Back pain has been one of the most common patient complaints in emergency medicine and outpatient appointments in recent years. Such pain is not a separate nosological entity, but a clinical manifestation of a number of diseases. Of particular importance for this symptom is the fact that often with acute pain, motor activity is significantly reduced, and people's ability to work decreases.
The main cause of back pain are diseases of the spine, in addition, such a clinical manifestation can be caused by pathologies of internal organs, occupational characteristics (long sitting at the 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 examinations are required to make a diagnosis. Relief of pain syndrome depends on the underlying disease and the features of its course, treatment is selected for each case individually.
Medical statistics show that more than half of the world's population suffers from back pain. In addition, such a symptom in childhood indicates diseases of the internal organs and is quite rare, since with age they become more common back pain, and in old age almost everyone encounters it, and only about 25% of those suffering from this pathology consult a doctor.
What is the risk of back pain?
In most cases, back pain therapy that is started too early or is insufficiently prescribed leads to a chronic course. Chronic back pain is a very common cause of reduced performance in people aged 40 to 55 and is characterized by:
- permanent character;
- increased with exercise and physical activity;
- restriction of motor activity;
- Development of 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 a position. Exacerbations are replaced by periods of remission, during which there is no pain at all or its expression is minimal. In most cases, back pain does not pose a direct threat to a person's health or life, but there are serious diseases of the spine and internal organs that manifest this symptom and require immediate medical attention.
Back pain in general diseases
Common conditions that are manifested by the presence of back pain are sciatica and a herniated disc.
The severity of the pain syndrome in these diseases depends on the stage of their course and the patient's threshold of sensitivity.
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 autonomic disorders against a 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 the injury and intensification with movements and coughing (even with a slight cough). The pain can be of different types (painful, dull or sharp), intermittent or 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 impaired sensitivity in the limbs.
disc prolapse
A bulging or bulging of disc fragments into the spinal canal is referred to as a herniated disc. The disease is most common in people between the ages of 25 and 50. The risk group includes drivers, people who sit for a long time and have to lift weights every day.
Clinical Manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent, increasing with physical exertion, coughing and prolonged exposure to a 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 every elderly person experiences pain in the spine, the most common cause of such a symptom are 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 already recognized with injuries characteristic of it, or rather fractures, which can occur with minimal stress or slight bruising.
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 occurs with prolonged static loads and with a sharp change in weather conditions;
- hair and nails become brittle;
- possible development of non-inflammatory periodontal diseases;
- change in 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 on their surface of bone outgrowths and spines (osteophytes).
Clinical Manifestations
In the initial stage, it manifests itself as a slight restriction in the mobility of the spine. With the progression of the disease due to the fixation of the overloaded area, a pronounced pain syndrome develops. Acute, unbearable pain is accompanied by muscle tension, limitation of movement 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, which 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 trauma, long-term increased load on the joint (during pregnancy, work related to lifting weights or constant sitting), congenital anomalies, metabolic disorders, neoplasms.
Clinical Manifestations
The pain is localized in the pelvic area and spreads from the affected side along the sciatic nerve, can intensify with pressure on the wing of the ilium and bending 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 surgical departments.
Spinal osteomyelitis
Osteomyelitis is a purulent infectious disease affecting bone tissue, periosteum and bone marrow. It can be acute (first-onset) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical Manifestations
It begins with chills, fever (often to 40. 0), and increased heart rate. After 2-4 days, local pain over the lesion site, local edema and hyperemia (redness) of tissues and restriction of motor activity develop. In chronic osteomyelitis, there are traces of fistula tracts on the skin (round wounds with purulent discharge). If there is a suspicion of the development of osteomyelitis, then an urgent need to consult a doctor. The surgeon deals with the treatment of such a pathology.
spondylolisthesis
Spondylolisthesis is the forward displacement of a vertebra as a result of congenital nonunion of the arch with the body or a degenerative-dystrophic change 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, which is due to slipping of the vertebra and injury to nerve endings. The pain often radiates to the buttocks and worsens when you try to relax. May 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 has not yet been clarified. It is more common in middle-aged women.
Clinical Manifestations
- moderate or severe persistent aching back pain;
- Headache;
- pain in the neck and shoulders;
- spinal pain and stiffness in the morning;
- sleep disturbance;
- Irritability.
Muscle soreness intensifies in the cold season, outdoors, after excessive exertion, after emotional stress, in the morning.
Musculoskeletal pain
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 pain to develop. Various injuries, excessive physical activity, as well as a 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 radiating to the back and lumbar spine (stenosis)
With a stenosis (narrowing of the spinal canal or openings of the exit of the roots of the spinal nerves), as a result of which there is a compression of the nerve fibers, the pain that appears in the back radiates then when walking on the leg of the patient changes, he limps.
The pain is dull and constant. The reason for the development of this disease are age-related changes, so young and middle-aged people are not prone to its occurrence. An operative method is used for treatment, the so-called decompression surgery, in which the arches of the vertebrae are dissected.
Post traumatic back pain
Back injuries can be caused by:
- sharp lifting of weights often leads to the development of stretching or tearing of muscle fibers or ligaments;
- the autumn;
- shock or injury;
- mechanical action.
Along with the appearance of pain in case of injury, a spasm of muscle fibers develops, which disappears over a period of several hours to several days, depending on the severity of the damage. With severe injuries, muscle spasms can last for several weeks. Immediately after the injury, the pain is sharp, which after some time is replaced by soreness.
back pain during pregnancy
Some women experience constant pulling pains in the lumbar region from the first months of pregnancy, which do not go away until childbirth. The cause of the pain is the increased release of relaxin, a hormone that is responsible for preparing the birth canal for the passage of the child, namely for softening the ligaments in the sacral region. Since relaxin acts on all ligaments, and the load on the spine of a pregnant woman is increased, chronic pain in the lumbar region can develop.
How to relieve the symptoms of back pain during pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- You can't lift weights;
- If you urgently need to lift something heavy, try to distribute the weight between both hands, do not bend or jerk;
- do not bend to the ground, you must kneel;
- no need to remove high placed objects.
Causes of Lower Back Pain
The main causes of pain above the lower back are:
- osteochondrosis;
- Myofascial Syndrome.
osteochondrosis
A degenerative-dystrophic process leading to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis. Allocate cervical, thoracic and lumbosacral osteochondrosis. The disease is often accompanied by a herniated disc and a herniated disc.
Clinical Manifestations
Features of the symptoms of the disease depend on their localization:
- Cervical osteochondrosis is manifested by pain and stiffness of movements in the neck and arms, headaches, with compression of the vertebral artery, dizziness, hearing impairment and fainting may appear.
- The thoracic form of the disease presents with acute pain in the back and chest (palpitation), cardiac pain, and difficulty breathing.
- Lumbosacral localization is characterized by pain in the lumbar region, radiating to the legs and aggravated during movement, back pain, numbness of the extremities, disorders of the urogenital system may appear.
Myofascial Syndrome
Myofascial syndrome is a disease characterized by intensely painful overstretching of the muscles of the spine. 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 and is aggravated by pressure, overuse, injury, or sudden hypothermia. The pain can vary in intensity, from a mild, almost imperceptible discomfort to severe, excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blocks.