Back pain has been one of the most common complaints of patients in emergency medicine and outpatient appointments in recent years. Such pains are not a separate nosological unit, but a clinical manifestation of numerous 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 these, such a clinical manifestation can be caused by pathologies of the internal organs, professional features (sitting for a long time at a table or in the driver's seat, hard physical work) , trauma or pregnancy. In most cases, it is possible to find out the cause of the pain by carefully examining the patient, sometimes additional tests are needed to establish a diagnosis. Relief from 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 internal organs and is quite rare, as they get older, back pain is more common, and in old age almost everyone encounters it, and only about 25% of those who suffer of this pathology ask your doctor for advice.
What is the risk of back pain?
In most cases, prematurely initiated 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;
- developing a feeling of stiffness in the back.
The chronic process is characterized by a recurrent course with frequent episodes of exacerbations, provoked 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 exhibit this symptom and require immediate medical attention.
Back pain in general diseases
Common diseases that manifest with the presence of back pain include sciatica and herniated disc.
The severity of the pain syndrome in these diseases depends on the stage of their 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 the background of severe pain. Allocate 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 during movements and coughing (even with mild cough). Pain can be of a different nature (pain, 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 reduced sensitivity of the limbs.
Slipped disc
A protrusion or protrusion of fragments of the intervertebral discs into the canal of the spine is called a herniated disc. Most often, the disease occurs in people between the ages of 25 and 50, the risk group includes drivers, people who spend a lot of time sitting, and those who are forced to lift weights every day.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent in nature 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
Almost all elderly people experience pain in the spine, the most common cause of such a 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 detected already with characteristic lesions of it, or rather fractures that can occur with minimal load or slight bruises.
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, which appears 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 bony growths and spikes (osteophytes) on their surface.
Clinical manifestations
In the early stages it manifests itself as a slight limitation of the mobility of the spine. With the progression of the disease due to fixation of the overloaded area, a pronounced pain syndrome develops. Sharp and unbearable 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
Most often, the following pathologies become the cause of pain in the lumbar region or thoracic spine that occurs at a young age or in 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 trauma, increased stress on the joint for a long time (during pregnancy, work associated with weight lifting or constant sitting), congenital anomalies, 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 ileum 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 the surgical wards.
Spinal osteomyelitis
Osteomyelitis is a purulent infectious disease that affects the bone tissue, periosteum and bone marrow. It can be acute (first appearing) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical manifestations
It starts with chills, fever (often up to 40. 0), and increased heart rate. After 2-4 days, local pain develops at the site of the lesion, local edema and hyperaemia (redness) of the tissues and limitation of motor activity. In chronic osteomyelitis, there are traces of fistulous passages on 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 this pathology.
Spondylolisthesis
Spondylolisthesis is the displacement of a vertebra forward due to a congenital failure of the arch to 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 slippage of the vertebra and violation of nerve endings. The pain often radiates to the gluteal region and intensifies when trying to relax. It can be accompanied by pain in the legs, muscle weakness and numbness in the limbs.
Fibrositis
Fibrositis is a nonspecific inflammatory process characterized by fibrous and fatty degeneration of the fibrous connective tissue. The exact cause of the disease has not yet been clarified. It is more common in middle-aged women.
Clinical manifestations
- moderate or severe persistent and aching back pain;
- heachache;
- pain in the neck and shoulders;
- pain and stiffness in the spine in the morning;
- sleep disorders;
- irritability.
Pain intensifies in the cold season when away from home, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to keep the body in space and move, has spatial and pain sensitivity. Damage to any, even the smallest element of this system from injury or disease 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 causes pain.
Pain that radiates to the back and lower back (stenosis)
With stenosis (narrowing of the spinal canal or openings of the exit of the roots of the spinal nerves), 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 gait of the patient change, limp.
The pain is dull and constant. The reason for the development of this disease is age-related changes, so young people and middle-aged people are not susceptible to its occurrence. An operative method is used for treatment, called decompression surgery, in which the arches of the vertebrae are dissected.
Post-traumatic back pain
Back injuries can be caused by:
- heavy lifting often causes the development of strains or tears of muscle fibers or ligaments;
- the fall;
- blow or injury;
- mechanical impact.
Along with the appearance of pain in the event of an injury, a spasm of muscle fibers develops, which disappears in a period of several hours to several days, depending on the severity of the damage. In severe injuries, the muscle spasm can last for several weeks. Immediately after the injury, the pain is acute, which after some time is replaced by pain.
Back pain during pregnancy
In some women, constant pulling pain in the lumbar region appears already during the first months of pregnancy and does not go away until delivery. The cause of the pain is the increased secretion of relaxin, the hormone responsible for preparing the birth canal for the passage of the baby, or for the softening of the ligament 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 can develop.
How To Relieve Back Pain Symptoms During Pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- you cannot lift weights;
- in case of an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend over and do not jump;
- do not bend to the ground, you must kneel;
- there is no need to remove the top objects.
Causes of pain above the lower back
The main causes of pain localized 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 hernia.
Clinical manifestations
The characteristics of the symptoms of the disease depend on its localization:
- Cervical osteochondrosis is manifested by pain and stiffness in the movements of the neck and arms, headache, with compression of the vertebral artery, dizziness, hearing problems and fainting may appear.
- In the thoracic form of the disease, there is sharp pain in the back and chest (sensation of a pole), pain in the heart, difficulty in breathing.
- Low back localization is characterized by pain in the lumbar region, which radiates to the legs and worsens during movement, back pain, numbness of the extremities, disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by painful excessive tension of the muscles of the spinal column. The main reason for the development is the static overload of the muscular structure of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
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 mild, almost imperceptible discomfort to severe shooting pain for several days.
One of the most effective ways to relieve back pain istherapeutic blocks.