Back Pain in the Lumbar Region: Lumbar Osteochondrosis?


Back pain- one of the most frequent complaints of patients with a wide range of diseases. Almost all people, at least once in their lives, have experienced pain, located mostly in the sacral spine or between the lower edge of the XII pair of ribs and the gluteal folds, ie,pain in the lower back(BNS).

Low back pain is usually accompanied by muscle tension, often with the presence of tender points. It can radiate (give) to other parts of the body, for example, the leg, the gluteal muscles, the stomach, the pelvic area, etc.

Acute low back pain usually comes on suddenly and can last from a few minutes to several weeks. Typically, in 90% of cases, low back pain resolves on its own within 3-4 weeks; however, in the remaining 10% of cases it becomes chronic and can last for years, sometimes getting worse and then decreasing. Most of the time, the true cause of low back pain cannot be established.

Back pain in the lower back - cause

A variety of ailments can cause back pain in the lower back.Pain in the lower back(BNS) is actually just a symptom that arises with the development of a large number of pathological processes in the organs of the chest and abdominal cavity, small pelvis and spinal structures; moreover, it can be psychogenic.

Pain above the lower back

Back pain above the lower back can occur with gastric ulcer and duodenal ulcer. Reflected pain is usually located in the lower back or slightly higher, less frequently in the upper quadrant of the body.

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

In genitourinary sphere pathology, reflected pain is often located in the lumbar region and in the lower thoracic levels of the spine.

Pain in lower back, right or left

Lower back pain on the right or left side is most often a sign of kidney stones. In the case of kidney stones, a stone growing in the kidney puts pressure on the delicate parenchyma of the kidney from the inside, sometimes causing severe pain in the lower back, left or right in the kidney where the stone is located.

Lower back pain radiates to the leg

When kidney stones pass through the ureters, severe pain occurs in the lower back, which can radiate to the lower back, leg, abdominal cavity, and genitals. Often, back pain radiating to the leg can be a sign.renal colicwith urolithiasis of the kidneys.

In addition, the lower back pain radiates to the leg with lumbar sciatic pain. Ishalgia appears as leg pain, especially during recovery.

Back and lower back pain

Low back pain radiates to the left and right sides in acute or chronic kidney inflammation. Kidney pain, which lasts for several days in a row, and accompanied by fever, chills, dysuric phenomena (urinary disorders) indicates a diseaseacute pyelonephritis. . .

Back pain

Processes in the pelvic region (uterus, appendages, bladder, intestines) cause pain located in the lumbosacral region. Often, however, there are secondary tonic muscle syndromes (reflex disorders in the gluteus small and medium muscles, piriformis syndrome, pelvic floor syndrome, symphysisternal syndrome) in combination with lumbar spine pathology with chronic processes in the organs and tissues of the small pelvis. These patients need collegiate treatment from a neurologist-neurosurgeon, urologist, gynecologist, proctologist.

Pain in the lower back

Pelvic bone tumors, especially early in the disease, can mimic lumbar sciatic pain and, in the presence of a concomitant vertebrogenic process, patients sometimes undergo neurosurgical intervention for a hernia at the lower lumbar level. that worrieschondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand a few others. Mandatory X-ray examination usually solves the diagnostic problem. It should not be forgotten that the patient's general somatic and hematological status 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 may mimic the lumbar ischialgic syndrome of lumbar osteochondrosis. The process can secretly occur from childhood and adolescence and reveal itself in an adult in the form of sacroiliitis. 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 lower back and lower back may often have nothing to do with any spinal disease and are alarming symptoms of completely different ailments of Organs internal organs. Therefore, in case of back pain, a comprehensive examination is necessary.

Low back pain in women - causes

pulling back pain

back pain in womenoften associated with premenstrual syndrome. These pains usually have a tug-like character, occur a few days before menstruation and continue for 2-3 days after it starts and go away on their own.

Lower back and abdominal pain in women

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

Abdominal pain radiates to the lower back

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

It should be remembered that pain in the abdomen and lower back in women can be symptoms of dangerous disorders in the pelvic region, such as: formation of uterine fibroids, proliferationendometrioid tissueoutside the uterus, the formation of adhesions, cancers of Organs reproductive organs, etc.

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

Low back pain during pregnancy

Pain in the lower back and abdomen in women often indicates natural physiological changes associated with an increase in the size of the uterus during the development of a normal pregnancy.

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

Low back pain in men - causes

Low back pain in men is more often associated with degenerative spine diseases, especially with heavy physical exertion, work associated with weight lifting. In addition, low back pain can be associated with various diseases of Organs internal organs.

severe back pain

Acute pain in the lumbar spine can occur with clumsy movements, inadequate load distribution, etc. This pain is usually associated with muscle spasm or displacement of the vertebral discs. Pain can also be caused by the tightening of muscles at the roots of the spinal nerve endings.

