Back pain, lumbar region - Causes, symptoms and treatment. MF.

Lower back pain may occur right, left, pregnancy( early and late term).

Pain in the lower back is a kind of mankind's payback for straightness, when the greatest burden falls on the lumbar spine, bearing the main burden of the mass of the human body. Impact on the spine and have disabilities, malnutrition, obesity, stress. For many, back pain( lumbalgia) is so common that it becomes part of everyday life. It can only occur once and disappear without a trace, and can come back again and again. As a rule, the majority of patients recover within 2-3 months, only a small number of patients with complaints of lumbar symptoms are diagnosed with serious diseases.

Lumbar pain can be of a different nature - aching after prolonged sitting or sleeping at night, or sharp shooting pains, which are found in the most uncomfortable pose and do not give an opportunity to straighten. The pains can be associated with by jamming the nerve roots , by irritation of the nerve of the vertebral column, and

with swelling and irritation of the muscles and ligaments of the in the innervation zone of the lumbar spine, or may be sacrificed in internal organs .The most famous lumbar syndromes are lumbago and sciatica( lumboschialgia).

Back pain can be divided into primary and secondary.

The causes of primary pain in the back of the are due to the pathology of the spinal column - dystrophic and functional changes in vertebral joints, intervertebral discs, muscles, tendons, ligaments.

The spine is a series of vertebrae, interconnected by elastic tissues - muscles and ligaments. They( except for bone tissue) contain nerve endings and can become a source of pain in the back.

Secondary back pain syndrome is associated with traumatic spinal lesions, tumor and infectious processes, diseases of internal organs, including pelvic organs in women, osteoporosis and other pathologies. This is a kind of alarm signal about problems in the body. Back pain has many causes, not necessarily related to the pathology of the spine. Especially common causes of constant low back pain are benign and malignant diseases of pelvic organs in women and men( endometriosis, uterine myoma, dysmenorrhea, inflammatory diseases of the ovaries, lesions of large vessels, kidneys, chronic prostatitis, certain diseases of the nervous system).

The most common cause of back pain is osteochondrosis, which is manifested by pinching of the nerve roots leaving the spinal cord at one level or another.

Back pain, spine osteochondrosis, disc hernia, disk protrusion

There are many health conditions that lead to pain in the spine( back and waist).Some of them are congenital, like the back of Bifida( spina Bifida), others are formed with age( osteochondrosis, spondylosis, spondylarthrosis, osteoporosis, etc.).However, most of the causes of pain in the spine( back and waist) in the working-age population are related in their origin with the same physical loads at work( sitting behind the wheel in the car or sitting at the computer) and spinal injuries.

In outpatient practice, in patients with osteochondrosis of the spine, the most common memory mechanism is the occurrence of back pain. The appearance of a persistent pain symptom in the spine( back and waist) against the background of already existing osteochondrosis is preceded by the presence of discomfort in the patient for a long period of time.

Pain in the spine( back and lower back) is much less common among people who lead a sporty lifestyle. Prevention of the development of osteochondrosis of the spine and the appearance of pain in the spine( back and lower back) are promoted primarily by self-employment in gymnastics, active rest. This removes the daytime workload of the same muscles, ligaments and joints of the lumbar spine.

The compression of the sciatic nerve with the development of pain in the leg with osteochondrosis of the spine with herniated disc.

Common causes of pain in the spine( back and lower back) include:

• muscular spasm( acute or chronic)
• protrusion or hernia of the intervertebral disc( with possible nerve blocking)
• degenerative processes of the spine( osteochondrosis, spondylosis, spondylolisthesis)
• Scheerman-Mau disease
• Bechterew's disease
• spinal stenosis
• is sacroiliitis( inflammation of the sacroiliacarticulation)
• arthrosis of the sacroiliac joint
• arthrosis of the intervertebral joint( spondylarthrosis), etc.

