Back pain has been one of the most common patient complaints in emergency medicine and outpatient appointments in recent years. Such pains are not a separate nosological unit, but a clinical manifestation of a number of diseases. Of particular importance for this symptom is the fact that often with acute pain, motor activity is significantly limited, and people's working capacity decreases.
The main cause of back pain is diseases of the spine, in addition to them, such a clinical manifestation can be caused by pathologies of internal organs, professional characteristics (sitting for a long time at a table or in the driver's seat, physical labor hard), trauma 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 features of its course, treatment is selected individually for each case.
Medical statistics show 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 they age, back pain is more common, and in old age almost everyone encounters it, and only about 25% of those who suffer from it this pathology. seek medical advice.
What is the risk of back pain?
In most cases, untimely started or improperly prescribed back pain therapy leads to a chronic process. Chronic back pain is a very common cause of decreased performance in people between the ages of 40 and 55 and is characterized by:
- permanent character;
- increased during movement and physical activity;
- limitation of motor 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 replaced by periods of remission, in which there is no pain or it is minimally expressed. 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 this symptom and require immediate medical attention.
Back pain in general diseases.
Common conditions manifested by the presence of back pain include sciatica and a herniated disc.
The severity of the pain syndrome in these diseases depends on the stage of its course and the sensitivity threshold of the patient.
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 a background of severe pain. Assign cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestations
It manifests itself as a pronounced pain syndrome with localization at the site of infringement and intensification when making movements and coughing (even with a slight 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 altered sensation in the extremities.
disc herniation
A bulge or protrusion of fragments of the intervertebral discs into the spinal canal is called a herniated disc. Most often, the disease occurs in people aged 25-50 years, the risk group includes drivers, people who spend a lot of time sitting, and those who are forced to lift weights daily.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent and increases with physical exertion, coughing and prolonged exposure to one position. As the pain progresses, it 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 pain in the spine, the most common cause of this symptom is the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost imperceptible onset, similar in symptoms to osteochondrosis. Often the pathology is already detected with lesions characteristic of it, or rather fractures that can occur with minimal load or with light bruising.
It is very difficult to notice the disease at an early stage, it usually manifests itself with the following symptoms:
- pain in the lumbar region or thoracic spine, appearing with prolonged static load and with a sharp change in weather conditions;
- hair and nails become brittle;
- possible development of non-inflammatory periodontal diseases;
- change of posture and decrease in height;
- leg cramps at night
spondylosis
Chronic degenerative-dystrophic lesion of the spine, caused by deformation of the vertebrae and the appearance of outgrowths and bone spikes (osteophytes) on their surface.
Clinical manifestations
In the early stages it manifests as a slight limitation of the mobility of the spine. With the progression of the disease due to fixation of the area subject to overload, a pronounced pain syndrome develops. Sharp, excruciating pain is accompanied by muscle tension, limitation of 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 region or thoracic spine that occurs at a young 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 can be trauma, increased stress on the joint for a long time (during pregnancy, work associated with lifting weights or constant sitting), congenital abnormalities, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve from the affected side, it can increase with pressure on the wing of the ilium and flexion of the limbs. With severe pain, the patient takes a forced position with his legs bent at the knees. In addition to pain, there may be an increase in body temperature, the development of purulent abscesses, and a pronounced intoxication syndrome. 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 (appearing for the first time) or chronic (of long duration and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, a fever (often up to 40. 0), and an increased heart rate. After 2 to 4 days, local pain develops over the injury site, local edema and hyperemia (redness) of the tissues, and limitation of motor activity. In chronic osteomyelitis, there are traces of fistulous passages in the skin (rounded wounds with purulent discharge). If there is a suspicion of the development of osteomyelitis, it is urgent to seek help from a doctor. The surgeon deals with the treatment of said pathology.
spondylolisthesis
Spondylolisthesis is the displacement of a vertebra forward as a result of congenital lack of union of the arch with the body or degenerative-dystrophic 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, due to slipping of the vertebra and infringement of the nerve endings. The pain often radiates to the gluteal region and intensifies when trying to unfold. 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. It is more common in middle-aged women.
Clinical manifestations
- persistent moderate or severe back pain;
- Headaches;
- pain in the neck and shoulders;
- pain and stiffness of the spine in the morning;
- Sleep disturbance;
- irritability.
The pain intensifies in the cold season when in the fresh air, after excessive exercise, after emotional stress, in the morning.
Musculoskeletal pain
The musculoskeletal system, which allows you to hold your body in space and move, has spatial and pain sensitivity. Damage to any element of this system, even the smallest, by injury or disease causes the development of pain. Various injuries, excessive physical activity, as well as displacement of the articular processes of the vertebrae lead to the development of an inflammatory process in the tissues of the spine, which causes pain.
Pain radiating to the back and lumbar (stenosis)
With stenosis (narrowing of the spinal canal or 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 reason for the development of this disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence. For the treatment, a surgical method is used, called decompression surgery, in which the arches of the vertebrae are dissected.
post traumatic back pain
Back injuries can be caused by:
- a sudden lifting of weights often provokes the development of stretching or tearing of muscle fibers or ligaments;
- the fall;
- blow or injury;
- mechanical impact.
Along with the appearance of pain in case of injury, a spasm of muscle fibers develops, which disappears over a period of several hours to several days, depending on the severity of the damage. In severe injuries, muscle spasm can last for several weeks. Immediately after the injury, the pain is sharp, which after a while is replaced by pain.
back pain during pregnancy
In some women, the constant drawing pain in the lower back appears already during the first months of pregnancy and does not disappear until delivery. 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 lower back can develop.
How to relieve symptoms of back pain during pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- you can't lift weights;
- in case of an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend over or shake;
- do not bow to the ground, you should kneel;
- no need to remove objects placed in high places.
Causes of pain above the lower back.
The main causes of localized pain above the lower back are:
- osteochondrosis;
- myofascial syndrome.
osteochondrosis
A degenerative-dystrophic process that leads to a change in the normal structure of the cartilage tissue of the spine is called osteochondrosis. Assign cervical, thoracic and lumbosacral osteochondrosis. Often the disease is accompanied by protrusion of the vertebral disc and intervertebral herniation.
Clinical manifestations
The features of the symptoms of the disease depend on its localization:
- Cervical osteochondrosis is manifested by pain and stiffness of movements in the neck and arms, headaches, with compression of the vertebral artery, dizziness, hearing loss, and fainting may appear.
- In the thoracic form of the disease, there is a sharp pain in the back and chest (stake sensation), pain in the heart, shortness of breath.
- Lumbo-sacral localization is characterized by pain in the lumbar region, radiating to the legs and aggravated during movement, back pain, numbness of the extremities, disorders of the genitourinary system may appear.
myofascial syndrome
Myofascial syndrome is a disease characterized by acutely painful excessive tension of the muscles of the spine. The main reason for the development is static overload of the muscular frame of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is localized to one or both sides of the spine, aggravated by pressure, overwork, injury, or sudden hypothermia. The pain can be of varying severity, from a mild almost imperceptible discomfort to intense and unbearable pain for several days.
One of the most effective ways to relieve back pain istherapeutic blocks.