Back pain is one of the most common complaints among emergency medicine and outpatient patients 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 in cases of acute pain, physical activity is significantly limited and people's work capacity is reduced.
Spinal diseases are the main cause of back pain;In addition, such a clinical manifestation can be provoked by pathologies of internal organs, professional characteristics (long sitting at a table or in the driver's seat, heavy physical labor), 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 necessary to establish a diagnosis.Relief from 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.In addition, in childhood, such a symptom indicates diseases of internal organs and is quite rare;As we age, back pain occurs more and more often, and in old age, almost everyone suffers from it and only about 25% of people suffering from this condition seek advice from a doctor.
What are the dangers of back pain?
In most cases, untimely or insufficiently prescribed treatment for back pain leads to chronicity of the process.Chronic back pain is a very common cause of decreased performance in people aged 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 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 immediate consultation with a specialist.
Back pain due to common illnesses
Common conditions that manifest as back pain include sciatica and spinal disc herniation.
The intensity of pain in these diseases depends on the stage of their development 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 are cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It manifests itself as a pronounced pain syndrome, localized at the site of the damage and intensified by movements and coughing (even in case of mild coughing).The pain can be of different nature (aching, dull or sharp), appear periodically or be constant.In most cases, the pain radiates to the upper or lower limbs.In addition to pain, the disease is characterized by muscle weakness and loss of sensation in the limbs.
Herniated disc
The protrusion or prolapse of fragments of intervertebral discs 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 long periods 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 exertion, coughing 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
Almost all older people experience pain in the spine;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, pathology is detected already with characteristic injuries, or rather fractures, which can occur with minimal load or slight bruising.
It is very difficult to detect the disease at an early stage;it generally manifests itself by the following signs:
- pain in the lumbar or thoracic spine, which appears during prolonged static load and during sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal diseases is possible;
- postural changes and height reduction;
- the appearance of cramps in the legs at night.
Spondylosis
Chronic degenerative-dystrophic lesion of the spine, caused by deformation of the vertebrae and the appearance of bony growths and thorns (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests itself as a slight limitation of spinal mobility.As the disease progresses, a pronounced pain syndrome develops due to 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
Very often, the following pathologies become the cause of pain in the lumbar or thoracic spine that occurs in young or middle-aged people:
- sacroiliitis;
- vertebral 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 injury, increased load on the joint for a long time (during pregnancy, work associated with heavy lifting or constant sitting), congenital developmental anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve on the affected side;it can intensify with pressure on the wing of the ilium and flexion of 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 severe intoxication syndrome can be observed.The disease is usually treated in surgical departments.
Vertebral 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, an increase in body temperature (often up to 40.0) and an increase in heart rate.After 2-4 days, local pain develops at the site of the lesion, local swelling and hyperemia (redness) of the tissues, as well as limitation of motor activity.In chronic osteomyelitis, there are traces of fistulas on the skin (round sores 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 resulting from congenital nonfusion 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 vertebral slippage and pinched nerve endings.The pain often radiates to the gluteal region and intensifies when trying to stand up.May be accompanied by leg pain, muscle weakness and numbness of the limbs.
Fibrosis
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
- moderate or severe, constant, painful back pain;
- headaches;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disturbances;
- 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 keeps the body in space and moving, 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 becomes the cause of pain.
Pain radiating to the back and lumbar region (stenosis)
In the event of stenosis (narrowing of the spinal canal or the exit holes of the spinal nerve roots), leading to compression of the nerve fibers, the pain that appears in the back then radiates towards 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, 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
The causes of back injuries can be:
- sudden lifting of weight often causes sprains or tears of muscle fibers or ligaments;
- autumn;
- blow or bruise;
- mechanical impact.
Along with the appearance of pain in case of injury, a spasm of muscle fibers develops, which disappears within a few hours to several days, depending on the severity of the injury.In cases of serious injuries, muscle spasms can last for several weeks.Immediately after an injury, the pain is sharp, and after a while it is replaced by soreness.
Back pain during pregnancy
In some women, constant shooting pain in the lumbar region appears from the first months of pregnancy and disappears only with childbirth.The cause of the pain is the increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of a child, in particular for softening the ligamentous apparatus of the sacral region.Since relaxin acts on all ligaments and an increased 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 should be performed smoothly;
- 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 shake;
- You must not bend over the ground, you must kneel;
- It is not necessary to remove objects located at height.
Causes of pain above the lower back
The main causes of localized pain above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process leading to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis.There are cervical, thoracic and lumbosacral osteochondroses.The disease is often accompanied by protrusion of the vertebral disc and intervertebral herniation.
Clinical manifestations
The characteristics of the symptoms of the disease depend on its location:
- Cervical osteochondrosis is manifested by pain and stiffness in movements of 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 (spiking sensation), heart pain and difficulty breathing appear.
- The lumbosacral location is characterized by pain in the lumbar region, radiating towards the legs and intensifying during movements;lumbago, numbness of the extremities and disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a condition characterized by excessive and extremely painful tension in the muscles of the spine.The main reason for the development is static overload of the muscular structure of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is localized on one or both sides of the spine and intensifies with pressure, overexertion, injury or sudden hypothermia.Painful sensations can vary in intensity, from mild, almost imperceptible discomfort to excruciating, intense pain lasting several days.
One of the most effective ways to relieve back pain istherapeutic blockages.