Back pain: causes, diagnosis, treatment and prevention.

According to statistics, 80% of people know back pain first-hand. More than a third of all "sick leave" issued are related to this problem. The reason can be considered the weakness of the fragile muscles and their rapid growth. To identify the problem, in addition to visual inspection, hardware diagnostics (X-ray, myography, computed tomography, etc. ), laboratory blood tests are performed. Treatment is prescribed only after the diagnosis has been established.

Why does my back hurt?

Pain in the spine can occur immediately after injuries, pathologies of the vertebrae, ligaments and discs, soft tissue damage. It depends on the position of the body, the level of physical activity, but it can also be reflected, for example, in diseases of the internal organs. To some extent, the back itself is vulnerable due to its structure.

It is based on the column, which provides support, protection, motor and cushioning functions. This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time with an improper lifestyle and lead to degenerative diseases of the musculoskeletal system.

Within the spinal column is the spinal cord, its paired roots innervate almost all organs and tissues. Any alteration in this complex system can cause pain. More often than others, the cervical and lumbar region suffers due to its increased loads and mobility.

What to do with back pain?

A medical examination is mandatory to discover the cause, especially if the pains have become frequent. Only a specialist can make the correct diagnosis and prescribe treatment. You cannot perform a self-diagnosis.

First, you can contact a therapist who will identify a set of symptoms and refer you to the appropriate specialist with a narrow profile. If the cause is known and obvious, the prescribed therapy can be continued. Back problems are treated by neurologists, orthopedists, and vertebrologists.

Causes of back pain

Back pain is a nonspecific symptom that can have various causes.

Physiological causes (common):

• weight gain
• recent delivery or pregnancy;
• hypodynamic work - in the office, at the computer, driving a car;
• foot work: hairdressers, waiters and salesmen, street advertisers, surgeons, teachers;
• intense physical activity in combination with sharp turns of the body;
• overload in training;
• postmenopausal with a tendency to osteoporosis.

Pathological causes:

• diseases of the spine (osteochondrosis, spondylosis, ankylosing spondylitis, tumors, arthritis, osteomyelitis, Reiter's syndrome) and spinal cord;
• growing pains: scoliosis and kyphosis;
• infectious lesions of the spine;
• osteoporosis, osteomalacia;
• diseases of internal organs: kidneys, pancreas, stomach, spleen, liver;
• atherosclerosis of the abdominal aorta.

Acute pain can occur with disc bulging, spondyloarthritis, spinal cord epiduritis, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, spinal cord strokes, inflammation of the appendages in men and women and prostate cancer in women. .

Varieties of diseases by the nature of back pain.

Causes of achy pain:

• hypothermia;
• Stiff neck;
• myositis;
• prolonged awkward posture while sleeping or working;
• lumbago (work becomes the cause);
• osteochondrosis;
• intervertebral hernia or displacement of the intervertebral discs due to a sudden lifting of weights or a sharp turn of the body;
• kidney disease - causes back pain due to the proximity of the kidneys to the lower back;
• stomach diseases.

Causes of stabbing pains:

• intervertebral hernia - with them, the condition worsens with any physical stress;
• sciatica - this back pain often occurs on one side, radiates to the thigh or buttock, causes numbness in the legs, and also depends on physical exertion;
• Osteochondrosis - The patient may experience pulling pains that radiate to the leg and are aggravated by coughing, sneezing, straining, walking, or bending over.

Etiology of stabbing pain:

• osteochondrosis;
• intervertebral hernia;
• lumbago;
• spondylosis: they are acute and cannot be relieved with pain relievers.

Busting back pain:

• ischemia;
• myocardial infarction;
• CLOTH;
• inflammation of the gallbladder;
• a sharp increase in pressure;
• atherosclerosis.

Why does my back hurt after sleeping?

