms of completely different diseases of the internal organs. Therefore, if there is back pain, a comprehensive examination is required.

Low back pain in women - causes

Withdrawal from pain

Back pain in womenoften associated with premenstrual syndrome. Such pains usually have a pulling character, they appear a few days before menstruation and last 2-3 days after their onset, and they go away on their own.

Abdominal and abdominal pain in women

Abdominal and abdominal pain associated with premenstrual syndrome, accompanied by cramps in the lower abdomen and painful periods of heavy bleeding, can be symptoms of serious reproductive diseases such as: Endometriosis, uterine fibroids, polycystic ovarian disease (PCOS)etc.

Abdominal pain radiates to the lower back

Abdominal pain in women can radiate to the lower back, lower abdomen, vagina, and external genitals.

It must be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous diseases in the pelvic area, such as: the formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, formation of adhesions, cancer of the reproductive organs, etc.

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

Back pain during pregnancy

Lower back and abdominal pain in women are often indicative of natural physiological changes associated with enlargement of the uterus during the development of a normal pregnancy.

Back pain during pregnancyis associated with additional stress on the spine and is normal and does not require any special treatment. However, pregnant women with severe back pain should always see a doctor who is leading a pregnancy.

Lower back pain in men - causes

Lower back pain in men is most often associated with degenerative diseases of the spine, especially with heavy physical exertion and work that involves lifting weights. In addition, lower back pain can be associated with various diseases of the internal organs.

Severe back pain

In the case of awkward movements, improper load distribution, etc. This pain is usually associated with either muscle spasms or dislocation of the intervertebral discs. Pain can also be caused by muscle clamping of the roots of the nerve endings of the spine.

Back pain and groin pain

Groin pain in men radiating to the lower back may be associated with prostate adenoma, testicular torsion, oncology, urological disorders, etc.

Classification of back pain

The classification for optimizing medical care, which is widely used in several countries, differs from LPSspecific, radicular and unspecific BNS. . .

Specific back painis a symptom of a certain disease, often severe and even life-threatening (cancer, including metastases on the spine; infectious - tuberculosis, osteomyelitis of the spine, epidural abscess, etc. ; inflammatory, - for example, ankylosing spondylitis and other spondyloarthritis; traumatic and osteoporotic vertebral fracture; Aneurysms of the abdominal aorta, gynecological, urological and renal diseases, stenosis of the spinal canal and cauda equina syndrome, etc. ).

Specific LPS is often accompanied by "red flags" characteristic of the underlying disease, which help the doctor suspect a serious pathology in the patient and examine him specifically (preferably with the involvement of an appropriate specialist) in order to make the correct diagnosis and treatment.

Radicular (radicular) pain in the lower back, including sciatica, is a result of compression of the spinal root.

The treatment of patients with radicular LNS is the responsibility of a neurologist, with special indications the involvement of a neurosurgeon is required. In practice, such patients often resort to the help of chiropractors.

A distinction is made among the radicular pain in the lower back:

  • Lumbago,orlumbago;
  • Lumbodynia- long-term pain in the lower back only;
  • Lumboishalgia- back pain radiating into the leg.

Nonspecific lower back pain- the most common severe pathology of the spine, spinal cord and its roots, not related to visceral disease. It can be caused by overloading the lumbar spine, especially when combined with heavy lifting, prolonged uncomfortable position during sleep or work, etc.

It is therefore entirely reasonable that a planned X-ray of the spine should not be included in the recommendations for examining patients with unspecific lumbar spine syndrome (NLP). Such patients do not require the mandatory consultation of a neurologist, but should be treated by a family doctor, district therapist or family doctor.

Lower back pain and "lumbar osteochondrosis"

Lumbar osteochondrosis(Lumbar spine osteochondrosis)- the most common diagnosis made in patients with lumbar pain. However, it is impossible to identify every case of the development of an episode of pain in the lower back region with "degenerative-dystrophic" changes in the spine often actually present in the patient, whereby a "habitual" diagnosis is made"Exacerbation of Osteochondrosis"or simply"Osteochondrosis". . .

For lower back or lower back pain, a diagnosis is often written such as:"Dorsopathy. Lumbar spine osteochondrosis. Sciatica. Lumbarization ". . . However, the correct diagnosis in this case should sound like this:"Lumbago with sciatica against the background of osteochondrosis of the lumbar spine. Lumbarization. (Code М54. 4) ".

It should be noted that there is no nosological unit in any of the foreign classifications of degenerative-dystrophic diseases."Osteocondritis of the Spine". . . Besides, neither is the term"Osteochondrosis"Another term that characterizes dystrophic changes in the spine should not be used as a synonym for clinical diagnosis.

Chondrosisis a dystrophic change in the intervertebral disc cartilage,Osteochondrosis- dystrophic changes in the intervertebral disc and adjacent vertebral bodies. Ignorance of both radiologists and clinicians about the signs of dystrophic changes in the spine(Chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, fixing hyperostosis, etc. )leads to overdiagnosis: these types of pathologies are found where they are not.

Osteochondrosis is often referred to as all of the degenerative changes listed, as the differences between them are not known. According to misunderstandings, osteochondrosis includesdisc prolapsewhich is a consequence of their rupture, and usually a normal disc, and not altered by a dystrophic process. However, the term slipped disc osteochondrosis is just as wrong as a meniscus tear in the knee joint - osteoarthritis.

The International Association of Vertebro-Neurologists recommends the use of the generic term "vertebral dysfunction" (which, by the way, is not included in the ICD-10 classification of diseases) if the relevant clinical symptoms occur.

Many modern, especially foreign, authors emphasize the lack of a connection between the presence of radiological signs of degenerative changes in the spine on the one hand and the occurrence or intensity of lower back pain (LBS) on the other. since only 1 in 10 patients with radiological signs of degenerative spinal lesions are clinical manifestations of the disease.

Back pain treatment at home

For low back pain associated with muscle tension and tension, low back pain ointments can significantly alleviate the symptoms and help relieve muscle tension.

Ointment and tablets for low back pain

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

At the same time, it should be borne in mind that self-treatment of back pain at home with creams, ointments, mustard plasters and other procedures can lead to neglect of the underlying disease that causes this pain and very sad consequences. Self-medication of the lower back is especially dangerous with kidney diseases likeacute pyelonephritisorrenal colicrequires qualified emergency care.

Prevention of Loin Pain

Individuals who have had an attack of the disease, especially before the formation of stable remission, must follow certain instructions for prevention:

  • Do not tilt your body without support from your arm; With your knees bent, pick up objects from the floor.
  • Change your posture more often, do not stand for long, do not sit.
  • If you work at a table or workplace, keep an upright position with one leg bent at the knee in front of the other.
  • Be sure to perform certain yoga or aerobics exercises without the recommendation of an exercise therapy doctor or specialist vertebrologist.
  • Watch out for hypothermia, drafts and prolonged heating in a hot bath, as muscle relaxation removes the immobilizing protection of the muscle corset for some time.