Back pain has been one of the most common complaints among 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 spine;in addition, such a clinical manifestation can be caused by pathologies of internal organs, occupational characteristics (long sitting at a table or in the driver's seat, heavy physical work), injury or pregnancy.In most cases, it is possible to determine the cause of the pain by carefully examining the patient;sometimes additional tests are needed to establish the diagnosis.Relief of the pain syndrome depends on the underlying disease and the characteristics 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.In addition, in childhood, such a symptom indicates diseases of the internal organs and is quite rare;with age, back pain appears more and more often, and in old age almost everyone experiences it, 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 work capacity in people aged 40 to 55 and is characterized by:
- permanent nature;
- increased during movements and physical activity;
- limiting 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, provoked by prolonged hypothermia, physical activity or staying in one position.Exacerbations are followed by periods of remission during which the pain is absent or 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 with this symptom, which requires immediate consultation with a specialist.
Back pain due to general ailments
Common ailments that manifest as back pain include sciatica and spinal disc herniation.
The severity 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 compression of the roots of the spinal cord and is manifested by motor and vegetative disorders against the background of severe pain.Cervical, thoracic and lumbar (lumbosacral) radiculitis are distinguished.
Clinical manifestations
It manifests itself as a pronounced pain syndrome, localized at the site of damage and intensified by movements and coughing (even with a slight cough).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 extremities.In addition to pain, the disease is characterized by muscle weakness and loss of sensation in the limbs.
Disc herniation
The protrusion or prolapse of fragments of the intervertebral discs into the spinal canal is called a herniated disc.Most often, the disease occurs in people aged 25 to 50 years;the risk group includes drivers, people who spend a long time in a sitting position and those who are forced to lift heavy objects every day.
Clinical manifestations
The main symptom is the pain, which at the beginning of the disease is dull and inconstant and increases with physical effort, coughing and prolonged stay in one 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 old
Almost every adult experiences 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, the pathology is detected already with characteristic injuries, or rather fractures, which can occur with a minimal load or a slight bruise.
It is very difficult to notice the disease at an early stage;usually manifests itself with the following signs:
- pain in the lumbar or thoracic part of the spine, which occurs with prolonged static load and with sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal diseases is possible;
- changes in posture and height reduction;
- the appearance of leg cramps at night.
spondylosis
Chronic degenerative-dystrophic lesion of the spine caused by deformation of the vertebrae and the appearance of bone growths and spikes (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 area subjected to overload.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
Very often, the following pathologies become the cause of pain in the lumbar or thoracic region of the spine, which appears in young or middle age:
- sacroiliitis;
- spinal osteomyelitis;
- spondylolisthesis;
- fibrositis.
Sacroiliitis
The inflammatory process localized in the sacroiliac joint is called sacroiliitis.The reason for the development of this disease can be injury, increased load on the joint for a long time (during pregnancy, work related to lifting weights or constant sitting), congenital anomalies of development, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvis and spreads along the sciatic nerve on the affected side;may increase 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, development of purulent abscesses and severe intoxication syndrome can be observed.The disease is usually treated in surgical wards.
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-lasting and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, elevated body temperature (often up to 40.0) and rapid heart rate.After 2-4 days, local pain over the site of the lesion, local swelling and hyperemia (redness) of the tissues and limitation of motor activity develop.In chronic osteomyelitis, there are traces of fistulas (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 forward displacement of a vertebra as a result of congenital non-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 slipped vertebrae and pinched nerve endings.The pain often radiates to the gluteal region and worsens when trying to stand up.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 fibrous connective tissue.The exact cause of the disease is not yet known.More common in middle-aged women.
Clinical manifestations
- moderate or severe persistent back pain;
- headache;
- neck and shoulder pain;
- pain and stiffness of spine in morning;
- sleep disorder;
- irritability.
The pain intensifies in the cold season, when you are outside, after excessive physical exertion, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to hold the body in space and move, has spatial and pain sensitivity.Damage to any, even the smallest element of this system through 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)
With stenosis (narrowing of the spinal canal or the exit openings of the spinal nerve roots), resulting in compression of the nerve fibers, 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 people 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 cut.
Post-traumatic back pain
The causes of back injuries can be:
- sudden weight lifting often causes sprains or tears of muscle fibers or ligaments;
- fall
- bump or bruise;
- mechanical impact.
Along with the onset of pain in an injury, a spasm of 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 an injury, the pain is sharp, which after a while is replaced by pain.
Back pain during pregnancy
In some women, constant pain in the lumbar region appears already in 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, namely for softening the ligamentous apparatus of the sacral region.Since relaxin acts on all ligaments and there is an increased load on the spine of a pregnant woman, chronic pain in the lumbar region can develop.
How to relieve back pain during pregnancy:
- Do not wear high-heeled shoes;
- all movements must be performed smoothly;
- you cannot lift weights;
- if there is an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend or pull;
- You must not bend to the floor, you must fall to your knees;
- There is no need to remove high objects.
Causes of lower back pain
The main causes of pain located above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process leading to a change in the normal structure of the cartilage tissue of the spine is called osteochondrosis.He has cervical, thoracic and lumbosacral osteochondrosis.Often the disease is accompanied by bulging of the spinal 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, headache;when the vertebral artery is compressed, dizziness, hearing loss, and fainting may occur.
- In the thoracic form of the disease, sharp pain in the back and chest (feeling of a stake), pain in the heart and difficulty breathing appear.
- Lumbosacral localization is characterized by pain in the lumbar region, radiating to the legs and intensifying during movement;lumbago, numbness of the limbs and disorders of the genitourinary system may occur.
Myofascial syndrome
Myofascial syndrome is a disease characterized by sharp painful excessive tension in the muscles of the spine.The main reason for the development is a 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, intensifies with pressure, overload, injury or sudden hypothermia.Pain sensations can vary in severity from mild, almost imperceptible discomfort to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.