Today, back pain is the second most common cause of patients seeking medical assistance. According to statistics from the National Institutes of Health, one in five middle-aged people suffer from pain.
At the same time, the incidence of the disease only increases with age. In medical practice, soreness (back pain) is considered an interdisciplinary pathology, because clinical symptoms of neurological and physical diseases are present.
What is the cause of back pain?
In 90% of cases, back pain occurs from spinal disease (vertebral pain). In other cases, the cause may be internal organs, spinal cord and other diseases (non-vertebral pain).
Therefore, the vertebral formation group includes:
- Intervertebral hernia; Ossification of sa bone or lumbar vertebrae;
- Spondylopathy;
- Osteoporosis;
- Tumor process of vertebrae;
- Trauma (vertebral fracture, spondylolisthesis).
Non-vertebral groups include:
- Psychological pain;
- Fibromyalgia;
- Pathology of internal organs (heart disease, pneumothorax, pancreatitis, urolithiasis, etc. );
- Tumor formation (neuroma) and metastasis;
- Epidural abscess;
- Syringomyelia.
Symptoms
The nature, intensity and duration of back pain vary with the underlying pathology.
- Intervertebral hernia.With the development of osteochondrosis, a herniated disc may appear between the vertebrae. In this case, the pain may be severe or painful and local in nature (depending on the level of the affected intervertebral disc). The soreness often extends to the limbs and is accompanied by numbness and tingling. In advanced cases (when the hernia sac compresses the nerve root), there may be an abnormality in the sensitivity of the arm or leg and the abnormality of the exercise ball. Urination, defecation, and sexual function violations (damage to the pelvic spine) are rare.
- Crab bone or lumbar spine.Cra ossification is a congenital abnormality related to the fusion of the last lumbar vertebrae with the bone. In this case, when the first vertebra of the defect bone separates and becomes another lumbar vertebra, the opposite defect is lumbar vertebralization. Under normal circumstances, the symptoms are asymptomatic, but excessive physical exercise or weightlifting can arouse the clinical condition. In this case, waist pain will occur in the bone area, and this pain will aggravate with exercise and spread to the lower limbs. The pathology is also characterized by its occurrence at a young age (usually between 20-25 years old).
- Spondylopathy.Spondylosis (different from previous diseases) mainly occurs in the elderly. The disease develops due to age-related changes in the spine-its "wear and tear". The pathology is accompanied by the growth of bone tissue in the form of osteophytes, which may result in complete fusion of the vertebrae. The latter has the risk of harming neurovascular bundles, muscles and surrounding organs. This disease is accompanied by chronic pain, which will get worse until the end of the day. Sometimes the pain syndrome manifests not only during exercise, but also during rest, leading to insomnia. For an uncontrolled disease, vertebral joint fixation and nerve fiber contraction often occur, accompanied by the development of characteristic neurological diseases.
- Osteoporosis.Osteoporosis is a metabolic disease in which bone destruction is better than bone formation. The clinical manifestations of the disease are few: the usual pathological process is asymptomatic and is discovered accidentally (using X-rays). However, in the later stages of the disease, dull pain and postural curvature can occur.
- The tumor process of the vertebrae.Vertebral tumors are usually asymptomatic until they are long enough to compress nerve fibers. In this case, chronic back pain (usually in the lower spine) occurs, and this pain may spread to the thighs and calves. Sooner or later, tumor growth will cause nerve root compression, which is manifested in neurological diseases: reduced limb sensitivity and insufficient exercise.
- was injured.The common causes of acute pain, restricted mobility and neurological symptoms are spinal injuries: fractures, contusions, dislocations/subluxations, and spondylolisthesis-lumbar spondylolisthesis due to ligament injuries. Often, patients will notice intense diffuse pain in the back, bleeding ("bruising"), local swelling and restricted mobility.
- Psychological pain.In situations of emotional outburst or high stress, similar views will appear in the context of complete health. Patients describe pain in different ways, which is only limited by the patient's imagination. Sometimes there are so-called. When people tend to use auxiliary supports while maintaining mobility: "painful behavior": crutches, crutches or even wheelchairs.
- Fibromyalgia.The pain syndrome of fibromyalgia is very similar to psychotic pain. At the same time, stress, weather and emotional overload can also cause soreness. However, an important difference is that pain should be observed for more than three months, accompanied by local sensitivity of characteristic points (attachment position of the occipital muscle, middle part of the trapezius muscle, etc. ). In addition, diagnosis needs to completely rule out various somatic diseases.
- Pathology of internal organs.Diseases of various organs of the body often cause back pain. Therefore, during a heart attack, the pain syndrome is located behind the sternum and spreads to the shoulder cap bone and under the left arm and into the spine. With pneumothorax (the accumulation of air in the lungs), acute chest pain occurs and radiates to the spine. Symptom complex appears against the background of dyspnea and facial hair. In pancreatitis (inflammation of the pancreas), pain syndromes have different characteristics, appearing in the upper abdomen in a "band" pattern, covering the sides and back. Back pain, vomiting, and indigestion occurred. The complication of urinary tract stones is renal colic-acute paroxysmal pain syndrome. Often, the pain is so severe that it causes the patient to bend over to seek relief. In the context of the attack, the urine turns dirty red due to impurities in the blood.
