Lumbar back pain: lumbar osteonecrosis?

Backache

Backache- one of the most frequent complaints of patients with a variety of diseases. Most people experience pain at least once in their life, most often localized in the sacral spine, or between the lower edge of the XII pair of ribs and the folds of the gluteal muscles, ie.lower back pain(BNS).

Low back pain is often accompanied by muscle tension, often with pain points. It can radiate (deliver) to other parts of the body, for example, to the legs, glutes, stomach, pelvic region, etc. v.

Acute low back pain usually comes on suddenly and can last from a few minutes to several weeks. Usually, in 90% of cases, low back pain goes away on its own within 3-4 weeks, however, in the remaining 10% of cases, it becomes chronic and can last for years, sometimeswhen getting worse, then remission. Often, the true cause of lower back pain cannot be determined.

Back pain in the lumbar region - causes

A variety of diseases can cause low back pain.Lower back pain(BNS), in fact, is just a symptom that appears with the development of a large number of pathological processes in the organs of the thoracic and abdominal cavity, the small pelvis and structures of the spine; In addition, it can be psychological.

Pain on lower back lưng

Lower back pain can occur with gastric and duodenal ulcers. The reflected pain is usually localized in the lower back or slightly higher, less often in the upper quadrant of the body.

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

In pathology of the genital field, the reflected pain is usually localized in the lumbar and lower thoracic regions of the spine.

Lower back pain, right or left side

Right or left back pain is often a sign of kidney stones. In the case of kidney stones, a stone that develops in the kidney will press on the kidney parenchyma from the inside, sometimes causing severe pain in the lower back to the left or right of the kidney where the stone is located.

Lower back pain spreading to legs

When a kidney stone passes through the ureter, severe pain occurs in the lower back, which can spread to the lower back, legs, abdominal cavity and genitals. Very often, back pain that radiates down the legs can be a signkidney painwith kidney stones.

In addition, low back pain radiates down the leg accompanied by hemiplegia. Sciatica presents as pain in the legs mainly during recovery.

Side and lower back pain

Lower back pain radiating to the left and right in acute or chronic nephritis. Pain in the kidney area, which persists for several days in a row and is accompanied by fever, chills, and dyspepsia (urinary disorder) are signs of diseaseacute pyelonephritis. . .

Back pain in the back

Pelvic processes (uterus, appendages, bladder, bowel) cause pain localized in the abdomen. However, there are often secondary hypertonic syndromes (reflex disturbances in the gluteus medius and midgut muscles, piriformis syndrome, pelvic floor syndrome, sympathomimetic syndrome) associated with lumbar spondylosis withChronic processes in the organs and tissues of the small pelvis. Such patients need to be treated collectively with a neurologist-neurosurgeon, urologist, gynecologist, obstetrician.

Lower back pain

Tumors of the pelvis, especially at the onset of the disease, can mimic migraine, and in the presence of concurrent osteogenesis, patients sometimes require neurosurgical intervention. for lumbar hernia. This concernchondrosarcomas, Ewing's sarcomas, reticulosarcomas, osteoblastomasand some others. Mandatory X-ray examination often resolves the diagnostic problem. It should not be forgotten that the general somatic and hematological status of the patient can determine the oncological aspect of the disease.

Low back pain and pelvic pain

Difficulty in differential diagnosis is noted in the latent course of pelvic tuberculosis, in the absence of an increase in temperature and ESR, and the pain may resemble a lumbar ischialgic syndrome of lumbar osteonecrosisback. This process can proceed secretly from childhood and adolescence and manifests itself in adults in the form of sacral osteomyelitis. In recent years, the problem of tuberculosis has become urgent again, and doctors must keep in mind the manifestations of this disease.

So, pain in the lumbar region and in the lower back is not usually associated with any disease of the spine and is an alarming symptom of completely different diseases of the internal organs. Therefore, in the case of back pain, a comprehensive examination is required.

Low back pain in women - causes

Relieve back pain

Low back pain in womenoften associated with premenstrual syndrome. Such pains are usually of a pulling nature, they occur a few days before menstruation and continue for 2-3 days after the onset and disappear on their own.

Lower back pain and abdominal pain in women

Lower back and abdominal pain associated with PMS and accompanied by lower abdominal cramps and dysmenorrhea with heavy bleeding can be symptoms of serious reproductive problems such as:endometriosis, uterine fibroids, polycystic ovary disease (PCOS)and so on.

Abdominal pain spreading to lower back

Abdominal pain in women may radiate to the lower back, lower abdomen, vagina and external genitalia.

It is important to remember that pain in the abdomen and lower back in women can be a symptom of dangerous disorders in the pelvic area such as the formation of uterine fibroids, prolapse.endometrial tissueoutside the uterus, the formation of adhesions, cancer of the reproductive organs, etc. v.

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

Low back pain during pregnancy

Usually, back and lower abdominal pain in women indicates natural physiological changes related to the increase in size of the uterus during the development of a normal pregnancy.

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

Lower back pain in men - causes

Low back pain in men is often related to degenerative spine diseases, especially when doing heavy exercise, working related to lifting weights. In addition, lower back pain can be associated with various diseases of the internal organs.

Severe back pain

Sharp pain in the lumbar spine can occur with clumsy movements, improper load distribution, etc. v. This pain is often associated with muscle spasms or displacement of the vertebral disc. Pain can also be caused by muscle clamping of the nerve roots of the spine.