Back and groin pain

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

Back Pain Classification

The classification, disseminated in several countries, which aims to optimize the provision of medical care for LPS, distinguishesSpecific, root and non-specific BNS. . .

specific back painit is a symptom of a certain disease, often serious and even life-threatening (cancer, including spinal metastases; infectious - tuberculosis, spinal osteomyelitis, epidural abscess, etc. ; inflammatory, - for example, ankylosing spondylitis and other spondyloarthritis; traumatic and osteoporotic fracture of the vertebra; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal canal 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 that the patient has a serious condition and to purposefully examine the patient (preferably with the involvement of an appropriate specialist) to establish the diagnosis andcorrect treatment.

Root (radicular) pain in the lower back, including sciatica syndrome, is a consequence of spinal root compression.

The management of patients with radicular SNL is the prerogative of a neurologist, with special indications the participation of a neurosurgeon. In practice, these patients often resort to the help of chiropractors.

Among the radicular pains in the lower back are distinguished:

  • lumbago,orlumbago;
  • lumbodynia- long-lasting pain only in the lumbar region;
  • lumbar sciatic pain- back pain radiating to the leg.

Non-specific low back pain- the most common, not associated with any visceral disease, severe pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially associated with heavy lifting, prolonged uncomfortable position during sleep or work, etc.

Therefore, it is quite reasonable that a planned spinal radiograph should not be included in the recommendations for examining patients with nonspecific low back pain syndrome (NLP). These patients do not need the mandatory consultation of a neurologist, but should be treated by a family physician, district therapist, or general practitioner.

Low back pain and "lumbar osteochondrosis"

lumbar osteochondrosis(Lumbar spine osteochondrosis)- the most frequent diagnosis, which is given to patients with complaints of pain in the lumbar spine. However, it is impossible to identify each case of development of an episode of low back pain with "degenerative-dystrophic" changes often actually present in the patient in the spine, making a "usual" diagnosis."Exacerbation of osteochondrosis"or simply"Osteochondrosis". . .

For pain in the lower back or lower back, a diagnosis is usually written as follows:"Doropathy. Osteochondrosis of the lumbar spine. Sciatica. Lumbarization". . . Although, the correct diagnosis in this case should sound like this:"Lumbago with sciatica in the background of osteochondrosis of the lumbar spine. Lumbarization. (code М54. 4)".

It should be noted that there is no nosological unity in any of the foreign classifications of degenerative dystrophic diseases. "spine osteochondritis". . . Also, not the term"Osteochondrosis", nor any other term that characterizes dystrophic changes in the spine, should not be used as a synonym for clinical diagnosis.

chondrosisis a dystrophic change in disc cartilage,osteochondrosis- dystrophic changes in the disc and adjacent vertebral bodies. However, the ignorance of radiologists and physicians about the signs of dystrophic changes in the spine(chondrosis, osteochondrosis, spondyloarthrosis, spondylosis, fixation hyperostosis, etc. )leads to overdiagnosis: these types of pathology are found where they are not.

Osteochondrosis is often called all the degenerative changes listed because of ignorance of the differences between them. Misunderstanding, osteochondrosis includesherniated disc, which is a consequence of its rupture, and, as a rule, a normal disk, and not altered by a dystrophic process. Although, calling a herniated disc osteochondrosis is as wrong as a meniscal tear in the knee joint - osteoarthritis.

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

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

Home Back Pain Treatment

For low back pain associated with muscle tension and muscle stiffness, low back pain ointments 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 pills that contain non-steroidal anti-inflammatory drugs (NSAIDs).

At the same time, it should be remembered that home self-treatment for low back pain with creams, ointments, mustard plasters and other procedures can lead to the abandonment of the underlying disease that causes these pains, with very sad consequences. Self-medication of the lower back is especially dangerous for kidney diseases such asacute pyelonephritisorrenal colicrequiring qualified emergency medical care.

Low back pain prevention

People who have had an attack of the disease, especially before a stable remission has formed, need to follow certain prevention instructions:

  • Do not lean your body without arm support; pick up objects off the floor with your knees bent.
  • Change your body position more often, don't stand for too long, don't sit.
  • Work at a table or workplace, keeping upright, for this leg, bent at the knee, placed in front of the other.
  • Be careful when performing specific yoga, aerobics exercises without the recommendation of a physical therapist or specialist vertebrologist.
  • Beware of hypothermia, drafts, and prolonged warm-up in a hot bath, as muscle relaxation deprives the muscle corset's immobilizing protection for a while.