Back pain has become one of the most common complaints among emergency medicine inpatients and outpatient visits in recent years.Such pain is not a separate nosological unit, but a clinical manifestation of several diseases.What makes these symptoms so serious is that often with acute pain, physical activity is severely limited and people's ability to work is reduced.
The main cause of back pain is spinal disease;in addition, such clinical manifestations can be caused by pathology of internal organs, professional characteristics (long sitting at the desk or in the driver's seat, heavy physical work), injury or pregnancy.In most cases, it is possible to find out the cause of the pain by carefully examining the patient;Sometimes additional tests are needed to establish a diagnosis.Relief of the pain syndrome depends on the underlying disease and the characteristics of its course;Treatment is selected individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain.Moreover, in childhood, such symptoms indicate diseases of internal organs and are relatively rare;as you get older, back pain occurs more and more often, and in old age, almost everyone experiences it and only about 25% of those who suffer from this pathology seek advice from a doctor.
What are the dangers of back pain?
In most cases, untimely or untimely therapy for back pain causes a chronic process.Chronic back pain is a very common cause of decreased performance in people aged 40 to 55 and is characterized by:
- permanent character;
- increases during movement and physical activity;
- physical activity limitations;
- development of stiffness in the back.
The chronic process is characterized by a repeated course with frequent episodes of exacerbation provoked by prolonged hypothermia, physical activity or being in one position.Exacerbation is followed by a period of remission, during which there is no pain at all or it is minimally 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 indicated by these symptoms, which require urgent consultation with a specialist.
Low back pain due to common diseases
Common ailments that manifest as back pain include sciatica and spinal disc herniation.
The severity of pain in this disease depends on the stage of its development and the sensitivity threshold of the patient.
Radiculitis
Radiculopathy or radiculitis is a symptom complex that develops as a result of spinal cord root compression and is manifested by motor and autonomic disturbances against the background of severe pain.There is cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It manifests itself as a significant pain syndrome that is localized at the site of the violation and is intensified by movement and coughing (even with a mild cough).Pain can be of a different nature (aching, dull or sharp), appear periodically or continuously.In most cases, the pain radiates to the upper or lower part.In addition to pain, the disease is characterized by muscle weakness and loss of sensitivity in the limbs.
Herniated disc
Protrusion or prolapse of a fragment of an intervertebral disc into the spinal canal is called a herniated disc.Most often, this disease occurs in people aged 25 to 50 years;risk groups include drivers, people who spend a long time sitting and those who have to lift heavy objects every day.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent and worsens with physical exertion, coughing and staying in one position for a long time.As the hernia develops, the pain increases and radiates to the arms, buttocks or thighs, depending on the location of the hernia.
Causes of pain in people over 50 years old
Almost every elderly person experiences pain in the spine;The most common causes of these symptoms are the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or barely noticeable onset, with symptoms similar to osteochondrosis.Often, pathology is detected already with a characteristic injury, or rather a fracture, which can occur with minimal load or light bruising.
It is very difficult to see this disease in the early stages;it usually shows itself with the following signs:
- pain in the lumbar or thoracic spine, which appears during prolonged static loads and during sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal disease is possible;
- changes in posture and height reduction;
- the appearance of leg cramps at night.
Spondylosis
Chronic degenerative-dystrophic lesions of the spine, caused by the deformation of the vertebrae and the appearance of bone and spine growths (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests itself as a slight limitation in the mobility of the spine.As the disease progresses, a significant pain syndrome develops due to the fixation of the area subjected to excessive load.Acute, unbearable pain accompanied by muscle tension and limited mobility due to the gradual straightening of the physiological curve of the spine.
Causes of pain in people under the age of 50
Often, the following pathologies are the cause of pain in the lumbar or thoracic spine that 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 injuries, increased load on the joints for a long time (during pregnancy, work related to heavy lifting or constant sitting), congenital developmental anomalies, metabolic disorders, neoplasms.
Clinical manifestations
Pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side;it can intensify with pressure on the wings of the ilium and flexion of the limb.In case of severe pain, the patient takes a forced position with bent knees.In addition to pain, an increase in body temperature, the development of purulent abscesses and severe hangover syndrome can be observed.This disease is usually treated in the surgical department.