Most people experience back pain in the morning after sleeping, which can be due to:

• overload the day before, if he lifted weights and moved sharply;
• weak back muscles;
• hypothermia;
• hernia of the vertebrae or osteochondrosis;
• scoliosis - the curvature of the spine leads to uneven muscle contraction;
• pregnancy - with it, the center of the body shifts;
• obesity - the load on the spine is also uneven.

Sleep conditions are important too. The bed should not be too hard or soft; In any case, a person is forced to adopt an uncomfortable and unphysiological position during sleep, which causes the muscles to become overloaded and not rest at night. Posture is so important that even an orthopedic mattress won't help. Sleeping on your back with your legs raised is recommended.

Also, the causes of pain after sleep can be diseases of the spine and internal organs (urological, gastrointestinal tract, including oncological).

Diseases associated with the joints and the spine.

All pathologies in which back pain occurs have a common basis - uneven load on the spine. These include:

1. Ankylosing spondylitis: Persistent inflammation of the ligaments and joints causes a chronic spasm of the surrounding muscles. The process is autoimmune, over time the vertebrae begin to grow together, which drastically disrupts the work of the spine.
2. Spondylolisthesis: The vertebrae are in an abnormal position. They travel and affect the brain or roots.
3. Osteochondrosis - The intervertebral discs become thinner, cracked, and replaced by bone tissue. Depreciation becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammation of the joints. It most often affects the cervical spine.
5. Osteomyelitis is an inflammation of the bone marrow and surrounding soft tissues. Causes severe pain.
6. Reiter's disease is a simultaneous rheumatic lesion of the urogenital tract, the joints, and the conjunctiva of the eyes. The small muscles of the back are affected. Most often typical of young people, it develops gradually. The pain is severe in the morning and subsides at night.
7. Spinal canal stenosis: the cause can be a herniated disc, protrusion (protrusion into the spinal canal). Most often, the process involves the lower roots of the spinal cord, which innervate the legs. The pain is felt from the lower back to the foot and intensifies both when resting and walking.
8. Facet syndrome is an injury to the intervertebral (facet) joints. The pain can be local or radiating to the groin, coccyx, or thigh. Physically dependent. At night, the condition worsens, after rest it improves. It is more common in the elderly.

Diseases associated with the musculature.

Muscle tissue is affected secondarily, in the context of bone tissue or joint pathology. Painful spasms and compaction in the muscles appear, mobility is impaired:

1. Fibromyalgia is a pain syndrome from the neck to the lower back. Neurological symptoms can be added: increased sensitivity when pressing on certain points on the back, stiffness and stiffness.
2. Polymyositis - occurs with hypothermia, trauma, sprains, or severe physical exertion. Muscle weakness appears, in which even turning to the side is painful and troublesome.
3. Dermatomyositis is a chronic disease of the muscles, organs, and skin, often autoimmune in nature.
4. Charcot's disease is an inflammation of the peripheral nerves that run through the spine. This leads to changes in gait, muscle weakness, and increased sensitivity of the nerve roots.
5. Polymyalgia rheumatica is a negativity of the environment in the form of hypothermia, overload, uncomfortable posture, etc. It produces spasms in individual muscles and the appearance of pain. The so-called trigger points appear, when pressing on which the muscle reacts with sharp pain. Neurologists know. Pains of this type are removed with warm ointments and a needle applicator.

Spinal cord pathologies

These include the infringement of the spinal cord, which has 31 paired branches, where each nerve is responsible for the innervation of its site. This condition occurs when:

• trauma (spinal fracture);
• tumors
• osteochondrosis or herniated disc;
• inflammation as a result of an abscess, hematoma;
• cerebral haemorrhage;
• myositis;
• mineral and vitamin deficiency;
• complications of HIV or neurosyphilis;
• sclerosis.

Back pain due to psychosomatics.

In recent years, back pain has begun to manifest itself in psychosomatics. In this case, with complaints of back pain, the examination does not reveal the pathology. This condition occurs with chronic stress, depression, lack of libido. The result can be not only pain, but also a change in gait, exacerbation of low back pain, and sensory disturbances.

