Back pain: causes, diagnosis, treatment and prevention

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

Why does my back hurt?

Pain in the spine can occur directly after injury, pathology of 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 exposed due to its structure.

The basis is the spine, which provides support, protection, motor and shock-absorbing functions.This is caused by intervertebral disc cartilage, muscles and ligaments, which tend to wear out over time with a wrong lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spinal column is the spinal cord, the paired roots of which innervate almost all organs and tissues.Any disturbance in this complex system can cause pain.The cervical and lumbar regions suffer most often due to the greatest load and mobility.

What to do if you have back pain?

A doctor's examination is necessary to determine the cause, especially if the pain has become frequent.Only a specialist can make a 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 clear, 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 childbirth or pregnancy;
• hypodynamic work - in the office, at the computer, driving a car;
• standing work - hairdressers, waiters and salesmen, street advertisers, surgeons, teachers;
• heavy physical activity combined with sudden turns of the body;
• overload during training;
• postmenopausal with a tendency to osteoporosis.

Pathological causes:

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

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

Types of diseases based on the nature of back pain

Causes of excruciating pain:

• hypothermia;
• muscle tension;
• myositis;
• prolonged uncomfortable posture while sleeping or working;
• lumbago (caused by labor);
• osteochondrosis;
• intervertebral hernia or intervertebral disc displacement due to sudden weight lifting or sudden twisting of the body;
• kidney disease - causes back pain due to the close location of the kidney to the lower back;
• stomach disease

Causes of shooting pain:

• intervertebral hernia - with them the condition worsens with any physical stress;
• radiculitis - this type of back pain often occurs on the side, radiates to the thigh or back, causes numbness in the legs and is also dependent on physical exertion;
• osteochondrosis - the patient may experience nagging pain that radiates to the legs and worsens when coughing, sneezing, straining, walking, bending.

Etiology of throbbing pain:

• osteochondrosis;
• intervertebral hernia;
• back pain;
• spondylosis - is acute and cannot be relieved by analgesics.

Broken back pain:

• ischemia;
• heart attack;
• TELA;
• gallbladder inflammation;
• sudden increase in pressure;
• atherosclerosis.

Why does my back hurt after sleeping?

Most people often feel back pain in the morning after sleeping, the reasons may be:

• overload the day before, if you lift heavy and move suddenly;
• weak back muscles;
• hypothermia;
• vertebral hernia or osteochondrosis;
• scoliosis - curvature of the spine leads to uneven muscle contraction;
• pregnancy - when the center of the body shifts;
• obesity - the load on the spine is also uneven.

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

Also, the cause of pain after sleep can be diseases of the spine and internal organs (urology, gastrointestinal tract, including oncology).

Diseases related to joints and spine

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

1. Ankylosing spondylitis - persistent inflammation of the ligaments and joints causing chronic spasm of the surrounding muscles.The process is autoimmune;Over time, the vertebrae begin to fuse together, which dramatically disrupts the function of the spine.
2. Spondylolisthesis - the vertebrae are in an abnormal position.They are displaced and affect the brain or roots.
3. Osteochondrosis - the intervertebral disc becomes thinner, cracks, and is replaced by bone tissue.Depreciation becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammation of the joints.Often affects the cervical spine.
5. Osteomyelitis is an inflammation of the bone marrow and the soft tissue around it.Causing severe pain.
6. Reiter's disease is a simultaneous rheumatic lesion of the urogenital tract, joints and conjunctiva of the eye.The small muscles of the back are affected.More often typical for young people, it develops gradually.The pain is worse in the morning and lessens in the evening.
7. Spinal canal stenosis - the cause may be a herniated disc or protrusion (protrusion into the spinal canal).More often, the process involves the lowest root of the spinal cord, which innervates the legs.The pain is felt from the lower back to the legs, getting worse at rest and when walking.
8. Facet syndrome is a lesion of the intervertebral joints (facets).The pain can be localized or radiate to the groin, tailbone, or thigh.Physically dependent.In the evening the condition worsened, after resting it improved.Occurs more often in the elderly.

Muscle related diseases

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

1. Fibromyalgia is a pain syndrome from the neck to the lower back.Neurological symptoms may occur: increased sensitivity when pressing certain points on the back, stiffness and stiffness.
2. Polymyositis - occurs as a result of hypothermia, injury, sprain or severe physical exercise.Muscle weakness appears, where even turning to the side is painful and problematic.
3. Dermatomyositis is a chronic disease of the muscles, organs, and skin, often autoimmune in nature.
4. Charcot disease is inflammation of the peripheral nerves that run along the spine.This leads to changes in gait, muscle weakness and increased nerve root sensitivity.
5. Polymyalgia rheumatica is a negative environment in the form of hypothermia, overload, uncomfortable posture, etc.Leads to spasms in individual muscles and the appearance of pain.The so-called trigger point appears, when pressed the muscle reacts with acute pain.Neurologists know about this.This kind of pain can be relieved with warming ointments and needle applicators.

Pathology of the spinal cord

This includes violations of the spinal cord, which has 31 paired branches, where each nerve is responsible for the conservation of its area. This situation occurs when:

• injury (spinal fracture);
• tumors;
• osteochondrosis or disc herniation;
• inflammation due to abscess, hematoma;
• cerebral hemorrhage;
• myositis;
• lack of minerals and vitamins;
• complications of HIV or neurosyphilis;
• sclerosis.

Back pain due to psychosomatics

In recent years, back pain has begun to appear due to psychosomatics.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, aggravation of lumbago and sensory disturbances.

Causes of back pain according to location

Pain can occur in various places in the back.Then they talk about its localization.

