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Low pain

Low pain

Low painIndicates a disease or damage to the spine, nerve structures, soft tissues, internal organs, is observed with feverish states of various genes.It is acute, stupid, constant, periodic, burning, shooting, bursts.Sometimes it is associated with physical activity, time changes.The pathologies, manifested by back pain, are diagnosed on the basis of complaints, anamnesis, exam data and additional studies: radiography, MRI, CT.Before making a diagnosis, peace is necessary, it is sometimes allowed to use ointments, taking pain relievers.

Why does the lower back hurts

Vertebral diseases

A common cause of back pain is congenital anomalies and the diseases acquired from the spine.The nature of pain syndrome varies.The pain caused directly by the pathological process, often periodic, local, painful or drawing, is associated with weather, physical activity, remains in an uncomfortable position.

Due to the spasm of the muscles, lumbago (lateral) occurs - acute pain accompanied by a restriction of movements.With many pathologies of the spine, the lumboyshialgia is observed - painful, burning or firewood, radiating at the back of the thigh.Painful sensations are often found in root syndrome.Can be detected in the following diseases of the spine:

  • Degenerative pathologies: osteochondrosis, projection of the intervertebral disc, intervertebral hernia, spondylosis, spondylo arthrosis.
  • Congenital anomalies: sacralization, lomination.
  • Polyetiological conditions: spondylolis, spondylolist.
  • Vascular diseases: Violations of vertebral traffic.
  • Other diseases: Drilling disease.
  • Secondary lesions of nerve structures: Lombosacral radiculitis, lumbosacre plexite, myelopathy of various genes.
Low pain with spine curvature

Spine curvature

Minor or moderate painful pains are noted for all types of curvature of the spine, which is associated with a non-violaological redistribution of the load, the overvoltage of muscles and back ligaments.The pain appears as a result of an uncomfortable body position, sleeping on an too hard or too soft bed.The symptom is accompanied by:

  • lordosis;
  • Cyphosis;
  • Scoliosis;
  • Kyphoscoliosis;
  • Flat rear syndrome.

Osteoporosis

Pulling or making painful sensations in the lumbar column and the chest spine for a long time are the only symptom of osteoporosis.Pain syndrome is expressly expressed, intensifies after the load, before changing the weather conditions.The symptom is observed in the following varieties of osteoporosis:

  • postmenopausic;
  • Juvenile;
  • idiopathic;
  • senile.

Similar pain is detected in patients with secondary forms of pathology, due to genetic diseases, endocrine disorders, chronic poisoning and taking certain drugs.Secondary osteoporosis can also occur in the context of malabsorption syndrome, liver diseases, KHPN, rheumatoid arthritis.

Strengthening pain, increasing the duration of pain can be associated with the development of a pathological fracture.Other signs of trauma are often not expressed, so that the fracture is often not diagnosed.

Spine injuries

The most common damage is the bruise of the spine.In light cases, pathology manifests itself in pain in moderate lower back, the intensification of movements, local edema and sometimes hematomas and hemorrhages.In serious bruises, neurological disorders are added to listed symptoms.

The lumbar column compression fracture occurs due to a violent flexion of the body.It is characterized by acute pain, holding breathing at the time of the injury.Then, an increase in pain in the event of a body turn is noted, edema of the soft tissue is detected.The palpation of the thorny process is painful.Other possible fractures include damage to arcs, transverse processes, thorny processes.

In addition, lower back pain can be found in patients with traumatic spondylolistis and subluxation of the vertebrae.The painful sensations are paroxysmal, resemble Lumbago, supplemented by a feeling of gravity and numbness of the lower limbs.

Sun and kidneys injuries

The injury of soft tissues is accompanied by insignificant or moderate and moderate local pain, a small edema.Hemorrhages are possible.There is no blood in the urine.Renal bruises are manifested by pain and hematuria in the insignificant short term.In case of renal lesions, the painful syndrome is intense, the pain radiates in the bottom of the abdomen, the groin and the genitals.A hematoma is visible in the lumbar region.In serious cases, severe pain, prolonged macrohematuria are observed.The shock condition is developing.