Osteomyelitis of the spine
Osteomyelitis is a purulent infectious disease that affects bone tissue, periosteum and bone marrow.It can be acute (occurring for the first time) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, an increase in body temperature (often up to 40.0) and an increase in heart rate.After 2-4 days, local pain develops over the lesion site, local swelling and tissue hyperemia (redness), and limitation of motor activity.In chronic osteomyelitis, there are traces of fistulous channels on the skin (circular lesions with purulent discharge).If you suspect the development of osteomyelitis, you should immediately seek help from a doctor.This pathology is treated by a surgeon.
Spondylolisthesis
Spondylolisthesis is a forward displacement of the vertebrae as a result of congenital nonfusion of the arch with the body or degenerative 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, caused by slipped vertebrae and pinched nerve endings.The pain often radiates to the gluteal area and intensifies when trying to straighten.Can be accompanied by pain in the legs, muscle weakness and numbness of the limbs.
Fibrositis
Fibrosis is a non-specific inflammatory process characterized by fibrous degeneration and fat of fibrous connective tissue.The exact cause of the disease is still unclear.More common in middle-aged women.
Clinical manifestations
- moderate or severe persistent, back pain;
- headache;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disorders;
- irritable
Pain worsens in winter when outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to hold the body in space and move, has spatial and pain sensitivity.Damage to any, even the smallest, element of this system by injury or disease causes the development of pain.Various injuries, excessive physical activity, as well as displacement of vertebral articular processes lead to the development of inflammatory processes in the spinal tissue, which is the cause of pain.
Pain radiating to the back and lumbar (stenosis)
With stenosis (narrowing of the spinal canal or exit hole from the spinal nerve root), as a result of which compression of nerve fibers occurs, the pain that appears in the back then radiates to the legs, while the gait of the patient changes, he limps.
The pain is dull and constant.The cause of the development of this disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence.For treatment, a surgical method called decompression surgery is used, in which the vertebral arch is dissected.
Back pain after trauma
Causes of back injuries can be:
- sudden heavy lifting often causes sprains or tears in muscle fibers or ligaments;
- falling;
- a blow or bruise;
- mechanical effect.
Along with the appearance of pain in case of injury, spasms of muscle fibers develop, which disappear within a few hours to a few 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 some time is replaced by pain.
Back pain during pregnancy
In some women, persistent pain in the lumbar region appears in the first months of pregnancy and does not disappear until delivery.The cause of the pain is the increased secretion of relaxin, the hormone responsible for preparing the birth canal for the passage of the child, that is to soften the ligaments of the sacral area.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 back pain during pregnancy:
- Do not wear high-heeled shoes;
- all movements must be made smoothly;
- you can't lift weights;
- if there is an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend or jerk;
- You should not bend to the floor, you should kneel;
- No need to remove tall objects.
Causes of pain above the lower back
The main causes of pain located above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process that leads to changes in the normal structure of the cartilage tissue of the spine is called osteochondrosis.There are cervical, thoracic and lumbosacral osteochondrosis.Often this disease is accompanied by protrusion of the vertebral disc and intervertebral hernia.
Clinical manifestations
Symptoms of the disease depend on its location:
- Cervical osteochondrosis is indicated by pain and stiffness of movement in the neck and arms, headache;when the vertebral artery is compressed, dizziness, hearing loss, and fainting may occur.
- In the chest form of this disease, acute pain in the back and chest (spiking feeling), heart pain, and difficulty breathing appear.
- Lumbosacral localization is characterized by pain in the lumbar region, radiating to the legs and intensifying during movement;lumbago, numbness in the legs, and disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by painful excessive tension in the muscles of the spine.The main reason for the development is the static load of the spinal muscular frame for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is localized on one or both sides of the spine, intensifies with stress, overwork, injury or sudden hypothermia.Pain sensations can vary in severity from a slight, barely noticeable discomfort to very severe pain that lasts for several days.
One of the most effective ways to relieve back pain istherapeutic restrictions.