2 days late cramping and lower back pain: Cramps but No Period: Are You Pregnant?

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Cramps but No Period: Are You Pregnant?

Cramps but No Period: Are You Pregnant?

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Medically reviewed by Kimberly Dishman, MSN, WHNP-BC, RNC-OB — By Jessica Timmons on June 9, 2016

Your breasts are sore, you’re tired and cranky, and you’re craving carbs like crazy. You also may be experiencing uncomfortable cramping.

Sounds like you’re about to start your period, right? It may surprise you to learn that these symptoms could all be early signs that you’re pregnant, not premenstrual.

Here are seven common early pregnancy symptoms.

Every woman and every pregnancy are different. But many moms-to-be experience early pregnancy symptoms. The majority of these symptoms are related to surging hormones. It’s important to understand that all of these symptoms aren’t exclusive to pregnancy. That means there are other reasons that you could be experiencing them.

According to a poll from the American Pregnancy Association, 29 percent of the women surveyed noted that a missed period was their first sign of pregnancy. Often, there are other common symptoms of early pregnancy.

Cramps are a typical part of your monthly menstrual cycle, but did you know they could be experienced in early pregnancy, too? Some women notice mild uterine cramps in the first few weeks of pregnancy.

Breasts that are tender, sore, or swollen can be a sign of an impending period. But these same symptoms can also indicate that you’re pregnant. Hormonal changes during early pregnancy can cause breasts to feel sensitive or sore. They can also feel heavier or more full. You may notice that your areolas, or the skin around your nipples, are becoming darker.

Morning sickness is a classic symptom of early pregnancy. It can persist into later trimesters, too. Despite the name, moms-to-be may feel nauseated at any time of the day or night, not just in the morning. Morning sickness can sometimes begin as early as three weeks after conception.

Blame this symptom on those early pregnancy hormones and an increase in the volume of your blood. Together, they can mean more frequent headaches. If you suffer from migraines, you may experience more of them during pregnancy. Some women also experience fewer migraines.

Fatigue is another by-product of soaring hormones at the beginning of a pregnancy. Progesterone in particular is the culprit here: It can make you feel very tired.

Food cravings and aversions are another classic sign of pregnancy. Again, blame this on hormones.

You may notice feelings of dizziness or lightheadedness if you move quickly from a reclined to a seated position, or if you stand up suddenly. During pregnancy, your blood vessels dilate and your blood pressure drops. Together, they can make you feel lightheaded.

There are other symptoms of early pregnancy you might experience, including:

  • You’re bleeding, but only slightly. For some women, an early symptom of pregnancy is spotting. It’s called implantation bleeding, and it happens about 10 to 14 days after conception when the fertilized egg attaches to the uterine lining. This kind of bleeding doesn’t last long, and it usually happens around the time you’d normally have a period. This can be misleading. The difference is that implantation bleeding isn’t typically as heavy as menstrual bleeding.
  • You’re having mood swings. If you’re feeling particularly emotional or find yourself bursting into tears, it can be a result of pregnancy hormones.
  • You’re constipated. It’s not comfortable, but a sluggish digestive system is another hormone-related issue that some women experience during pregnancy.
  • You’re experiencing backaches. While lower back pain can be a problem for the length of a pregnancy, some women notice it very early on.
  • You need to use the bathroom more frequently. Somewhere between six to eight weeks after conceiving, you may find that you have an increased need to urinate, but don’t feel any pain or urgency.

While all of these symptoms can be signs of early pregnancy, they can also mean something else altogether. The reverse is also true: You may have none of these symptoms, but be pregnant.

A missed period can also be unrelated to a pregnancy. It could be due to:

  • stress
  • illness
  • a change in your birth control
  • fatigue
  • excessive changes in your weight
  • a hormonal imbalance

Even so, if you miss a period, or if you notice any of these symptoms, it’s not a bad idea to take a home pregnancy test. A positive test means you should schedule an appointment with your doctor.

