Low back pain treatment

Low back pain is just a symptom, an external manifestation of a certain disease or pathology.Every pain has its reason.There are many causes of back pain.

Patients are often told that back pain is caused by overloading the muscles and ligaments.Unfortunately, it's easy to relieve the pain if the cause lies solely in the muscles.For example, massage can relieve pain.But massage doesn't always help because it removes the cause of the pain.

Severe back pain may occur due to a herniated disc or disc herniation.If the disc herniation is right-sided, you may experience right-side back pain, right-side pain, or right-leg pain (large hernia sciatica).If the hernia is on the left side, then you may feel pain on the left side of your back and may be bothered by pain on the left side. 

If the hernia is large and compresses the root of the left lumbar spine (Radiculitison the left side), then lower back pain may occur in the left leg and pain may begin in the left leg.When it is impossible to stand upright and upright (the so-called analgesic position of the trunk), large hernias often cause the trunk to twist with acute "twisting" pain, leading to postural violations.

Right lower back pain may be caused by a hernia or joint problems on the right side of the spine or pathology in the sacral area (right iliosacral joint).

Pain in the left shoulder blade area (or pain below the left shoulder blade) may be the result of a hernia or joint disease, or it may be the result of a heart problem.This pain can be caused by angina and heart attack.Pain between the shoulder blades is associated not only with spinal pathologies and osteochondrosis, but also with gastric diseases (gastritis, ulcers, cancer, etc.) and intestinal diseases.

Cholecystitis and cholelithiasis most commonly cause pain in the right side of the back and under the right shoulder blade.Gallbladder pathology usually presents with pain under the right rib cage.Diagnosis is needed.

protrusiondisk, more accidental findings on MRI,CanContinue without any pain at all.disc herniation– This is not a common cause of severe back pain.However, the development of a hernia, for example when lifting heavy objects, does cause lumbar pain (severe pain in the back) in the lower back or chest.If you have ongoing back pain, the hernia found on the MRI may not be relevant.The causes of this ongoing pain are usually different. Diagnosis will help you find out.

Therefore, to effectively treat back and lower back pain, you need:

1. Determine the cause of low back pain (make a diagnosis).
2. The cause of low back pain will be determined by a neurologist, an orthopedic traumatologist with skills in the fields of spondylology and spinal neurology, or a spondylologist (vertebral neurologist).Diagnosis is confirmed by clinical and hardware examination.
3. Treatment strategies for low back pain depend on the diagnosed cause.
4. If you have lower back pain, it's important to make sure the pain doesn't come back.To achieve this goal, we offer a variety of methods, including physical rehabilitation of the spine.

Lower back pain.Why does my lower back hurt?

Low back pain is pain in the area between the 12th pair of ribs and the hip crease.This pain is already a social problem.In fact, the lower back is the most heavily loaded part of the spine and is overloaded with stress every day, every hour.85% of people experience lower back pain at least once in their lives.What's the reason?

lower back painThere could be many reasons.The most common causes are osteochondrosis, disc herniation, radiculitis, and lumbar joint pathology.

osteochondrosis

osteochondrosis–Natural aging of spinal tissue.

Osteochondrosis is generally believed to be a sign of spinal disease, accompanied by pain.This is a little different.

The image below shows a normal disk being damaged (see the damaged disk in the image).These injuries accelerate the aging of the disc and reduce its height (see "Narrowing of the Intervertebral Space").Next, aging begins to affect the bone tissue of the vertebrae themselves, and osteophytes grow (see "osteophytes" in the picture).

Previously, osteochondrosis was thought to be associated with pain.Therefore, they tried to use osteochondrosis to explain the cause of spinal and low back pain.For this reason, there is even the issue of spinal neurological failure.In 1978, the first spinal osteochondral problem research laboratory was established and conducted more than 10 years of research on osteochondral problems, proving that the cause of pain is not osteocartilage, but joint pathology. 

Osteochondrosis is not accompanied by pain because the discs have no nerve endings.Therefore, osteochondrosis is painless.

disc herniation

A herniated disc may be the cause of pain.The image above shows several types of disc herniation - a small herniated disc (herniation) and a large disc herniation.A herniated disc itself does not cause harm.

