Back pain

Back pain is a symptom that manifests itself in various diseases and conditions. Most often, back pain is a reflection of bone pathology, changes in the joints of the spine and periarticular tissues, muscles, nerve trunks and skin above the spine. Back pain can accompany other diseases, including diseases of the internal organs.

back pain

Symptoms of back pain

Depending on the cause, back pain may have its own characteristics. In rheumatic diseases, the following symptoms are distinguished:

  • pain occurs in the lumbar spine, buttocks, gives the thigh;
  • the pain increases at rest and decreases with movement;
  • the pain is accompanied by morning stiffness in the lumbar spine;
  • the lesion of the spine is bilateral.

With infectious processes:

  • acute pain in the spine;
  • with a lesion in the lumbar region, the pain radiates to the buttocks, legs;
  • the pain increases with pressure on the affected area;
  • swelling and redness of the skin in the affected area are often noted;
  • the process is often unilateral (on one side of the spine).

With muscle pathology:

  • in fibromyalgia the pain is constant, widespread, covering both the right and left halves of the body above and below the waist. It is intensified by emotional and mental overload, by the action of low temperatures, abrupt changes in the climate. Painful spots appear in various anatomical areas, which are revealed when pressed on them;
  • tension of the affected muscle;
  • decreased muscle strength.

Disc herniation (osteochondrosis), spondyloarthritis:

  • back pain resulting from strain on the spine (eg prolonged standing), aggravated by turning and leaning back, resting;
  • discomfort may occur during prolonged stay in one position;
  • possible nerve compression by hernia or subluxation in the joint. In such cases, pain may be given in the arm, occipital region (with damage to the cervical spine), in the leg (with damage to the lumbar spine), accompanied by tingling, numbness and muscle weakness in the leg or arm;
  • subluxation of the joints in the cervical vertebrae can compress the vertebral artery, causing headache, dizziness, impaired coordination of movements, vision, hearing;
  • the stiffness of the spine disappears after heating.

With damage to internal organs:

  • with renal pathology, in addition to back pain, abdominal pain, frequent urination may occur;
  • in diseases of the pancreas - the surrounding nature of the pain;
  • with lung disease - pain in the back and chest behind or in front, under the shoulder blade, exacerbated by cough.

Reasons

The causes of the disease are very diverse.

  • Back pain caused by pathology of the spine (bones, ligaments, tendons, intervertebral discs):
    • osteomyelitis (an infectious and inflammatory process that affects the site of the bone marrow and then the elements of bone tissue);
    • tumors of the spine and metastases ("screening" of a tumor of any organ that has spread to the spine with the formation of a new focus);
    • disc herniation (osteochondrosis);
    • osteoporosis (a disease characterized by increased fragility of bone tissue);
    • spondylolisthesis (displacement of one vertebra relative to the others);
    • scoliosis (curvature of the spine);
    • spondyloarthritis (a disease based on the defeat of all components of the joint, mainly articular cartilage);
    • fractures;
    • stenosis (obstruction) of the spinal canal.
    • Back pain due to muscle abnormalities:
      • fibromyalgia (symptom complex manifested by chronic generalized (spreading to many muscles) muscle pain, depression, sleep disturbance, morning stiffness, rapid fatigue);
      • muscle cramps;
      • stretching the muscles.
      • Back pain due to other conditions:
        • pelvic bleeding;
        • purulent hematoma (accumulation of spilled blood) of the retroperitoneal space;
        • diseases of the pelvic organs;
        • aortic dissection;
        • kidney disease;
        • diseases of the abdominal organs;
        • rheumatic diseases (ankylosing spondylitis (a disease characterized by an inflammatory process in the spine and joints), reactive arthritis (inflammatory diseases of the joints with an infectious nature), psoriatic arthritis (inflammation of the joints combined with the appearance of scaly plaques on the skin));
        • shingles, shingles.
        • Provoking factors can be:
          • injury;
          • weight lifting;
          • unprepared movements;
          • prolonged stay in an unphysiological (uncomfortable) position;
          • hypothermia.

          Diagnosis

          • Analysis of complaints (back pain, back discomfort with prolonged exposure in one position, morning stiffness; tingling, numbness, muscle weakness in the arm or leg).
          • Analysis of the anamnesis (history of development) of the disease - asking how the disease began and progressed.
          • General examination (examination and palpation of the spine, determining the range of motion in the spine).
          • General blood and urine tests to identify the infectious process and renal pathology.
          • X-ray of the spine - allows you to detect pathological changes in the vertebrae.
          • Computed tomography, magnetic resonance imaging of the spine - allows you to determine in more detail the nature of the lesion of the spine and surrounding tissues.
          • Electromyography - to detect muscle pathology.
          • Radioisotope bone scintigraphy is a contrast study that is based on the observation of the peculiarities of the distribution of the contrast agent introduced into the body in the bones. Outbreaks appear to be exacerbated during pregnancy.
          • Densitometry - determination of bone density. It is performed to detect osteoporosis (a disease characterized by increased bone fragility).
          • Consultation with a neurologist, vertebrologist, rheumatologist, orthopedist.

          Treatment of back pain

          • Treatment of the underlying disease causing back pain.
          • Rest for a few days (2 to 5).
          • Wearing a bandage (corset) to relieve the spine.
          • Non-steroidal anti-inflammatory drugs (oral, in the form of injections, in the form of topical agents - ointments, gels) - to reduce pain.
          • Muscle relaxants are muscle relaxants.
          • Surgical treatment depending on the cause of the pain - for example, removal of a purulent lesion in the spine; installation of a prosthesis between the vertebrae to restore the normal distance between them by narrowing the intervertebral fissure and squeezing the nerve trunks.
          • After the disappearance of acute pain - physiotherapy procedures (consultation with a physiotherapist is required), massage, physiotherapy exercises.

          Complications and consequences

          • It depends on the cause and severity of the disease that caused the pain.
          • It is possible for the disease to become chronic (osteochondrosis).
          • In severe cases, disability (trauma, rheumatic diseases).

          Prevention of back pain

          • Treatment of the underlying disease.
          • Elimination of injuries, physical overload, hypothermia.
          • Proper posture.
          • Proper positioning of the work and sleeping area (to exclude the non-physiological position of the spine, in which it is subject to distortion).
          • Correction of overweight.