According to medical statistics, acute back pain is the second most common cause of disability. At least 80% of people have had them at least once. They can occur sporadically or be observed with exacerbations of spinal diseases. But in any case, acute and chronic back pain requires competent treatment and specific action on the causes of its occurrence.
Acute back pain: causes
Acute pain is pain that persists for less than 6 weeks. For most, it goes away in 2 weeks. Although initially it is impossible to predict how long it will last. However, in almost half of the cases, similar or more severe attacks recur later and turn into chronic pain.
Acute pain can be of different intensity, dull, burning, etc. Sometimes it radiates to arms, legs, buttocks. The so-called back pain often occurs after hypothermia, excessive physical exertion and as a result of sprains. Several days may pass between the impact of the traumatic factor and the direct manifestation of the pain syndrome, and this will manifest itself under the influence of slight physical exertion, for example, bending over.
They can also be the result of a back injury or the first manifestation of diseases of the spine, including:
- osteochondrosis;
- intervertebral hernia;
- spondyloarthrosis;
- spinal stenosis, etc.
Increase the probability of back problems:
- frequent stress;
- regular increase in physical activity;
- overweight;
- Frequent and prolonged standing.
In addition to severe back pain, there may be headaches, a burning sensation in the legs, and dizziness. All these symptoms should be reported to the doctor at the appointment.
Regardless of the anatomical structure damaged first, this entails a whole chain of successive changes that increase discomfort. Initially, inflammation factors are formed in the injury, causing swelling and irritation of the nerve fibers. In response to this, muscle spasms often occur, further aggravating the situation and causing circulatory disturbances in the affected area. This leads to a decrease in the amount of nutrients and oxygen that enter the focus of the injury, as well as the retention of metabolic products in it.
Treatment of acute back pain
To relieve pain, lie on your back on a hard surface. This will allow your back muscles to relax and relieve tension on your spine. To enhance the effect, orthopedic pillows can be placed under the knees and under the head, but it is important to avoid sagging in the lower back. With severe pain, a short-term intake of drugs from the NSAID group is allowed. In the future, you should definitely contact a neurologist or spine surgeon to determine the cause of the pain syndrome.
As soon as possible you should visit a doctor if there is no improvement within a week, a recurrence of an attack or irradiation of pain in the feet or knees, a violation of urination and defecation. To diagnose existing disorders, patients are shown:
- MRI;
- CT;
- radiography;
- biochemical blood test;
- UAC.
Based on the results of the investigation and the characteristics of the symptoms, the doctor makes a diagnosis and develops treatment tactics. In case of acute pain that deprives a person of the ability to work, he may be offered a spinal block, which relieves the pain syndrome in a few minutes.
Once the discomfort subsides, it is important not to stay in bed. Moderate physical activity, supplemented with special exercises in medical gymnastics, is the best prevention of the recurrence of such attacks in the future.
When you go to the hospital, you will definitely receive high-quality treatment for pain syndrome and its causes. Specialists will be able to develop the most effective treatment tactics and quickly relieve pain with an affordable and well-made blockage.
Chronic back pain: causes
People suffer from chronic back pain just as often. They can worsen and turn into a sharp pain attack, which completely disconnects a person from the usual rhythm. Most of the time they are the result of:
- A sedentary lifestyle, leading to a weakening of the muscular corset. This causes increased load on the spine and compression of the vertebrae. The result is osteochondrosis, protrusion of intervertebral discs and herniated intervertebral discs, spondyloarthrosis.
- Posture disorders. Long-term preservation of any position of the body, in which the natural curves of the spine are disrupted, causes its curvature and the development of scoliosis or kyphosis. This leads to degenerative changes in the intervertebral discs, redistribution of load on the muscles, and pinching of the nerve roots.
- Weakening of the abdominal muscles. Since they act as support for the internal organs and partially relieve the spine, when they are weak, the load on the lower back increases, which increases lordosis and causes chronic pain. In addition to a sedentary lifestyle, weakening of the abdominal muscles can be a consequence of pregnancy or obesity.
- Age changes. Over the years, the intervertebral discs gradually dehydrate, causing a decrease in their elasticity, strength, and size. The annulus fibrosus that surrounds the gelatinous nucleus pulposus dries out and becomes more fragile. The loads provoke the formation of cracks in it, which leads to the formation of bumps and hernias. The resulting bulge can squeeze nearby blood vessels, nerve roots, and spinal cord, leading to pain syndrome.
