Lower back pain

Usually, people of working, elderly and senile age suffer from low backache. The human spine bears almost the entire body weight. It consists of 33-34 vertebrae connected by intervertebral discs. Due to this connection, the vertebrae can move relative to each other. The sacrum and tailbone are special parts of the spine. The sacrum is formed by five fused vertebrae, and the coccyx is a rudimentary part of the spine that does not perform a supporting function.

Sudden lower back pain can develop in one or all three parts of the spine. Most often, it occurs in the cervical, thoracic and lumbar spine. It can be caused by disease and injuries of the discs, as protrusion of the disc, herniated disc, and intervertebral joints, as arthrosis of the facet joints or other causes.

The number of people with back hurt has increased dramatically in recent years and decades, making this the most common complaint in the world. 

Low back pain can manifest itself in different ways. So, experts distinguish 4 main types of pain. So below, you will find out more about types, causes, intensity, and diagnostics of low back pain.

Types of Low Back Pain

The types of pain are distinguished depending on the origin. The main ones are:

1. Specific low back pain. This type of pain is one of the most common (31% of all cases). You can find out the cause of this type of pain using standard examination methods, since it is associated with a specific disease. These can be tumors, compression fractures of the spine, diseases of the pelvic organs, etc.
2. Radicular pain. This type of pain is the second most frequent (up to 27%). If the spinal root is pinched or inflamed, this type of pain can develop. Symptoms of radicular pain include increased back pain when coughing, exercising, sneezing, and other activities.
3. Dysfunctional pain. This type of pain syndrome can be caused by psychological problems and chronic stress.
4. Non-specific low back pain. This type of low back pain can be acute, and the cause is difficult to determine. Most often, such pain can occur after dystrophic changes in the bones, cartilage tissue of the spine, and the muscles and ligaments that make up the supporting apparatus of the back. Such dorsalgia – a special section for the definition of a syndrome, in the international classification of diseases – accounts up to 85% of all cases. It is mainly associated with a disruption in the normal functioning of individual structures of the spine, and any can become a source of pain impulses.

This pain can be of two types:

• compression – from squeezing the nerve roots;
• reflex – from all other tissues, including spasmodic muscles.

Causes of Low Back Pain

The main reason that triggers low back pain is a disturbance in the muscle mass that supports the spine. The symptoms are:

• weakness;
• asymmetry, due to which there is uneven support of the spinal column, and it causes pain.

The muscles of the back create a kind of corset that supports the spine. If they lose their stamina, they get tired faster than usual, and, as a result, the spinal column feels an increased load. At the same time, its intervertebral discs, joints, and ligaments suffer.

When there is back pain, the muscles develop asymmetrically; some muscles are permanently tense while others are relaxed and do not load enough. The consequences are following: 

• violation of posture (curvature of the back);
• pathology of individual vertebrae;
• disorders of the intervertebral discs.

Asking why the back hurts in the lumbar section, sacrum, or between the shoulder blades, you should remember about factors that can significantly aggravate pathological changes in the spinal muscles:

• endocrine disruptions;
• a chronic focus of infection in the body;
• condition after back injuries;
• severe operations suffered in the recent past;
• past and current complex somatic diseases, for example, ischemic heart disease.

Low back pain can occur with diseases and pathological conditions:

• radicular syndrome – inflammation of the nerve branches that pass through the intervertebral foramen;
• intervertebral hernia – displacement of the nucleus pulposus (central part) of the intervertebral disc, which occurs with rupture of the annulus fibrosus located around the nucleus;
• protrusion of intervertebral discs – partial displacement of the nucleus pulposus;
• ankylosing spondylitis is an inflammatory lesion of the spine’s joints and many others.

Diseases of Internal Organs and Pelvic organs. Pain Intensity, and Diagnostics

Diseases of internal and pelvic organs

Low back pain can be caused by diseases of the internal organs, for example:

• Urolithiasis.
• Diseases of the pelvic organs; most often in women, but men suffer too (pathology of the uterus, prostate, etc.).
• Pancreatitis; inflammation of the pancreas caused by damage to the organ by its enzymes.
• Peptic ulcer and 12 duodenal ulcer.
• Cholecystitis; inflammation of the gallbladder wall.

Low back pain intensity

In case of acute and intense abdominal pains radiating to the lumbar spine, it is always necessary to exclude surgical pathology that requires urgent surgical intervention (gastrointestinal bleeding, appendicitis, peritonitis, etc.).

• The intense pain in the lumbar spine

It can be a reflex spasm – a muscle spasm caused by irritation of receptors in the paravertebral muscles. It hurts a person while coughing, sneezing, and there are painful sensations while moving. When the nerve root is compressed (disc protrusion, disc herniation), the sudden lower back pain spreads to the lower extremities – often from one side.

• Myofascial syndrome

It is caused by irritation of hurt receptors in muscles and fascia. There is the formation of triggers (hurt nodes) in the muscles- hurt syndrome is chronic, often recurrent.

Any trauma to soft tissues or bone structures is also accompanied by intense pain.

Low back pain diagnostics

For back pain, the following diagnostics are carried out:

• Magnetic resonance imaging of the lumbar spine.
• CT (X-ray computed tomography).
• Blood and urine tests.
• Ultrasound of the kidneys, pelvic organs, and prostate gland (for men).

FAQ

• How to understand that the sciatic nerve hurts?

The main symptom of a pinched sciatic nerve is severe pain. It can have a different nature (sharp, stabbing, aching, or pulling), spread from the lumbosacral spine, and pass through the buttock along the entire back of the leg to the very feet.

• What happens if the sciatic nerve pain is left untreated?

It can lead to various complications: stiffness of movement when walking, impaired gait, or inability to perform certain activities with the toes or feet.

• Can the sciatic nerve be massaged?

Massage, when the sciatic nerve is pinched, is used quite often. With its help, it is possible to relieve spasms and swelling of muscle tissue, and eliminate tendon hypertonicity. In addition, massage improves the general condition of a patient, speeds up metabolism, and increases muscle tone.

• How is the sciatic nerve treated?

The course of treatment depends on the stage of the disease. In most cases, conservative treatment is carried out, including taking medications and carrying out physiotherapy procedures, gymnastics, massage, and manual therapy.