Back pain has become one of the most common patient complaints in emergency medicine and outpatient appointments over the past few years. Such pain is not a separate nosological unit, but a clinical manifestation of several diseases. Of particular interest to these symptoms is the fact that often with acute pain, motor activity is significantly limited and a person’s ability to work is reduced.
The main causes of back pain are diseases of the spine, in addition to them, such clinical manifestations can be caused by pathology of internal organs, professional features (long sitting at a desk or in the driver's seat, hard physical work), trauma or pregnancy. In most cases, it is possible to find out the cause of the pain by examining the patient carefully, sometimes additional examinations are needed to establish the 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 symptoms indicate disease of internal organs and are quite rare, as they get older, back pain is more common, and in old age almost everyone suffers from it, and only about 25% ofthose who suffer from this pathology. seek medical advice.
What is the risk of back pain?
In most cases, back pain therapy initiated prematurely or not adequately 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;
- motor activity limits;
- development of a sense of stiffness in the back.
The chronic process is characterized by a recurrent course with frequent episodes of exacerbation, provoked by prolonged hypothermia, physical activity or being in one position. Exacerbation is replaced by a period of remission, during which there is no pain at all or is expressed minimally. 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 show these symptoms and require immediate medical attention.
Back pain in common diseases
Common diseases indicated by the presence of back pain include sciatica and herniated discs.
The severity of pain syndromes in this disease depends on the stage of their course and the threshold of sensitivity 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 disturbances against a background of severe pain. Allocation of cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestation
It manifests itself as a marked pain syndrome with localization at the site of violation and intensification when making movements and coughing (even with a slight cough). Pain can be of different nature (painful, dull or sharp), appear periodically or continuously. In most cases, the pain radiates to the top or bottom. In addition to pain, the disease is characterized by muscle weakness and impaired sensitivity in the limbs.
Disc herniation
The protrusion or protrusion of fragments of the intervertebral disc into the spinal canal is called a herniated disc. Most often, the disease occurs in people aged 25 to 50 years, the risk group includes drivers, people who spend a long time sitting and those who have to lift weights every day.
Clinical manifestation
The main symptom is pain, which at the beginning of the disease is dull and intermittent and increases with physical exertion, coughing and prolonged exposure to one position. As the pain progresses, it increases and radiates to the arms, buttocks, or thighs, depending on the location of the hernia.
Causes of pain in people over 50 years of age
Almost every parent suffers from pain in the spine, the most common causes of such symptoms are the following diseases:
Osteoporosis
Clinical manifestation
The disease is characterized by asymptomatic or almost invisible onset, similar to the symptoms of osteochondrosis. Often, pathology has been detected with the characteristics of an injury, or rather a fracture that can occur with minimal load or little bruising.
It is very difficult to see 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 sudden changes in weather conditions;
- hair and nails become brittle;
- possible development of non -inflammatory periodontal disease;
- changes in posture and a decrease in height;
- leg cramps at night.
Spondylosis
Chronic degenerative-dystrophic lesions of the spine, caused by deformities of the vertebrae and the appearance of bone growth and spikes (osteophytes) on its surface.
Clinical manifestation
In the early stages, it manifests itself as a slight limitation of spinal mobility. With the progression of the disease due to the fixation of the area subject to excessive load, a pronounced pain syndrome develops. Acute, unbearable pain accompanied by muscle tension, limitation of mobility caused by the gradual straightening of the physiological curve of the spine.
Causes of pain in people under 50 years
Often, the following pathologies are 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, which is localized in the sacroiliac joint, is called sacroiliitis. The causes of the development of the disease can be trauma, increased pressure on the joints for a long time (during pregnancy, work associated with lifting weights or constant sitting), congenital anomalies, metabolic disorders, neoplasms.
Clinical manifestation
The pain is localized in the pelvic area and spreads along the sciatic nerve from the affected part, can increase with pressure on the ilium wing and flexion of the limb. 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, development of purulent abscesses and obvious intoxication syndrome. The 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 (appearing for the first time) or chronic (long -term and characterized by periods of deterioration and remission).
Clinical manifestation
It begins with chills, fever (often up to 40. 0) and an increase in heart rate. After 2–4 days, local pain develops at the site of the lesion, local edema and hyperemia (redness) of the tissues, and limitation of motor activity. In chronic osteomyelitis, there is an effect of fistulous ducts on the skin (round lesions with purulent discharge). If there is a suspicion of the development of osteomyelitis, it is urgent to seek help from a doctor. Surgeons deal with the treatment of such pathologies.
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 manifestation
The main manifestation is chronic pain in the lumbar region, due to slippage of the vertebrae and violation of nerve endings. The pain often radiates to the gluteal area and intensifies when trying to release the bend. 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 degeneration and fatty fibrous connective tissue. The exact cause of the disease has yet to be clarified. It is more common in middle -aged women.
Clinical manifestation
- moderate or severe persistent, painful back pain;
- Headache;
- pain in the neck and shoulders;
- pain and stiffness of the spine in the morning;
- sleep disorders;
- easily upset.
The pain increases in the winter 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 moving, has space 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 tissues, which cause pain.
Pain spreading to the back and lumbar (stenosis)
With stenosis (narrowing of the spinal canal or an opening out of the spinal nerve root), as a result of which compression of the nerve fibers occurs, the pain that appears in the back then radiates to the legs, while the gait. the sick person changes, he is lame.
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 prone to its occurrence. For treatment, a surgical method is used, called decompression surgery, in which the vertebral arch is dissected.
Back pain after trauma
Back injuries can be caused by:
- sharp weight lifting often leads to the development of stretching or tearing of muscle fibers or ligaments;
- fall;
- blows or injuries;
- mechanical effects.
Along with the appearance of pain in the event of an injury, muscle fiber spasm develops, which disappears within a few hours to a few days, depending on the severity of the damage. 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.
Low back pain during pregnancy
In some women, persistent pulling pain in the lumbar region appears in the first months of pregnancy and does not go away until delivery. The cause of pain is an increase in the secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of children, that is, for softening the ligaments of the sacral area. Because relaxin acts on all ligaments, and an increased load is placed on the spine of pregnant women, chronic pain in the lumbar region may develop.
How to relieve back pain symptoms during pregnancy:
- do not wear high heels;
- all movements must be performed smoothly;
- you can't lift weights;
- in case of an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend and do not jerk;
- do not bow to the floor, you have to kneel;
- no need to remove objects placed high.
Causes of pain in the upper 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 spinal cartilage tissue is called osteochondrosis. Provision of cervical, thoracic and lumbosacral osteochondrosis. Often the disease is accompanied by protrusion of the vertebral disc and intervertebral hernia.
Clinical manifestation
The symptomatic characteristics of the disease depend on its localization:
- Cervical osteochondrosis is indicated by pain and stiffness of movement in the neck and arms, headache, with compression of the vertebral arteries, dizziness, hearing impairment, and fainting may appear.
- In the thoracic form of the disease, there is acute pain in the back and chest (spikes), heart pain, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, radiating to the legs and exacerbated during movement, back pain, numbness of the legs, disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by extremely painful excessive tension in the muscles of the spine. The main reason for development is the static load of the spinal muscle frame for a long time (being in an uncomfortable position).
Clinical manifestation
Pain is localized on one or both sides of the spine, exacerbated by stress, overwork, injury, or sudden hypothermia. The pain can vary in severity from a slight almost invisible discomfort, to severe severe pain lasting several days.
One of the most effective ways to relieve back pain istherapeutic restrictions.