Last medically reviewed on June 9, 2016

  • Parenthood
  • Pregnancy
  • Getting Pregnant

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Mayo Clinic Staff. (2013, July 13). Symptoms of pregnancy: what happens right away
    mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853
  • Pregnancy and headaches. (2015, July)
    americanpregnancy.org/pregnancy-health/headaches-and-pregnancy/
  • Pregnancy symptom alternatives. (n.d.)
    americanpregnancy.org/getting-pregnant/pregnancy-symptom-alternatives/
  • Pregnancy symptoms – early signs of pregnancy. (2015, December)
    americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 9, 2016

Written By

Jessica Timmons

Edited By

Frank Crooks

Medically Reviewed By

Kimberly Dishman, MSN, WHNP-BC, RNC-OB

Share this article

Medically reviewed by Kimberly Dishman, MSN, WHNP-BC, RNC-OB — By Jessica Timmons on June 9, 2016

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Cramps but No Period: Are You Pregnant?

Cramps but No Period: Are You Pregnant?

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Medically reviewed by Kimberly Dishman, MSN, WHNP-BC, RNC-OB — By Jessica Timmons on June 9, 2016

Your breasts are sore, you’re tired and cranky, and you’re craving carbs like crazy. You also may be experiencing uncomfortable cramping.

Sounds like you’re about to start your period, right? It may surprise you to learn that these symptoms could all be early signs that you’re pregnant, not premenstrual.

Here are seven common early pregnancy symptoms.

Every woman and every pregnancy are different. But many moms-to-be experience early pregnancy symptoms. The majority of these symptoms are related to surging hormones. It’s important to understand that all of these symptoms aren’t exclusive to pregnancy. That means there are other reasons that you could be experiencing them.

According to a poll from the American Pregnancy Association, 29 percent of the women surveyed noted that a missed period was their first sign of pregnancy. Often, there are other common symptoms of early pregnancy.

Cramps are a typical part of your monthly menstrual cycle, but did you know they could be experienced in early pregnancy, too? Some women notice mild uterine cramps in the first few weeks of pregnancy.

Breasts that are tender, sore, or swollen can be a sign of an impending period. But these same symptoms can also indicate that you’re pregnant. Hormonal changes during early pregnancy can cause breasts to feel sensitive or sore. They can also feel heavier or more full. You may notice that your areolas, or the skin around your nipples, are becoming darker.

Morning sickness is a classic symptom of early pregnancy. It can persist into later trimesters, too. Despite the name, moms-to-be may feel nauseated at any time of the day or night, not just in the morning. Morning sickness can sometimes begin as early as three weeks after conception.

Blame this symptom on those early pregnancy hormones and an increase in the volume of your blood. Together, they can mean more frequent headaches. If you suffer from migraines, you may experience more of them during pregnancy. Some women also experience fewer migraines.

Fatigue is another by-product of soaring hormones at the beginning of a pregnancy. Progesterone in particular is the culprit here: It can make you feel very tired.

Food cravings and aversions are another classic sign of pregnancy. Again, blame this on hormones.

You may notice feelings of dizziness or lightheadedness if you move quickly from a reclined to a seated position, or if you stand up suddenly. During pregnancy, your blood vessels dilate and your blood pressure drops. Together, they can make you feel lightheaded.

There are other symptoms of early pregnancy you might experience, including:

  • You’re bleeding, but only slightly. For some women, an early symptom of pregnancy is spotting. It’s called implantation bleeding, and it happens about 10 to 14 days after conception when the fertilized egg attaches to the uterine lining. This kind of bleeding doesn’t last long, and it usually happens around the time you’d normally have a period. This can be misleading. The difference is that implantation bleeding isn’t typically as heavy as menstrual bleeding.
  • You’re having mood swings. If you’re feeling particularly emotional or find yourself bursting into tears, it can be a result of pregnancy hormones.
  • You’re constipated. It’s not comfortable, but a sluggish digestive system is another hormone-related issue that some women experience during pregnancy.
  • You’re experiencing backaches. While lower back pain can be a problem for the length of a pregnancy, some women notice it very early on.
  • You need to use the bathroom more frequently. Somewhere between six to eight weeks after conceiving, you may find that you have an increased need to urinate, but don’t feel any pain or urgency.

While all of these symptoms can be signs of early pregnancy, they can also mean something else altogether. The reverse is also true: You may have none of these symptoms, but be pregnant.

A missed period can also be unrelated to a pregnancy. It could be due to:

  • stress
  • illness
  • a change in your birth control
  • fatigue
  • excessive changes in your weight
  • a hormonal imbalance

Even so, if you miss a period, or if you notice any of these symptoms, it’s not a bad idea to take a home pregnancy test. A positive test means you should schedule an appointment with your doctor.