Intervertebral discs have no nerve endings (are not innervated).Pain from a herniated or herniated disc occurs when the herniated disc puts pressure on the innervated tissue.For example, regardingspineor onrearYuyuportraitWowbundleexist.In the first case, nerve root pain occurs - radiculitis (see below).In the second case, back pain (lumbar pain) or acute pain - lumbago (lumbar pain) occurs when the receptors of the posterior longitudinal ligament are irritated.

A herniated disc can usually be treated without surgery.

spondyloarthropathy

Spondyloarthropathy is an arthropathy of the spinal joints.Arthropathy itself is characterized by disease of articular cartilage.In this condition, the cartilage height is reduced (degenerated, "dried out"), and the joint surface of the bone loses its protective cartilage layer.The joints in the spine begin to hurt.This pain feels like lower back pain.

Radiculitis

Radiculitis is inflammation of the roots.Radiculitis most commonly occurs when a nerve root is injured due to a herniated disc or spinal joint.Often it's not so much lower back pain as it is pain in the legs, buttocks, and even pain or numbness in the toes.

Radiculitis is most effectively treated by releasing the root.If it is caused by a herniated disc, the hernia will need to be reduced as it can put pressure on the roots.

Back and waist pain due to internal organ disease

Back pain may be due to pathology in the internal organs.For example,Female back painMay be the result of pelvic organ disease.

Female back pain

Low back pain in women may be caused by inflammatory diseases of the female reproductive organs.

If women have pelvic and lower back pain, then you should always remember gynecology.Inflammatory diseases of the female reproductive organs are not uncommon.The causes may be adnexal inflammation, vaginal vulvar inflammatory diseases, salpingitis, fallopian tube inflammation, endometritis, bacterial vaginosis, etc.More often, these inflammatory diseases in women are caused by infections in the genital area, including sexually transmitted infections.

If there is soreness and pain in the lower back and pain in the lower abdomen, then women need to see a gynecologist.A gynecological ultrasound examination is necessary to initially confirm the diagnosis.

Persistent lower back pain can also occur when:Gynecological Oncology.

Cancer and low back pain in women

Cancer doesn’t hurt at first.By the time pain develops in the lower back or sacral area, it may already be too late.

Many people think that tumors come with pain.This is wrong.In the initial stages of tumor development, a person does not feel pain.The person feels actually healthy.For example, cervical cancer of the reproductive organs is asymptomatic.As a tumor grows, it begins to show itself.In this case, pain in the waist and below is often experienced.Pain in the lower lower back is located in the sacral area.

When you have cancer, severe pain in your lower back may not bother you at first.On the contrary, the waist does not hurt, but is sore.This pain may be the first call that helps a woman prevent serious tumor growth and get the correct diagnosis in time.If you have frequent pain in your waist or sacrum, you should pay special attention to avoid catastrophic consequences.

Unfortunately, if you don't pay attention to the soreness or discomfort in your lower back, the next sign of cervical cancer may be uterine bleeding.This is the stage when the tumor begins to disintegrate and metastases may already be present.Including the spine, when severe pain already occurs in the lower back.

Important points:If you have lower back pain, it's not necessarily osteochondrosis or a herniated disc.It never hurts to have a preventive consultation with your gynecologist.After all, cervical erosion found during examination is a precancerous lesion.

Why does my back hurt from a urological or genitourinary problem (inflammation)?

Acute low back pain may be caused by kidney disease

Kidney diseases such as pyelonephritis can cause severe pain in the lower back.

Pyelonephritis is an infectious disease most commonly caused by ascending infection.It can be linked to sexually transmitted infections and other types of household infections that are spread through swimming pools, bathrooms and personal hygiene products.For example, everything lingers in unwashed towels.

Inflammation activates pain receptors in the soft tissues of the pelvic organs.Pain signals (pulses) reach the spine through sensitive roots, activating its tissues.The soft tissues of the spine and the attachment points of the back muscles become reflexively swollen (inflamed).My lower back started hurting.

Persistent back and waist pain due to gastrointestinal dysfunction and other conditions

Back pain is common with intestinal spasms, bloating, ulcers or ulcerative colitis, stomach ulcers, and gastritis.

Stomach cancer linked to back pain

Treating back pain caused by gastrointestinal pathology will not lead to improvement.The cause needs to be treated.

