Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know firsthand about back pain.Of all sick leave issued, more than a third are related to this problem.The reason can be considered the weakness of fragile muscles and their rapid growth.To identify the problem, in addition to visual examination, hardware diagnostics (X-ray, myography, computed tomography, etc.) and laboratory blood tests are carried out.Treatment is prescribed only after the diagnosis has been established.

Why does my back hurt?

Spine pain can occur directly after injuries, pathologies of the vertebrae, ligaments and discs or damage to soft tissues.It depends on the position of the body, the level of physical activity, but can also be reflected, for example, in diseases of internal organs.To some extent, the back itself is vulnerable due to its structure.

Its basis is the spine, which provides supporting, protective, motor and shock-absorbing functions.This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time with an inadequate lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spinal column is the spinal cord, its paired roots innervate almost all organs and tissues.Any disturbance to this complex system can cause pain.The cervical and lumbar regions suffer most frequently due to their greater loads and mobility.

What to do if you have back pain?

A medical examination is necessary to determine the cause, especially if the pain becomes frequent.Only a specialist can make the correct diagnosis and prescribe treatment.You cannot self-diagnose.

First, you can contact a therapist, who will identify a set of symptoms and refer you to the right specialist.If the cause is known and obvious, you can continue the prescribed therapy.Neurologists, orthopedists, and vertebrologists treat back problems.

Causes of back pain

Back pain is a non-specific symptom that can be caused by a variety of reasons.

Physiological causes (common):

• weight gain;
• recent birth or pregnancy;
• hypodynamic work - in the office, at the computer, driving a car;
• standing work – hairdressers, waiters and salespeople, street advertisers, surgeons, teachers;
• intense physical activity combined with sudden turns of the body;
• overload during training;
• postmenopausal with a tendency to osteoporosis.

Pathological reasons:

• diseases of the spine (osteochondrosis, spondylosis, ankylosing spondylitis, tumors, arthritis, osteomyelitis, Reiter's syndrome) and spinal cord;
• growth diseases - scoliosis and kyphosis;
• infectious spinal injuries;
• osteoporosis, osteomalacia;
• diseases of internal organs - kidneys, pancreas, stomach, spleen, liver;
• atherosclerosis of the abdominal aorta.

Acute pain can occur with disc protrusion, spondyloarthritis, spinal epiduritis, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, spinal cord effusions, inflammation of the appendages in women and prostate cancer in men.

Types of Diseases Based on Nature of Back Pain

Causes of severe pain:

• hypothermia;
• muscle tension;
• myositis;
• prolonged uncomfortable posture during sleep or work;
• low back pain (caused by labor);
• osteochondrosis;
• intervertebral hernia or displacement of intervertebral discs due to sudden lifting of weights or sudden turning of the body;
• kidney diseases - cause back pain due to the close location of the kidneys in the lower back;
• stomach diseases.

Causes of acute pain:

• intervertebral hernia - with them the condition worsens with any physical stress;
• radiculitis – this type of back pain often occurs on one side, radiates to the thigh or buttock, causes numbness in the legs and also depends on physical exertion;
• osteochondrosis - the patient may feel a dull pain that radiates to the leg and intensifies when coughing, sneezing, straining, walking, bending over.

Etiology of throbbing pain:

• osteochondrosis;
• intervertebral hernia;
• lumbago;
• spondylosis – are acute and cannot be relieved with painkillers.

Back Pain Burst:

• ischemia;
• heart attack;
• SCREEN;
• gallbladder inflammation;
• a sharp increase in pressure;
• atherosclerosis.

Why does my back hurt after sleeping?

Most people tend to experience back pain in the morning after sleeping.The reasons may be:

• overload the day before if you lifted weights and moved suddenly;
• weak back muscles;
• hypothermia;
• vertebral hernia or osteochondrosis;
• scoliosis - curvature of the spine leads to irregular muscle contraction;
• pregnancy - when the center of the body changes;
• obesity - the load on the spine is also uneven.

Sleep conditions are also important.The bed should not be too hard or soft - in any case, the person is forced to take an uncomfortable and non-physiological position during sleep, which causes the muscles to overstrain and not rest at night.Posture is so important that not even an orthopedic mattress can help.It is recommended to sleep on your back with your legs elevated.

In addition, the causes of pain after sleep can be diseases of the spine and internal organs (urological, gastrointestinal tract, including oncological).

Diseases associated with the joints and spine

All pathologies that cause back pain have a common basis - uneven load on the spine.These include:

1. Ankylosing spondylitis – persistent inflammation of the ligaments and joints causes chronic spasm of the surrounding muscles.The process is autoimmune;Over time, the vertebrae begin to fuse, which dramatically disrupts the functioning of the spine.
2. Spondylolisthesis – the vertebrae are in an abnormal position.They are displaced and affect the brain or roots.
3. Osteochondrosis - intervertebral discs become thinner, crack and are replaced by bone tissue.Depreciation becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammation of the joints.Most often it affects the cervical spine.
5. Osteomyelitis is an inflammation of the bone marrow and surrounding soft tissues.It causes intense pain.
6. Reiter's disease is a simultaneous rheumatic lesion of the urogenital tract, joints and conjunctiva of the eyes.The small back muscles are affected.More often typical of young people, it develops gradually.The pain is intense in the morning and lessens at night.
7. Spinal canal stenosis - the cause may be a herniated disc or protrusion (protrusion into the spinal canal).Most often, the process involves the lowest roots of the spinal cord, which innervate the legs.The pain is felt from the lower back to the foot, intensifying both at rest and when walking.
8. Facet syndrome is an injury to the intervertebral (facet) joints.The pain may be local or radiate to the groin, coccyx or thigh.Physically dependent.At night the condition worsens, after rest it improves.It occurs more frequently in the elderly.