- Tumor process.Neuroma is a schwannoma. When the root of the spinal cord is infected, back pain usually occurs, as well as loss of sensitivity and motor activity below the diseased level. It is also worth noting that this tumor process is usually benign. However, similar clinical conditions may be caused by breast cancer, prostate cancer, lung cancer, kidney cancer and other metastases.
- Epidural abscess.An epidural abscess is a collection of subdural pus in the spinal cord. The disease is accompanied by acute pain syndrome and neurological diseases: paresis (decreased muscle strength), decreased sensitivity, pelvic disease, etc. , purulent processes occur in infections, wounds, immunodeficiency or other conditions. Complications of lumbar puncture (or epidural anesthesia).
- Syringomyelia.Syringomyelia is a pathology of the nervous system in which a cavity appears in the spinal cord. Injuries, tumors, pressure on the brain, etc. can cause diseases. In the initial stage, the spine will be slightly sore and will not cause discomfort. Then there is weight loss, muscle weakness, loss of pain sensitivity, no sweating, and bones become weak. Joints and bones are often injured (burns, fractures, cuts), but due to lack of pain, they pass through imperceptibly.
Diagnosis
As a diagnosis, a qualitative investigation and physical examination of the patient is required through palpation (feeling), per diagnosis (percussion) and auscultation (authentication). For certain pathologies, it is necessary to perform laboratory blood tests (heart disease, pancreatitis, tumor processes).
To visualize soft tissues and internal organs, you will need instrumental diagnostic methods: ultrasound or magnetic resonance imaging. X-rays and computed tomography scans are used to directly examine bones.
In some cases, it may be necessary to use less common techniques: bone scintigraphy, electromyography, etc.
Low back pain treatment
To relieve acute back pain, add ice cubes (every 4 hours and 20 minutes), exclude physical activity, and fix the spine as much as possible. If the pain is unbearable, you can take painkillers. However, it is worth remembering that anesthetics can "lubricate" the clinical of the disease. Subsequently, this will complicate the diagnosis of the disease. Only the attending physician can prescribe medication.
Intervertebral disc herniation
The main medical treatment is based on the use of anti-inflammatory drugs (diclofenac, ibuprofen) and analgesics (Ketorolac). In some cases, surgical removal of intervertebral hernias and intradiscal prostheses may be required.
cra bone or lumbar spine
When pain occurs, anesthetics and physical therapy (paraffin application, electrophoresis, etc. ) will be prescribed. Because conservative treatment is ineffective, reconstructive surgery is required.
Cervical spondylosis
Anti-inflammatory drugs (meloxicam, indomethacin) and physical therapy (ultrasound, electrophoresis) can be used to eliminate inflammation and pain syndrome.
Osteoporosis
The treatment of osteoporosis starts with a diet high in calcium and vitamin D.
Perhaps these substances are appointed in the form of drugs. In some cases, estrogen, calcitonin, and parathyroid hormone are used for hormone therapy.
Tumor process
The treatment of tumor diseases includes chemotherapy and surgery. In this case, the amount of assistance depends on the specific clinical situation.
Damage
In the case of minor injuries, a gentle posture and warm-up should be prescribed. In some cases, it is necessary to reduce traction or bone traction. When neurological symptoms appear, surgery to fix bone fragments will be performed.
Psychological pain
Help for psychological pain includes complex psychotherapy and taking antidepressants (fluoxetine, sertraline).
Fibromyalgia
As the cause of the disease is still unknown, symptomatic treatment is needed: antidepressants (paroxetine, amitriptyline), anticonvulsants (pregabalin), hypnotics (zopiclone) or tranquilizers (diazepa)). Self-regulation, active thinking, avoiding stressful environments and maintaining a warm and dry environment are also important.
Visceral Pathology
Each possible internal pathology requires a separate treatment strategy. Urgent care for a heart attack is to take nitroglycerin (one pill every five minutes until the ambulance arrives); people with pancreatitis-colds, hunger and rest; pneumothorax-open lung wounds with a sealed (occlusive) dressing; andRenal colic-antispasmodics (Drotaverin, Metamizole sodium) and warming.
Epidural abscess
Treatment includes emergency surgery to normalize the pressure in the spinal canal and expel the meninges. Antibiotic therapy (amoxicillin, cefotaxime) supports surgical intervention.
Syringomyelia
Generally, patients are advised to protect their skin from cuts and burns (the latter often occurs because the patient loses sensitivity and does not feel traumatized). Analgesics, antidepressants (fluoxetine) and antipsychotics (chlorpromazine) were also prescribed. In some cases, surgery can be performed to repair the cavity formed by the spinal cord.
Back protection
In order to prevent back pain, it is necessary to prevent the occurrence of the above-mentioned diseases. To do this, you need:
- Normalize the lifestyle: reduce weight to a normal level; form the correct diet rich in trace elements and vitamins; ensure proper physical exercise without overwork.
- Give up bad habits: smoking and drinking.
- Correct posture curvature (scoliosis, lordosis) and plastic surgery pathology (flat feet, clubfoot, etc. ).
- Timely diagnosis and treatment of accompanying diseases of the musculoskeletal system or internal organs.
- Prevent or appropriately treat spinal injuries.
- Avoid emotional outbursts and stressful situations.
It is worth remembering that back pain is not an isolated pathology, but a symptom of the disease. The main disease can be very serious, and if left untreated, it will cause the patient to become disabled or even die!