Back pain in lumbar osteochondrosis

Lower back pain in osteochondrosis can be aggravated by coughing and sneezing, with any movement, especially when the torso is tilted forward. Along with back pain, lumbar osteochondrosis can be manifested by a violation of the sensitivity of certain areas of the skin or muscles of the lower half of the trunk and legs, the weakening or disappearance of tendon reflexes of the legs. As a rule, with osteochondrosis, there is a curvature of the lumbar spine. Depending on the plane in which the curvature occurs, scoliosis is distinguished( curvature to the right or left), lordosis( forward curvature) and kyphosis( smoothing of the lumbar region or even curvature of the lumbar region).In the event that there is a pinching of the spinal cord during osteochondrosis, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.

However, the most common lumbar osteochondrosis is manifested by radicular pain - i.e. Developed as a result of pinching the nerve roots, leaving the spinal cord at one level or another. So, one of the widely known lumbar syndromes is lumbago. It occurs at the time of physical stress or in an awkward position of the body, and sometimes without any apparent cause. Suddenly, within a few minutes or hours, there is a sudden shooting pain( "lumbago"), often it is searing and bursting( "as if the stake was stuck in the lower back").The patient freezes in an uncomfortable position, can not straighten up if the attack occurred at the moment of lifting the severity. Attempts to go down from the bed, cough or bend the leg are accompanied by a sharp increase in pain in the lower back and sacrum. If the patient is asked to stand on his feet, then a sharp immobility of the entire lumbar region is revealed due to muscle tension.

Backache in lumbago

Lumbago( lumbago, Latin lumbus loin, synonym for lumbago) is an attack of sudden and severe pain, as well as muscle strain in the lumbar region. It occurs, as a rule, at the time of physical activity or after it, and is provoked by overheating and subsequent cooling of the body.

Back pain with lumbago appears in the initial stage of the dystrophic process in the intervertebral disc, the gelatinous nucleus of which loses its elasticity and breaks up into separate fragments. Fragments of the nucleus with physical stress and movements of the spinal column exert pressure on the fibrous ring containing sensitive receptors. The irritation of the receptors in the segment of the spine is the cause of pain, reflex reactions and tonic tension in the muscles of the lumbar region.

The nature of the suddenly emerging sharp pain in the lower back is vomiting, pulsating, piercing, and shooting. The patient can not straighten, the muscles of the back are strained. The slightest movement, coughing or physical exacerbation aggravates the pain. Pressing on the lower back causes pain. During an attack a person becomes helpless, freezes in a forced posture, any movement attempt increases pain, spasm of the muscles of the lumbar region develops. Duration of pain in the waist from several minutes to several hours and days. At rest and lying on a hard surface, the acute pain subsides. Sometimes severe pain disappears as suddenly as it appeared. In this case, patients have a feeling that "something has come to its place" in the lower back.

In repeated attacks, lumbago pains often appear in the posterior or backside of the thigh or shin( lumboscialgia), which indicates the involvement of the corresponding spinal roots in the pathological process.

Sciatica develops as a result of pinching of the root, located somewhat lower than with lumbago.

Backache in sciatica

Sciatica( Greek ischiás, from ischíon - pelvis, hip, plural ischía - seat), lumbosacral radiculitis, disease of the roots of the lumbosacral spinal cord and, mainly, of the sciatic nerve. This nerve is the largest in the human body. It originates at five different levels of the spinal cord in the lumbar spine, the department bearing the main load. Then the sciatic nerve descends down the leg, dividing into smaller nerves that go into the thigh, knee, shin, ankle joint, foot and fingers. Because of the large length of the sciatic nerve and its close connection with many organs, sciatic nerve diseases are very common.

Pain in sciatica is the most diverse. Among the possible varieties of pain and sensation are shooting pain, burning, tingling, "creepy" and numbness at the same time. The pain in sciatica can be so severe that the patient can not sleep or perform such necessary actions as sitting, standing, walking, bending over or turning around.

Shooting pains occur in the buttock and the back of the foot, usually on one side of the body. As with lumbago, they become worse when the position of the body changes. On the leg are particularly painful for touching areas - it's bone protrusions on the lower edge of the buttock and in the knee area. Along with this, painful nodules are found in the muscles of the thigh and lower leg.

