Back pain has been one of the most common complaints in emergency medical care and outpatient visits in recent years.Such pain is not a separate nosological unit, but a clinical manifestation of many diseases.What makes this symptom particularly serious is that, often in the case of 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 clinical manifestations can be caused by pathologies of internal organs, professional characteristics (heavy physical work sitting at a long table or in the driver's seat), injury or pregnancy.In most cases, a careful examination of the patient can reveal the cause of the pain;sometimes additional tests are needed to make a diagnosis.Alleviation of the pain syndrome depends on the underlying disease and the characteristics of its course;The treatment is selected individually in 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;as age progresses, back pain occurs 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, early or improperly prescribed therapy for back pain leads to the process becoming chronic.Chronic back pain is a very common cause of reduced performance in people between the ages of 40 and 55 and is characterized by:
- permanent character;
- during increased movements and physical activity;
- restriction of physical activity;
- the development of a feeling of stiffness in the back.
The chronic process is characterized by a relapsing course with frequent episodes of exacerbation, which are triggered by prolonged hypothermia, physical activity or staying in one position.Exacerbations are followed by periods of remission, during which there is no or minimal pain.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 themselves in this symptom, which require immediate consultation with a specialist.
Back pain due to common diseases
Common conditions that present as back pain include sciatica and herniated discs.
The severity of pain in these diseases depends on the stage of progression and the sensitivity threshold of the patient.
Radiculitis
Radiculopathy or radiculitis is a set of symptoms that develops as a result of compression of the roots of the spinal cord and manifests itself in motor and autonomic disorders against the background of severe pain.There are cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It appears as a pronounced pain syndrome, which is localized at the site of the injury and is aggravated by movement and coughing (even a mild cough).The pain is of a different nature (painful, dull or sharp), may 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 sensitivity in the limbs.
Disc herniation
The protrusion or prolapse of fragments of the intervertebral discs into the canal of the spinal column is called a herniated disc.Most often, the disease occurs in people between the ages of 25 and 50;the risk group includes drivers, those 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 intermittent at the beginning of the disease and increases with physical exertion, coughing and prolonged stay in one position.As the hernia progresses, the pain increases and, depending on the location of the hernia, radiates to the arm, buttock, or thigh.
Causes of pain in people over 50 years old
Almost all elderly 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 appearance, with symptoms similar to osteochondrosis.Often, the pathology is already detected with characteristic injuries, or rather fractures, which can occur with minimal stress or slight bruising.
It is very difficult to notice 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 load and sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal diseases is possible;
- changes in posture and loss of height;
- appearance of leg cramps at night.
Spondylosis
Chronic degenerative-dystrophic change of the spinal column, 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 slight limitation of the mobility of the spine.As the disease progresses, a pronounced pain syndrome develops due to the fixation of the area exposed to overload.Acute, unbearable pain is accompanied by muscle tension and limited movement 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 causes of pain in the lumbar or thoracic spine, which occurs in young or middle age:
- sacroiliitis;
- spinal osteomyelitis;
- spondylolisthesis;
- fibrosis.
Sacroiliitis
The inflammatory process localized in the sacroiliac joint is called sacroiliitis.The cause of the disease can be injury, long-term joint stress (during pregnancy, work involving heavy lifting or constant sitting), congenital developmental disorders, metabolic disorders, tumors.
Clinical manifestations
The pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side;it can be aggravated by pressure on the wing of the hip bone and bending of the limbs.In case of severe pain, the patient assumes a forced position with bent knees.In addition to pain, an increase in body temperature, the formation of purulent abscesses and a severe poisoning syndrome can also be observed.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 (occurs for the first time) or chronic (long-term, characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, increased body temperature (often up to 40.0) and increased heart rate.After 2-4 days, local pain develops at the site of the lesion, local tissue swelling and hyperemia (redness), and limitation of motor activity.In chronic osteomyelitis, there are traces of fistulous tracks on the skin (round wounds with purulent discharge).If you suspect the development of osteomyelitis, you should urgently consult a doctor.This pathology is treated by a surgeon.
Spondylolisthesis
Spondylolisthesis is the forward displacement of a vertebra as a result of congenital non-fusion of the arch with the body or degenerative change of the intervertebral disc.In most cases, it develops when the fifth lumbar vertebra is displaced.
Clinical manifestations
Its 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 an attempt is made to straighten.It can be accompanied by leg pain, muscle weakness and numbness of 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 clear.It is more common in middle-aged women.
Clinical manifestations
- moderate to severe persistent, aching back pain;
- headache;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disorder;
- irritability.
The pain intensifies in the cold season when outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The locomotor system, which enables the body to hold and move in space, has spatial and pain sensitivity.Any damage to even the smallest element of the system caused by injury or disease leads to the development of pain.Various injuries, excessive physical activity, and displacement of the joint 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 exit openings of the spinal canal or spinal cord nerve roots), as a result of which the nerve fibers are compressed, the pain in the back then radiates to the legs, while the patient's gait changes and he limps.
The pain is dull and constant.The cause of the disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence.For the treatment, a surgical method called decompression surgery is used, during which the vertebral arches are cut into pieces.
Post-traumatic back pain
Back injuries can be caused by:
- sudden lifting of weights often causes muscle fibers or ligaments to sprain or tear;
- it is raining;
- bump or bruise;
- mechanical effect.
In the event of an injury, together with the appearance of pain, a spasm of muscle fibers develops, which disappears within a few hours or 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 a while is replaced by pain.
Back pain during pregnancy
In some women, constant nagging pain in the lumbar region appears in the first months of pregnancy and does not go away 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 ligaments of the sacral region.Since relaxin affects all ligaments and the spine of a pregnant woman is under increased load, chronic pain can develop in the lumbar region.
How to relieve back pain during pregnancy:
- Do not wear high heels;
- all movements must be performed smoothly;
- cannot lift weights;
- if you urgently need to lift something heavy, try to distribute the weight on both hands, do not bend or pull;
- You should not bend down on the floor, you should get down on your knees;
- There is no need to remove high objects.
Causes of pain in the lower back
The main causes of localized pain in the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process, which leads to a change in the normal structure of the cartilage tissue of the spinal column, is called osteochondrosis.There are 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 location:
- Cervical osteochondrosis manifests itself in pain and stiffness in the movement of the neck and arms, headaches;when the vertebral artery is compressed, dizziness, hearing loss, and fainting may occur.
- In the thoracic form of the disease, acute back and chest pain (feeling of a stake), heartache, and difficulty breathing occur.
- Lumbosacral localization is characterized by pain in the lumbar region, which radiates to the legs and increases during movement;lumbago, numbness of the limbs and disorders of the urogenital system may occur.
Myofascial syndrome
Myofascial syndrome is a disease characterized by acutely painful excessive tension in the muscles of the spinal column.The main cause of the development is long-term static overload of the spinal musculature (uncomfortable posture).
Clinical manifestations
The pain is localized on one or both sides of the spine and is aggravated by pressure, overload, injury or sudden hypothermia.The strength of pain sensations can vary, from mild, almost imperceptible discomfort to unbearable pain lasting several days.
One of the most effective ways to relieve back pain istherapeutic blockades.