Last medically reviewed on June 9, 2016

  • Parenthood
  • Pregnancy
  • Getting Pregnant

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Mayo Clinic Staff. (2013, July 13). Symptoms of pregnancy: what happens right away
    mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853
  • Pregnancy and headaches. (2015, July)
    americanpregnancy.org/pregnancy-health/headaches-and-pregnancy/
  • Pregnancy symptom alternatives. (n.d.)
    americanpregnancy.org/getting-pregnant/pregnancy-symptom-alternatives/
  • Pregnancy symptoms – early signs of pregnancy. (2015, December)
    americanpregnancy.org/getting-pregnant/early-pregnancy-symptoms/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jun 9, 2016

Written By

Jessica Timmons

Edited By

Frank Crooks

Medically Reviewed By

Kimberly Dishman, MSN, WHNP-BC, RNC-OB

Share this article

Medically reviewed by Kimberly Dishman, MSN, WHNP-BC, RNC-OB — By Jessica Timmons on June 9, 2016

related stories

  • 8 DPO: The Early Pregnancy Symptoms

  • Could You Be Pregnant If You Have Cramps, No Period, and White Discharge?

  • Early Pregnancy Symptoms

  • What Causes Ovary Pain in Early Pregnancy?

  • Weird Early Pregnancy Symptoms No One Tells You About

Read this next

  • 8 DPO: The Early Pregnancy Symptoms

    Medically reviewed by Kimberly Dishman, MSN, WHNP-BC, RNC-OB

    If you miss your period, you might wonder if you’re pregnant. Some women have symptoms of pregnancy as early as eight days past ovulation (8 DPO). We…

    READ MORE

  • Could You Be Pregnant If You Have Cramps, No Period, and White Discharge?

    Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI

    If you have cramps, white discharge, and no period, you may be wondering if you’re pregnant. Find out more about these and other signs of pregnancy…

    READ MORE

  • Early Pregnancy Symptoms

    Medically reviewed by Valinda Riggins Nwadike, MD, MPH

    What are the telltale early symptoms of pregnancy? Every person is different, but here are a few top signs.

    READ MORE

  • What Causes Ovary Pain in Early Pregnancy?

    Medically reviewed by Holly Ernst, PA-C

    Ovary pain in early pregnancy may be a sign of shifting hormones or implantation. It may also be a sign of something more serious, like miscarriage…

    READ MORE

  • Weird Early Pregnancy Symptoms No One Tells You About

    Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT

    You might be surprised by certain symptoms that the first trimester of pregnancy can bring. Get the facts on 10 unusual symptoms, such as tasting…

    READ MORE

  • Premenstrual Breast Swelling and Tenderness

    Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT

    Premenstrual breast swelling and tenderness are common symptoms of premenstrual syndrome, or PMS.

    READ MORE

  • What Helps Menstrual Cramps: 6 Home Remedies and OTC Options to Manage Pain

    Medically reviewed by Valinda Riggins Nwadike, MD, MPH

    Looking for quick relief from your menstrual cramps? From scientifically proven to popular treatments, find out what can work for you.

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  • What You Should Know About Consuming Turmeric During Pregnancy

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    READ MORE

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    READ MORE

causes of pain in the early stages and in the second trimester

From the moment of conception, the woman’s body is rebuilt. The composition of the produced hormones changes, nutrients are distributed between the mother and the fetus. At an early stage, these changes are invisible to others. But the woman notices that menstruation did not begin at the appointed time. Taste preferences change, nausea appears in the morning, fatigue, drowsiness, irritability or unusual peace. If you notice signs of pregnancy, you need to see a doctor. A few days after the delay in menstruation, pregnancy can be confirmed by laboratory tests. The doctor will give advice on how to prevent the development of pathologies and bear a healthy child.

At the first appointment, the doctor will warn you about early symptoms that indicate a threat of miscarriage:

  • spotting appeared, as during menstruation;
  • the temperature has risen;
  • frequent vomiting – more than three times a day.
  • Lower back pain may occur during the first trimester of pregnancy. It is often encountered by women in the later stages. It arises due to increased weight and a shift in the center of gravity. But in the first trimester, the weight and size of the abdomen change slightly. You need to analyze your condition and understand if there is a danger.

    Causes that do not cause concern

    Pulling the lower back during pregnancy can be due to various processes occurring in the body. Some of them create inconvenience, but do not pose a threat.