Attacks of lumbago and sciatica tend to repeat throughout life. Therefore, it is very important to identify the type of load or position of the body that provokes their appearance. This will prevent the development of seizures. Acute manifestations of diseases are stopped by analgesics, anesthetizing blockades in the spine, as well as special methods for stretching the spine and the gluteal region. The treatment of the syndrome should be complex.

Back pain in kidney disease

Pain in the lumbar region is one of the characteristic signs of kidney disease.

For kidney pathology, there is a constant "dull" aching pain in the costal-vertebral corner from the side of the diseased kidney. Often the pain radiates( "gives") in the hypochondrium, the navel and the lower abdomen. The described pain is caused by rapid stretching of the renal capsule, for example, with swelling on the background of acute pyelonephritis or a blocked ureter. Meanwhile, many diseases - chronic pyelonephritis, hydronephrosis, malignant tumors and polycystic kidneys - flow without pain, since they are accompanied by very slow stretching of the renal capsule.

Possible causes of back pain

Low back pain can occur if you:

- Spend a lot of time driving a car or computer
- Engaged in dynamic physical work with a sharp change in body position( especially if your specialty is associated with severe physical exertion)
-Excessively stress yourself in the gym or fitness club. Be extremely careful if you started training recently
- Lead predominantly sedentary( office workers) or stand-up( sellers, waiters, street advertising employees, surgeons) lifestyle
- Take a great interest in summer work
- Suffer excess weight
- Additional risk for women
-Are you pregnant or have recently given birth
- Have reached postmenopause, which has to develop osteoporosis

Diseases that cause back pain

- Osteochondrosis of the spine
- Benign and malignant diseases of the pelvic organs.(diseases of the prostate, including chronic prostatitis, the presence of certain diseases in the pelvic region, for example, tumors).
- Hernia of the intervertebral discs
- Back pain, appearing after a long walk, indicates the possibility of stenosis of the spinal canal. The disease manifests itself as a syndrome of spinal( pseudo-intermittent) lameness. The patient complains of pain and cramps in the lower back and buttocks that appear when walking. The pain calms down in a sitting or lying position, but again reinforces with the resumption of physical activity.
- Rheumatic polymyalgia is a syndrome that develops in elderly patients, which usually begins with gradually increasing pain and stiffness in the proximal parts of the upper limbs, rheumatic polymyalgia can also be manifested by pain in the proximal parts of the lower limbs and lower back.

1. Osteochondrosis( dorsopathy) is the most frequent source of pain in the lower back. At the examination, degenerative diseases of the spine are detected - osteoarthritis, osteoarthritis, osteoporosis. The height of intervertebral discs decreases, which leads to disturbances in the mechanical balance between the structures of the spinal column - hence the constant, quite tolerable, but periodically increasing pain in the lower back.

2. Muscular spasm .When performing unusual and intense and excessive physical exertion, acute back pain appeared? Predisposing factor - a long static wrong position of the body( behind the computer, squatting, bending in half during the summer work).As a result, muscle spasm develops, which limits the mobility of a certain part of the spine. The clenched muscles become a source of suffering, triggering a vicious circle of "back pain - muscle spasm - pain."This condition can persist for a long time and causes many unpleasant minutes. Attention! With constant low back pain, especially if it starts quickly and acutely, see a doctor to identify the diseases that caused it and develop a modern and proper treatment.

3. The herniated intervertebral disc , which compresses the roots of the spinal cord, is especially common in men older than 40 years. The first symptom of ill-being is lumbulgia in combination with a number of additional signs: pain along the root from the buttock to the foot when coughing, sneezing and laughing, difficulties with tilting and extension of the spine in the lumbar region( this is especially evident when wearing socks and shoes)sensations when lifting a straight leg lying on his back. This back pain is often called the obsolete term "radiculitis" or the prosthetic word "chamber".The pain intensifies in an upright position and subside in the horizontal position.

4. Spine instability is a typical problem for middle-aged women. It is manifested by pain in the back, which increases with prolonged physical activity and standing. This gives a feeling of fatigue and a desire to lie down. The disease is caused by a lesion of the disc or the intervertebral joint and often occurs against a background of moderate obesity. It is hard for such patients not to bend, but to straighten themselves, to do "unnecessary" movements.