Causes of back pain by location.

Pain can occur in a wide variety of areas of the back. Then they talk about its location.

Pain in the right side

The right side of the back may hurt due to curvature of the spine, kyphosis, lordosis, myositis, displacement of the intervertebral disc, obesity.

Somatic pathologies can also cause pain in this area:

• the formation of stones in the organs of the urinary system;
• inflammation of the appendix of the cecum (appendix);
• inflammation of the gallbladder;
• nephritis;
• inflammation of the ovaries;
• salpingitis.

Pain in the left side

This area of the back can hurt when:

• splenitis
• ICD;
• pinching of the roots;
• duodenitis;
• oophoritis.

Pain located above the lower back may be associated with inflammation of the serous membranes that cover the lungs, bronchial damage, intercostal neuralgia, ischemia.

Lumbar pain

The lower back suffers very often, as it has a huge load. This section becomes inflamed with nerve root damage, osteochondrosis, or hernial protrusion. Less often, the cause may be tuberculosis of the spine, arthritis, lumboischialgia, decreased density and violation of the structure of bone tissue, Reiter's syndrome, a combination of urethritis and prostatitis.

Low back pain is usually chronic.

In the lumbar region on the right.

Low back pain occurs with scoliosis, tuberculosis, myositis, neuralgia, tumors, osteomyelitis, spondylitis. An acute attack can be caused by urolithiasis or pyelonephritis.

Lumbago is characteristic of diseases of the lower back with frequent involvement of the spinal roots in the process (radiculitis). Constant, dull, monotonous pain is more characteristic of an organ like the liver.

In the lumbar region on the left.

Most often, the left side begins to hurt after physical exertion. The condition improves after rest. Also, pain can occur with diabetes, pinching the root. If it doesn't go away at rest, the reasons may be:

• scoliosis;
• osteochondrosis (with a sedentary lifestyle or incorrect posture);
• vertebral infections;
• circulatory disorders.

Pinched nerve

Most often the sciatic nerve is pinched - sciatica. In this case, your myelin sheath is not altered. It is usually a consequence of osteochondrosis. When pinched, a sharp, sharp pain occurs, radiating to the leg, sacrum, and lower back.

With compression radiculopathy, the roots of the spinal nerves are also compressed due to a herniated disc or a decrease in its height and, as a result, the distance between the vertebral bodies. This pain feels like "superficial", increases sharply when coughing, exercising or sneezing.

Intervertebral hernia

A hernia is the extrusion of the nucleus of the intervertebral disc into the spinal canal. Most often it becomes a consequence of untreated osteochondrosis. The central part protrudes into the spinal cord, squeezing it. Even a small load in such cases leads to a decrease in the height of the cartilage and an even larger bulge of the hernia. The pain is sharp and sharp, returning to the arm or leg.

In the area of the shoulder blades.

A characteristic of pain may indicate a diagnosis:

1. Stomach ulcer: increasing dull pain. Eliminated by drugs.
2. Intercostal neuralgia - the disease is characterized by sharp pain with any physical exertion.
3. Osteochondrosis: dizziness, pressure changes, numbness of the hands.
4. Exacerbation of angina pectoris - the pain is localized in the region of the left scapula, radiating to the chest and below the clavicle.

Pain along the spine and back.

Most of the time it occurs when nerve endings are pinched. Exacerbations are associated with curvature of the spine. If the pain is not pronounced, we can speak of protrusion. With increased pain, you can think of osteochondrosis. Pain along the spine is typical of myositis, fractures, thinning and wear of the intervertebral discs, spondyloarthritis. They are always sharp and steady.

Causes of low back pain

Such pain is most often associated with osteochondrosis and spondyloarthrosis. Less often, such sensations can appear when:

• diseases of the genital area in women (endometritis, adnexitis, vulvitis, cervicitis, oophoritis);
• the pregnancy;
• menses;
• ulcerative colitis;
• appendicitis;
• diseases of the prostate or bladder - in men.