    Attachment of the ovum to the uterus

    Attachment of the ovum to the wall of the uterus occurs 5-7 days after fertilization, even before the woman notices a delay in menstruation and thinks about a possible pregnancy. The process may be accompanied by an increase in vaginal discharge. They are not white, but pink. Women often believe that menstruation begins. Due to the production of various hormones, a few days can pull the lower back. These sensations are caused by natural, not pathological changes in the body. They are harmless, do not require treatment and disappear after 5-6 days.

    Changes in the circulatory system

    After the attachment of the fetal egg in the uterus, the fetus begins to grow. He needs more nutrients and oxygen every day. To deliver them, the circulatory system begins to work differently, directing more blood to the uterus. Vessels from the pelvic area overflow, increase in volume and come into contact with the nerve endings in the lumbar region. There is a pulling pain. It is felt at 5-7 weeks of pregnancy. If the pain symptoms are not very pronounced, you can not worry. The body will rebuild, and the pain will pass without treatment.

    Softening of the joints, ligaments

    During childbirth, the joints and ligaments in the spine and pelvis should be well stretched. The body prepares in advance for the upcoming work. He already at an early stage begins to produce the hormone relaxin, which softens the joints and ligaments. Due to a change in their density, it can pull the lower back.

    Uterine growth

    At 9-10 weeks of pregnancy, the volume of the uterus already noticeably increases. The woman feels that the lower abdomen has become more firm and convex. The growing uterus begins to come into contact with other organs. With increased sensitivity, its pressure can be felt at an early stage. But more often women experience discomfort, mild pressing back pain in the second trimester.

    Braxton-Higgs contractions

    At the end of the first and beginning of the second trimester, spontaneous uterine contractions may occur, resembling labor pains, but less intense. Drawing cramping pain is given in the lower back. They can periodically disturb 2-3 weeks. If there are no other dangerous symptoms, medication, restriction of motor activity is not required.

    Drawing back pain in pregnant women often occurs from natural causes. They do not pose a threat to the health of the expectant mother and the development of the fetus, do not require treatment. But it is necessary to tell the doctor about them in the antenatal clinic. He correlates them with other symptoms and will not miss the signs of an incipient miscarriage, other pathologies.

    Dangerous conditions

    Drawing pain in the lower back is often one of the signs of dangerous conditions:

    • missed pregnancy, threatened miscarriage;
    • diseases of the genitourinary system;
    • osteochondrosis;
    • symphysite;
    • colds.

    Missed pregnancy, threatened miscarriage

    In case of missed pregnancy, threatened miscarriage, lower back pain is accompanied by bloody discharge from the vagina, cramping or constant aching pain in the lower abdomen. This is a dangerous condition. You need to immediately go to the hospital or call an ambulance. Do not refuse if the doctor suggests treatment in a hospital. To stop an incipient miscarriage, you need to administer drugs intravenously, limit physical activity, and constantly monitor the condition of the woman and fetus.

    In case of miscarriage, examinations should be carried out to make sure that there are no particles of the fetus left in the uterus. This can cause a life-threatening inflammatory process or further infertility. Requires the introduction of drugs that enhance uterine contraction, relieve inflammation, or surgical intervention.

    Diseases of the genitourinary system

    Immunity in pregnant women is weakened. Hypothermia, malnutrition, increased stress can cause kidney disease. If the lower back is pulled during pregnancy on one side, on the right or on the left, check the functioning of the genitourinary system. Additional symptoms indicate problems with the kidneys: legs and arms swell, pressure and temperature rise, and pain occurs when urinating. Women with chronic kidney disease should be especially careful. They can worsen when the load on the diseased organ increases – in the second or third trimester, with a cold or eating salty, spicy, smoked, fatty foods. You cannot self-medicate. Taking the usual antibacterial drugs (Canephron, Levofloxacin, Furadonin) is undesirable for pregnant women. You need to see a nephrologist. He will prescribe a safe treatment.

    Osteochondrosis

    Starting from 7-8 weeks, the hormone relaxin begins to be produced, softening the joints and ligaments. If before conception a woman suffered from osteochondrosis, scoliosis, kyphosis, an exacerbation of diseases is possible even in the first or second trimester. An additional risk factor is rapid weight gain.