5. Narrow vertebral canal. The most common symptom is pain at rest in combination with pain when walking. It spreads along the root from the buttock to the foot, and it always hurts, even when lying or sitting, until it is impossible to sit on the "sick" buttock. The syndrome of the narrow spinal canal is the result of degenerative changes, growth of the bony and articular structures of the spine, which leads to infringement of the roots of the spinal nerves. Your actions. Whatever the cause of back pain, it is impossible to determine it. If the back does not give rest, day or night, it is better to turn to a specialist in time to tell the tactics of treatment.

Diagnosis for back pain

For back pain and lumbago, it is recommended to go through a computer( shows the condition of the bone tissues of the spine) and magnetic resonance( allows to assess the state of soft tissues) tomography and make ultrasound of internal organs.

One of the diagnostic methods is radiography - a relatively cheap method, and can be useful for identifying a variety of disorders, from bone fractures to kidney stones. Many of the changes detected can only provide a correct diagnosis, and additional studies may be required to confirm it. In addition, some radiologic changes may be associated with findings that are not the cause of pain.

Diagnosis of lumbar pain, spinal osteochondrosis, disc herniation,

disc protrusion All begins with a neurologic and orthopedic examination by a doctor. In this examination, the neurological status of the patient is assessed, and possible violations in the biomechanics of the spine with mandatory assessment of the muscles of the back and gluteal region are identified. Already at this stage of the study, a patient with osteochondrosis and back and lower back pain can be diagnosed and treated.

Sometimes, according to the results of a neurological and orthopedic examination of a patient with a pain symptom against a backbone osteochondrosis, the following diagnostic procedures can be prescribed:

• X-ray of the lumbosacral spine with functional tests
• CT of the lumbosacral spine
• MRI of the lumbosacral spine

Nerve compression of a hernia of the intervertebral disc with the appearance of pain in the leg with osteochondrosis of the spine.

The center of the intervertebral disc occupies a gelatinous pulpous nucleus. It is surrounded and supported by a fibrous ring consisting of fibrous-cartilaginous and connective tissue. More on this can be found in the article about the anatomy of the spine and the human spinal cord.

The thickness of the discs decreases, the bodies of the vertebrae approach each other, reducing the intervertebral foramen and jeopardizing the nerves and vessels in them( osteochondrosis).

Spondylolisthesis( vertebral displacement) with spinal instability with nerve compression.

Disk protrusion( protrusion of the intervertebral disc) with their further fall into the lumen of the vertebral canal( herniated intervertebral disc) often leads to compression of the nerve roots, causing pain along the compressed nerve( pains that give up the leg, hand, neck, neck, intercostal spacesdepending on the level of compression of the nerve) with a weakening of the muscle strength in the areas of their innervation and a violation of sensitivity.

Often protrusion or a herniated intervertebral disc is accompanied by muscle pain along the nerve( along the arm or leg).At the same time, one or at least( rarely) two nerves are squeezed.

In addition to nerve compression, the stability of the vertebral segment may also be impaired. With instability of the spine, the vertebra is displaced forward( anterolisthesis), or backward( retrolistesis).To clarify the diagnosis, it may be necessary to conduct X-rays of the lumbosacral spine with functional tests.

Scoliosis of the spine with a protective spasm of the back muscles against the background of the spine osteochondrosis with a hernia or protrusion of the intervertebral disc.

The most common suffer from the compression of the hernia or protrusion of the intervertebral disc is the nerve bundles that form the sciatic nerve in view of their anatomical location. Sciatic nerve consisting of fibers L5, S1, S2, S3 - spinal nerves.

Stenosis of the spinal canal with compression of the spinal cord.

A hotbed of chronic inflammation in the lumen of the spinal canal can lead to its narrowing( stenosis of the spinal canal) and compression of the nerves and spinal cord passing through it. That is why when stenosis of the spinal canal is always necessary to complete a full course of treatment using a whole arsenal of different treatment techniques, and in case of inefficiency - surgical treatment.