Associated symptoms

The manifestations of spinal pain differ depending on the location. With the defeat of the cervical spine, migraines and dizziness, weakness and numbness of the hands, sudden increases in pressure, flies and flashes in the eyes will be noted. With the involvement of the thoracic region, there is a burning sensation and stiffness in the chest, shortness of breath, pain in the area of the shoulder blades.

Situations that require urgent medical attention.

An urgent visit to a doctor requires back pain, which occurs in the following cases:

• injury;
• neurological symptoms in the form of tingling and numbness in the extremities;
• temperature is combined with back pain;
• numbness in the hands and feet, weakness and a tingling sensation;
• the gear has changed or the legs have been removed;
• history of cancer;
• weight loss for no apparent reason;
• disturbance of urination and defecation - a person cannot control these processes;
• back pain radiates to the chest, jaw, and neck;
• consciousness is confused and dizzy;
• numbness in genitals and weak, "milkweed" legs;
• leg cramps;
• problems conceiving or erection;
• problems with the gastrointestinal tract, in which the treatment of a gastroenterologist does not help;
• pain in the coccyx, small pelvis, aggravated by a change in the position of the body;
• increased pain when sitting or standing for a long time.

Experts will help you find out the cause of the pain.

Diagnosis

To identify the cause of back pain, a neurologist prescribes a comprehensive examination:

1. Blood test. They help identify the presence of infection and inflammation in the form of leukocytosis and increased ESR. A decrease in hemoglobin will indicate anemia, which can have many reasons, one of which is cancer.
2. Magnetic resonance. . .Displays the status of all components in the column. It helps to differentiate the type and nature of the tumor, determines the distance between the vertebrae and the degree of compression of the root.
3. CONNECTICUT. Identifies fractures, allows you to find the smallest fragments after injuries. All of this is in 3D.
4. Bone scan. The most cost-effective way to diagnose back pain and identify the condition of bone tissue. It is prescribed for suspected fracture, arthritis, scoliosis, osteoporosis, spondyloarthrosis.
5. Electromyography (EMG). Determines the indicators of the bioelectric activity of the muscles and peripheral nerve endings.
6. Ultrasound of the vessels of the neck and brain. In triplex or duplex mode, it is used to assess the permeability of blood flow through arteries and vessels. Its condition is verified: wall thickness, permeability, etc.

Back pain treatment

There are several treatments for back pain. A neurologist will select the optimal treatment for you, taking into account the age, lifestyle, level of physical mobility and clinical manifestations of the patient.

In the medical treatment of back pain, NSAIDs, painkillers, muscle relaxants, B vitamins are usually used. Along the way, physiotherapy, exercise therapy, IRT, massage, spinal traction, muscle relaxation are prescribed.

For back pain, in order for the treatment to be of high quality, it is advisable to see a doctor.

Prophylaxis

Precautionary measures:

• learn to maintain your posture and stand correctly;
• do not stoop;
• keep your back straight while sitting, put a support under your feet;
• correctly organize the place to sleep;
• do not jump abruptly after waking up - stretch slowly, do simple exercises with arms and legs;
• distribute the weights in both hands; do not carry everything in one hand, refuse a bag over your shoulder; a backpack is better;
• do not carry the child with his back bent;
• lifting weights by squatting;
• do not wash floors without a mop, leaning forward or kneeling;
• balance your diet with a sufficient amount of minerals and vitamins;
• stop smoking and drinking alcohol;
• do not forget about physical exercises: swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• protects the liver, produces collagen for the ligaments of the spine and vertebral bodies;
• strengthen immunity;
• control weight;
• it is advisable to undergo a course of manual therapy of 5 to 10 sessions every 6 months (as recommended by a specialist);
• avoid stress;
• do not forget the medical examinations.

If you develop back pain, see a doctor who can give you the proper assistance. Remember, any disease is easier to treat in the early stages.