    In women who have not previously suffered from osteochondrosis, it can develop in the later stages, when the spine is under a lot of stress due to a significant increase in body weight, a shift in the center of gravity, uterine pressure and softening of the joints and ligaments. The pain is pulling, exhausting, aggravated after a long stay in one position. With dystrophic tissue lesions, it can be felt on one side, left or right. Spinal problems can complicate childbirth. If you do not start treatment in a timely manner, do not engage in prevention, they will continue to progress after childbirth.

    Symphysitis

    If the production of the hormone relaxin is strongly activated, premature softening of the joints occurs, which can cause the pubic bones to diverge. This increases the risk of preterm birth. With the divergence of the pubic bones, the pain is shooting, sharp. She gives to the lower abdomen and lower back. There are swelling in the pubic area. To diagnose symphysitis, the doctor examines blood and urine tests, conducts an additional ultrasound examination, observes the dynamics of the development of the disease and decides on the possibility of natural childbirth or the need for a planned caesarean section. In the later stages, motor activity may be limited, strict bed rest is recommended.

    Colds

    Pregnancy increases the risk of complications from colds. Especially dangerous is the early period when the organs of the fetus are formed. A significant increase in temperature, infection, uncontrolled use of antibiotics can provoke serious pathologies.

    It is necessary to consult a doctor and start treatment at the first symptoms of a cold. Lower back pain and body aches can occur when the temperature rises. It passes if it is knocked down using traditional medicine recommended by a doctor. But if it hurts in the lower back on the right or left, the temperature rises to 39degrees, there was a strong cough, shortness of breath – pneumonia is possible. You need to call a doctor at home or an ambulance.

    Prevention and treatment

    If you have pain in your lower back during pregnancy, do not take painkillers. If the pain is severe, but examinations have not shown dangerous pathologies, consult a doctor. After studying the causes and symptoms of pain, he will choose safe ways to alleviate the condition.

    In the first trimester, you need to be especially careful. A woman may still not know about pregnancy, but pain is already appearing. With a delay in menstruation, even for 2-3 days, you need to coordinate drug treatment with your doctor.

    The second trimester is the time when a woman intensively gains weight and the load on the musculoskeletal system increases, pressure on the internal organs. The doctor will advise you to wear a bandage for pregnant women and other non-drug ways to relieve and prevent pain.

    The third trimester – the body prepares for childbirth, the joints soften, the bones in the pelvic area diverge. If it pulls the lower back, the lower abdomen hurts, you need to lie down. If the pain intensifies, becomes cramping, childbirth may begin. If the period is less than 38 weeks, call the doctor who manages the pregnancy and describe the symptoms.

    Prevention of pain in the lower back

    To reduce the risk of lower back pain, the development of diseases of the musculoskeletal system:

    • do not lift heavy loads, in the early term, power loads can provoke a miscarriage, in the late term – premature birth;
    • do not wear tight shoes, shoes and boots with high heels, they create an additional load on the spine;
    • watch your weight, no need to eat “for two”;
    • Eat more foods containing calcium, a mineral-vitamin complex recommended by your doctor;
    • consult a doctor and start herbal medicine at the first sign of a cold, avoiding a significant increase in temperature;
    • do not slouch, keep your back straight so that the load is distributed evenly;
    • do not overwork, do not work for a long time in one position.

    Keep fit. The muscular frame will reduce the load on the spine. Regular, but not too intense exercise, walks in the fresh air will strengthen the immune system, help control weight. Useful swimming in the pool or ponds with clean running water. Learn and regularly do a set of exercises for pregnant women.

    Back pain – treatment, symptoms, causes, diagnosis

    Back pain is often referred to by such terms as lumbago or lumbalgia. Lumbago or “lumbago” refers to an attack of acute pain in the lower back, which is usually associated with hypothermia and exercise. Lumbago occurs in many people and is often the cause of temporary disability. Often the cause of lumbago can be sports injuries or sprains, but sometimes the factor that provokes the onset of pain remains unknown. Lumbago is characterized by pain that does not radiate to the legs. Lower back pain (lumbago) may appear acutely and progress gradually over the course of the day. Often there is stiffness in the morning and gradually the stiffness turns into pain. It is also possible curvature of the spine (antalgic scoliosis) as a result of muscle spasm. The pain itself may be due to muscle spasm, which in turn is associated with other causes. It can be overuse or sprain, sports injuries, herniated disc, spondylarthrosis (spondylosis), kidney disease (infection or kidney stones). Sometimes the patient accurately determines the causal relationship between the appearance of malaise and exercise, hypothermia, but often the pain appears for no apparent reason. Sometimes lower back pain can occur even after sneezing, bending over, or putting on shoes. This can be facilitated by deforming diseases of the spine, such as scoliosis.