Another possible cause of lower back pain is overloading the back

Overloading the lower back is a common cause of back pain or exacerbation of back pain.Overload typically affects the lower back joints, lower back ligaments, tendons, or muscles.In addition, the muscles of the lower back actively work under load.Therefore, if you experience lumbar spine pain after exercise, it is not necessarily a disease.It could be a muscle tear.If this pain does not go away within 1-2 days, then you should consider a lumbar spine problem.Especially if this pain worsens with movement.

The cause of this pain is usually excessive inflammation of the muscles and their attachments.Or – Inflammation of the joint capsule.

If this deterioration occurs more than once a year, you should look for the cause of this deterioration.To do this, it is not enough to consult a doctor and undergo massage, painkillers, massage and other procedures.

Examination is needed to determine the cause of this frequent exacerbation.

Lumbar soft tissue injuries

Severe pain in the lower back when moving awkwardly or lifting heavy objects is most likely a spinal injury.

If you are concerned about pain on that side, such as pain in the right lower back, then you should consider pathology in the right joint.Or about a right lumbar hernia.

Types of low back pain

Taking into account its duration, pain can be acute, chronic, or have (transient) transistor characteristics.

The pain points are as follows:

• local pain– Pain occurs only in the lower back.
• referred pain– When pain occurs not only in the lower back, but also in the buttocks, pelvic area.Or, lesions in internal organs may cause lower back pain.In this case, they talk about referred pain.
• radicular pain– Significantly different in intensity and located within the boundaries of root innervation (from spinal to peripheral).The cause is invasion (stretch, compression, bending, compression) of the nerve roots of the spinal nerves.Activities and even coughing can increase pain due to what is called "pain."urge to cough.This is severe pain in the lower back that may conduct (radiate) into the legs.
• myofascial pain– is the result of reflex muscle spasm.The cause of myofascial pain may be disease of the internal organs, or damage to the spine itself.Muscle spasms can wreak havoc on the biomechanics of human movement.Chronic muscle spasms can also cause lower back pain and cramping pain.

When should you consult a doctor about lower back pain and what should you do?

• Severe (acute) pain in the lower back;
• If back or lower back pain lasts for more than 3 days;
• If you develop back pain after an injury;
• If the pain is in the lower back, feet, and calves at the same time;
• If lower back pain is accompanied by numbness in the thighs, buttocks, calves, feet, or groin;
• If lower back pain is accompanied by muscle twitching (fasciculations) in the limbs;
• Impaired urinary and defecation function (urinary retention, incontinence, urinary frequency or pseudo-urgency);
• If the perineum is numb.
• If pain in your back or lower back (sacrum) persists and is worse in the morning

What should I do if I have lower back pain?

There are many causes of low back pain, so treatment of low back pain should be done after diagnosis and by a qualified physician.Any pain in the spinal area requires a medical examination to determine why it is occurring.

Seeing a doctor has 3 purposes:

1. Establish a correct diagnosis.
2. Eliminate pain.
3. Develop measures to help maintain the patient's health so the pain does not reoccur.

Possible causes of low back pain

The following conditions may be the cause of your complaints of lower back pain:

• osteochondrosis;
• osteoarthritis;
• spondylolisthesis;
• Spondylosis;
• ankylosing spondylitis;
• spondyloarthropathy;
• muscle damage;
• ligament damage;
• intervertebral disc herniation"herniaDisc herniation can be treated without surgery in 98% of cases (World Statistics)”;
• Abdominal aortic atherosclerosis;
• spinal malignant tumors;
• transfer to spine;
• urinary tract infection;
• spinal stenosis;
• Biliary tract disease;
• Penetrating duodenal ulcer;
• pancreatitis;
• kidney disease;
• Abdominal aortic dissecting aneurysm;
• Retroperitoneal tissue bleeding;
• Inflammatory diseases of female reproductive organs;
• Female reproductive organ tumor diseases;
• endometriosis;
• prostatitis;
• prostate cancer;
• Epithelial coccygeal canal abscess;
• lower extremity arterial embolism;
• intermittent claudication;
• pseudointermittent claudication;
• Eliminates atherosclerosis in blood vessels of the lower limbs;
• rheumatoid spondylitis;
• polymyalgia rheumatica;
• Fibromyalgia
• depression;
• other.

