Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people experience back pain first hand. More than a third of all "sick leave" issued are linked 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-rays, myography, computed tomography, etc. ), laboratory blood tests are performed. Treatment is not prescribed until the diagnosis is made.

Why is my back hurting?

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

It rests on the spine, which provides support, protection, traction and cushioning functions. This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear down over time with improper lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spine is the spinal cord, its root pairs innervate almost every organ and tissue. Any disruption of this complex system can cause pain. More often than others, the cervical and lumbar region suffers due to its greater loads and mobility.

What to do in case of back pain?

An examination by a doctor is mandatory to find out the cause, especially if the pain has become frequent. Only a specialist can make the correct diagnosis and prescribe treatment. You cannot engage in self-diagnosis.

First, you can contact a therapist who will identify a set of symptoms and direct you to the right specialist with a narrow profile. If the cause is known and obvious, the prescribed treatment can be continued. Back problems are treated by neurologists, orthopedists and vertebrologists.

Causes of back pain

Back pain is a nonspecific symptom that can have a variety of causes.

Physiological causes (common):

• increased weight;
• childbirth or recent pregnancy;
• hypodynamic work - in the office, at the computer, driving a car;
• standing work - hairdressers, waiters and vendors, street announcers, surgeons, teachers;
• strenuous physical activity associated with tight turns of the body;
• overload in 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;
• growing pains - 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 may occur with disc protrusion, spondylitis, epiduritis of the spinal cord, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, stroke. the spinal cord, inflammation of the appendages in men and women, and prostate cancer in women.

Varieties of diseases according to the nature of back pain

Causes of aching pain:

• hypothermia;
• Cramp;
• myositis;
• prolonged uncomfortable posture during sleep or work;
• lumbago (work becomes the cause);
• osteochondrosis;
• intervertebral hernia or displacement of intervertebral discs due to heavy lifting of weight or a sharp turn of the body;
• kidney disease - cause back pain due to the proximity of the kidneys to the lower back;
• stomach diseases.

Causes of shooting pains:

• intervertebral hernia - with them the condition worsens with any physical stress;
• sciatica - such back pain often occurs on the one hand, radiates to the thigh or buttock, causes numbness in the legs, and also depends on physical exertion;
• osteochondrosis - the patient may experience pulling pains that radiate to the leg and are aggravated by coughing, sneezing, straining, walking, bending.

Etiology of stabbing pain:

• osteochondrosis;
• intervertebral hernia;
• lumbago;
• spondylosis - are acute and cannot be relieved with pain relievers.

Bursting back pain:

• ischemia;
• heart attack;
• TELA;
• inflammation of the gallbladder;
• a sharp increase in pressure;
• atherosclerosis.

Why does my back hurt after sleeping?

Most people often experience back pain in the morning after sleeping, which may be due to:

• overload the day before, if you lifted weights and moved abruptly;
• weak back muscles;
• hypothermia;
• hernia of the vertebrae or osteochondrosis;
• scoliosis - the curvature of the spine leads to uneven muscle contraction;
• pregnancy - with it the center of the body shifts;
• 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, a person is forced to take an uncomfortable, non-physiological position during sleep, which forces the muscles to overwork and not rest at night. Posture is so important that even an orthopedic mattress does not help. It is recommended that you sleep on your back with your legs raised.

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 in which back pain occurs have one common basis - the uneven load on the spine. These include:

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

Diseases associated with the musculature

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

1. Fibromyalgia is a pain syndrome from the neck to the lower back. Neurological symptoms can be associated: increased sensitivity to pressure on certain points of the back, stiffness and stiffness.
2. Polymyositis - occurs with hypothermia, trauma, sprains or severe physical exertion. Muscle weakness appears, in which even turning to the side is painful and problematic.
3. Dermatomyositis is a chronic disease of the muscles, organs, and skin, often of an autoimmune nature.
4. Charcot's 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 a negativity of the environment in the form of hypothermia, overload, uncomfortable posture, etc. It causes spasms in individual muscles and the onset of pain. The so-called trigger points appear, by pressing on which the muscle reacts with acute pain. Neurologists know this. Pain of this type is eliminated with warming ointments and a needle applicator.

Spinal cord pathologies

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

• trauma (vertebral fracture);
• tumors;
• osteochondrosis or herniated disc;
• inflammation as a result of an abscess, hematoma;
• cerebral hemorrhage;
• myositis;
• deficiency of minerals and vitamins;
• complications of HIV or neurosyphilis;
• sclerosis.

Back pain due to psychosomatics

In recent years, back pain has started to manifest itself in psychosomatics. In this case, with complaints of back pain, the examination does not reveal the pathology. This condition occurs with chronic stress, depression, lack of libido. The result can be not only pain, but also a change in gait, exacerbation of lumbago, and sensory disturbances.

Causes of back pain by location

Pain can occur in a wide variety of areas of the back. Then they talk about its location.

Pain in 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, obesity.

Somatic pathologies can also cause pain in this area:

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

Pain in the left side

This area of the back can hurt when:

• splenitis;
• CIM;
• pinching of the roots;
• duodenitis;
• oophoritis.

Pain localized above the lower back may be associated with inflammation of the serous membranes covering the lungs, bronchial damage, intercostal neuralgia, ischemia.

Lower back pain

The lower back very often suffers, because it has a huge load. This section becomes inflamed with nerve root damage, osteochondrosis, or hernial protrusion. Less commonly, the cause may be tuberculosis of the spine, arthritis, lumboischialgia, a decrease in density and a violation of the structure of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Lower back pain is usually chronic.

