According to statistics, 70-80% of our population at least once in their life encountered back pain in the lower back, or medically speaking, pain in the lower back. Its prevalence in the united KINGDOM, 59% in Denmark and 70% in Finland to 75%. Between all granted "sick leave" in our country, and the third is in cases of back pain.
Causes of pain in the low back can be very diverse — from the psychogenic factors, to metastasis of cancer. Fortunately, serious pathology is not more than 5% of cases of pain in the lower back, its main cause is overexertion or muscle spasm and other problems of locomotor apparatus.
Back pain, than any other organ, are diverse. More often it is a sign of pain is the first sign that the doctor may make assumptions about the nature of the disease.
The origin of the back pain may be:
For the duration of the pain, which may be:
The typical clinical manifestations will depend on the source of the pain.
Muscle-tonic and other pain syndromes
Hypothermia, constant uncomfortable posture at work or rest, improper movement patterns, degenerative diseases of the spine, changing the height and elasticity of intervertebral discs, lead to the fact that muscle load is distributed unevenly. Some of them are becoming more and more congested, which, on the contrary, do not receive the required cargo. As a result, in the individual muscle starts to spasm, which causes pain. There are so-called trigger points, effect, which increases the spasm and pain. The characteristic features of the pain:
This is for this type of pain, and ointments that are warm or popular devices. However, the effect of them is short, after all, is the reason to cause muscle spasm, which is not possible to resolve the problem. A more reliable method — the injection of pain medication directly into the trigger point, as well as kinesiotherapy, physiotherapy, manual therapy.
Due to compression or stretching of the spinal nerve roots due to disc herniation, or reduce its height and as a consequence the distance between the vertebrae. This pain often feels like a shallow, extending rather in the skin than in the deep tissues. This strongly increases with sneezing, coughing, pressure on the spine. It is this pain felt like a classic "cross", the transmission along the nerve roots.
Caused due to disc herniation, protrusion (bulging) of part into the spinal canal or the appearance of seizure — detached part of the disk. Anyway compressed entity called "pony tail" — the roots of the lowest spinal nerves innervating the lower limbs. The pain spreads along the course of nerve roots from the waist to the foot, and there to himself, and walking, increases with extension of the spine and decreases when tilted forward.
Is caused by pathology of the small intervertebral (facet) joints. Pain may be local, but also broadcast (please specify) in the groin, tailbone, back of the thigh. Is worse when bending and rotating at the waist.
All of these types of pain, the syndrome occurs acutely, sometimes the patient may even tell you what day post exposure (something lifted up, not turned, etc). Pain worse towards evening and after exercise to reduce after the holidays. Often this type of pain is typical for people in middle and old age.
Due to inflammatory damage to the joints of the spine — the various types of arthritis: rheumatoid, Reiter's disease, ankylosing spondylitis, etc., Inflammatory pain often occurs in relatively young people, develops gradually. This is the maximum in the early afternoon and decreases in the evening or after physical activity. Often accompanied by morning stiffness.
Other potential causes for pain in the low back — the pathology of internal organs, such as kidney failure or inflammation of the appendages in women. Because many conditions can manifest in similar ways, at least in terms of pain, it is better not to do diagnostics yourself, and consult a doctor.
Immediate specialist consultation is necessary if:
These signs may be signs of serious illness that requires immediate treatment.
For pain in the back and lumbar region, the doctor only to exclude a life-threatening condition — fortunately they are quite rare.
General and biochemical blood analysis allows to reveal the inflammatory changes, to detect the elevated calcium levels, characteristic of a metastasis of malignant tumors to bone structures, changes in the number of blood cells in multiple myeloma and so on. A man can be determined by analysis of the prostate specific antigen to rule out the possibility of prostate cancer.
X-ray examination will reveal a change of the height of the intervertebral discs, osteophytes can be — the growth of bone tissue, caused by an incorrectly distributed load on the vertebrae, changing the shape of the vertebrae themselves.
CT and MRI will show bulging of the intervertebral disc, calcification (areas of calcification), spinal stenosis.
Today these studies is gradually coming to an ultrasound of the spine for the detection of similar changes, without exposing the patient to excessive radiation load.
Mandatory consultation with a neurologist, according to the testimony — chiropractor.
After a complete examination, it becomes clear, the treatment strategy. As a rule, to cope with pain in the lumbar possible therapeutic methods, surgery is indicated is relatively rare.
In 95% of cases the patient has no need to worry — usually, back pain does not pose a threat to health and can be curable. Myofascial syndrome is adjusted to more quickly eliminate the radicular pain may require several months. Anyway, in most cases it is necessary medical therapy. The use of nonsteroidal anti-inflammatory drugs (nsaids) to relieve pain and reduce swelling, drugs to maintain the intervertebral cartilage. Sometimes to reduce the pain and swelling and is prescribed hormonal medications — work more quickly nonsteroidal anti-inflammatory, to be administered in the form of closures and droppers under the supervision of a physician.
The drug can be in the form of ointments and gels — this method of treatment of pain in the back of popular commercials. But as a way of introduction into the organism of the active substance, the use of external means, that is the most inefficient, it is possible to predict, as most funds do not even penetrate through the skin.
Another popular method is oral medications, or more simply, pills and capsules. For pill is simply, effect occurs very quickly, usually within half an hour-hours, but long-term use of medication can affect the gastrointestinal tract.
Therefore, the quickest and most effective way to relieve the pain of injections directly into the muscle or area affected at the nerve roots, the so-called lock-in. Their only disadvantage is the strict requirement of high qualification of the doctor who performs this manipulation.
Typically, the medicinal product for the treatment of non-drug methods. What physiotherapy will be necessary, solves a doctor. This can be a classic massage or chiropractic, and osteopathic treatments, and acupuncture. Increasingly popular and physiotherapy — specific exercises in the form of classes on a special pressure equipment, which helps to relieve tense muscles, to form new patterns of movement and, thereby, remove the cause of pain in the back.
Therefore, the best option to treat back pain — the combination of medical methods and non-pharmacological approach. Such a complex work in several directions, which enables faster, to cope with the disease, to get rid of the pain or for the production of a lasting effect.