Treat low back pain (back pain)

During the initial treatment phase of low back pain, a preliminary diagnosis is established.This is done based on investigation, medical history, neurological and orthopedic examination.During this stage, medications may be prescribed to reduce pain, relieve tissue swelling, and general anti-inflammatory treatment.Reflexology, topical medications, regional anesthesia, various injection methods for low back pain, laser therapy, etc. are all effective.In the acute and subacute phases, rest is important during drug therapy.Physiotherapy, massage, manual therapy and other treatments that may exacerbate this process are not mentioned.In the acute phase, traction is also not used: hardware, ramps, wall poles.

In order to treat lower back pain more effectively, you need to understand its causes.For this reason, the patient is further examined to confirm the diagnosis.There are many causes of lower back pain.An indicative list of conditions associated with low back pain is given above.Each of them has their own treatment protocol, which outlines the most effective methods, medications, and procedures.The protocol also contains data from methods that do not target this disease.For example, for inflammatory diseases of the spine (spondylitis, spondyloarthropathy, spondyloarthritis, myositis, ligamentitis, etc.), manual therapy, massage and physiotherapy are not suitable due to their ineffectiveness and risk of complications.It is necessary to identify the cause of inflammation and treat it.

Spondylosis visible on radiographs may occur without clinical symptoms and often masks more complex disease.Therefore, treating spondylosis is useless and often dangerous: removing bony growths in the spine is impractical and unnecessary.Patients may encounter some strange diagnoses, such as "muscle injury," "muscle spasm," "ligament damage."Unfortunately, it is not always true that muscle spasms are the cause of pain.Muscle spasm of the paravertebral muscles is a reflex behavior that usually accompanies most diseases, including those not related to the spine.The muscles actively participate in segmental reflex processes and can respond to any stimulus inside or outside the spine.So-called "cramps" must be distinguished from reflex or projected pain in the lower back, which can be caused by pathologies of the internal organs: diseases of the pelvic organs, retroperitoneal space, kidneys, pancreas and prostate, gynecological diseases of inflammatory or neoplastic origin, diseases of the aorta, bleeding of retroperitoneal tissues, etc.Osteopathic techniques for treating secondary spastic paravertebral muscles can provide temporary relief at the reflex level.For example, manual therapy, osteopathic techniques, ramps, massage, traction, physical therapy will not help with prostatitis or adenomatosis.So-called "therapeutic removal."In this case, the "muscle spasms" are simply the manipulator's desires.

Treating lower back hernias and herniated discs

Often, an MRI will reveal a hernia or herniation, which is interpreted as the cause of low back pain.The question immediately arises: remove the hernia or try to cope without surgery?

first things to do– Clarify the clinical significance of this hernia.The fact is, if you performed a diagnostic MRI on 100 perfectly healthy people with no low back pain, you would find that 80% of them had some kind of herniated disc ("hernia") but would not experience any symptoms.

Often, a herniated disc may be discovered incidentally and is often attributed to another cause of pain.

At the same time, practice shows that not all hernias are clinically significant.To determine the cause of pain, a complete medical history is taken, a neurological examination is performed to identify neurological deficits, and the function of the pelvic organs is clarified.

It turns out that not all hernias and herniated discs require surgery.No more than 2% of patients require such surgery.

Neurosurgeons have prescribed clear absolute indications for surgery.Usually, the presence of a herniated disc is not a reason for emergency surgery.

There are sufficient arsenals for treating disc herniation, including traction, the formation of back-stabilizing movement patterns, local and systemic drug treatments, physical therapy, reflexology, etc.Alignment treatment without surgical intervention is often accompanied by resolution of symptoms, and the hernia (herniation) may decrease over time.

Relevant indicators for surgical treatment formally prescribed by the neurosurgeon must be considered when making surgical decisions.Each specific case is considered individually, taking into account clinical symptoms, medical history, medical history, neurological and orthopedic examination, hardware, and laboratory findings. 

It is important to note that surgical intervention often brings a variety of complications, and the intensity of dealing with these complications after surgery is many times stronger than preoperative pain relief.

Degenerative changes of the spine, such as osteochondrosis, spondyloarthropathies, spondylosis, etc., are treated on the basis of identifying the triggers of the pain syndrome. 

Massage and manual therapy are very effective treatments when indicated for use.Over the past three decades, the institute has developed the best options for treating patients with low back pain, taking into account its range of possible causes.