Pain on the right side

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

Somatic pathology can also cause pain in this area:

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

Pain on the left side

This back area may hurt in the following cases:

• splenitis;
• ICD;
• pinching the roots;
• duodenitis;
• oophoritis.

Localized pain over the lower back may be associated with inflammation of the serous membrane covering the lungs, damage to the bronchi, intercostal neuralgia, and ischemia.

Pain in the lumbar region

The lower back often suffers, because it bears a large load.This part becomes inflamed when the nerve root is damaged, osteochondrosis or hernia protrusion.Less commonly, the cause may be spinal tuberculosis, arthritis, lumboischialgia, decreased density and structural disorders of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Pain in the lumbar region is usually chronic.

In the lumbar region on the right side

Pain in the lumbar region occurs with scoliosis, tuberculosis, myositis, neuralgia, tumors, osteomyelitis, spondylitis.Acute attacks can be caused by urolithiasis or pyelonephritis.

Shooting is typical for diseases of the lower back with frequent involvement of the spinal roots (radiculitis).Constant dull and dull pain is more typical for organs like the liver.

Left lumbar region

Often, the left side starts to hurt after physical activity.Things get better after rest.Pain can also occur with diabetes or root pinching. If it does not go away during rest, the reasons may be:

• scoliosis;
• osteochondrosis (with an inactive lifestyle or poor posture);
• vertebral infection;
• circulatory disorders.

Pinched nerves

Often, the sciatic nerve is pinched - sciatica.The myelin sheath is not damaged.This is usually the result of osteochondrosis.When pinched, a sharp, acute pain occurs, radiating to the legs, sacrum, and lower back.

With compressive radiculopathy, the roots of the spinal cord are also compressed due to a herniated disc or a decrease in its height and, as a result, the distance between the vertebral bodies.Such pain is felt as "superficial", it increases sharply when coughing, exercising or sneezing.

Intervertebral hernia

Hernia is the extrusion of the intervertebral disc core into the spinal canal.More often it is a result of untreated osteochondrosis.The central part protrudes towards the spinal cord, compressing it.Even a small load in such cases leads to a decrease in the height of the cartilage and a greater protrusion of the hernia.The pain is sharp and sharp, radiating to the arm or leg.

In the shoulder blade area

Symptoms of pain may indicate the diagnosis:

1. Stomach ulcers are a pain that gets boring.Eliminated with medication.
2. Intercostal neuralgia is a disease characterized by acute pain with any physical effort.
3. Osteochondrosis - dizziness, pressure changes, numbness of hands.
4. Severity of angina - pain localized in the area of the left shoulder blade, radiating to the chest and below the collarbone.

Pain along the spine and in the back

More often it happens when nerve endings are pinched.Exacerbations are associated with curvature of the spine.If the pain is not expressed, we can talk about protrusion.With increasing pain, you can 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 persistent.

Causes of pain under the lower back

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

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

Associated symptoms

Manifestations of spinal pain vary depending on the location.If the cervical spine is affected, migraines and dizziness, weakness and numbness of the hands, pressure surges, spots and flashes in the eyes will be observed.When the thoracic region is involved, there is burning and stiffness in the chest, difficulty breathing, and pain in the shoulder blades.

Situations that require immediate medical attention

Immediate consultation with a doctor is required for back pain that occurs in the following cases:

• bruises;
• neurological symptoms in the form of tingling and numbness in the limbs;
• temperature combined with back pain;
• numbness in the arms and legs, weakness and tingling sensations;
• gait has changed or legs are missing;
• there is a history of cancer;
• weight loss for no apparent reason;
• urination and defecation are disturbed - a person cannot control this process;
• back pain radiating to the chest, jaw and neck;
• confused consciousness and dizziness;
• numbness in the genitals and weakness, "hair" on the legs;
• leg cramps;
• problems with conception or erection;
• problems with the gastrointestinal tract, for which treatment by a gastroenterologist does not help;
• pain in the coccyx and pelvis, intensifies with changes in body position;
• increased pain when sitting or standing for a long time.

A specialist will help you find out the cause of the pain.

Diagnostics

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

1. Blood test.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 many causes, and one of the possible causes is oncology.
2. MRI. Visualize the condition of all components of the spine.Helps distinguish the type and nature of the tumor, determine the distance between the vertebrae and the degree of root compression.
3. CT. Detects fractures and allows you to find the smallest fragments after an injury.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).Determine the indicators of bioelectrical activity of muscles and peripheral nerve endings.
6. Ultrasound of the neck and brain.In triplex or duplex mode, it is used to assess the patency of blood flow through arteries and vessels.Their condition is checked - wall thickness, permeability, etc.

Treatment for back pain

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

In the treatment of back pain medications, NSAIDs, analgesics, muscle relaxants, and B vitamins are commonly 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 see a doctor.

Prevention

Preventive measures:

• learn to maintain posture and stand correctly;
• don't bend over;
• keep your back straight when sitting, put a stand under your feet;
• arrange your sleeping area properly;
• do not jump suddenly after waking up - stretch slowly, do simple exercises with your hands and feet;
• distribute the weight on both hands - don't carry everything in one hand, push the bag over your shoulder - a backpack is better;
• do not carry a child in your arms bent over 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 training - swimming, Nordic walking, yoga;
• contrast shower in the morning;
• takes care of the liver, it produces collagen for the ligaments of the spine and the vertebral body;
• strengthen immunity;
• control weight;
• It is advisable to undergo a course of manual therapy every 6 months for 5-10 sessions (on expert recommendation);
• avoid stress;
• Do not forget about the medical examination with the doctor.

If you suffer from back pain, seek the advice of a doctor who will provide appropriate help.Remember, any disease is easier to treat in the early stages.