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 variety of diseases. Of particular importance for 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 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 the table or in the driver's seat, hard physical work), trauma or pregnancy. In most cases, it is possible to discover the cause of pain by carefully examining the patient, sometimes additional examinations are required to establish a diagnosis. 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 increase, back pain is more common and in old age almost everyone encounters it and only about 25% of those whosuffer from this pathology. seek medical advice.
What is the risk of back pain?
In most cases, timely therapy or inadequately prescribed therapy for back pain leads to a chronic process. Chronic back pain is a very common cause of decreased performance in people aged 40 to 55 years and is characterized by:
- permanent character;
- increase during movement and physical activity;
- restriction of motor activity;
- development of a feeling of stiffness in the spine.
The chronic process is characterized by a recurrent course with frequent episodes of irritation, provoked by prolonged hypothermia, physical activity, or standing in one position. Exacerbations are replaced by periods of remission, in 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 that manifest this symptom and require immediate medical attention.
Back pain in general diseases
Common diseases manifested by the presence of back pain include sciatica and a disc herniation.
The severity of pain syndrome in these diseases depends on the stage of their progression and the sensitivity threshold of the patient.
Radiculitis
Radiculopathy or radiculitis is a complex of symptoms that develops as a result of compression of the spinal cord roots and is manifested by motor and autonomic disorders against the background of severe pain. Allocate pain to the sciatic nerve of the cervix, chest and lumbar (lumbosacral).
Clinical manifestations
It appears as a pronounced pain syndrome with localization at the site of injury and intensification during movements and coughing (even with mild cough). The pain can be of a different nature (pain, dull or sharp), appear periodically or be constant. In most cases, the 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.
Disc herniation
An elongation or elongation of fragments of intervertebral discs in the spinal canal is called a disc herniation. Most often, the disease occurs in people from 25 to 50 years, the risk group includes drivers, people who spend a long time sitting and those who are forced to lift weights every day.
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 grows and radiates to the arm, buttocks or thighs, depending on the location of the hernia.
Causes of pain in people over 50 years old
Almost every elderly person experiences back pain, the most common cause of such symptoms are the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost invisible 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 usually manifests itself with the following symptoms:
- pain in the lumbar region or thoracic spine, which manifests itself with prolonged static load and with a sharp change of 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.
spondilosis
Chronic degenerative-dystrophic lesion of the spine, caused by deformation of the vertebrae and the appearance of bony protrusions and bumps (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests as a slight restriction of spinal mobility. As the disease progresses due to fixation of the area subject to overload, a pronounced pain syndrome develops. Acute, unbearable pain is accompanied by muscle tension, restriction of mobility due to the gradual direction of physiological curves of the spine.
Causes of pain in persons under 50 years of age
Very often, the following pathologies become the cause of pain in the lumbar region or thoracic spine that appears at a young or middle age:
- sakroiliiti;
- spinal osteomyelitis;
- spondylolisthesis;
- fibrosis.
sakroiliiti
The inflammatory process, located in the sacroiliac node, is called sacroiliitis. The cause of the development of this disease can be trauma, increased stress on the wrist for a long time (during pregnancy, work associated with weight lifting or constant weight loss), congenital anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve on the affected side, may increase with pressure on the ilium arm and flexion of the limbs. With severe pain, the patient assumes a forced position with the 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 the bone tissue, periosteum and bone marrow. It can be acute (appears for the first time) or chronic (long-term and characterized by periods of irritation and remission).
Clinical manifestations
It starts with chills, fever (often up to 40. 0) and increased heart rate. After 2-4 days, local pain develops at the site of the lesion, edema and local tissue hyperemia (redness) and limitation of motor activity. In chronic osteomyelitis, there are traces of fistulous passages in the skin (rounded lesions with purulent discharge). If there is a suspicion of developing 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 misalignment 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 slipping of the vertebrae and damage to nerve endings. The pain often radiates to the gluteal region and intensifies when you try to undress. It can be accompanied by leg pain, muscle weakness and numbness of the limbs.
Fibrosis
Fibrosis 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 pain, back pain;
- headache;
- neck and shoulder pain;
- back pain and stiffness in the morning;
- sleep disturbance;
- irritability.
The pain intensifies in the cold season when it is outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to keep your body in space and move, has spatial sensitivity and pain. Damage to anyone, even the smallest element of this system from 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 spinal tissues, which causes pain.
Radiating pain in the back and lumbar region (stenosis)
With stenosis (narrowing of the spinal canal or opening of the outlet of the spinal nerve roots), as a result of which compression of the nerve fibers occurs, the pain that appears in the back then radiates to the legs while walking. of the sick varies, he lame.
The pain is dull and constant. The reason for the development of this disease are age-related changes, so young people and the elderly are not susceptible to its occurrence. An operative method, called decompression surgery, is used for treatment, in which the vertebral arches are dissected.
Post traumatic back pain
Back injuries can be caused by:
- sharp weight lifting often causes the development of stretching or rupture of muscle fibers or ligaments;
- the fall;
- blow or injury;
- mechanical impact.
In addition to the onset of pain in the event of injury, a spasm of muscle fibers develops, which disappears over a period of several hours to several 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 pulling pain in the lumbar region already appears during the first months of pregnancy and does not go away until birth. The cause of the pain is the increased secretion of relaxin, a hormone responsible for the preparation of the birth canal for the passage of the child, respectively for the softening of the ligament apparatus of the sacral region. Since relaxation acts on all ligaments and an added load is placed on a pregnant woman’s spine, chronic pain can develop in the lumbar region.
How to relieve the symptoms of back pain during pregnancy:
- do not wear high heels;
- all movements should be performed smoothly;
- you can not lift weights;
- in case of urgent need to lift something heavy, try to distribute the weight on both hands, do not bend and do not shake;
- do not bend to the floor, you must kneel;
- there is no need to remove the objects placed above.
Causes of pain in the lower back
The main causes of pain localized on the lower back are:
- osteochondrosis;
- myofascial syndromes.
Osteochondrosis
A degenerative-dystrophic process that leads to a change in the normal structure of the cartilage tissue of the spine is called osteochondrosis. Allocate osteochondrosis of the cervix, chest and lumbosacral. Often the disease is accompanied by vertebral disc lengthening 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 movements in the neck and arms, headache, with compression of the vertebral artery, dizziness, hearing impairment and fainting.
- In the form of the disease chest is observed an acute pain in the back and chest (feeling of pushing), pain in the heart, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, which radiates to the legs and is aggravated during movement, back pain may occur, numbness of the extremities, disorders of the genitourinary system.
Myofascial Syndrome
Myofascial syndrome is a disease characterized by excessively sharp painful tension of the spinal muscles. The main reason for development is static overload of the muscular frame of the spine for a long time (being in an uncomfortable position).
Clinical manifestations
The pain is localized to one or both sides of the spine, aggravated by pressure, overwork, injury, or sudden hypothermia. The pain can vary in severity from a slight almost invisible discomfort, to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.