Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know about back pain firsthand. More than a third of all issued "sick leave" are 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-ray, 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 it 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, protective, motor and shock-absorbing functions. This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time with an improper lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spinal column is the spinal cord, its paired roots innervate almost all organs and tissues. Any disturbance in this complex system can cause pain. More often than others, the cervical and lumbar region suffers due to its greatest 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-diagnostics.

First, you can contact a therapist who will identify a set of symptoms and refer you to the right specialist with a narrow profile. If the cause is known and obvious, the prescribed therapy 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 (common) causes:

• increased weight;
• recent childbirth or pregnancy;
• hypodynamic work - in the office, at the computer, driving a car;
• standing work - hairdressers, waiters and salespeople, street advertisers, surgeons, teachers;
• heavy physical activity in combination with sharp 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 can occur with disc protrusion, spondyloarthritis, spinal cord epiduritis, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, spinal cord strokes, inflammation of the appendages in men and women, and prostate cancer in women.

Varieties of diseases by the nature of back pain

Causes of aching pain:

• hypothermia;
• Crick;
• myositis;
• prolonged uncomfortable posture while sleeping or working;
• lumbago (labor becomes the cause);
• osteochondrosis;
• intervertebral hernia or displacement of the intervertebral discs due to a sharp 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 effort;
• osteochondrosis - the patient may experience pulling pains that radiate to the leg and are aggravated by coughing, sneezing, straining, walking, bending over.

Etiology of throbbing pain:

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

Bursting back pains:

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

Why does my back hurt after sleep?

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

• overload the day before, if you lifted weights and moved sharply;
• 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 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 makes the muscles overstrain and do not rest at night. The posture is so important that even an orthopedic mattress does not help. It is recommended to 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 joints and the spine

All pathologies in which back pain occurs have a common basis - the uneven load on the spinal column. 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 sharply disrupts 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 - intervertebral discs become thinner, cracked, 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 an 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. Small muscles of the back are affected. More often typical for young people, it develops gradually. The pain is severe in the morning and decreases in the evening.
7. Stenosis of the spinal canal - the cause may be a herniated disc, protrusion (protrusion into the spinal canal). Most often, the process involves the lowest roots of the spinal cord, which innervate the legs. The pain is felt from the lower back to the foot, and intensifies both when resting and when walking.
8. Facet syndrome is a lesion of the intervertebral (facet) joints. The pain can be local, or radiate to the groin, tailbone, thigh. Physically dependent. In the evening, the condition worsens, after rest it improves. It is more common in the elderly.

Diseases associated with 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 may join: increased sensitivity when pressing 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 muscles, organs, 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 negative environment in the form of hypothermia, overload, uncomfortable posture, etc. Leads to spasms in individual muscles and pain. The so-called trigger points appear, by pressing on which the muscle reacts with acute pain. Neurologists know about it. Pains of this kind are eliminated with warming ointments and a needle applicator.

Spinal cord pathologies

These include infringement 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 (spinal fracture);
• tumors;
• osteochondrosis or disc herniation;
• 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 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 lumbago 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 localization.

Pain in the right side

The right side of the back can hurt due to curvature of the spine, kyphosis, lordosis, myositis, displacement of the intervertebral disc, obesity.

Somatic pathologies can also give pain in this area:

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

Lumbar pain

The lower back suffers very often, since it has an enormous load. This section becomes inflamed with damage to the nerve roots, osteochondrosis or hernial protrusion. Less commonly, the cause can be tuberculosis of the spine, arthritis, lumboischialgia, decreased density and violation of the structure of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Lumbar pain is usually chronic.

In the lumbar region on the right

Lumbar 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 and 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 improper posture);
• vertebral infections;
• circulatory disorders.

Pinched nerve

More often the sciatic nerve is pinched - sciatica. In this case, its myelin sheath is not disturbed. This is usually a consequence of osteochondrosis. When pinched, a sharp and 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 sharply increased by coughing, exertion or sneezing.

Intervertebral hernia

A hernia is the extrusion of the core 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, squeezing it. Even a small load in such 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, with a return to the arm or leg.

In the area of the shoulder blades

A characteristic of pain may indicate a diagnosis:

1. Stomach ulcer - growing dull pain. Eliminated by medicines.
2. Intercostal neuralgia - the disease is characterized by acute pain with any physical effort.
3. Osteochondrosis - dizziness, pressure changes, numbness of 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 curvature of the spine. If the pain is not pronounced, we can talk about protrusion. With increased pain, you can think about osteochondrosis. Pain along the spine is typical for myositis, fractures, thinning and wear of intervertebral discs, spondyloarthritis. They are always sharp and constant.

Causes of lower back pain

Such pain is more 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

The manifestations of spinal pain differ depending on the location. With damage to the cervical spine, migraines 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 area of 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 combined with back pain;
• numbness in hands and feet, weakness and tingling sensation;
• gait has 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 dizzy;
• numbness in the genitals and weakness, "cottoniness" in the legs;
• leg cramps;
• problems conceiving 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 body position;
• 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 tests. They help to 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. MRI. . .Visualizes the condition of all components of the spine. Helps to differentiate the type and nature of the tumor, 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 this is in 3D.
4. Radiography. The most cost-effective way to diagnose back pain and identify the condition of the bone tissue. 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 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, analgesics, muscle relaxants, vitamins of group B are usually used. Along the way, physiotherapy, exercise 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 see one doctor.

Prophylaxis

Preventive measures:

• learn to keep your posture and stand correctly;
• do not slouch;
• keep your back straight while sitting, put a stand under your feet;
• correctly organize the place of sleep;
• do not jump up abruptly after waking up - stretch slowly, do simple exercises with arms and legs;
• distribute weights to both hands - do not carry everything in one hand, refuse a bag over your shoulder - a backpack is better;
• do not carry the child in your arms with a back bend;
• lift weights by squatting;
• do not wash floors without a mop, bending forward or kneeling;
• balance your diet with a sufficient amount of minerals and vitamins;
• quit smoking and alcohol;
• do not forget about physical exercises - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• protect the liver, it produces collagen for the ligaments of the spine and vertebral bodies;
• strengthen immunity;
• control weight;
• it is advisable to undergo a course of manual therapy for 5-10 sessions every 6 months (as recommended by a specialist);
• avoid stress;
• do not forget about medical examinations.

If you develop back pain, see a doctor who can provide appropriate assistance. Remember, any disease is easier to treat in the initial stages.