Muscle-related diseases

Muscle tissue is affected secondarily, against the background of pathology of bone tissue or joints. Painful spasms and stiffness appear in the muscles, mobility is impaired:

1. Fibromyalgia is a pain syndrome that runs from the neck to the lower back.Neurological symptoms may occur: increased sensitivity when pressing certain points on the back, stiffness and rigidity.
2. Polymyositis - occurs due to hypothermia, injury, sprain or intense physical exertion.Muscle weakness appears, in which even turning to one side is painful and problematic.
3. Dermatomyositis is a chronic disease of muscles, organs and skin, usually autoimmune in nature.
4. Charcot disease is an inflammation of the peripheral nerves that run along the spine.This leads to changes in gait, muscle weakness and increased sensitivity of the nerve roots.
5. Polymyalgia rheumatica is the negativity of the environment in the form of hypothermia, overload, uncomfortable posture, etc.It leads to spasms in individual muscles and the appearance of pain.So-called trigger points appear, when pressed the muscle reacts with sharp pain.Neurologists know this.Pain of this type can be eliminated with warming ointments and a needle applicator.

Spinal cord pathologies

These include infringement of the spinal cord, which has 31 paired branches, where each nerve is responsible for the innervation of its area. This condition occurs when:

• injuries (spinal fracture);
• tumors;
• osteochondrosis or herniated disc;
• inflammation as a result of abscess, hematoma;
• cerebral hemorrhage;
• myositis;
• mineral and vitamin deficiency;
• complications from HIV or neurosyphilis;
• sclerosis.

Back pain due to psychosomatics

In recent years, back pain due to psychosomatics has begun to appear.In this case, if there is a complaint of back pain, the examination does not reveal pathology.This condition occurs with chronic stress, depression and lack of libido.The result can be not only pain, but also changes in gait, exacerbation of low back pain and sensory disturbances.

Causes of back pain by location

Pain can occur in various locations on the back.Then they talk about their location.

Pain on the right side

The right side of the back may hurt due to curvature of the spine, kyphosis, lordosis, myositis, displacement of the intervertebral disc, and obesity.

Somatic pathologies can also cause pain in this area:

• formation of stones in the organs of the urinary system;
• inflammation of the vermiform appendix of the cecum (appendix);
• gallbladder inflammation;
• nephritis;
• inflammation of the ovaries;
• salpingitis.

Pain on the left side

This area of the back may hurt in the following cases:

• splenitis;
• CDI;
• root pinching;
• duodenitis;
• oophoritis.

Pain located above the lower back may be associated with inflammation of the serous membranes covering the lungs, damage to the bronchi, intercostal neuralgia and ischemia.

Pain in the lower back

The lower back suffers very often, as it bears a colossal load.This section becomes inflamed when nerve roots are damaged, osteochondrosis or hernial protrusion.Less commonly, the cause may be spinal tuberculosis, arthritis, lumbosciatica, decreased density and disruption of the structure of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Lower back pain is often chronic.

In the lumbar region on the right

Pain in the lower back occurs with scoliosis, tuberculosis, myositis, neuralgia, tumor, osteomyelitis, spondylitis.An acute attack can be caused by urolithiasis or pyelonephritis.

The shot is typical of diseases of the lower back with frequent involvement of the spinal roots (radiculitis).Constant, dull, dull pain is more typical for an organ such as the liver.

Left lumbar region

Most often, the left side starts to hurt after physical activity.The condition improves after rest.Pain can also occur with diabetes or root impingement. If it does not disappear at rest, the reasons may be:

• scoliosis;
• osteochondrosis (with a sedentary lifestyle or poor posture);
• spinal infections;
• circulatory disorders.

Pinched nerve

Most often, the sciatic nerve is pinched - sciatica.Its myelin sheath is not damaged.This is often a consequence of osteochondrosis.When pinched, a sharp, sharp pain occurs, radiating to the leg, sacrum and lower back.

In compression radiculopathy, the roots of the spinal nerves are also compressed due to a herniated disc or a decrease in their height and, consequently, the distance between the vertebral bodies.This pain is felt as “superficial” and intensifies markedly when coughing, straining or sneezing.

Intervertebral hernia

A hernia is an extrusion of the nucleus of the intervertebral disc into the spinal canal.More often it becomes a consequence of untreated osteochondrosis.The central part projects towards the spinal cord, compressing it.Even a small load in these cases leads to a decrease in the height of the cartilage and an even greater protrusion of the hernia.The pain is sharp and sharp, radiating to the arm or leg.

