Back pain has been one of the most common patient complaints in emergency medicine and outpatient appointments in recent years. Such pains are not a separate nosological unit, but a clinical manifestation of a number of diseases. Of particular importance to this symptom is the fact that often with acute pain, motor activity is significantly limited and people's ability to work decreases.
The main cause of back pain is diseases of the spinal column, in addition to them, such a clinical manifestation can be caused by pathologies of internal organs, professional features (long sitting at a table or in a driver's seat, hard physical work), trauma or pregnancy. In most cases, it is possible to find out the cause of pain by carefully examining the patient, sometimes additional examinations are required to establish a diagnosis. The relief of 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 a symptom indicates diseases of the 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 those suffering from this pathology seek advice fromdoctor.
What is the risk of back pain?
In most cases, untimely started or inadequately prescribed back pain therapy leads to 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;
- 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, in which there is no pain at all or 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 that manifest this symptom and require immediate medical attention.
Back pain in general diseases
Common diseases that are manifested by 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 sensitivity threshold of the patient.
Radiculitis
Radiculopathy or radiculitis is a symptom complex 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. Allocate cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestations
It manifests itself as a pronounced pain syndrome with localization at the site of infringement and intensification when making movements and coughing (even with slight coughing). The pain can be of a different nature (aching, dull or sharp), appear periodically or be constant. In most cases, 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.
Herniated disc
A protrusion or protrusion of fragments of the intervertebral discs into the canal of the spinal column is called a herniated disc. Most often, the disease occurs in people from 25 to 50 years old, the risk group includes drivers, people who spend a long time sitting 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 one 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 this symptom is the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost imperceptible onset, similar in symptoms to osteochondrosis. Often, pathology is detected already 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 usually manifests itself with the following symptoms:
- pain in the lumbar region or thoracic spine, which appears with 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 bone outgrowths and spikes (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests itself as a slight limitation of the mobility of the spine. With the progression of the disease due to the fixation of the area subject to 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), congenital anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve from the affected side, may increase with pressure on the wing of the ilium and flexion of the limbs. With severe pain, the patient takes a forced position with 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 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 begins with chills, fever (often up to 40. 0) and increased heart rate. After 2-4 days, local pain develops over the site of the lesion, local edema and hyperemia (redness) of the 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 help from a doctor. The surgeon deals with the treatment of such a pathology.
Spondylolisthesis
Spondylolisthesis is the displacement of a vertebra forward as a result of congenital nonunion of the arch 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 slippage of the vertebra and infringement of nerve endings. The pain often radiates to the gluteal region and intensifies when trying to unbend. May be accompanied by pain in the legs, muscle weakness and numbness of 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;
- headaches;
- pain in the neck and shoulders;
- soreness and stiffness of the spine in the morning;
- sleep disturbance;
- irritability.
Soreness intensifies in the cold season when outside, 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, 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 the articular processes of the vertebrae lead to the development of an inflammatory process in the tissues of the spinal column, which causes pain.
Pain radiating to the back and lumbar (stenosis)
With stenosis (narrowing of the spinal canal or openings of the exit of the roots of the spinal nerves), as a result of which compression of the nerve fibers occurs, the pain that appears in the back then radiates to the leg, while the gait of the sick person changes, he limps.
The pain is dull and constant. The reason for the development of this disease is 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:
- a sharp lifting of weights often causes 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 the event of an injury, a spasm of muscle fibers develops, which disappears in a period of several hours to several days, depending on the severity of the damage. In severe injuries, muscle spasm can last for several weeks. Immediately after the injury, the pain is sharp, which after some time is replaced by aching.
Back pain during pregnancy
In some women, constant pulling pain in the lumbar region appears already during the first months of pregnancy and does not go away until childbirth. The cause of pain is the increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the child, namely for softening 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 must be performed smoothly;
- you can not lift weights;
- in case of an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend over and do not jerk;
- do not bend down to the floor, you need to kneel down;
- no need to remove high-placed objects.
Causes of pain above the lower back
The main causes of pain localized 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 spinal column is called osteochondrosis. Allocate cervical, thoracic and lumbosacral osteochondrosis. Often the disease is accompanied by protrusion of the vertebral disc and intervertebral hernia.
Clinical manifestations
Features of the symptoms of the disease depend on its 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.
- In the thoracic form of the disease, there is an acute pain in the back and chest (feeling of a stake), heart pain, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, radiating to the legs and aggravated during movement, backache, numbness of the extremities, disorders of the genitourinary system may appear.
Myofascial Syndrome
Myofascial syndrome is a disease characterized by sharply painful excessive tension of the muscles of the spinal column. The main reason for the development is the static overload of the muscular frame of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is localized on one or both sides of the spine, aggravated by pressure, overwork, injury or sudden hypothermia. Pain can be of varying severity from a slight almost imperceptible discomfort, to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.