Infections of the spine and spinal cord

Osteomyelitis of the spine can be hematogenic, post-traumatic, contact, postoperative.The acute shape of the disease is manifested by a rapid increase in lower back pain, combined with chills, fever, poisoning syndrome and deterioration in a general condition.The pain contracts, bursts, so intense that it prevents movements, forces the patient to freeze in bed.In chronic osteomyelitis, the demonstrations are smoothed, a fistulous journey with a separate purulent is formed.

Tuberculosis of the spine is gradually developing.At the beginning, periodic deep pains are observed, improved after load, the increased sensitivity of the skin in the projection of affected vertebrae.The rigidity of the approach is formed.In the context of a significant destruction of bone structures, the nature of pain changes because it is caused by the compression of nerve roots.The pain becomes burning, radiates towards the legs, supplemented by paresthesia, numbness.

In patients with epidural abscess of the spine, the pain is severe, deep, paid, combined with chills, hyperthermia, muscle tension.A recording on the thorny processes of the vertebrae is painful.With the progression of pathology, the rooster syndrome occurs, then paresis, the disorders of the pelvic organs develop.

Local inflammatory processes

Purulent processes in surface tissues and near-ground fibers are accompanied by intense pain in the lower back.The possible causes of pain syndrome are boils, carbunks and paranephritis.

In the first two cases, the abscess is formed in the skin, resembles a limited and highly painful seal with a diameter of 1 cm of crimson or crimson blue with one or more stems in the center.The pain intensifies quickly, becomes contracted, pulsed, losing sleep.General hyperthermia, insignificant or moderate violation of the general state is noted.

With paranephritis, a pronounced fever occurs at the beginning.Pain syndrome is developing after 2 to 3 days.The pain is very intense, can be given in the stomach or hypochondrium, intensify during walking, movements, deep breathing.In certain forms of paranephritis due to pain, the patient takes a forced position.The lumbar muscles are tense.Edema, local hyperemia, hyperthermia are detected.The condition is serious.

Infectious diseases

The painful pain diffuse in the lower back, causing a desire to change the position of the body, is characteristic of acute infections, accompanied by an increase in temperature and poisoning syndrome.In most cases, they are due to myositis, often combined with pain in the members of the limbs.Observed with the flu, tonsils, acute respiratory viral infections.Sometimes pain is caused by kidney damage.Infectious diseases accompanied by pain in the lower back area include:

  • hemorrhagic fever;
  • Encephalitis of Japanese mosquitoes;
  • Ebola fever;
  • aphteuse fever;
  • severe form of coronavirus infection;
  • Generalized forms of bacterial, fungal and viral infections.

In a number of patients, lower back pain is observed with a cytokine storm - an inflammatory reaction that develops in the context of serious infectious diseases.Epidemiological myalgia is accompanied by intense paroxysmal pain up to 10 minutes, which appear not only in the lower back, but also in other parts of the back, in the abdominal wall, chest, limbs.Repeated with an interval of 30 to 60 minutes.Combined with rhinitis, conjunctivitis, severe hyperthermia.

Other muscle lesions

The painful pain in the muscles of the lumbar region is determined after an intense physical effort - the performance of the force exercises for the back muscles, a long stay in a forced position with a tight lower back.Myalgia adapts to rest, intensifies during movements, weakens after warming, hot and hot, disappears after a few days.

Myosites are developing not only with infectious diseases, but also after hypothermia or overload, in the context of exogenous poisoning, metabolic disorders.Accompanied by long -term pain pain.There are also special forms of myositis:

  • specific infectious myositis for syphilis and tuberculosis;
  • Idiopathic, juvenile dermatomyosite and polymiosite;
  • Polymiosite and dermatomyositis for oncological pathologies, systemic diseases of connective tissue.

Chronic diffuse pain throughout the body, including lower back, is observed with fibromyalgia.They are combined with sleep disorders, asthenia, neurotic disorders.

