Back pain has been one of the most common complaints among patients in emergency medicine and outpatient visits in recent years.Such pain is not a separate nosological unit, but a clinical manifestation of a number of diseases.What makes this symptom especially serious is that often with acute pain, physical activity is significantly limited and people’s ability to work is reduced.
The main cause of back pain is diseases of the spinal column; in addition, 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, heavy physical work), injury 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.Relief of pain syndrome depends on the underlying disease and the characteristics of its course; treatment is selected individually for each case.
Medical statistics indicate 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 you get older, back pain occurs more and more often, and in old age, almost everyone experiences it and only about 25% of those suffering from this pathology seek advice from a doctor.
What are the dangers of back pain?
In most cases, untimely or inadequately prescribed therapy for back pain leads to chronicity of the 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;
- increased during movements and physical activity;
- limitation of physical activity;
- development of a feeling of stiffness in the back.
The chronic process is characterized by a relapsing course with frequent episodes of exacerbations provoked by prolonged hypothermia, physical activity or being in one position.Exacerbations are followed by periods of remission, during 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 are manifested by this symptom, which require immediate consultation with a specialist.
Back pain due to common diseases
Common diseases that manifest as back pain include sciatica and spinal disc herniation.
The severity of pain in these diseases depends on the stage of their progression and the patient’s sensitivity threshold.
Radiculitis
Radiculopathy or radiculitis is a symptom complex 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.There are cervical, thoracic and lumbar (lumbosacral) radiculitis.
Clinical manifestations
It manifests itself as a pronounced pain syndrome localized at the site of infringement and intensified by movements and coughing (even with light 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 loss of sensitivity in the limbs.
Herniated disc
The protrusion or prolapse of fragments of 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 long periods of time sitting and those who are forced to lift heavy objects every day.
Clinical manifestations
The main symptom is pain, which at the beginning of the disease is dull and intermittent and intensifies with physical exertion, coughing and prolonged stay in one position.As the hernia progresses, the pain increases and radiates to the arm, buttock or thigh, depending on the location of the hernia.
Causes of pain in people over 50 years of age
Almost every elderly person experiences pain in the spine; the most common causes of this symptom are the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by an asymptomatic or almost imperceptible onset, with symptoms similar to osteochondrosis.Often, pathology is detected already with characteristic injuries, or rather fractures, which can occur with minimal load or mild bruise.
It is very difficult to notice the disease at an early stage; it usually manifests itself with the following signs:
- pain in the lumbar or thoracic spine, which appears during prolonged static load and during sudden changes in weather conditions;
- hair and nails become brittle;
- the development of non-inflammatory periodontal diseases is possible;
- changes in posture and reduction in height;
- the appearance of 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 spines (osteophytes) on their surface.
Clinical manifestations
In the early stages, it manifests itself as a slight limitation in the mobility of the spine.As the disease progresses, a pronounced pain syndrome develops due to fixation of the area subject to overload.Acute, unbearable pain is accompanied by muscle tension and limited mobility due to the gradual straightening of the physiological curves of the spine.
Causes of pain in people under 50 years of age
Very often, the following pathologies become the cause of pain in the lumbar or thoracic spine that occurs in young or middle age:
- sacroiliitis;
- spinal osteomyelitis;
- spondylolisthesis;
- fibrositis.
Sacroiliitis
The inflammatory process localized in the sacroiliac joint is called sacroiliitis.The cause of the development of this disease can be injury, increased load on the joint for a long time (during pregnancy, work associated with heavy lifting or constant sitting), congenital developmental anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side; it can intensify with pressure on the wing of the ilium and flexion of the limbs.In case of severe pain, the patient takes a forced position with his knees bent.In addition to pain, an increase in body temperature, the development of purulent abscesses and severe intoxication syndrome may be observed.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 (occurring for the first time) or chronic (long-term and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, increased body temperature (often up to 40.0) and increased heart rate.After 2-4 days, local pain develops over the site of the lesion, local swelling and hyperemia (redness) of the tissues, and limitation of motor activity.In chronic osteomyelitis, there are traces of fistulous tracts on the skin (round wounds with purulent discharge).If you suspect the development of osteomyelitis, you should urgently seek help from a doctor.This pathology is treated by a surgeon.
Spondylolisthesis
Spondylolisthesis is the forward displacement of a vertebra as a result of congenital nonfusion of the arch with the body or degenerative 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, caused by vertebral slippage and pinched nerve endings.The pain often radiates to the gluteal region and intensifies when trying to straighten.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.More common in middle-aged women.
Clinical manifestations
- moderate or severe constant, aching back pain;
- headaches;
- neck and shoulder pain;
- pain and stiffness of the spine in the morning;
- sleep disturbance;
- irritability.
The pain intensifies in the cold season when being outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to hold 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 becomes the cause of pain.
Pain radiating to the back and lumbar region (stenosis)
With stenosis (narrowing of the spinal canal or the exit holes 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 leg, while the gait of the sick person changes, he limps.
The pain is dull and constant.The cause of the development of this disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence.For treatment, a surgical method called decompression surgery is used, in which the vertebral arches are dissected.
Post-traumatic back pain
Causes of back injuries can be:
- sudden lifting of weights often causes sprains or tears in muscle fibers or ligaments;
- fall;
- blow or bruise;
- mechanical impact.
Along with the appearance of pain in case of injury, a spasm of 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 spasms can last for several weeks.Immediately after injury, the pain is sharp, which after some time is replaced by aching.
Back pain during pregnancy
In some women, constant nagging 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 a 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 back pain during pregnancy:
- Do not wear high-heeled shoes;
- all movements must be made smoothly;
- you cannot lift weights;
- if there is an urgent need to lift something heavy, try to distribute the weight on both hands, do not bend over or jerk;
- You shouldn’t bend over to the floor, you need to get down on your knees;
- There is no need to remove high-lying objects.
Causes of pain above the lower back
The main causes of pain localized above the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process leading to a change in the normal structure of the cartilage tissue of the spinal column is called osteochondrosis.There are 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 location:
- Cervical osteochondrosis is manifested by pain and stiffness of movement in the neck and arms, headaches; when the vertebral artery is compressed, dizziness, hearing loss, and fainting may occur.
- In the chest form of the disease, acute pain in the back and chest (a feeling of a stake), heart pain, and difficulty breathing appear.
- The lumbosacral localization is characterized by pain in the lumbar region, radiating to the legs and intensifying during movement; lumbago, numbness of the extremities, and disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by sharply painful excessive tension in the muscles of the spinal column.The main reason for the 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 on one or both sides of the spine, intensifying with pressure, overwork, injury or sudden hypothermia.Pain sensations can vary in severity from slight, almost imperceptible discomfort to severe excruciating pain for several days.
One of the most effective ways to relieve back pain istherapeutic blockades.