Back pain — what to do?

Every day one–two of the patient necessarily. Irrespective of age and sex, type of activity and the physical. What is pain? It is a defense reaction of the body, is very useful, because if there is pain, we do not know that in the body there are violations, that your health is in danger.

The mechanism of pain development in the body similar to all reflex – from receptors of pain momentum before in the spinal cord, then is processed and sent to the brain. In this way are involved all departments of the nervous system and brain a lot of pain centers at different levels. This suggests that the perception of pain is very important for the body.

But it sometimes happens that the damage is there and there is no pain. Often, this happens when the tumor processes, or when there is a violation of the pain receptors. When, as a result of the constant irritation of the receptors and nerve fibers, these fibers and centers in the brain irritated, you experience chronic pain. Their treatment is much more difficult, because here amazed not only of the organs and tissues where the receptors, but also the same transmit the pain of the cells of the nervous system neurons.

The back pain can be caused by a variety of causes. Here, we share their location (i.e. the place) the pain in different departments back and look at what can hurt at different levels, and that affects the spine. There we touch on rare diseases: to describe the most common causes of pain in the back, encountered in practice.

1. The pain in the upper regions of the back

• First of all, it is necessary to eliminate the most dangerous state of disease of the heart. Therefore, when the pain in the upper regions of the back, in the area of the shoulder blades, especially on the left, is prescribed an ECG (electrocardiography), to exclude an acute coronary syndrome, myocardial infarction, if the person in advanced age. Myocarditis, and other inflammatory diseases of the heart, if the young age.
• If cardiogram without malocclusion, we think of back pains, in this part of the back correctly called torakalgiya (from the Latin word chest – to- chest), that is, the violation of the spine or the muscles associated with the spine. Torakalgiya may be caused osteochondrosis of the spinal column in the event of corruption of the department of maternal. This is the most frequent cause. Increased pain occurs while driving, especially in curves. If you look back, you saw how tense the muscles around the patient space. Related this pain with a specific event – it has raised the severity, removed the jam, nervous, it was a great strain on the back. Often accompanied by pain in the sternum, pain, growth night in the supine position. If the pain is fresh is given injections of painkillers, vitamins of group b, muscle relaxants, everything takes place within the span of 3 days, rarely weeks. If there is no damage to the spine, hernia of intervertebral discs, damage the roots of the nerves which depart the spinal column – the long-term treatment. Here it is necessary to make a radiograph, and these patients carry the neurologists. Because it is formed by chronic pain, with which it is most difficult to cope with. In this step, you connect stronger drugs.
• We can not exclude malocclusion of the shoulder – arthritis or injury. Happens that give back pain.
• Of the internal organs at the level of the upper part of the back are easy. Back hurt begins when the inflammation passes to the pleura – product characteristics of the lungs, rich with pain receptors. Severe pain, and are enriched with breathing to reduce the pain, people go on the sick part. If there is temperature and pain in the chest the doctor necessarily suspected infringement in the lungs. We take a radiograph, in which, often, well you can see it all. The treatment is always in the hospital. Inflammation of the pleura – pleural effusion — for several reasons. Call the can the bacteria, viruses, mycobacterium tuberculosis, and other infections.
• Spontaneous pneumothorax — entry of air in the pleura. Often stanichnyj young people with a hereditary defect of the connective tissue (dysplasia of the connective tissue or JSP). Happens with a strong cough during SARS, net a deep breath, lesions.

2. The pain, medium-sized departments of the back, in the lumbar region and above

• Osteochondrosis of the vertebral column at the lumbar level, manifested as low back pain is a pain without radiation into the leg, and lumbalgia – when the pain spreads to the outer surface of the thigh. This happens when jamming the roots of the nerves. Therefore, the doctor checks the so-called "radicular symptoms" or symptoms of tension. The patient lies on her back and raises a leg. When jamming of the nerve because of the pain can lift leg only with a slight angle.



• Around this level are the kidneys. Here the doctor checks the symptom Pasternatskogo, that is, slightly staggers up to his back in the alleged area of the kidneys, and if there is pain, it means that the kidneys are sick. This is a sign of acute inflammation of the renal or kidney stones. Then the algorithm of investigation of pain in the lumbar region of the back, which necessarily enters into the common analysis of the urine. When the inflammation of the kidneys, acute pyelonephritis, acute or chronic, sometimes high fever, back pain may be at the slightest touch. In general the analysis of urine high number of white blood cells – the inflammatory changes.
• The stones are not only in the kidneys, but also in the gall bladder. Very often confused with pain from malocclusion of the spine and the pain from inflammation of the gall bladder. The gallbladder is located right under the flap, and the pain is given in the right half of the back. But this organ is so clever, what a pain cholecystitis can give the right shoulder, in the lower part of the back and also in the leg. The stone can "stare", not only in bile, but also in the bayou. Could the stone not be, and may be the inflammation of the gall bladder and ducts, caused, for example, Giardia, opisthorchis, and other pests. Usually the inflammation of the gallbladder is detected during the abdominal palpation and definition of particular reflexes symptoms of inflammation of the gallbladder. If it shows signs of an acute cholecystitis, the patient was assigned to do an abdominal ULTRASOUND and a gastroenterologist. If gallstones disease in the acute phase, it is already a surgical treatment. Insidious this disease, however, it may not be the temperature of bitterness in the mouth, the feces, but only pain. This happens in the long course, when it is already formed chronic pain.
• Inflammation of the pancreas pancreatitis. The pain often gives to the back, already just to the left. This happens when the inflammation covers the tail of the pancreas. If the inflammation in the area of the head, the pain in the lower back right, and center. Here everything is more clear, acute pancreatitis, simply can not proceed without dyspeptic phenomena. Here, in addition to severe pain, most often is, "dagger" pain in the abdomen, may be nausea, vomiting. And, of course, the aches and pains are always connected with the violation of a diet, is the intake of spirits in combination with fatty foods. Cutting processes – work for the surgeons. Because the pancreas can start to digest itself, it is called pancreatic necrosis and requires an emergency intervention. If the process is chronic, this observation gastroenetrology. And diet except for the fat.
• Herpes Zoster – herpes zoster (shingles). Occurs in the area of the back, often in lumbar. Appear for the first time the pain, then herpetic precipitation in the form of small bubbles. Is called a type of herpes infection. Usually a therapist and a neurologist. The pain can be very strong, burning. This virus is spread in the nerves. Sometimes from the beginning of the pain in the rashes goes a week and the diagnosis is difficult to establish.

3. The pain in the lumbar-sacral

• The most common reason — manifestations of arthritis of the spine. Breach of, or degenerative changes in the vertebrae at the level of lumbo-sacral joint, the pain gives to the tailbone or the spine.
• Gynaecological causes can give you back pain (it all depends on anatomical location) — inflammatory diseases female organs.
• Urolithiasis, if the stone is the ureter, more often the case in the lower lateral departments of stomach, but can be part of the back.
• The malocclusion of the hip (as in our case, which is reported at the beginning of the article), arthritis, osteoarthritis, or even a fracture of the neck of the femur may give back pain.
• Diseases of the colon-the rectum – hemorrhoids, tumors, benign or malignant (if malignant, causing pain not only for themselves, but it can be a pain from the metastases in the spine, liver, lungs).
• Finally, the diseases of the prostate — this can be high-grade dysplasia and benign prostate can be prostate cancer. These diseases develop in adulthood, therefore, often occur in the long term, even without visible symptoms, but with the weakening of the body can give metastases in the lumbar spine, lungs, local lymph nodes.

