Back pain is one of the most common complaints of patients in emergency medicine and outpatient meetings in recent years. Such pain is 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 in acute pain physical activity is significantly limited and people's ability to work decreases.
The main causes 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 driver's seat, heavy physical work), trauma or pregnancy. In most cases, it is possible to determine the cause of pain through careful examination of the patient, sometimes additional tests are needed to establish the diagnosis. The relief of the pain syndrome depends on the underlying disease and the characteristics of its course, the treatment is chosen individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain. In addition, in childhood such a symptom indicates diseases of the internal organs and is quite rare, because with age back pain is more common, and in old age almost everyone faces it and only about 25% of those suffering from this pathologyseek medical advice.
What is the risk of back pain?
In most cases, untimely or inadequately prescribed therapy for back pain leads to a chronic process. Chronic back pain is a very common cause of reduced work capacity in people aged 40 to 55 years and is characterized by:
- permanent character;
- increases 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 staying in one position. Exacerbations are replaced by periods of remission in which the pain is absent or minimal. In most cases, back pain is not a direct threat to human 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 common diseases
Common diseases that manifest with back pain include sciatica and disc herniation.
The severity of the pain syndrome in these diseases depends on the stage of their course and the threshold of sensitivity 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 on the background of severe pain. Distribute cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestations
It manifests itself as a pronounced pain syndrome with localization at the site of the disorder and intensification when performing movements and coughing (even with a mild cough). The pain can be of different nature (pain, dull or sharp), recurring or 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 in the extremities.
Disc herniation
Protrusion or protrusion of fragments of intervertebral discs in the spinal canal is called a herniated disc. The disease is most common in people aged 25 to 50, the risk group includes drivers, people who spend a long time in a sitting position and those who are forced to lift weights daily.
Clinical manifestations
The main symptom is the pain, which at the beginning of the disease is dull and periodic in nature and intensifies with exercise, coughing and prolonged exposure in one position. As the pain progresses, it increases and radiates to the arm, buttocks or thigh, depending on the location of the hernia.
Causes of pain in people over 50 years
Almost every adult experiences pain in the spine, and the most common cause of this symptom are the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost imperceptible onset, similar to the symptoms of osteochondrosis. Often the pathology is detected already with characteristic injuries or rather fractures, which can occur with minimal stress or light bruising.
It is very difficult to detect the disease at an early stage, it usually manifests itself with the following symptoms:
- pain in the lumbar region or chest, which occurs with prolonged static load and 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 deformity of the vertebrae and the appearance of bone growths and spines (osteophytes) on their surface.
Clinical manifestations
In the early stages it manifests itself as a slight restriction of the mobility of the spine. With the progression of the disease due to fixation of the area subjected to overload, a pronounced pain syndrome develops. Acute, unbearable pain is accompanied by muscle tension, limited mobility due to the gradual straightening of the physiological curves of the spine.
Causes of pain in people under 50 years
Very often the following pathologies cause pain in the lumbar region or chest, which occurs at a young or middle age:
- sacroiliitis;
- osteomyelitis of the spine;
- spondylolisthesis;
- fibrosis.
sacroiliitis
The inflammatory process localized in the sacroiliac joint is called sacroiliitis. The reason for the development of this disease can be trauma, increased stress on the joint for a long time (during pregnancy, work related to weightlifting or constant sitting), congenital anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side, may be exacerbated by pressure on the wing of the ilium and flexion of the limbs. In severe pain, the patient takes a forced position with his legs bent at the knees. In addition to the pain, there may be a rise in body temperature, the development of purulent abscesses and a pronounced syndrome of intoxication. The disease is usually treated in surgical wards.
Osteomyelitis of the spine
Osteomyelitis is a purulent infectious disease that affects the bone, periosteum and bone marrow. It can be acute (first time) or chronic (prolonged and characterized by periods of exacerbation 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, local swelling and redness (redness) of the tissues and limitation of motor activity. In chronic osteomyelitis there are traces of fistula passages on the skin (rounded wounds with purulent secretions). If osteomyelitis is suspected, a doctor should be consulted immediately. The surgeon deals with the treatment of such pathology.
Spondylolisthesis
Spondylolisthesis is a forward displacement of the vertebrae 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 slipping of the vertebrae and disruption of nerve endings. The pain often radiates to the gluteal area and intensifies when trying to expand. It may be accompanied by leg pain, muscle weakness and tingling in the limbs.
Fibrosis
Fibrosis is a non-specific inflammatory process characterized by fibrous and fatty degeneration of fibrous connective tissue. The exact cause of the disease is still unclear. It is more common in middle-aged women.
Clinical manifestations
- moderate or severe persistent, painful back pain;
- headache;
- neck and shoulder pain;
- soreness and stiffness of the spine in the morning;
- sleep disturbance;
- irritability.
The pain intensifies during the cold season, when you are 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 anyone, even the smallest element of this system from injury or illness 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 spine, which causes pain.
Pain radiating to the back and lumbar region (stenosis)
In stenosis (narrowing of the spinal canal or openings at the exit of the roots of the spinal nerves), resulting in compression of nerve fibers, the pain that occurs in the back, then radiates to the legs, while the patient's gait changes, he is lame.
The pain is dull and constant. The reason for the development of this disease are age-related changes, so young and middle-aged people are not susceptible to its occurrence. An operative method called decompression surgery is used to treat the vertebral arches.
Post-traumatic back pain
Back injuries can be caused by:
- sudden weight lifting often causes the development of stretching or tearing of muscle fibers or ligaments;
- autumn;
- blow or injury;
- mechanical impact.
Along with the appearance of pain in the injury, a spasm of the muscle fibers develops, which disappears in a period of several hours to several days, depending on the severity of the injury. In severe injuries, muscle spasm can last for several weeks. Immediately after the injury, the pain is sharp, which after a while is replaced by pain.
Back pain during pregnancy
In some women, the constant pulling pain in the lumbar region appears in the first months of pregnancy and does not disappear until birth. 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, namely for softening the ligament apparatus of the sacral region. Because relaxin acts on all ligaments and a pregnant woman's spine is overloaded, chronic lumbar pain can develop.
How to relieve the symptoms of back pain during pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- you can't lift weights;
- in case of urgent need to lift something heavy, try to distribute the weight on both hands, do not bend or pull;
- do not bend to the floor, you must kneel;
- there is no need to remove high objects.
Causes of pain over 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 cartilage tissue of the spine is called osteochondrosis. Distribute cervical, thoracic and lumbosacral osteochondrosis. The disease is often accompanied by a protrusion of the spinal disc and an intervertebral hernia.
Clinical manifestations
The characteristics of the symptoms of the disease depend on its location:
- Cervical osteochondrosis is manifested by pain and stiffness in the neck and arms, headache, compression of the vertebral artery, dizziness, hearing loss and seizures.
- In the thoracic form of the disease there is acute pain in the back and chest (feeling of sting), heart pain, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, radiating to the legs and intensifying during movement, back pain, numbness of the limbs, disorders of the genitourinary system may occur.
Myofascial syndrome
Myofascial syndrome is a disease characterized by a sharp painful excessive tension of 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 (in an awkward position).
Clinical manifestations
The pain is localized on one or both sides of the spine, aggravated by pressure, overload, injury or sudden hypothermia. The pain can range in severity from mild, almost imperceptible discomfort to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.