In the lumbar region on the right

Lower back pain occurs with scoliosis, tuberculosis, myositis, neuralgia, tumors, osteomyelitis, spondylitis. An acute attack can be caused by urolithiasis or pyelonephritis.

Lumbago is characteristic of diseases of the lower back with frequent involvement of the spinal roots in the process (radiculitis). Constant, dull, monotonous pain is more characteristic of an organ like the liver.

In the lumbar region on the left

Most often, the left side begins to hurt after physical exertion. The condition improves after rest. In addition, pain can occur with diabetes, a pinching of the root. If it does not go away with 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. In this case, his myelin sheath is not disturbed. This is usually a consequence of osteochondrosis. When pinched, sharp, sharp pain occurs, radiating to the leg, sacrum, lower back.

With compression radiculopathy, the roots of the spinal nerves are also compressed due to a herniated disc or a decrease in its height and, as a result, the distance between the vertebral bodies. This pain is felt as "superficial", it is greatly increased by coughing, straining or sneezing.

Intervertebral hernia

A hernia is the extrusion of the core of the intervertebral disc into the spinal canal. Most often it becomes the consequence of untreated osteochondrosis. The central part protrudes towards the spinal cord, squeezing it. Even a small load in such cases leads to a decrease in the height of the cartilage and an even larger protrusion of the hernia. The pain is sharp and sharp, with a return to the arm or the leg.

At the level of the shoulder blades

A feature of pain may indicate a diagnosis:

1. Stomach ulcer - increasing dull ache. Eliminated by drugs.
2. Intercostal neuralgia - the disease is characterized by sharp pain with any physical exertion.
3. Osteochondrosis - dizziness, pressure changes, numbness in the hands.
4. Exacerbation of angina pectoris - the pain is localized in the region of the left scapula, radiating to the chest and under the collarbone.

Pain along the spine and back

Most often occur when nerve endings are pinched. Exacerbations are associated with a curvature of the spine. If the pain is not pronounced, we can speak of protrusion. With increased pain, you can think of osteochondrosis. Pain along the spine is typical of myositis, fractures, thinning and wear of the intervertebral discs, spondylitis. They are always sharp and constant.

Causes of lower back pain

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

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

Associated symptoms

The manifestations of spinal pain differ depending on the location. With the defeat of the cervical spine, migraines and dizziness, weakness and numbness in the hands, pressure spikes, flies and flashes in the eyes will be noted. With the involvement of the chest region, there is a burning sensation and stiffness in the chest, difficulty in breathing, pain in the shoulder blades.

Situations requiring urgent medical attention

An urgent visit to a doctor requires back pain, which occurs in the following cases:

• injury;
• neurological symptoms in the form of tingling and numbness in the limbs;
• temperature is associated with back pain;
• numbness in the hands and feet, weakness and tingling sensation;
• the gait has changed or the legs are removed;
• a history of cancer;
• weight loss for no apparent reason;
• impaired urination and defecation - a person cannot control these processes;
• back pain radiates to the chest, jaw and neck;
• consciousness is confused and dazed;
• numbness of the genitals and weakness, "cottoniness" of the legs;
• leg cramps;
• conception or erection problems;
• problems with the gastrointestinal tract, for which treatment by a gastroenterologist does not help;
• pain in the tailbone, small pelvis, worse by a change in the position of the body;
• increased pain with long sitting or standing.

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

Diagnostic

To identify the cause of back pain, a neurologist orders 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 level will indicate anemia, which can have many reasons and one of the possible is cancer.
2. MRI. . .Visualizes the state of all components of the spine. Helps to differentiate the type and nature of the tumor, to determine the distance between the vertebrae and the degree of root compression.
3. CT. Identifies fractures, allows you to find the smallest fragments after injuries. All of this is in 3D.
4. X-ray. The most economical way to diagnose back pain and identify the condition of bone tissue. It is prescribed in case of suspected fracture, arthritis, scoliosis, osteoporosis, spondylarthrosis.
5. Electromyography (EMG). Determines indicators of bioelectric 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 permeability of blood flow in arteries and vessels. Their condition is checked - wall thickness, permeability, etc.

Back pain treatment

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

In the medical treatment of back pain, NSAIDs, pain relievers, muscle relaxants, group B vitamins are usually used. Along the way, physiotherapy, exercise therapy, ESRD, massage, spinal traction, muscle relaxation are prescribed.

For back pain, for the treatment to be of good quality, it is advisable to consult a single doctor.

Prophylaxis

Preventive measures:

• learn to maintain your posture and stand correctly;
• do not slouch;
• keep your back straight in a sitting position, place a support under your feet;
• properly organize the place of sleep;
• do not jump abruptly after waking up - stretch slowly, do simple exercises with the arms and legs;
• distribute the weight on both hands - do not carry everything in one hand, refuse a shoulder bag - a backpack is better;
• do not carry the child in your arms with a hunched back;
• lifting weights while squatting;
• do not mop floors without a mop, leaning forward or kneeling;
• balance your diet with a sufficient amount of minerals and vitamins;
• stop smoking and alcohol;
• do not forget about physical exercises - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• protects the liver, it produces collagen for the ligaments of the spine and vertebral bodies;
• strengthen immunity;
• control the weight;
• it is advisable to follow a manual therapy course of 5 to 10 sessions every 6 months (according to the recommendations of a specialist);
• avoid stress;
• don't forget the medical exams.

If you develop back pain, see a doctor who can provide you with appropriate assistance. Remember that any illness is easier to treat at the start.