Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know back pain firsthand. More than a third of all "sick leave" issued is 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 inspection, hardware diagnostics (X-rays, myography, CT, etc. ), 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 immediately after injuries, pathologies of the vertebrae, ligaments and discs, soft tissue damage. It depends on the position of the body, the level of physical activity, but can also be reflected, for example, in diseases of the internal organs. To some extent, the back itself is vulnerable due to its structure.

It is based on the spine, which provides support, protection, motor and cushioning functions. This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time with an incorrect lifestyle and cause degenerative diseases of the musculoskeletal system.

Within the spinal column is the spinal cord, its paired roots innervating almost all organs and tissues. Any disturbance in this complex system can cause pain. More often than others, the cervical and lumbar region suffer from its increased loads and mobility.

What to do with back pain?

An examination by a doctor is mandatory to find out the cause, especially if the pains have 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 range of symptoms and direct you to the right specialist with a narrow profile. If the cause is known and evident, the prescribed therapy can be continued. Back problems are treated by neurologists, orthopedists and vertebrologists.

Causes of back pain

Back pain is a non-specific symptom that can have various causes.

Physiological causes (common):

• weight gain;
• recent childbirth or pregnancy;
• hypodynamic work: in the office, at the computer, driving a car;
• standing job - hairdressers, waiters and salespeople, street advertisers, surgeons, teachers;
• heavy physical activity in combination with sharp bends of the body;
• overload in training;
• postmenopause 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 the internal organs - kidneys, pancreas, stomach, spleen, liver;
• atherosclerosis of the abdominal aorta.

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

Variety of diseases by the nature of back pain

Causes of aching pain:

• hypothermia;
• ratchet;
• myositis;
• prolonged uncomfortable posture while sleeping or working;
• lumbago (labor becomes the cause);
• osteochondrosis;
• intervertebral hernia or displacement of the intervertebral discs due to heavy lifting of weights 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 throbbing pain:

• osteochondrosis;
• intervertebral hernia;
• lumbago;
• spondylosis - are acute and cannot be relieved by analgesics.

Explosive back pain:

• ischemia;
• heart attack;
• TELE;
• 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 sleep, which can 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 - curvature of the spine leads to uneven muscle contraction;
• pregnancy: with it the center of the body moves;
• 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 and non-physiological position during sleep, which makes the muscles overloaded and does not rest at night. Posture is so important that even an orthopedic mattress doesn't help. It is recommended that you sleep on your back with your legs raised.

Also, 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 the ligaments and joints causes chronic spasm of the surrounding muscles. The process is autoimmune, over time the vertebrae begin to grow together, which abruptly stops the work 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 discs become thinner, cracked, 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 inflammation of the bone marrow and surrounding soft tissues. 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 lessens in the evening.
7. Spinal canal 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 a lesion of the intervertebral joints (facets). The pain can be local or radiate to the groin, coccyx, thigh. Physically dependent. 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 the pathology of bone tissue or joints. Painful spasms and compaction appear in the muscles, mobility is impaired:

1. Fibromyalgia is a painful syndrome from the neck to the lower back. Neurological symptoms can join: increased sensitivity when pressing on certain points on the back, stiffness and stiffness.
2. Polymyositis - occurs with hypothermia, trauma, sprains, or severe physical exertion. Muscle weakness appears, in which turning to the side is also painful and problematic.
3. Dermatomyositis is a chronic disease of the muscles, organs, skin, often of an autoimmune nature.
4. Charcot's disease is 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 leads to spasms in individual muscles and the appearance of pain. So-called trigger points appear, 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 disorders

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

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

Psychosomatic back pain

In recent years, back pain has begun 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 low back pain and sensory disturbances.

Causes of back pain by localization

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 can hurt due to the 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;
• ICD;
• pinching of the roots;
• duodenitis;
• oophoritis.

Pain located 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 suffers very often, as 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, low back schialgia, decreased density and 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.

Low back pain is characteristic of diseases of the lower back with frequent involvement of the spinal roots in the process (radiculitis). Constant monotonous pain is more characteristic of an organ such as 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. Also, pain can occur with diabetes, pinching of the root. If it does not go away at rest, the reasons may be:

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

Pinched nerve

Most often the sciatic nerve is pinched - sciatica. In this case, its myelin sheath is not disturbed. It 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, consequently, in the distance between the vertebral bodies. This pain is felt as "superficial", it is markedly increased by coughing, exertion or sneezing.

Intervertebral hernia

A hernia is the extrusion of the nucleus of the intervertebral disc into the spinal canal. More often it becomes a consequence of untreated osteochondrosis. The central part protrudes 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, returning to the arm or leg.

In the area of the shoulder blades

A pain feature can indicate a diagnosis:

1. Stomach ulcer - increasing dull pain. Eliminated by drugs.
2. Intercostal neuralgia - the disease is characterized by acute pain with any physical exertion.
3. Osteochondrosis: dizziness, pressure changes, numbness of the hands.
4. Exacerbation of angina pectoris: pain is localized in the region of the left shoulder blade, which radiates to the chest and below the collarbone.

Pain along the spine and back

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

Causes of lower back pain

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

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

Associated symptoms

Manifestations of spinal pain differ depending on the location. With the defeat of the cervical spine, headaches and dizziness, weakness and numbness of the hands, pressure surges, flies and flashes in the eyes will be noted. With the involvement of the thoracic region, there is a burning sensation and stiffness in the chest, difficulty in breathing, pain in the shoulder blade area.

Situations that require urgent medical attention

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

• wound;
• neurological symptoms in the form of tingling and numbness in the limbs;
• the temperature is combined with back pain;
• numbness in the hands and feet, weakness and tingling sensation;
• gait is changed or legs are taken away;
• 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 dizzying;
• numbness of the genitals and weakness, "cottony" in the legs;
• leg cramps;
• problems with conception or erection;
• problems with the gastrointestinal tract, in which treatment by a gastroenterologist does not help;
• pain in the coccyx, small pelvis, aggravated by a change in the position of the body;
• increased pain with a long sitting or standing position.

Experts 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 analysis. 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 reasons and one of the possible is cancer.
2. magnetic resonance. . .View the condition of all components of the spine. It helps to differentiate the type and nature of the tumor, determine the distance between the vertebrae and the degree of compression of the root.
3. CT. Identifies fractures, allows you to find the smallest fragments after injuries. All of this is in 3D.
4. X-ray. The most convenient way to diagnose back pain is to identify bone conditions. It is prescribed for suspected fracture, arthritis, scoliosis, osteoporosis, spondyloarthrosis.
5. Electromyography (EMG). Determines the indicators of the 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 patency of blood flow through the arteries and vessels. Their conditions are controlled: 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, analgesics, muscle relaxants, vitamins of group B are usually used. Along the way, physiotherapy, physical therapy, IRT, massage, spinal traction, muscle relaxation are prescribed.

For back pain, in order for the treatment to be of high quality, it is advisable to consult a doctor.

Prophylaxis

Preventive measures:

• learn to maintain posture and stand correctly;
• do not bend over;
• keep your back straight while sitting, put a support under your feet;
• correctly organize the place of sleep;
• do not jump sharply after waking up - slowly stretch out, do simple exercises with arms and legs;
• distribute weights to both hands - do not carry everything in one hand, refuse a shoulder bag - a backpack is better;
• do not carry the baby in your arms by bending the back;
• lifting weights by squatting;
• do not scrub floors without a mop, bent forward or on your knees;
• balance your diet with a sufficient amount of minerals and vitamins;
• quitting smoking and alcohol;
• do not forget about physical exercises: swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• protect the liver, produce collagen for the ligaments of the spine and vertebral bodies;
• strengthen immunity;
• check weight;
• it is recommended to undergo a cycle of manual therapy for 5-10 sessions every 6 months (as recommended by a specialist);
• avoid stress;
• don't forget the medical exams.

If back pain develops, see a doctor who can provide adequate assistance. Remember, any disease is easier to treat in the early stages.