4. Some diseases affect the spine and / or departments

• Low back pain – more often – is degenerative changes in the spine, which has affected all the departments of the vertebral column. There is polysegmental low back pain. The manifestations of damage symptoms in all the departments of the spine, then the diagnosis may be particular difficulties, and very often this happens because of osteoporosis.
• Osteoporosis – the reduction of the calcium content in the bones that occurs with age. Men and women happen for different reasons, but still lose. In women after the menopause is associated with a low estrogen level, who are of childbearing age regulate the metabolism of calcium, the men often due to a lesion of the gastro-intestinal tract and malabsorption of calcium. In osteoporosis are the bones brittle, thin. With regard to the spinal column. Occur in micro-fractures to minimize the trauma in the cases in very advanced stages.
• Multiple myeloma disease – refers to a group of leukemia or blood cancer, when the tumor develops in the bone marrow. Increases the number of cells in the blood, from which to grow white blood cells, the pressure of this mass causes bone pain. This disease affects flat bones, often the sternum, but it can be a pain and in the spine. Now grown, the number of cases of leukemia. Diagnosed by the presence of protein in the urine, Ben Jones, modified proteins produced by the tumor cells.
• Ankylosing Spondylitis and other autoimmune diseases — when the inflammation of the vertebrae lead to the autoimmune in nature, that is, when the body produces antibodies against its own cells. Today has been an increase of autoimmune diseases.
• Infectious diseases of the spine – tuberculosis (may be combined with HIV infection), syphilis, osteomyelitis are very rare, but the physician must take account of their knowledge. The tubercular osteomyelitis difficult to diagnose, often the diagnosis is final and is not exposed, but the treatment should be carried out seriously. Tuberculosis is an insidious disease, any weakened immune system, can penetrate in the body and manifest symptoms of a sudden. In the last year I have seen two of these patients.

5. Persistent back pain can indicate a serious illness

With the following symptoms the doctor suspected cancer and focuses on an in-depth investigation:

• back pain bad place in the treatment of pain,
• the reduction of body weight,
• low-grade fever (37-37,5 degrees, which for a long time does not pass),
• anemia, decrease in hemoglobin, on the outside looks like a pale or yellow color of the skin, cyanotic tint lips, "circles" under the eyes,
• increase in the velocity of erythrocyte sedimentation (ESR) in general, the analysis of a blood,
• the bleeding tendency.

The algorithm of investigation for back pain

1. First of all you must pass a routine test – the common blood analysis, urine analysis. This will give us an idea about the state of the body, inflammatory processes in this mode, conditions of the urinary system. If we see a change in the analysis of the urine, once on the suspicion that the pain is due to kidney disease.

2. Biokhimicheski the analysis of the blood, count liver function tests (ALT, AST, bilirubin, alkaline phosphatase), PSA (c-reactive protein), rheumatoid factor — indicators of activity inflammation, the amount of protein, the ratio of different types of proteins in the blood – albumin and immunoglobulins, and other indicators, if the doctor suspects a kind of disease.

3. Tumour markers – in the case of suspected tumor.

4. The tests for infectious diseases: HIV, viral hepatitis, tubercules, syphilis.

5. X-rays of the spinal column – shows the changes in the vertebral column, the presence of hernias vertebral, the metastasis of tumors, and inflammatory phenomena.

6. CT of the spine and internal organs – very important the examination, the better and more plate visible changes in the tissues.

7. Magnetic RESONANCE imaging – more expensive and only method applies, in order to refine the results of computed tomography. It is possible to make combined survey, that capture the internal organs and the same spine. This examination allows one to accurately identify the causes of damage to the internal organs.

8. If the doctor think of some rare disease, then assign a special survey (for autoimmune diseases, infections are rare, studies to determine the state of the body).

The treatment of back pain, of course, it is assigned depending on the cause. But we always start with painkillers – non steroidal anti-inflammatory or anti-spasmodic.

Despite the variety of causes of back pain, our medicine is quite developed, in order to establish an accurate diagnosis and proceed to treatment. The most important thing – do not run the disease and seek medical attention if the pain does not pass for three days, not to mention long intense pains.

Be in health!