Treatment of back pain

Treatment of back pain, spinal osteochondrosis, disc herniation, disk protrusion

Depending on the severity of the manifestations and the causes of pain in the back and lower back against the background of spine osteochondrosis with disc herniation or protrusion of the disc, the following therapeutic actions are possible:

• drug therapy( NSAIDs, analgesics, hormones)
• blockade - injection of drugs into the intervertebral joint, spinal canal, into trigger points in the muscles
• manual therapy( muscular, articular and radicular technique)
• physiotherapy( UHF, CMT, etc.).)
• Curative gymnastics
• Acupuncture
• Surgical treatment
• Application of funds based on a group of vitamins B with pain caused by neuralgia. Studies have shown that the intake of a complex of vitamins B1, B6, B12 has a positive effect on the nerve tissue in diseases such as neuritis, radiculitis and various neuralgia. For the analgesic effect and restoration of the structure of the nerve, it is recommended to use Neuromultivitis - a drug containing a combination of vitamins B1( 100 mg), B6 ​​(200 mg) and B12( 200 mg) in dosages higher than in standard multivitamin preparations. The use of a complex agent is more effective than the use of analgesics: the drug not only relieves unpleasant symptoms, but also eliminates the cause of pain. The drug is available in the form of tablets, which is especially convenient for use at home and at work, and the economical packing of 60 tablets is enough for a full course of treatment.

In the treatment of pain in the back and lower back against the background of spine osteochondrosis with a disc herniation or disc protrusion, elimination of swelling, inflammation, soreness, restoration of the volume of movements in the joints and muscles of the waist is accelerated by the use of physiotherapy.

Intervertebral joints( facet joints) can also be treated with therapeutic blockade, when conventional treatment does not have a positive effect. Usually, low doses of the anesthetic and cortisone injected into the lumen of the affected joint are sufficient for this purpose.

The use of acupuncture is very effective in the treatment of pain in the back and lower back against a backbone osteochondrosis with a disc herniation or protrusion of the disc.

When combined with a properly selected physiotherapy regimen, these therapeutic blockades can give a good and lasting effect for lumbar pain and pain in the sacrum with a disc herniation or protrusion of the disc in a patient with osteochondrosis of the spine.

In the treatment of pain in the leg and buttock on the background of spine osteochondrosis with a herniated disc or disc protrusion, the elimination of soreness, tingling and restoration of sensation in the leg with neuritis of the sciatic nerve in case of its compression by hernia or protrusion of the disc is accelerated by the use of physiotherapy.

Wearing a semi-rigid lumbosacral corset in the treatment of pain in the back and lower back against a backbone osteochondrosis with a disc herniation or protrusion of the disc helps to limit the amount of movement in the lumbar spine. This primarily helps reduce pain in the area of ​​inflammation of the intervertebral joints and remove excessive protective tension and spasm of the muscles of the back.

A variant of a semi-rigid lumbosacral corset that helps in the treatment of pain in the back and lower back against a backbone osteochondrosis with a disc herniation or protrusion of the disc.

In such a corset, a patient with back and lower back pains against a background of spinal osteochondrosis with herniated disc or protrusion of the disc can move independently at home and on the street, and even sit in the car and in the workplace. The need to wear a corset in a patient disappears as soon as pain passes in the back.

But it must be remembered that during the period of exacerbation of pain in the back and lower back against the background of osteochondrosis of the spine with a herniated disc or protrusion of the disc, work loads should be avoided and peace should be observed. This is a temporary restriction, but it significantly shortens the recovery time and, against the backdrop of treatment, does not allow the spine disease to develop further.

A variant of a semi-rigid lumbosacral corset that helps in the treatment of pain in the back and lower back against a backbone osteochondrosis with a disc herniation or protrusion of the disc.

There are several types of lumbosacral semi-rigid corsets. All of them are selected individually in size and can be repeatedly used in case of repeated occurrence of pain in the back and lower back against the background of osteochondrosis of the spine, as well as to prevent possible exacerbations of the pain symptom.