    In contrast to lumbago, the term lumbodynia refers to pain that is not acute, but subacute or chronic. As a rule, pain with lumbodynia appears gradually over several days. Pain can also occur in the morning and may decrease with physical activity. Lumbalgia is characterized by increased pain during prolonged static loads (sitting, uncomfortable body position). It is also characteristic of lumbodynia that the pain decreases in the supine position in a certain position. Patients with lumbodynia have difficulty performing normal activities such as washing or putting on shoes due to muscle spasm. Due to the disease, there is a decrease in the range of motion of the body (forward bends or, to a lesser extent, side bends or extension). Due to the pain syndrome, the patient often has to change position when it is necessary to sit or stand. Unlike lumbago, muscle spasm is less pronounced and, as a rule, does not cover the entire lower back, and there are often signs of spasm predominance on one side.

    Causes of back pain

    Back pain is a symptom. The most common causes of back pain are diseases (injuries) of muscles, bones, and intervertebral discs. Sometimes back pain may be due to diseases of the abdominal cavity, pelvis and chest. Such pains are called reflected. Abdominal disease (eg, appendicitis), aortic aneurysm, kidney disease (kidney stones, kidney infection, bladder infections), pelvic infections, ovarian infections can all present back pain . Even a normal pregnancy can lead to lower back pain due to sprains in the pelvic area, muscle spasm due to stress, irritation of the nerves.

    The most common low back pain associated with the following diseases:

    • Compression of the nerve root, which causes symptoms of sciatica and is most often due to disc herniation. As a rule, with compression of the nerve root, the pain is acute, has irradiation and sensitivity disturbances in the zone of innervation of the nerve root. A herniated disc occurs mainly as a result of degeneration of the disc. There is a protrusion of the gelatinous part of the disc from the central cavity and pressure on the nerve roots. Degenerative processes in the intervertebral discs begin at the age of 30 and older. But the very presence of a hernia does not always lead to an effect on the nervous structures.
    • Spondylosis – degenerative changes occur in the vertebrae themselves, resulting in bone growths (osteophytes) that can affect nearby nerves, resulting in pain.
    • Spinal stenosis may occur due to degenerative changes in the spine (spondylosis and osteochondrosis). A patient with spinal stenosis in the lumbar region may experience low back pain radiating to both legs. Lower back pain can occur as a result of standing or walking.
    • Cauda equina syndrome. This is a condition requiring emergency medical attention. Cauda equina syndrome occurs as a result of compression of the elements of the cauda equina (terminal part of the spinal cord). A patient with cauda equina syndrome may experience pain and dysfunction of the intestines and bladder (incontinence and bladder atony). This syndrome requires emergency surgery.
    • Pain syndromes such as myofascial pain syndrome or fibromyalgia. Myofascial pain syndrome is characterized by pain and tenderness at certain points (trigger points), decreased muscle movement in painful areas. The pain syndrome decreases with the relaxation of the muscles located in the painful zones. In fibromyalgia, pain and soreness is distributed throughout the body. Fibromyalgia is not characterized by tightness and pain in the muscles.
    • Bone infections (osteomyelitis) of the spine are extremely rare.
    • Non-communicable inflammatory diseases of the spine (ankylosing spondylitis) can cause stiffness and pain in the spine (including the lower back itself), which is especially worse in the morning.
    • Tumors, most often metastases of cancer, can be a source of discomfort in the lower back.
    • Inflammation of the nerves and, accordingly, pain manifestations (in the chest or in the lumbar region) may be due to damage to the nerves themselves (for example, with herpes zoster)
    • Given the variety of causes of symptoms, such as acute or subacute low back pain, it is very important to fully evaluate the patient and perform all necessary diagnostic procedures.

    Symptoms

    Pain in the lumbosacral region is the main symptom of lumbago, lumbodynia, lumbar ischialgia.

    • The pain may radiate down the front, side, or back of the leg (lumbar ischialgia), or it may be limited to the lower back (lumbago, lumbalgia).
    • Feeling that the lower back hurts, may increase after exercise.
    • Sometimes the pain may be worse at night or when sitting for a long time, such as during a long car ride.
    • Possibly numbness and weakness in the part of the leg that is in the zone of innervation of the compressed nerve.

