Back pain has been one of the most common complaints of patients in emergency and outpatient care in recent years. Such pains are not a separate nosological unit, but a clinical manifestation of various 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 is reduced.
The main cause of back pain is diseases of the spine, in addition to them, such a clinical manifestation can be caused by pathologies of internal organs, professional characteristics (long sitting at a table or in the driver's seat, strenuous physical work), trauma 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 painful 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. Also, in childhood, this symptom indicates diseases of Organs internal organs and is quite rare, as they get older, back pain is more common, and in old age, almost everyone encounters it, and only about 25% of people suffer from it. this pathology, seek medical advice.
What is the risk of back pain?
In most cases, therapy for back pain started prematurely or inappropriately prescribed 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 a position. Exacerbations are replaced by periods of remission, in which there is no or minimal pain. 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 illnesses
Common ailments that are manifested by the presence of back pain include sciatica and herniated discs.
The severity of the pain syndrome in these diseases depends on the stage of its 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 spinal cord roots and is manifested by motor and autonomic disorders in the context of severe pain. Allocate cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestations
It manifests as a pronounced pain syndrome with localization at the site of the violation and intensification when making movements and coughing (even with a 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 extremities. In addition to pain, the disease is characterized by muscle weakness and impaired sensation in the limbs.
herniated disc
A bulge or bulge of fragments of the intervertebral discs in the spinal canal is called a herniated disc. Most often, the disease occurs in people aged 25 to 50, the risk group includes drivers, people who spend a lot of time sitting and those who are forced to lift weights daily.
Clinical manifestations
The main symptom is pain, which early in 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 every elderly person experiences back pain, the most common cause of such a symptom is the following diseases:
osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or barely noticeable onset, similar in symptoms to osteochondrosis. Often, the pathology is already detected with lesions characteristic of it, or rather, fractures that can occur with minimal load or light 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 in the thoracic spine, which appears with prolonged static loading and with a marked change in weather conditions;
- hair and nails become brittle;
- possible development of non-inflammatory periodontal diseases;
- change in posture and decrease in stature;
- leg cramps at night.
spondylosis
Chronic-degenerative-dystrophic lesion of the spine, caused by the deformation of the vertebrae and the appearance of bony protuberances and tips (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests as a slight limitation of spinal mobility. With the progression of the disease due to the fixation of the area subject to overload, a pronounced pain syndrome develops. Acute and 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 years old
Often, the following pathologies become the cause of pain in the lower back or thoracic spine that occurs in young or middle-aged people:
- sacroiliitis;
- spine osteomyelitis;
- spondylolisthesis;
- fibrositis.
sacroiliitis
The inflammatory process, located 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 heavy lifting or constant sitting), 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, and may increase with pressure on the wing of the ilium 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 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 increased heart rate. After 2-4 days, local pain over the injury site, local swelling and hyperemia (redness) of the tissues and limitation of motor activity develop. In chronic osteomyelitis, there are traces of fistulous passages in the skin (rounded sores with purulent discharge). If osteomyelitis is suspected of developing, it is urgent to seek help from a doctor. The surgeon deals with the treatment of such a pathology.
spondylolisthesis
Spondylolisthesis is the forward displacement of a vertebra as a result of congenital non-union 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 lower back, due to slippage of the vertebra and violation of nerve endings. The pain usually radiates to the gluteal region and intensifies when trying to let go. It may be accompanied by leg pain, muscle weakness and limb numbness.
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 back pain;
- headaches;
- neck and shoulder pain;
- spinal pain and stiffness in the morning;
- sleep disorders;
- irritability.
The pain intensifies in the cold season when outdoors, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which keeps the body in space and in motion, has spatial and painful sensitivity. Damage to anyone, even the smallest element of this system through injury or illness, causes pain to develop. 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 lower back (stenosis)
With stenosis (narrowing of the spinal canal or openings at the exit of the roots of spinal nerves), as a result of compression of nerve fibers, pain that appears in the back radiates to the leg, while the sick person's gait 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:
- heavy lifting often causes the development of stretching or tearing of muscle fibers or ligaments;
- the fall;
- blow or wound;
- mechanical impact.
Along with the onset of pain in the event of an injury, a spasm of the muscle fibers develops, which disappears over 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 pain.
Back pain during pregnancy
In some women, constant pain in the lower back appears during the first few months of pregnancy and does not go away until delivery. The cause of the pain is the increase in the secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the child, that is, for the softening of the ligament apparatus of the sacral region. As relaxin acts on all ligaments and an increased load is placed on the spine of a pregnant woman, chronic pain in the lower back can occur.
How to relieve back pain symptoms during pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- you cannot 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 pull;
- do not lower yourself to the ground, you need to kneel;
- there is no need to remove objects placed high up.
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. Allocate cervical, thoracic and lumbosacral osteochondrosis. Often the disease is accompanied by spinal disc protrusion and intervertebral hernia.
Clinical manifestations
The characteristics of the symptoms of the disease depend on their location:
- 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 a sharp pain in the back and chest (feeling like a stake), heart pain, difficulty breathing.
- The lumbosacral location is characterized by pain in the lumbar region, radiating to the legs and aggravated during movement, back pain, numbness of the extremities, disorders of the genitourinary system may appear.
Myofascial Syndrome
Myofascial syndrome is a disease characterized by acutely painful excessive tension of the spinal muscles. The main reason for the development is the static overload of the muscular structure 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, made worse by pressure, overwork, injury, or sudden hypothermia. The pain can be of varying severity, from mild, barely noticeable discomfort to intense, excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blocks.