Back pain has been one of the most common complaints among patients attending emergency and outpatient clinics in recent years.This pain is not a separate nosological unit, but a clinical manifestation of a number of diseases.What makes this symptom especially serious is that often with acute pain, physical activity is significantly limited and people's ability to work is reduced.
The main cause of back pain is spinal diseases;In addition, such a clinical manifestation can be caused by pathologies of internal organs, professional characteristics (prolonged sitting at a table or in the driver's seat, intense physical work), injuries or pregnancy.In most cases, it is possible to discover the cause of the pain by carefully examining the patient;Sometimes additional tests are required to establish a diagnosis.Relief of pain syndrome depends on the underlying disease and the characteristics of its course;Treatment is selected individually for each case.
Medical statistics indicate that more than half of the world's population suffers from back pain.Also, in childhood, such a symptom indicates diseases of the internal organs and is quite rare;As we age, back pain occurs more and more frequently, and in old age almost everyone experiences it and only about 25% of those who suffer from this pathology go to the doctor.
What are the dangers of back pain?
In most cases, untimely or inappropriately prescribed therapy for back pain leads to chronicity of the process.Chronic back pain is a very common cause of decreased performance in people ages 40 to 55 and is characterized by:
- permanent character;
- increased during movements and physical activity;
- limitation of physical activity;
- development of a feeling of stiffness in the back.
The chronic process is characterized by a recurrent course with frequent episodes of exacerbations caused by prolonged hypothermia, physical activity or being in one position.Exacerbations are followed by periods of remission, during which there is no pain or its intensity is minimal.In most cases, back pain does not pose a direct threat to a person's health or life, but there are serious pathologies of the spine and internal organs that manifest themselves with this symptom, which require immediate consultation with a specialist.
Back pain due to common diseases.
Common diseases that manifest as back pain include sciatica and spinal disc herniation.
The severity of pain in these diseases depends on the stage of progression and the patient's sensitivity threshold.
radiculitis
Radiculopathy or radiculitis is a symptom complex that develops as a result of compression of the roots of the spinal cord and is manifested by motor and autonomic disorders against the background of severe pain.There is cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It manifests itself as a pronounced pain syndrome localized at the site of the infringement and intensified by movements and cough (even with a mild cough).The pain can be of a different nature (painful, dull or sharp), appear periodically or be constant.In most cases, the pain radiates to the upper or lower extremities.In addition to pain, the disease is characterized by muscle weakness and loss of sensation in the extremities.
herniated disc
The protrusion or prolapse of fragments of intervertebral discs into the spinal canal is called a herniated disc.Most often, the disease occurs in people aged 25 to 50;The risk group includes drivers, people who spend a lot of time sitting, and those who are forced to lift heavy objects every day.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent and intensifies with physical effort, cough and prolonged stay in the same position.As the hernia progresses, the pain increases and radiates to the arm, buttock, or thigh, depending on the location of the hernia.
Causes of pain in people over 50 years of age.
Almost all older people experience spinal pain;The most common causes of this symptom are the following diseases:
osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost imperceptible onset, with symptoms similar to those of osteochondrosis.Often, pathology is detected already with characteristic injuries, or rather fractures, which can occur with minimal loading or slight bruising.
It is very difficult to detect the disease at an early stage;It usually manifests itself with the following signs:
- pain in the lumbar or thoracic spine, which appears during prolonged static loading and during sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal diseases is possible;
- posture changes and height reduction;
- the appearance of leg cramps at night.
spondylosis
Chronic degenerative-dystrophic lesion of the spine, caused by the deformation of the vertebrae and the appearance of bone excrescences and spines (osteophytes) on their surface.
Clinical manifestations
In the early stages it manifests itself as a slight limitation in the mobility of the spine.As the disease progresses, a pronounced pain syndrome develops due to fixation of the overloaded area.Sharp, unbearable pain is accompanied by muscle tension and limited mobility due to the gradual straightening of the physiological curves of the spine.
Causes of pain in people under 50 years of age.
Most often, the following pathologies become the cause of pain in the lumbar or thoracic spine that occurs in youth or middle age:
- sacroiliitis;
- spinal osteomyelitis;
- spondylolisthesis;
- fibrositis.
Sacroiliitis
The inflammatory process located in the sacroiliac joint is called sacroiliitis.The cause of the development of this disease may be injury, increased load on the joint for a long time (during pregnancy, work associated with lifting heavy objects or constant sitting), congenital developmental anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is located in the pelvic area and extends along the sciatic nerve on the affected side;It may be intensified by pressure on the wing of the ilium and flexion of the extremities.In case of severe pain, the patient assumes a forced position with bent knees.In addition to pain, an increase in body temperature, the development of purulent abscesses and severe intoxication syndrome can be observed.The disease is usually treated in surgical departments.