Doctor's recommendations for back pain

• Relax for 2-5 days. It's about bed rest on a hard flat surface.
• Wear a special bandage if necessary.
• Take painkillers and inflammatory drugs - non-steroidal anti-inflammatory drugs. The most effective are ketoprofen, diclofenac, ibuprofen and others. They are released in tablets, injectable solutions and in the form of ointments.
• A specialist can prescribe muscle relaxants to relieve muscle spasms, as well as diuretics and vascular drugs - to reduce the edema of the nerve root and improve blood circulation in the affected area.
• Recently, at the disposal of doctors have the means of double action - boleutolyayuschiie and miorelaksiruyuschee( muscle relaxation), which is very important in the treatment of pain in diseases of the musculoskeletal system and muscle spasm. This is Cathadolone( flupirtine), which has a triple effect - analgesic, myorelaxing and neuroprotective( protecting nerve cells from damage).In fact, this is a fundamentally new approach to the treatment of back pain.
• To resort to local therapy with ointments and gels containing painkillers, anti-inflammatory or warming ingredients.
• To undergo a course of physiotherapy to consolidate the positive effect, when your health will improve. Physiotherapy( magnetotherapy, electrophoresis, phonophoresis), as well as massage and physiotherapy relieve muscle tension, improve blood circulation and stop the inflammatory process

back pain on the right or the left

back pain right often indicate genital diseases( mainlyright appendages of the ovaries and pelvic peritoneum), the process of the blind intestine( appendix), right kidney, ureter, intestine, hernia, diseases of the abdominal wall.

Backache the left as well as right and, more often indicate genital diseases( mainly leftist appendages ovaries and pelvic peritoneum), left kidney, ureter, colon, hernia, diseases of the abdominal wall.

Which diseases arise pain on the right or the left:

Also back pain on the right may provoke the following diseases:

1. Diseases of the spine( lumbar vertebrae, sacrum, pelvis):
- Congenital anomalies: spondylosis, spondylolisthesis, lyubalizatsiya, sacralization.

- Acquired disease:
- trauma,
damage - inflammatory disease( spondylitis, sacroiliitis, osteomyelitis)
- degenerative conditions( spondylosis, spondylarthrosis, thickening yellow ligament)
- tumors.

2. Diseases of the muscles( lumbar and sciatic):
- traumatic injuries, inflammatory diseases.

3. Nervous System Disorders lumbosacral area:
- malformations nervous system, inflammatory disease( nevromialgiya, right-neuritis, plexitis, sciatica);
- metabolic disorders: general metabolic disorders( diabetes, gout), local metabolic disorder;
- compression of nervous elements( nerve columns, roots);
- functional diseases( neurasthenia, hysteria);

4. Diseases of internal organs:
- diseases of the abdominal cavity( kidneys, intestines);
- organs of the pelvic region( uterus, its appendages, parametric fiber and peritoneum, bladder).

To which doctor should I apply for back pain:

As a rule, low back pain is temporary and benign. Only a few pains in the back are chronic in consequence of any serious diseases. Most often, sharp and unexplained lumbar pains appear against the background of an unusual for the patient and intense physical activity.

If the pain is not a result of heavy physical exertion, then you should contact a specialist, for example, a manual therapist, a surgeon, a urologist, for a more thorough examination and diagnosis.

Back pain may require medical advice:

Gastroenterologist
Infektsionist
Trauma
Podiatrist
Chiropractor
therapist
Family Doctor
Cardiologist
Pulmonologist
Urologist
Nephrologist
Gynecologist
proctologist
surgeon
emergency doctors

back pain during pregnancy

During pregnancy, all the functions of the female organism to workwith increased load, ensuring the correct development of the baby. It is not surprising that in such harsh conditions, weaknesses in the health of the future mother are revealed. In particular, with fetal growth, the center of gravity of the body of the pregnant woman changes, and pains appear in the lower back.

According to statistics, the incidence of pain in the spinal column, pelvic area and pelvis during pregnancy is 30 - 50%, and in the puerperium reaches 65 - 70%.

Causes of low back pain during pregnancy:

Causes of back pain in early pregnancy

During pregnancy, the thigh joints, which are usually immobile, begin to relax under the action of the hormone relaxin, so that the baby can easily pass during childbirth. This, as well as an enlarged abdomen, disturb the balance. To compensate, you have to take your shoulders back and bend your neck. Stumping of the abdomen, so that all notice the condition of the mother, only complicates the problem. As a result - a strongly arched spine, tense muscles of the waist, as well as pain.

