Today, back pain is one of the most common reasons people seek qualified advice. According to some data, it occurs at least once in a lifetime in at least 80% of the adult population, and at least 4-9% annually seek qualified advice on this issue. Painful sensations just above the lower back in the back are among the common complaints. In this article we will talk about which problems can cause pain in this area, how they are identified, and we will also address the topic of combating them.
Some possible causes of pain
Most cases of back and lower back pain are musculoskeletal pain, which can be caused by osteochondrosis, myositis and intervertebral hernia. However, it can also be caused by other pathologies, as well as certain conditions of the human body. Let's look at some common reasons.
Osteochondrosis
Or, according to the term currently adopted in the international classification of diseases - dorsopathy. These are dystrophic changes in the cartilaginous tissue of the intervertebral discs, compensating for the load on the spine, providing shock absorption during movement, vibratory loads, etc. In most cases, pathology can arise due to genetic predisposition, as well as a sedentary lifestyle and lack of physical activity.
Myalgia
These are muscle pains that can be caused by several reasons. Just above the lower back are the muscles that support and stabilize the spine. Therefore, the cause of painful sensations in them can be various diseases of the spine itself, as well as increased physical activity, hypothermia, etc.
Intervertebral hernia
This is one of the complications of spinal osteochondrosis, in which the integrity of the intervertebral disc is disturbed and the aqueous nucleus located inside it protrudes into the spinal canal. Depending on the size of the hernia and its location in the back, sharp pains may occur, sometimes radiating to other parts of the body and limbs (with pathology above the lumbar region, it may be in the leg or arm).
Diseases of internal organs
Back pain is not always a sign of back problems. It can also often be a symptom of pathologies of internal organs: gastric and duodenal ulcers, pancreatitis, cholecystitis, urolithiasis, kidney disease, etc. However, it does not always hurt in the abdomen, side or other area where the affected organ is located.
Age-related changes
With age, the structure of the spine undergoes a series of changes, especially noticeable with a sedentary lifestyle and reduced load. They concern the ligamentous apparatus, muscles and bone tissue. Osteochondrosis and arthrosis, combined with muscle atrophy and loss of ligament elasticity, can periodically cause pain in the lower back.
Pregnancy
Back pain is not always a sign of some pathology. For example, late pregnancy can also cause this condition in women. According to available data, 90% of pregnant women complain of back pain and 50% of discomfort located specifically in the lower back. But why is this happening? The reasons are physiological changes in the biomechanics of the pelvis and spine. In most cases, pain can occur in women who have previously had back problems.
Types of painful sensations
Understanding what type of pain a person is experiencing is important for diagnosis. Back pain above the lower back can be rippling, aching, pulling, dull, sharp, etc. Sensations are just additional data used in diagnosis. You should not trust them completely, much less diagnose yourself based on this information alone.
Some possible diagnostic methods
During a qualified consultation, anamnesis and data on symptoms are collected. However, this is not enough: additional tests are needed to make a more accurate diagnosis. The specialist may limit himself to one of them or prescribe several.
Radiography
This is a diagnostic technique based on the use of X-rays. With the help of this examination it is possible to identify fractures, osteochondrosis of the spine, spondylosis, neoplasms, as well as curvatures and other disorders. When performing an x-ray, the image of the organ under study is projected onto film or paper in just one projection - a less informative method than computed tomography and magnetic resonance imaging.
X-ray computed tomography (X-ray computed tomography)
X-ray computed tomography is similar to radiography in the technology used: it is also based on X-ray radiation. However, as a result of this diagnosis, not a 2D image is obtained, but a 3D image, which is available for study layer by layer. To do this, stronger ionizing radiation is used, which should not be used very frequently. RCT can be performed with or without contrast, which provides a clearer image and increases the success in diagnosing certain diseases.
MRI
MRI is a diagnostic method that also allows you to obtain a multilayer image in several projections, but it is in no way related to the use of X-rays. It is based on MRI and therefore is safer than X-rays and CT scans, but is not suitable for patients with permanent metal structures in the body. Furthermore, this study is noisier and longer. Like CT scans, MRIs can be performed with contrast to diagnose certain diseases more accurately.
Ultrasound
This technique is based on the principle of echolocation and, as a rule, is used to diagnose diseases of internal organs if the symptoms give reason to suspect their presence. It is highly informative and safe when studying organs and tissues. Ultrasound of the spine is also performed, but extremely rarely.
Laboratory diagnosis
To diagnose an inflammatory process, the presence of an infection or tumor, a general blood test with the ESR-leukocyte formula may be prescribed. In the future, if pathologies of internal organs are suspected, additional laboratory tests may also be prescribed.
Other diagnostic methods
If pain of a specific nature or internal organ disease is suspected, other tests may be prescribed until the diagnosis is made and the cause of the pain is identified.
Treatment of back pain above the lower back
The most important step to getting rid of back pain is getting qualified advice. After diagnosis, exclusion of diseases of internal organs, serious pathologies of the spine and determination of pain as nonspecific, it may be recommended:
- taking NSAIDs.Non-steroidal anti-inflammatory drugs for internal and local use are often used to relieve non-specific back pain, osteochondrosis, hernias and other pathologies. The category of these medicines includes the active ingredient in the composition - nimesulide;
- taking muscle relaxants.They are designed to help combat muscle spasm, thus improving mobility and reducing pain;
- taking other medications.For diseases of internal organs or back pain during pregnancy, the set of medications will most likely be different;
- physiotherapy and exercise therapy.During the acute period, several physical procedures may be recommended to alleviate pain and speed improvement. These include, for example, electrophoresis with analgesics, pulsed currents, ultraviolet irradiation, massage, exercise therapy, as well as mineral baths, mud therapy, etc. ;
- surgical intervention.Surgery may be prescribed for a herniated disc if other methods of pain relief do not produce results for a long time, and may also be indicated based on the results of MRI, X-ray or radiography.
Some possible prevention measures
Since risk factors for developing musculoskeletal back pain, including in the region above the lower back, include heavy physical work, a sedentary lifestyle, as well as frequent bending of the body, heavy lifting and vibration, it is recommended to minimize these factors as a preventive measure. If your back is already hurting above the lower back, you should not immediately overload your muscles with gymnastics and especially sports - you must first seek qualified advice to rule out pathologies.