Chronic back pain diseases include:
- osteochondrosis;
- spondyloarthrosis;
- osteoporosis;
- intervertebral hernia;
- facet syndrome;
- ankylosing spondylitis;
- spondylolisthesis;
- rheumatoid arthritis;
- intercostal neuralgia;
- oncological diseases and others.
A common cause of chronic pain is deterioration of the facet joints. The cartilage located in them is also prone to thinning under excessive stress on the spine. As a result, when moving, they cease to perform a cushioning function, which causes friction of bone fragments and the development of inflammation.
Treatment of back pain
Treatment tactics are developed based on disorders that were detected during diagnostic studies. When spinal diseases are detected, conservative therapy is initially prescribed, including:
- drug therapy;
- physiotherapy;
- massage;
- Exercise therapy.
Conservative therapy
A holistic and individualized approach is important to treating back pain. Depending on the cause of its appearance, patients are prescribed various drugs, in particular:
- NSAIDs - drugs of this group have anti-inflammatory and analgesic effects, but with prolonged use they adversely affect the state of the digestive tract;
- corticosteroids - drugs with pronounced anti-inflammatory properties, prescribed in moderate to severe cases;
- muscle relaxants: help eliminate increased muscle tone and spasms;
- antidepressants - help eliminate psychological discomfort, which often reduces the effectiveness of conservative therapy;
- means for topical application: ointments or gels that contain anti-inflammatory components, that heat or cool can help reduce the severity of the pain and cause practically no side effects;
- chondroprotectors - preparations containing glucosamine and chondroitin have a beneficial effect on the state of cartilage tissue, increase its elasticity and help restore normal thickness.
In mild cases, oral medication is sufficient. But in more complex situations, intra-articular injections may be prescribed to patients. In severe pain, it is recommended to perform blocks once or as a full course, which can include up to 10 procedures.
To improve the effectiveness of drug therapy, patients are prescribed massage and physiotherapy sessions. The correct effect on the back muscles helps to activate blood and lymphatic flow, improve metabolic processes and eliminate muscle spasms. Manual therapy is very effective for deformities of the spine, especially scoliosis of 1 to 2 degrees. Regular sessions help restore the normal position of the spine and relieve pressure on internal organs.
In the framework of physical therapy, patients are assigned sessions:
- UHF;
- magnetic therapy;
- Bernard Currents;
- laser therapy;
- electrophoresis;
- UFO;
- balneological treatment.
If within six months it is not possible to improve the condition or there is a risk of complications, patients can be offered surgical treatment of existing diseases.
Surgical treatment
Modern methods of surgical intervention are distinguished by a high level of efficiency and safety. They allow you to quickly eliminate the pathological cause of the development of pain syndrome, and often do not require hospitalization. But most minimally invasive and microsurgical methods can be applied only when patients are referred to spine surgeons in the early stages of disease development.
The indications for surgical treatment are:
- progressive herniated intervertebral discs;
- spinal stenosis;
- abducted hernia;
- spinal fractures;
- scoliosis grade 3-4;
- severe forms of spondyloarthrosis;
- compression of the spinal cord or its nerve roots;
- hemangiomas of the vertebral bodies;
- instability of individual column segments;
- cauda equina syndrome.
The surgeon determines the type of operation based on the severity of the patient's condition. With the same diagnosis, surgical treatment can be performed in different ways, differing in the degree of invasiveness, effectiveness, duration of rehabilitation and cost.
Recently, minimally invasive methods of surgical treatment have been very popular. With their help, the treatment of intervertebral protrusions, herniated intervertebral discs, hemangiomas and a number of other diseases is carried out. Minimally invasive surgery takes no more than an hour, and upon completion, the patient can walk almost immediately and leave the clinic the same day or the next day.
The great advantages of the method are a good cosmetic effect (in most cases, all necessary surgical instruments are inserted via soft tissue punctures), ease of rehabilitation and an affordable price. In the case of intervertebral hernias, only cold plasma nucleoplasty or hydroplasty (hydrodiscectomy) can be considered a more promising approach.
In situations where microsurgical techniques cannot be applied, surgeons perform open operations. During them, it is possible to completely remove pathologically altered formations, level severe spinal deformities, replace irrecoverable structures with implants, and achieve normal spinal function by mounting titanium metal frameworks.
Modern spine surgery can treat almost any back problem. All the latest methods of surgical treatment of diseases of the spine are available in many institutions. A team of doctors of different profiles will help to get rid of acute or excruciating chronic back pain as soon as possible.
Back pain prevention
Once the seizure has passed and the pain is dull, to avoid another episode, it is recommended:
- do not lift too heavy objects;
- don't lean;
- walk more;
- gives up heavy physical work;
- when sitting, take regular breaks to warm up.