Back and groin pain

Pain in the groin area in men, radiating to the lower back can be related to prostate tumors, testicular torsion, cancer, urinary diseases, etc. v.

Classification of back pain

The classification, common in some countries, is intended to optimize medical care delivery for LPS, distinguishBNS specific, lens, and nonspecific. . .

Specific back painis a symptom of a certain disease, often severe and even life-threatening (cancer, including metastases to the spine; infection - tuberculosis, spinal osteomyelitis, epidural abscess, etc. ). . . ; inflammation, - eg, ankylosing spondylitis and other inflammatory diseases of the spine; vertebral trauma and fractures; abdominal aortic aneurysms, gynecological, urological and renal diseases, spinal stenosis andcauda equina syndrome, etc. ).

Specific LPS is often associated with a "red flag" characterization of pre-existing disease, which helps physicians suspect a patient for serious illness and provides a targeted examination (preferably with the involvement of a specialist). appropriate clinic) to establish the correct diagnosis and treatment.

Lenticular (lenticular) pain in the lower back, including sciatica, is the result of compression on the spinal roots.

The management of patients with lenticular LNS is the prerogative of a neurologist, with special indications requiring the involvement of a neurosurgeon. In fact, such patients often resort to the help of chiropractors.

Among the lens pain in the lower back are distinguished:

  • low back pain,orlow back painC & ocirc; ng;
  • paralysis- long-term pain only in the lower back;
  • lumboishalgia- Back pain radiating down the leg.

Non-specific lower back pain- most commonly, not associated with any visceral disease, serious pathology of the spine, spinal cord and its roots. It can be caused by overload of the lumbar spine, especially related to heavy lifting, prolonged uncomfortable posture while sleeping or working, etc. v.

It is therefore entirely reasonable that planned spine radiographs are not included in the recommendations to examine patients with nonspecific low back pain syndrome (NLP). Such patients do not require mandatory consultation with a neurologist but should be treated by a family physician, district therapist or general practitioner.

Low back pain and "lumbar osteonecrosis"

Lumbar bone necrosis(Lumbar spine osteosarcoma)- the most frequent diagnosis, given to patients presenting with pain in the lumbar spine. However, it is not possible to identify each individual case of developing a pain in the lower back with a true frequency present in a patient with "degenerative-dystrophic" spinal changes, making a "habitual" diagnosis."Acute exacerbation of osteonecrosis"or simply"Osteochondrosis". . .

For pain in the lower back or lower back, the diagnosis is usually written as:"Lumbar myopathy. Lumbar bone tumor. Sciatica. Lumbization". . . Although, the correct diagnosis in this case would look like this:"Low pain with sciatica against a background of degenerative lumbar spine disease. Polarization. (code М54. 4)".

It should be noted that there is no nosological unit in any foreign classification of degenerative-dystrophic diseases. "spondyloarthritis". . . Furthermore, not the term"Osteochondrosis", nor any other term describing dystrophic changes in the spine, should not be used as a synonym for the clinical diagnosis.

Chondrosisis a dystrophic change in the disc cartilage,bone necrosis- dystrophic changes in the intervertebral disc and adjacent vertebral bodies. However, both radiologists and clinicians lack understanding of the signs of dystrophic changes in the spine.(fibrocartilage disease, osteonecrosis disease, spondylolisthesis, spondylolisthesis, hyperostosis cure, etc. )leads to overdiagnosis: these types of pathologies are found where they are not.

Usually, osteonecrosis is referred to as all the listed degenerative changes because the difference between them is not known. By mistake, osteonecrosis includesdisc herniation, which is the result of rupture, and as a rule, a normal disc and is not altered by the dystrophy process. Although, calling cartilage degenerative disc herniation is also wrong like breaking meniscus in the knee joint - osteoarthritis.

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

Many modern authors, mainly foreigners, emphasize the absence of a link between the presence of radiographic findings of degenerative changes in the spine and the appearance or intensity of the spine, on the one hand. of lower back pain (LBS), on the other hand, since only 1 in 10 patients have radiographic findings of degenerative spondylolisthesis that are clinical manifestations of the disease.

Back pain treatment at home

For low back pain associated with muscle tension and strain, low back pain ointment can significantly relieve symptoms and help relieve muscle tension.

Ointments and back pain relievers

Ointments and creams are used to treat the lower back. Alternatively, you can take medications that contain non-steroidal anti-inflammatory drugs (NSAIDs).

At the same time, it must be remembered that self-treating low back pain at home with creams, ointments, mustard lotions and other procedures can lead to ignoring the underlying disease causing these pains and causing pain. very sad consequences. Self-medication for the lower back is especially dangerous for kidney diseases such asacute pyelonephritisorkidney painrequire emergency qualified medical care.

Prevention of low back pain

People who have had an attack of the disease, especially before the disease is in stable remission, need to follow some guidelines for prevention:

  • Do not tilt the body without support on the arms; Pick up objects from the floor with your knees.
  • Change body position more often, do not stand for long, do not sit.
  • Working at a desk or workplace, keep an upright position, one leg bent at the knee, in front of the other.
  • Be careful when performing specific yoga or aerobics exercises without the prescription of an exercise therapist or spine specialist.
  • Beware of hypothermia, drafts, as well as prolonged heating in a hot tub, as muscle relaxation will take away the corset's permanent protection for a while.