Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know directly about back pain.Of all sick days granted, more than a third are related to this issue.The reason can be considered to be due to the fragile muscles and their rapid growth rate.To determine 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?

Spinal pain can occur directly after injury, pathology 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 support, protection, mobility and shock absorption functions.The reason is that the cartilage of the intervertebral discs, muscles and ligaments tends to wear out over time due to an incorrect lifestyle and causes degenerative diseases of the musculoskeletal system.

Inside the spine is the spinal cord, whose twin roots innervate most of the organs and tissues.Any disturbance in this complex system can cause pain.The cervical and lumbar regions are most frequently affected 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 becomes frequent.Only a specialist can accurately diagnose and prescribe treatment.You cannot self-diagnose.

First, you can contact a therapist who will identify a range of symptoms and refer you to the appropriate specialist.If the cause is known and clear, you can continue with the prescribed treatment.Neurologists, orthopedists, and vertebrologists treat back problems.

Causes of back pain

Back pain is a non-specific symptom that can be caused by many causes.

Physiological causes (common):

• weight gain;
• recent childbirth or pregnancy;
• demotivating work - in the office, in front of the computer, driving a car;
• permanent work - hairdresser, waiter and salesman, street advertiser, surgeon, teacher;
• Heavy physical activity combined with sudden body movements;
• overload during training;
• After menopause, there is 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;
• spinal infectious lesions;
• osteoporosis, osteomalacia;
• diseases of internal organs - kidneys, pancreas, stomach, spleen, liver;
• atherosclerosis of the abdominal aorta.

Acute pain can occur with disc protrusion, spondylitis, spinal epidural inflammation, cartilage degeneration, intervertebral herniation, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, spinal cord stroke, adnexitis in women, and prostate cancer in men.

Types of diseases depend on the nature of back pain

Causes of pain:

• hypothermia;
• muscle tension;
• myositis;
• Prolonged uncomfortable posture when sleeping or working;
• low back pain (due to labor);
• osteoarthritis;
• disc herniation or disc displacement due to sudden weight lifting or sudden turning;
• kidney disease - causes back pain due to the location of the kidneys close to the lower back;
• stomach diseases.

Causes of pain when shooting:

• intervertebral hernia - with them, the condition worsens with any physical stress;
• radiculitis - this type of back pain usually occurs on one side, radiates to the thigh or buttocks, causes leg numbness and also depends on physical exertion;
• Osteoarthritis - patients may feel persistent pain spreading down the legs and gradually increasing when coughing, sneezing, exerting themselves, walking, or bending.

Causes of sharp pain:

• osteoarthritis;
• intervertebral hernia;
• low back pain;
• Spondylosis - acute and cannot be relieved by painkillers.

Severe back pain:

• ischemia;
• heart attack;
• PHONE;
• cholecystitis;
• pressure increases sharply;
• atherosclerosis.

Why does my back hurt after sleeping?

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

• overload the day before, if you lifted weights and moved vigorously;
• weak back muscles;
• hypothermia;
• vertebral herniation or osteonecrosis;
• Scoliosis - curvature of the spine leading to irregular muscle contractions;
• pregnancy - when the center of the body changes;
• obesity - the load on the spine is also uneven.

Sleeping conditions are also important.The bed should not be too hard or too soft - in any case, the person is forced to take an uncomfortable, physiological position while sleeping, causing excessive muscle tension and making it impossible to rest at night.Posture is so important that even an orthopedic mattress cannot help.You should sleep on your back with your legs elevated.

In addition, the cause of pain after sleep can be diseases of the spine and internal organs (urinary, gastrointestinal tract, including cancer).

