Back pain has been one of the most common complaints from emergency medicine and outpatients in recent years. These pains are not a separate nosological unit, 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 limited and people's working capacity decreases.
The main cause of back pain are diseases of the spine, in addition to them, 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), trauma or pregnancy. In most cases, it is possible to find the cause of the pain by carefully examining the patient, sometimes additional tests are necessary to establish a diagnosis. The relief of the pain syndrome depends on the underlying disease and the features of its course, the treatment is selected individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain. Also, in childhood, such a symptom indicates diseases of internal organs and is quite rare, as they grow older, back pain is more common, and in old age almost everyone encounters it, and only about 25% of people suffering from this pathology seek advice from the doctor.
What is the risk of back pain?
In most cases, untimely or insufficiently prescribed anti-back pain treatment leads to a chronic process. 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;
- increased during movement and physical activity;
- limitation 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 one position. Exacerbations are replaced by periods of remission, during which there is no pain at all or is poorly expressed. 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 this symptom and require medical attentionimmediate.
Back pain in general illnesses
Common illnesses that manifest with the presence of back pain include 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 the background of severe pain. Distribute cervical, thoracic and lumbar (lumbo-sacral) sciatica.
Clinical manifestations
It is manifested by a pronounced pain syndrome with localization at the site of attack and intensification during movement and coughing (even with mild cough). The pain can be of a different nature (painful, dull or sharp), 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 impaired sensitivity of the limbs.
Herniated disc
A protrusion or protrusion of intervertebral disc fragments into the spinal canal is called a herniated disc. Most often, the disease occurs in people aged 25-50 years, the risk group includes drivers, people who sit for a long time and those who are forced to lift weights daily.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent in nature and increases 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 all older people experience pain in the spine, the most common cause of such a symptom being 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 detected with injuries characteristic of it, or rather fractures that can occur with minimal load or slight bruising.
It is very difficult to notice the disease at an early stage, it is usually manifested by the following symptoms:
- pain in the lumbar region or thoracic spine, which appears with a prolonged static load 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 of bony growths and spikes (osteophytes) on their surface.
Clinical manifestations
At first, it is manifested by a slight limitation in the mobility of the spine. With the progression of the disease due to the attachment of the area subjected to the overload, a pronounced pain syndrome develops. Acute, unbearable pain is accompanied by muscle tension, limitation of 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 region or thoracic spine that occurs at a 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, increased stress on the joint for a long time (during pregnancy, work associated with lifting weights or constant sitting), birth defects, disordersmetabolic, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve on the affected side, can increase 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.
Vertebral osteomyelitis
Osteomyelitis is a purulent infectious disease that affects bone tissue, periosteum and bone marrow. It can be acute (appearing for the first time) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical manifestations
It starts with chills, fever (often up to 40. 0), and rapid heartbeat. After 2-4 days, local pain develops at the site of injury, local edema and hyperemia (redness) of tissues and limitation of motor activity. In chronic osteomyelitis, there are traces of fistulous passages on the skin (rounded wounds with purulent discharge). If there is a suspicion of the development of osteomyelitis, it is urgent to seek medical help. The surgeon deals with the treatment of such a pathology.
Spondylolisthesis
Spondylolisthesis is the displacement of a vertebra forward as a result of congenital pseudarthrosis of the arc with the body or degenerative-dystrophic 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, due to slipping of the vertebra and damage to the nerve endings. The pain often radiates to the buttock area and intensifies 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 and aching back pain;
- headache;
- neck and shoulder pain;
- pain and stiffness in the spine in the morning;
- sleep disorder;
- irritability.
The pain intensifies in the cold season outdoors, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to keep the body in space and move, has spatial and pain sensitivity. Damage to any element of this system, even the smallest, by injury or disease, causes the development of pain. Various injuries, excessive physical activity, as well as the 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 lower back (stenosis)
With stenosis (narrowing of the spinal canal or openings of the exit from the roots of the spinal nerves), as a result of which compression of the nerve fibers occurs, the pain that arises in the back then radiates to the leg, while the gait of thepatient changes, he limps.
The pain is dull and constant. The reason for the development of this disease is due to age-related changes, so young and middle-aged people are not susceptible to its occurrence. For treatment, an operative method is used, called decompression surgery, in which the arches of the vertebrae are dissected.
Post-traumatic back pain
Back injuries can be caused by:
- strong lifting of weights often provokes the development of stretching or tearing of muscle fibers or ligaments;
- the fall;
- blow or injury;
- mechanical impact.
Along with the appearance of pain in case of injury, a spasm of muscle fibers develops, which disappears within a few hours to several days, depending on the severity of the damage. 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 aching.
back pain during pregnancy
In some women, a constant pulling pain in the lumbar region appears already in the first months of pregnancy and does not disappear until childbirth. 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, including the softening of the ligamentous apparatus of the sacral region. Since relaxin acts on all ligaments and an increased load is placed on the spine of a pregnant woman, chronic pain in the lumbar region may develop.
How to relieve the symptoms of back pain during pregnancy:
- do not wear high heels;
- all movements should be carried out smoothly;
- you cannot lift weights;
- in case of urgent need to lift something heavy, try to distribute the weight on both hands, do not bend over and do not shake;
- do not bend to the ground, you need to kneel;
- no need to delete the objects placed in height.
Causes of pain above the lower back
The main causes of pain located above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
A degenerative-dystrophic process that leads to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis. Assign 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 localization:
- Cervical osteochondrosis is manifested by pain and stiffness of movement in the neck and arms, headache, with compression of the vertebral artery, dizziness, hearing impairment, and fainting may occur.
- In the chest form of the disease, sharp pain in the back and chest (feeling of a pile), pain in the heart, difficulty breathing is observed.
- Lumbosacral localization is characterized by pain in the lumbar region, radiating to the legs and aggravated during movement, back pain, numbness in the extremities, disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by very painful excessive tension in the muscles of the spine. The main reason for the development is the static overload of the muscular frame of the spine for a long time (awkward position).
Clinical manifestations
The pain is localized on one or both sides of the spine, aggravated by pressure, overexertion, injury, or sudden hypothermia. The pain can vary in intensity, ranging from mild, almost imperceptible discomfort to intense excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockages.