Back pain is one of the most common complaints of patients in emergency medicine and outpatient examinations in recent years. Such pains are not a special nosological unit, but a clinical manifestation of a number of diseases. Of special importance for this symptom is the fact that often in acute pain, motor activity is significantly limited and people's ability to work decreases.
The main cause of back pain are diseases of the spine, in addition to them, this clinical manifestation can be caused by pathologies of internal organs, occupational characteristics (long sitting at a table or in the driver's seat, hard physical work), trauma or pregnancy. The cause of pain in most cases can be detected by careful examination of the patient, sometimes additional examinations are needed to make 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 show that more than half of the world's population suffers from back pain. Moreover, in childhood such a symptom indicates a disease of internal organs and is quite rare because they are older, back pain is more common, and in old age almost everyone encounters it, and only about 25% of those suffering from this pathology seek medical advice.
What is the risk of back pain?
In most cases, untimely started or inadequately prescribed therapy for back pain leads to a chronic process. Chronic back pain is a very common cause of reduced performance in people aged 40 to 55 years and is characterized by:
- permanent character;
- increases during movement and physical activity;
- restriction 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, caused by prolonged hypothermia, physical activity, or being in one position. Exacerbations are replaced by periods of remission, in which pain is absent or 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 manifest this symptom and require urgent medical attention.
Back pain in general diseases
Common diseases that are manifested by the presence of back pain are 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 complex of symptoms that develops as a result of compression of the spinal cord roots and is manifested by motor and autonomic disorders on the background of severe pain. Identify cervical, thoracic, and lumbar (lumbosacral) sciatica.
Clinical manifestations
It is manifested by a pronounced pain syndrome with localization at the site of injury and intensification when moving and coughing (even with a mild cough). Pain can be of different nature (painful, dull or sharp), occurring periodically or constantly. In most cases, the pain spreads to the upper or lower extremities. In addition to pain, the disease is characterized by muscle weakness and impaired limb sensitivity.
Herniated disc
Protrusion or protrusion of fragments of intervertebral discs into the spinal canal is called a disc herniation. The disease most often occurs in people aged 25 to 50, the risk group includes drivers, people who sit for a long time and those who are forced to lift weights every day.
Clinical manifestations
The main symptom is pain, which is dull and occasional at the beginning of the disease, and intensifies with physical exertion, coughing and prolonged exposure to 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 older than 50 years
Almost every elderly person experiences back pain, and the most common causes of such symptoms 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, ie fractures that can occur with minimal load or small bruises.
It is very difficult to detect the disease at an early stage, it is usually manifested by the following symptoms:
- pain in the lumbar region or thoracic spine, which occurs with prolonged static load and with 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 deformation of the vertebrae and the appearance of bony growths and spikes (osteophytes) on their surface.
Clinical manifestations
In the early stages it manifests as a mild limitation of spinal mobility. As the disease progresses due to fixation of the area prone to overload, a pronounced pain syndrome develops. Acute, unbearable pain is accompanied by muscle tension, limited mobility due to the gradual correction of 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 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 cause of the development of this disease can be trauma, increased stress on the joint for a long time (during pregnancy, work associated with lifting weights 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, it can be intensified by pressing on the wing of the ilium and flexion of the limbs. In 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.
Osteomyelitis of the spine
Osteomyelitis is a purulent infectious disease that affects the bone tissue, periosteum and bone marrow. It can be acute (appears for the first time) or chronic (long-lasting and characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, fever (often up to 40, 0) and rapid heartbeat. After 2-4 days there is local pain at the site of the lesion, local edema and hyperemia (redness) of the tissue, and limitation of motor activity. In chronic osteomyelitis on the skin there are traces of fistulous passages (rounded wounds with purulent discharge). If osteomyelitis is suspected, seek medical attention immediately. The treatment of such pathology is performed by a surgeon.
Spondylolisthesis
Spondylolisthesis is a forward movement of the vertebrae as a result of congenital disconnection of the arch with the body or degenerative-dystrophic changes in the intervertebral disc. In most cases, it occurs when the fifth lumbar vertebra is moved.
Clinical manifestations
The main manifestation is chronic pain in the lumbar region, due to slipping of the vertebrae and injury to nerve endings. The pain often radiates to the gluteal region and intensifies when trying to bend. It can be accompanied by pain in the legs, muscle weakness and numbness of the limbs.
fibrosis
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;
- back pain and stiffness in the morning;
- sleep disorder;
- irritability.
The pain intensifies in the cold season outside, after excessive exercise, after emotional stress, in the morning.
Pain of musculoskeletal origin
The musculoskeletal system, which allows you to keep your body in space and move, has sensitivity to space and pain. 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 the 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 spreading to the back and lumbar region (stenosis)
In stenosis (narrowing of the spinal canal or opening of the spinal nerve root outlet), which causes compression of nerve fibers, the pain that occurs in the back then radiates to the leg, while the gait of the sick person changes, limps.
The pain is dull and constant. The reason for the development of this disease is age-related changes, so that young and middle-aged people are not susceptible to its occurrence. An operative method, called decompression surgery, is used to treat vertebral arches.
Posttraumatic back pain
Back injuries can be caused by:
- sharp lifting of weights often causes the development of stretching or tearing of muscle fibers or ligaments;
- pad;
- blow or injury;
- mechanical impact.
With the onset of pain in case of injury, a spasm of muscle fibers develops that disappears in 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 traction pain in the lumbar region occurs in the first months of pregnancy and does not pass until childbirth. The cause of pain is increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the child, or for softening the ligament apparatus of the sacral region. Since relaxin acts on all ligaments and increases the load on the pregnant woman's spine, chronic pain in the lumbar region 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 twitch;
- do not bend to the floor, you must kneel;
- there is no need to remove high-placed 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 that leads to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis. Determine 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 localization:
- Cervical osteochondrosis is manifested by pain and stiffness of movement in the neck and arms, headache, with compression of the vertebral artery, dizziness, hearing impairment and fainting may occur.
- In the thoracic form of the disease, there is acute pain in the back and chest (stinging sensation), heart pain, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, which radiates to the legs and is intensified during movement, back pain, numbness of the extremities, disorders of the genitourinary system may occur.
myofascial syndrome
Myofascial syndrome is a disease characterized by sharply painful excessive tension of the spinal muscles. The main reason for the development is static overload of the muscular frame of the spine for a long time (to be in an awkward position).
Clinical manifestations
The pain is localized on one or both sides of the spine, intensified by pressure, overwork, injury, or sudden hypothermia. The pain can vary in intensity from mild, almost imperceptible discomfort, to severe unbearable pain lasting several days.
One of the most effective ways to relieve back pain istherapeutic blockades.