Diseases related to 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 ligaments and joints causing chronic spasm of surrounding muscles.This process is autoimmune;Over time, the vertebrae begin to fuse together, which significantly disrupts the functioning of the spine.
2. Spondylolisthesis - vertebrae in an abnormal position.They are displaced and affect the brain or roots.
3. Osteonecrosis - the disc becomes thinner, cracks and is replaced by bone tissue.Depreciation becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammatory condition of the joints.Most commonly affects the cervical spine.
5. Osteomyelitis is an inflammation of the bone marrow and surrounding soft tissues.Causes severe pain.
6. Reiter's disease is a concomitant rheumatic lesion of the genitourinary tract, joints, and conjunctiva of the eye.Small muscles in the back are affected.More typical in young people, it develops gradually.The pain is severe in the morning and gradually subsides in the evening.
7. Spinal stenosis – can be caused by a herniated disc or a protruding disc (back into the spinal canal).Typically, this process involves the lowest roots of the spinal cord, which innervate the legs.The pain is felt from the lower back to the feet, gradually increasing when resting and walking.
8. Facial syndrome is a lesion of the intervertebral (face) joints.The pain can be localized or radiate to the groin, tailbone or thigh.Physical dependence.In the evening the condition worsens, after rest it improves.Occurs more often in older people.

Muscle-related diseases

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

1. Fibromyalgia is a pain syndrome from the neck to the lower back.Possible neurological symptoms: increased sensitivity when pressing on certain points on the back, stiffness and rigidity.
2. Polymyositis - occurs due to hypothermia, trauma, sprain or heavy exertion.Muscle weakness appears, even turning to one side is painful and uncomfortable.
3. Dermatomyositis is a chronic disease of muscles, organs and skin, often of an autoimmune 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 negative of the environment in the form of hypothermia, overload, uncomfortable posture, etc.Leading to spasms in each muscle and pain.So-called trigger points appear, when pressed, the muscle reacts with acute pain.Neuroscientists know about this.This type of pain can be eliminated with warming ointments and needle applicators.

Spinal cord disease

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

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

Psychological back pain

In recent years, back pain has begun to appear due to psychological reasons.In this case, if there is a complaint of back pain, the examination will not detect pathology.This condition occurs with chronic stress, depression and lack of sexual desire.The result can be not only pain but also gait changes, worsening low back pain, and sensory disturbances.

Causes of back pain by location

Pain can occur in many places in the back.Then they talked about its localization.

Pain on the right side

The right side of the back can be painful due to scoliosis, kyphosis, lordosis, myositis, disc displacement and obesity.

Physical diseases can also cause pain in this area:

• formation of stones in the organs of the urinary system;
• vermiform appendicitis of the cecum (appendix);
• cholecystitis;
• nephritis;
• ovarian inflammation;
• salpingitis.

Pain on the left side

This back area may be painful in the following cases:

• splenitis;
• ICD;
• pinch the roots;
• duodenitis;
• Ovarian inflammation.

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

Pain in the lumbar region

The lower back hurts very often because it has to bear a huge load.This part becomes inflamed when the nerve roots are damaged, cartilage degenerates or protrudes herniation.Less commonly, the cause can be spinal tuberculosis, arthritis, low back pain, decreased density and structural disorders of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Pain in the lumbar region is often chronic.

In the right lumbar region

Lumbar pain occurs with scoliosis, tuberculosis, myositis, neuralgia, tumors, osteomyelitis, and spondylitis.An acute attack may 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 monotonous pain is more typical for an organ such as the liver.

Left lumbar area

Usually, the left side begins to hurt after physical activity.The condition improves after rest.Pain can also occur with diabetes or root compression. If it does not go away with rest, the reasons may be:

• scoliosis;
• osteoarthritis (with a sedentary lifestyle or poor posture);
• vertebrae infection;
• circulatory disorders.

Nerves are compressed

Most often, the sciatic nerve is compressed - sciatica.Its myelin sheath is not damaged.This is often a consequence of osteoarthritis.When compressed, there will be sharp and acute pain, spreading to the legs, sacrum and lower back.

With compressed radiculopathy, the roots of the spinal nerves are also compressed due to disc herniation or due to a decrease in its height and, therefore, the distance between the vertebral bodies.Such pain is considered "superficial", it increases sharply when coughing, exertion or sneezing.

Intervertebral hernia

Herniation is a phenomenon in which the core of a disc is pushed into the spinal canal.Most often it becomes a consequence of untreated osteonecrosis.The central portion protrudes toward the spinal cord, compressing it.Even a small load in such cases leads to a decrease in the height of the cartilage and causes the hernia to protrude more.Severe pain, spreading down the arms or legs.