If before pregnancy you had problems with the musculoskeletal system:
- curvature of the spine;
- osteochondrosis;
- a weak development of the muscles involved in the pelvic incline,
, then you are at risk for lumbar and pelvic pain.

Painful sensations in different women can appear in different periods of pregnancy. As a rule, this occurs not earlier than the second trimester, i.e.approximately from the fifth month( 20 weeks).

However, pain in the lower back can occur before. For example, it depends on the lifestyle that the future mother leads.

By the eighth month, when the termination of pregnancy is around the corner, the pain can intensify - and not only because of the growing weight. But also because the head of the child can press on the lower back.

In late pregnancy, the woman's body prepares for childbirth, conducting "painful exercises".Some women experience very intense pain, others, on the contrary, hardly feel or feel them at all. Due to the approach of the delivery of pain, you will learn this: the abdominal wall suddenly becomes strained and becomes noticeably firmer to the touch than usual. This phenomenon appears especially often when you apply physical efforts, experience orgasms or are sad and angry, but sometimes for no apparent reason. If your belly then becomes soft again, then you do not have cause for concern.

Pain in late pregnancy indicates a critical condition in the case when the cervix is ​​shortened, and the uterine pharynx begins to open.

Back pain in late pregnancy.

1. Back pain in late pregnancy is observed in almost half of women. Most often, this pain is associated with increased stress on the spine and a weakening of the abdominal muscles due to their hyperextension. Usually, such pain appears after the 5th month of pregnancy, but decreases and passes only after childbirth. The pain sometimes "gives" in the leg, and is strengthened after physical exertion, prolonged walking, prolonged standing, sitting in an uncomfortable position. Pain in the region of the pubic joint( pubis) and sacroiliac joint( felt in the region of the hip joints and the anterior surface of the thigh) is caused by a slight softening of the ligaments caused by changes in the hormonal background in pregnant women and the production of the hormone relaxin.

Cope with the pain in the back with a diet rich in calcium, which includes dairy products, nuts, fish, meat, greens. If the pain in the lower back and pelvic bones is worried regularly, then you should take calcium carbonate or lactate. Pregnant women should also avoid movements that increase the burden on the back. Lifting anything off the floor, you have to squat and strain the muscles of the shoulders and legs, but not the back. Sitting should be based on the back of the chair, and in any case you can not sit "on the swing", sharply, as this affects the intervertebral discs. For sleep it is necessary to choose an orthopedic mattress, semi-rigid and elastic. The cushion should be of medium size, better - of an anatomical shape, taking into account the natural curves of the spine. Shoes should be worn comfortable with a low and stable heel. And of course, physical exercises that strengthen the muscles of the abdomen, back, thighs and buttocks are indispensable: aerobics, aqua aerobics, swimming.

2. Various neurological diseases, for example, a herniated disc, lumbar radiculitis can also cause back pain in later pregnancy. Treatment in this case involves bed rest, soft corset or bandage, therapeutic exercise, occasionally - the use of pain medications. Prolonged pains in the forearm and gait disturbance are signs of symphysopathy, a hereditary disease associated with considerable stretching and softening of the lonnous articulation and hemorrhage into it. In this case, the treatment is carried out permanently, and the entire pregnancy is carried out under the vigilant supervision of the doctor.

3. Periodic low back pain, in which the tension of the uterus is felt( it "seems to be" stony "), are found in the so-called Braxton-Hicks false bouts. These "training fights" in late pregnancy prepare the body for childbirth. However, if the gestation period is less than 37 weeks, there is secretion from the genital tract, pain is felt in the lower abdomen, and the intervals between contractions are reduced, this may indicate a threat of termination of pregnancy. In such a situation, it is urgent to seek medical help.

Other causes of back pain during pregnancy:

Pain in the lumbar region may be associated with pancreatitis, pyelonephritis, urolithiasis( the stone in the kidney is mobile and traumatizing the urinary tract mucous, causing pain).

