Back pain is one of the most common complaints of patients in emergency medicine and outpatient visits in recent years.Such pain is not a separate nosological unit, but a clinical manifestation of a number of diseases.What makes this symptom particularly 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 diseases of the spinal column;in addition, such a clinical manifestation can be caused by pathologies of internal organs, professional characteristics (long sitting at the desk or in the driver's seat, heavy physical work), injury or pregnancy.In most cases, it is possible to discover the cause of the pain by carefully examining the patient;sometimes additional tests are needed to make a diagnosis.Alleviating the pain syndrome depends on the underlying disease and the characteristics of its course;treatment is chosen individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain.Moreover, in childhood, such a symptom indicates diseases of the internal organs and is quite rare;As you get older, back pain occurs more and more often, and almost everyone experiences it in old age, and only about 25% of those suffering from this pathology seek advice from a doctor.
What are the dangers of back pain?
In most cases, untimely or inadequately prescribed therapy for back pain leads to chronicity of the process.Chronic back pain is a very common cause of reduced performance in people aged 40 to 55 and is characterized by:
- permanent character;
- increases during movement and physical activity;
- limitation of physical activity;
- development of a feeling of stiffness in the back.
The chronic process is characterized by a relapsing course with frequent episodes of exacerbations caused by prolonged hypothermia, physical activity or staying in one position.Exacerbations are followed by periods of remission, during which there is no pain at all 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 manifested by this symptom, which require urgent consultation with a specialist.
Back pain due to common ailments
Common diseases that manifest as back pain are sciatica and spinal disc herniation.
The intensity of pain in these diseases depends on the stage of their progression and the sensitivity threshold of the patient.
Radiculitis
Radiculopathy or radiculitis is a complex of symptoms that develops as a result of spinal cord root compression and is manifested by motor and autonomic disorders on the background of severe pain.There are cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It is manifested by a pronounced pain syndrome that is localized at the site of the injury and aggravated by movements and coughing (even with light coughing).Pain can be of different nature (painful, dull or sharp), occur periodically or constantly.In most cases, the pain spreads to the upper or lower extremities.In addition to pain, the disease is characterized by muscle weakness and loss of sensitivity in the limbs.
Herniated disc
Protrusion or prolapse of intervertebral disc fragments into the spinal canal is called disc herniation.Most often, the disease occurs in people aged 25 to 50;The risk group includes drivers, people who spend a long time sitting and those who are forced to lift heavy objects every day.
Clinical manifestations
The main symptom is pain, which is dull and occasional at the beginning of the disease, and is intensified by physical exertion, coughing and staying in one position for a long time.As the hernia progresses, the pain increases and spreads to the arm, buttock, or thigh, depending on the location of the hernia.
Causes of pain in people over 50 years old
Almost every elderly person experiences back 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 osteochondrosis.Often, the pathology is revealed already with characteristic injuries, i.e. fractures, which can appear with minimal stress or slight bruises.
It is very difficult to detect the disease in its early stages;it is usually manifested by the following signs:
- pain in the lumbar or thoracic spine, which occurs 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;
- changes in posture and decrease in height;
- occurrence 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 growths and spines (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests itself as a mild limitation of spinal mobility.As the disease progresses, a pronounced pain syndrome occurs due to the fixation of the area subject to overload.Acute, 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
Very often, the following pathologies become the cause of pain in the lumbar or thoracic spine that occurs in young or middle age:
- sacroiliitis;
- osteomyelitis of the spine;
- spondylolisthesis;
- fibrositis.
Sacroiliitis
The inflammatory process localized in the sacroiliac joint is called sacroiliitis.The cause of the development of this disease can be injury, increased load on the joint for a long time (during pregnancy, work associated with lifting heavy loads or constant sitting), congenital anomalies of development, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side;it can be increased by pressing the wing of the ilium and flexing the limbs.In case of severe pain, the patient takes a forced position with bent knees.In addition to pain, an increase in body temperature, the development of purulent abscesses and a severe intoxication syndrome can also be observed.The disease is usually treated in surgical wards.