In the shoulder area

Pain characteristics may indicate the diagnosis:

1. Stomach ulcers are a dull, growing pain.Removed with medication.
2. Intercostal neuralgia is a disease characterized by acute pain upon exertion.
3. Osteonecrosis - dizziness, pressure changes, hand numbness.
4. Aggravated angina - pain localized in the left shoulder blade area, spreading to the chest and under the collarbone.

Pain along the spine and in the back

They more commonly occur when nerve endings are compressed.Exacerbations are related to the curvature of the spine.If the pain is not pronounced, we can talk about protrusion.With increasing pain, you may be thinking about osteoarthritis.Pain along the spine is characteristic of myositis, fractures, thin and worn discs, and spondylitis.They are always sharp and constant.

Causes of lower back pain

Such pain is often associated with osteoarthritis and osteoarthritis of the spine. Less commonly, such feelings may appear when:

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

Related symptoms

Symptoms of spinal pain vary depending on location.If the cervical spine is affected, the person will experience migraines and dizziness, weakness and numbness in the arms, increased pressure, spotting and blinking of the eyes.When affected in the chest area, there will be a burning and hard feeling in the chest, difficulty breathing and pain in the shoulder blades.

Situations that require emergency medical attention

It is necessary to see a doctor urgently for urgent advice about back pain occurring in the following cases:

• bruises;
• neurological symptoms in the form of tingling and numbness in the limbs;
• temperature associated with back pain;
• numbness in the arms and legs, weakness and tingling feeling;
• your gait has changed or your leg is missing;
• have a history of cancer;
• weight loss for no apparent reason;
• impaired ability to urinate and defecate - a person cannot control these processes;
• back pain spreading to the chest, jaw and neck;
• confused, dizzy consciousness;
• numbness in the genitals and weakness and “hollowness” in the legs;
• leg cramps;
• problems conceiving or having an erection;
• Gastrointestinal problems for which treatment by a gastroenterologist does not help;
• pain in the coccyx and pelvic area, intensifies when changing body position;
• Pain increases when sitting or standing for long periods of time.

Experts will help you find the cause of your pain.

Diagnose

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

1. Blood test.They help determine the presence of infection and inflammation in the form of leukocytosis and increased ESR.A decrease in hemoglobin will indicate anemia, which can be due to many reasons and one of the causes can be cancer.
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 bone fractures and allows you to find the smallest fragments after injuries.All this in three dimensions.
4. X-ray.The cheapest way to diagnose back pain and determine the condition of bone tissue.Indicated when suspected fractures, arthritis, scoliosis, osteoporosis, and spondylosis.
5. Electromyography (EMG).Determine indicators of bioelectrical activity of muscles and peripheral nerve endings.
6. Ultrasound of blood vessels in the neck and brain.In triplex or duplex mode, it is used to evaluate the stability of blood flow through arteries and blood vessels.Their condition is checked - wall thickness, permeability, etc.

Back pain treatment

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

In the medical treatment of back pain, NSAIDs, pain relievers, muscle relaxants and B vitamins are often used.Physical therapy, exercise therapy, IRT, massage, spinal traction, and muscle relaxation are also indicated.

For back pain, to ensure quality treatment, you should see a doctor.

prevent

Precautions:

• learn to maintain correct posture and stand;
• don't be sluggish;
• keep your back straight when sitting, place a support under your feet;
• arrange your sleeping area correctly;
• do not jump up suddenly after waking up - stretch slowly, do simple exercises with your arms and legs;
• distribute weight on both hands - do not carry everything with one hand, refuse to wear a bag over your shoulder - it is better to wear a backpack;
• do not carry the child in your arms and bend it backwards;
• lift weights by squatting;
• Do not clean the floor without a mop, lean forward or kneel;
• balance the diet with a sufficient amount of minerals and vitamins;
• give up smoking and alcohol;
• don't forget to exercise - swimming, Nordic walking, yoga;
• contrast shower in the morning;
• takes care of the liver, produces collagen for spinal ligaments and vertebral bodies;
• enhance immunity;
• weight control;
• It is recommended to undergo a course of manual therapy every 6 months for 5-10 sessions (as recommended by a specialist);
• avoid stress;
• Don't forget to have a health check-up with your doctor.

If you have back pain, consult your doctor for appropriate assistance.Remember, any disease is easier to treat in the early stages.