In the shoulder blade area

The characteristics of the pain may indicate a diagnosis:

1. A stomach ulcer is a dull, growing pain.Eliminated with medication.
2. Intercostal neuralgia is a disease characterized by acute pain upon any physical exertion.
3. Osteochondrosis - dizziness, pressure changes, numbness in the hands.
4. Exacerbation of angina - the pain is localized in the region of the left shoulder blade, radiating to the chest and under the clavicle.

Pain along the spine and back

Most often, they occur when nerve endings are compressed.Exacerbations are associated with curvature of the spine.If the pain is not pronounced, we can talk about protrusion.With increasing pain, you may think about osteochondrosis.Pain along the spine is characteristic of myositis, fractures, thinning and wear of intervertebral discs, and spondyloarthritis.They are always sharp and constant.

Causes of pain below the lower back

This pain is often associated with osteochondrosis and spondyloarthrosis. Less commonly, these sensations may appear when:

• diseases of the genital region in women (endometritis, adnexitis, vulvitis, cervicitis, oophoritis);
• pregnancy;
• menstruation;
• ulcerative colitis;
• appendicitis;
• prostate or bladder diseases - in men.

Associated symptoms

The manifestations of back pain vary depending on the location.If the cervical spine is affected, migraines and dizziness, weakness and numbness in the hands, pressure spikes, spots and flashes in the eyes will be noted.When the thoracic region is involved, there is a burning sensation and stiffness in the chest, difficulty breathing and pain in the shoulder blades.

Situations requiring urgent medical attention

Urgent consultation with a doctor requires back pain that occurs in the following cases:

• hematoma;
• neurological symptoms in the form of tingling and numbness in the limbs;
• the temperature is combined with back pain;
• numbness in the arms and legs, weakness and tingling sensation;
• the gait has changed or the legs have been lost;
• there is a history of cancer;
• weight loss for no apparent reason;
• urination and defecation are impaired - the person cannot control these processes;
• back pain radiates to the chest, jaw and neck;
• consciousness is confused and dizzy;
• numbness in the genitals and weakness, “woolly” in the legs;
• leg cramps;
• problems with conception or erection;
• problems with the gastrointestinal tract, which treatment by a gastroenterologist does not help;
• pain in the coccyx and pelvis region, intensified with changes in body position;
• increased pain when sitting or standing for a long time.

Specialists will help you find out the cause of the pain.

Diagnosis

To identify the cause of back pain, the neurologist prescribes a comprehensive examination:

1. Blood tests.They help identify the presence of infection and inflammation in the form of leukocytosis and increased ESR.A decrease in hemoglobin will indicate anemia, which can have different causes, and one of the possible reasons is oncology.
2. MRI. Visualizes the condition of all components of the spine.It helps to differentiate the type and nature of the tumor, determines the distance between the vertebrae and the degree of compression of the roots.
3. TC. Detects fractures and allows you to find the smallest fragments after injuries.All this in three dimensions.
4. Radiography.The cheapest way to diagnose back pain and identify the condition of bone tissue.Prescribed for suspected fractures, arthritis, scoliosis, osteoporosis, spondyloarthrosis.
5. Electromyography (EMG).Determines indicators of bioelectrical activity of muscles and peripheral nerve endings.
6. Ultrasound of the vessels of the neck and brain.In triplex or duplex mode, it is used to assess the patency of blood flow through arteries and vessels.Its condition is checked - wall thickness, permeability, etc.

Back pain treatment

There are several methods to treat back pain.A neurologist will select the ideal treatment for you, taking into account the patient's age, lifestyle, level of physical mobility and clinical manifestations.

In the drug treatment of back pain, NSAIDs, analgesics, muscle relaxants and B vitamins are usually used. Physiotherapy, exercise therapy, IRT, massage, spinal traction and muscle relaxation are also prescribed.

For back pain, to ensure quality treatment, it is advisable to consult a doctor.

Prevention

Prevention measures:

• learn to maintain posture and stand correctly;
• do not become sloppy;
• keep your back straight when sitting, place a support under your feet;
• correctly organize your sleeping area;
• do not jump up suddenly when you wake up - stretch slowly, do simple exercises with your arms and legs;
• distribute weights on both hands - do not carry everything in one hand, refuse a bag on your shoulder - a backpack is better;
• do not carry the child in your arms folded backwards;
• lift weights by squatting;
• do not wash the floor without a mop, leaning forward or kneeling;
• balance your diet with sufficient amounts of minerals and vitamins;
• stop smoking and alcohol;
• do not forget about physical exercise - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• takes care of the liver, produces collagen for the spinal ligaments and vertebral bodies;
• strengthen immunity;
• control weight;
• It is advisable to take a course of manual therapy every 6 months for 5 to 10 sessions (on the recommendation of a specialist);
• avoid stress;
• Don't forget about medical examinations with a doctor.

If you experience back pain, consult a doctor who will provide you with appropriate assistance.Remember that any disease is easier to treat in the early stages.