Osteomyelitis of the spine
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 (long-lasting and characterized by periods of exacerbation and remission).
Clinical manifestations
It starts with chills, elevated body temperature (often up to 40.0) and rapid heartbeat.After 2-4 days, there is local pain at the site of the lesion, local swelling and hyperemia (redness) of the tissue, and limitation of motor activity.In chronic osteomyelitis, there are traces of fistulous tracts (round wounds with purulent discharge) on the skin.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 a movement of the vertebrae forward as a result of congenital non-union of the arch with the body or degenerative changes in the intervertebral disc.In most cases, it occurs when the fifth lumbar vertebra is displaced.
Clinical manifestations
The main manifestation is chronic pain in the lumbar region caused by the slipping of the vertebrae and pinching of nerve endings.The pain often radiates to the gluteal region and intensifies when trying to straighten.It can be accompanied by pain in the legs, muscle weakness and stiffness of the limbs.
fibrositis
Fibrositis is a non-specific 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
- moderate or severe constant back pain;
- headaches;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disorder;
- irritability.
The pain intensifies in the cold season outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to hold your body in space and move, has sensitivity to space and pain.Damage to any, even the smallest, element of this system by injury or disease causes the development of pain.Various injuries, excessive physical activity, as well as movement of the articular processes of the vertebrae lead to the development of an inflammatory process in the tissues of the spinal column, which becomes the cause of pain.
Pain radiating to the back and lumbar region (stenosis)
In the case of stenosis (narrowing of the spinal canal or exit openings of the spinal nerve roots), as a result of which nerve fibers are compressed, the pain that occurs 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 changes, so young and middle-aged people are not susceptible to its occurrence.For treatment, a surgical method called decompression surgery is used, in which the vertebral arches are dissected.
Post-traumatic back pain
Causes of back injuries can be:
- sudden lifting of weights often causes sprains or tears of muscle fibers or ligaments;
- fall;
- a bump or bruise;
- mechanical impact.
Along with the appearance of pain in the event of an injury, spasm of muscle fibers also develops, which disappears in 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 some time is replaced by pain.
Back pain during pregnancy
In some women, constant nagging pain in the lumbar region occurs already in the first months of pregnancy and does not disappear until childbirth.The cause of the pain is increased secretion of relaxin, the hormone responsible for preparing the birth canal for the passage of the child, i.e. for softening the ligamentous apparatus of the sacral region.Given that relaxin acts on all ligaments, and the increased load on the pregnant woman's spine, 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 smooth;
- you can't lift weights;
- if there is an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend or jerk;
- You should not bend down on the floor, you must get down on your knees;
- There is no need to remove high-lying objects.
Causes of pain above the lower back
The main causes of pain localized above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process that leads to a change in the normal structure of the cartilaginous tissue of the spinal column is called osteochondrosis.There are cervical, thoracic and lumbosacral osteochondrosis.Often the disease is accompanied by a protrusion of the spinal disc and an 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, headache;when the vertebral artery is compressed, dizziness, hearing loss and fainting can occur.
- In the thoracic form of the disease, there is acute pain in the back and chest (a stabbing sensation), pain in the heart and difficulty breathing.
- Lumbosacral localization is characterized by pain in the lumbar region, which spreads to the legs and intensifies during movement;lumbago, numbness of the extremities and disorders of the genitourinary system may occur.
Myofascial syndrome
Myofascial syndrome is a disease characterized by acutely painful excessive tension of the muscles of the spinal column.The main reason for the development is the static overload of the muscular framework of the spine for a long time (in an uncomfortable position).
Clinical manifestations
The pain is localized on one or both sides of the spine, aggravated by pressure, overwork, injury or sudden hypothermia.Pain sensations can vary in intensity from mild, almost imperceptible discomfort to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.