    For timely diagnosis and treatment, a number of criteria (symptoms) deserve special attention:

    • Presence in the recent past of injuries such as a fall from a height, a traffic accident or similar incidents.
    • Presence of minor injuries in patients over 50 years of age (for example, a fall from a small height as a result of sliding and landing on the buttocks).
    • History of long-term use of steroids (for example, these are patients with bronchial asthma or rheumatological diseases).
    • Any patient with osteoporosis (mostly elderly women).
    • Any patient over 70 years of age: at this age, there is a high risk of cancer, infections and diseases of the abdominal organs, which can cause back pain.
    • History of oncology
    • Presence of infectious diseases in the recent past
    • Temperature over 100F (37.7 C)
    • Drug use: drug use increases the risk of infectious diseases.
    • Pain in the lower back increases at rest: as a rule, this nature of pain is associated with oncology or infections, and such pain can also be with ankylosing spondylitis (Bekhterev’s disease).
    • Significant weight loss (no apparent reason).
    • The presence of any acute nerve dysfunction is a signal for urgent medical attention. For example, this is a walking disorder, foot dysfunctions are usually symptoms of acute nerve injury or compression. Under certain circumstances, such symptoms may require emergency neurosurgery.
    • Impaired bowel or bladder function (both incontinence and urinary retention) may be a sign of an emergency requiring emergency care.
    • Failure to respond to recommended treatment or increased pain may also require medical attention.

    The presence of any of the above factors (symptoms) is a signal to seek medical help within 24 hours.

    Diagnosis

    The medical history is important in making an accurate diagnosis, as low back pain can be caused by a variety of conditions. The time of onset of pain, the relationship with physical activity, the presence of other symptoms, such as cough, fever, bladder or bowel dysfunction, the presence of seizures, etc. are important. A physical examination is carried out: identification of pain points, the presence of muscle spasm, a study of the neurological status is carried out. If there are suspicions of diseases of the abdominal cavity or pelvic organs, then an examination is carried out (ultrasound of the abdominal organs, ultrasound of the small and pelvic organs, urine blood tests).

    If the somatic origin of low back pain is ruled out, then such instrumental research methods as radiography, CT or MRI can be prescribed.

    Radiography is the initial method of examination and allows you to determine the presence of changes in bone tissues and indirect signs of changes in the intervertebral discs.

    CT allows to visualize the presence of various changes, both in bone tissue and in soft stones (especially with contrast).

    MRI is the most informative research method that allows diagnosing morphological changes in various tissues.

    Densitometry is necessary in cases where there is suspicion of osteoporosis (usually in women over 50 years old)

    EMG (ENMG) is used to determine conduction disturbances in nerve fibers.

    Laboratory tests are ordered (blood, urine, blood biochemistry) mainly to exclude inflammatory processes in the body.

    Treatment of pain

    After the diagnosis and confirmation of vertebral origin in lumbago and lumbalgia, a specific treatment for back pain is prescribed.

    In acute pain, rest for 1-2 days is necessary. Bed rest allows you to reduce the load on the muscles and reduce muscle spasm. In most cases, when the pain syndrome is due to muscle spasm, the pain syndrome decreases within a few days without the use of drugs, only due to rest.

    Medical treatment. For pain syndrome, drugs of the NSAID group (movalis ibuprofen voltaren) are used. COX-2 inhibitors, such as celecoxib (Celebrex), have fewer side effects, but long-term use of these drugs also has certain risks. Considering that all drugs of this group have a lot of side effects, taking drugs of this group should be short and under the obligatory supervision of a doctor.

    Muscle relaxants (mydocalm, sirdalud, baclofen) may be used to relieve spasm. But the use of these drugs is effective only in the presence of spasm.

    Steroids may be used to treat pain, especially when there are signs of sciatica. But due to the presence of pronounced side effects, the use of steroids should be selective and short in time.

    Manual therapy. This method can be very effective in the presence of muscle blocks or subluxations of the facet joints. Mobilization of motor segments can reduce both muscle spasm and lower back pain.

    Physiotherapy. There are many modern physiotherapy procedures that can both reduce pain and reduce inflammation, improve microcirculation (for example, electrophoresis, cryotherapy, laser therapy, etc.