1. Pancreatitis is an inflammation of the pancreas. Its development is favored by the violation of outflow of bile, non-compliance with diet, in particular abundant meat and fatty foods, alcohol consumption, hereditary predisposition, stress. But immediately I must say that during pregnancy this disease occurs, fortunately, quite rarely. Acute pancreatitis is manifested by acute pain in the upper abdomen( epigastric region, right or left hypochondrium), lower back, more often surrounding nature. Often there is vomiting, a stool, a decrease in blood pressure, In this case, you need to call an ambulance or go to the hospital itself.

Laboratory tests of blood and urine, ultrasound, FGDS( fibrogastroduodenoscopy), MRI, etc. are used for the diagnosis of the disease. Most often, the treatment is conservative, in a hospital. A strict diet, preparations for the normalization of the function of the pancreas, as well as anti-inflammatory and anesthetic agents are prescribed. In severe disease, surgery is not ruled out.

2. In kidney diseases, pains in the lower back are pulling, aching - with pyelonephritis( inflammation of the kidneys) or sharp, cramping - with renal colic usually associated with movements of the stone from the renal pelvis to the ureter. With colic, the pain is so severe that it is almost impossible to find a position in which it could be tolerated. Sometimes the pain spreads along the ureter, toward the groin and urethra. It is often possible to loosen it with the help of heat, attaching a heating pad to the waist region. Another symptom of this disease is a change in urine;it becomes turbid, in some cases there is an admixture of blood. In addition, with pyelonephritis, a temperature increase is possible,

To establish the diagnosis, ultrasound is performed, laboratory tests of blood and urine. For the treatment of pyelonephritis antibacterial drugs are prescribed - it is better if they are selected individually, taking into account the sensitivity of the microorganisms that caused the inflammatory process. Treatment can be done on an outpatient basis, but more often in a hospital. With renal colic, antispasmodics are used to reduce pain, anesthetics, and inflammatory prophylaxis. If the stone is small in size, it is possible that it will come out on its own, But if the stone is large and covers the lumen of the ureter, then it may need to be removed promptly.

How to ease back pain during pregnancy

In the early stages of pregnancy, women usually suffer from painful sensations in the lumbar region. However, this pain can absolutely disappear after the twentieth week of pregnancy. Most women suffer from back pain in the early stages of pregnancy due to softening of supporting ligaments and discs and because of the increase in the hormone progesterone. If during pregnancy the woman is ill with any infectious disease of the bladder, then this can also be the cause of back pain. Constant pain in the lower back of pregnant women is due to the fact that the center of gravity of the abdomen changes, in which the child grows and develops.

The best way to overcome back pain during pregnancy is to do physical exercises. The sooner you start exercising, the faster you reduce the signs of lower back pain. In addition, you will support your body in tone and be ready to ensure that during labor, you have good attempts, which will facilitate childbirth. You must pay attention to your posture. If the doctor has determined that your posture affects your signs of lower back pain, you need to pay special attention to how you walk or sit during pregnancy, then it will be easier for you to cope with the pain, since posture plays a major role especially onearly pregnancy.

Every time you sit or stand, pay attention to the position of your back, it should be straight in relation to your shoulders, and in no case do not slouch. In the last weeks of pregnancy, women suffer from back pain due to the fact that the abdomen increases, the baby develops even more intensively and the woman has to stoop to cope with the extra weight. This can again lead to stress, which will cause back pain.

Pay proper attention to ensure that you get enough rest and sleep. You need to avoid stressful situations, nervous tension, which can only worsen the situation with back pain during pregnancy. Another way that will help you cope with the painful sensations in the lumbar region is to connect the yoga postures to the basic physical exercises. Massage will also help you, but only one that is allowed to pregnant women, which is also effective in the early stages of pregnancy. You will be able to relieve your back pain if you do the appropriate yoga exercises. However, if your back pain does not pass and you find it difficult to do your daily activities, you need to consult a doctor who will prescribe a physiotherapy treatment that can also reduce back pain.

To which doctors to consult if there is pain in the lower back during pregnancy:

Obstetrician-gynecologist
Neurologist
Urologist
Vertebrologist
Gastroenterologist