Other diseases

In addition to the listed pathologies of the lower back, they can bother with conditions such as:

  • Spine column tumor, spinal cord: Sarcoma, hemangioma, metastases, intramedullary and extragraural neoplasms of the spinal cord.
  • Kidney disease: Pyelonephritis, glomerulonephritis, uurolithiasis, renal heart attack, renal vein thrombosis, kidney cancer, purulent processes.
  • Hereditary diseases: Hereditary cerebellar ataxia Pierre-Marie.
  • Exogenous poisoning: abuse of phenylpropanolamine.
  • Pathologies of the heart and blood vessels: Endocarditis Leffler, aneurysm of the abdominal aorta.
  • Emergency conditions: Hemotransfusion shock.

For diseases of the pelvis, the irradiation of pain in the lower back is sometimes noted.The appearance of a symptom is possible with a number of female diseases, prostate cancer, projection, sigmoid.

Diagnosis

The primary diagnosis is made by an orthopedic traumatologist.In the presence of neurological symptoms of the patient, the neurologist examines.The doctor interviews the patient, performs an objective exam.According to the testimony, the consultations of a surgeon, a rheumatologist, an urologist and other specialists are appointed.The diagnostic program may include:

  • Neurological examination.In the research process, the specialist assesses reflexes, muscle strength, coordination of movements, deep and superficial sensitivity.
    • Manual therapy to eliminate lower back pain
  • X -Ray.On the radiographs of the lumbar department, fractures, a decrease in the height of intervertebral discs, other degenerative changes, volumetric formations, signs of inflammatory processes and spondylolisthesis are visible.If necessary, standard x -rays are supplemented by functional studies.
  • Other neuroimagery methods.To clarify data from radiography, CT and MRI are used.During computed tomography, the structure of solid structures is studied in detail, the state of the ligaments and intervertebral discs is examined on MRI.To exclude stenosis, myelography is carried out.
  • Functional research.The condition of the muscles and nervous conductivity is evaluated using electromyography, electronography and caused potential studies.
  • Laboratory tests.To confirm the infectious nature of the disease, the determination of the pathogen makes blood tests and a microbiological examination.To detect neuroinfections, serological reactions are used.

According to testimony, an ultrasound of kidneys, prostates, pelvic organs, urine tests, abdominal aorta, other studies and other studies are carried out.

Treatment of line pain

Help at the prehospital stadium

With traumatic damage to the spine, it is necessary to place the patient on the shield and immediately deliver to the medical institution.In case of non -human pain, it is necessary to reduce the load to the back, to optimize the position of the body during work and rest.Acute pain syndrome is an indication for consulting a neurologist.

Before the expert exam, a single contribution of pain relievers is possible.In Lumbago, the lumbar Ilgie caused by degenerative diseases previously diagnosed with the spine, the use of warming and analgesics of local acts is authorized.If there is a suspicion of the presence of an infectious process, local funds are not shown.

Conservative therapy

The basis of treatment is physiotherapeutic measures and pharmacotherapy.The patient is prescribed a protective regime.Apply the following methods:

  • NSAID.Effective in acute and chronic muscles and spine.Used in the form of tablets, local products.
  • Neurotropic vitamins.Patients are introduced by B vitamins, which improve the effect of drugs from other groups, help reduce pain.
  • Local anesthetics.With obstinate and acute pain, therapeutic blockages with anesthesia are carried out.To improve the result of treatment, pain relievers are combined with glucocorticosteroids.
  • Physique.Apply ultrasound, magnetotherapy, percutaneous electrical stimulation, laser treatment, drug electrophoresis.It is possible to prescribe a massage, manual therapy, acupuncture.

Surgical treatment

Given the characteristics of the pathology, the following surgical interventions are carried out:

  • Instability: Inter -Core spondylodesis, transpédicular fixing, fixing with plates.
  • Tumors, osteoporosis, osteomyelitis, tuberculosis: sequestralctomy, vertebroplasty, cyphoplasty, company.
  • Hernies intervertebral: Discotomy, microdiscectomy, nucleoplasty.
  • Put the spinal canal: laminectomy, facetectomy, discomposition of punctuation of the disc.

During the postoperative period, pain relievers, antibiotics are prescribed.Rehabilitation measures include the treatment of the exercise, massage, physiotherapy.