Spinal osteomyelitis
Osteomyelitis is a purulent infectious disease that affects bone tissue, periosteum and bone marrow.It can be acute (occurring for the first time) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, increased body temperature (often up to 40.0) and increased heart rate.After 2 to 4 days, local pain develops at the site of injury, local swelling and hyperemia (redness) of tissues and limitation of motor activity.In chronic osteomyelitis, there are traces of fistulous tracts on the skin (round wounds with purulent discharge).If you suspect the development of osteomyelitis, you should urgently seek help from a doctor.This pathology is treated by a surgeon.
spondylolisthesis
Spondylolisthesis is the forward displacement of a vertebra as a result of a congenital lack of fusion of the arch with the body or degenerative changes in the intervertebral disc.In most cases, it develops when the fifth lumbar vertebra is displaced.
Clinical manifestations
The main manifestation is chronic pain in the lumbar region, caused by spinal sliding and pinching of nerve endings.The pain often radiates to the buttock region and intensifies when trying to straighten up.It may be accompanied by leg pain, muscle weakness, and numbness in the extremities.
fibrositis
Fibrositis is a nonspecific inflammatory process characterized by fibrous and fatty degeneration of fibrous connective tissue.The exact cause of the disease has not yet been clarified.More common in middle-aged women.
Clinical manifestations
- constant, moderate or severe back pain;
- headaches;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disturbance;
- irritability.
The pain intensifies in the cold season when outdoors, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin.
The musculoskeletal system, which allows the body to maintain space and move, has spatial and pain sensitivity.Damage to any, even the smallest, element of this system from injury or illness causes the development of pain.Various injuries, excessive physical activity and displacement of the articular processes of the vertebrae lead to the development of an inflammatory process in the tissues of the spine, which becomes the cause of pain.
Pain that radiates to the back and lower back (stenosis)
In case of stenosis (narrowing of the spinal canal or the exit openings of the spinal nerve roots), as a result of which compression of the nerve fibers occurs, the pain that appears in the back then radiates to the leg, while the patient's gait changes, he limps.
The pain is dull and constant.The cause of the development of this disease is age-related changes, therefore young and middle-aged people are not susceptible to its occurrence.A surgical method called decompression surgery is used for treatment, in which the vertebral arches are dissected.
post-traumatic back pain
The causes of back injuries can be:
- Sudden lifting of weights often causes sprains or tears in muscle fibers or ligaments;
- fall;
- blow or bruise;
- Mechanical impact.
Along with the appearance of pain in the event of an injury, a spasm of the muscle fibers develops, which disappears over a period of several hours to several days, depending on the severity of the injury.In severe injuries, muscle spasms can last for several weeks.Immediately after the injury, the pain is sharp, which after a while turns into soreness.
Back pain during pregnancy
In some women, persistent and constant pain in the lumbar region appears already during the first months of pregnancy and does not disappear until childbirth.The cause of the pain is the increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the child, that is, for softening the ligamentous apparatus of the sacral region.Since relaxin acts on all ligaments and a greater load is placed on the spine of a pregnant woman, chronic pain in the lumbar region may develop.
How to relieve back pain during pregnancy:
- Do not wear high-heeled shoes;
- all movements must be performed smoothly;
- you can't lift weights;
- if there is an urgent need to lift something heavy, try to distribute the weight between both hands, do not bend over or shake;
- You must not bow to the ground, you must kneel;
- It is not necessary to remove elevated objects.
Causes of pain above the lower back.
The main causes of pain located above the lumbar area are:
- osteochondrosis;
- myofascial syndrome.
osteochondrosis
The degenerative-dystrophic process that leads to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis.There are cervical, thoracic and lumbosacral osteochondrosis.Often the disease is accompanied by protrusion of the vertebral disc and intervertebral hernia.
Clinical manifestations
The characteristics of the symptoms of the disease depend on its location:
- Cervical osteochondrosis is manifested by pain and stiffness of movements in the neck and arms, headaches;When the vertebral artery is compressed, dizziness, hearing loss, and fainting can occur.
- In the thoracic form of the disease, sharp pain in the back and chest (stacking sensation), heart pain and shortness of breath appear.
- Lumbosacral localization is characterized by pain in the lumbar region, which radiates to the legs and intensifies during movement;Lumbago, numbness of the extremities and disorders of the genitourinary system may appear.
myofascial syndrome
Myofascial syndrome is a disease characterized by excessive, very painful tension in the muscles of the spine.The main cause of its development is the static overload of the muscular structure of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is located on one or both sides of the spine and is intensified by pressure, overwork, injury, or sudden hypothermia.Pain sensations can vary in intensity, from mild, almost imperceptible discomfort, to intense unbearable pain for several days.
One of the most effective ways to relieve back pain istherapeutic blocks.