Back pain is a symptom that occurs with various illnesses 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 also accompany other illnesses, including diseases of internal organs.
Symptoms of back pain
Depending on the cause, back pain can have its own characteristics. In rheumatological diseases, the following symptoms are distinguished:
- pain occurs in the lumbar spine, buttocks, gives to the thigh;
- pain increases at rest and decreases with movement;
- the pain is accompanied by morning stiffness of the lumbar spine;
- the defeat of the spine is bilateral.
With infectious processes:
- sharp pain in the spine;
- with a lesion in the lumbar region, the pain radiates to the buttocks, leg;
- pain increases with pressure on the affected area;
- swelling and redness of the skin in the affected area is often noted;
- the process is often unilateral (on one side of the spine).
With muscular pathology:
- with fibromyalgia the pain is constant, extensive, covering both the right half and the left half of the body above and below the waist. It intensifies with emotional and mental overload, with the action of cold temperatures, sudden changes in climate. Painful points appear in different anatomical areas, which are revealed by pressing on them;
- tension of the affected muscle;
- decrease in muscle strength.
Herniated disc (osteochondrosis), spondylarthrosis:
- back pain resulting from stress on the spine (for example, prolonged standing in an upright position), aggravated by rotating and bending backwards, switching to rest;
- discomfort may occur during prolonged stay in one position;
- possible compression of nerves by herniation or subluxation in the joint. In such cases, pain may be felt in the arm, occipital region (with injury to the cervical spine), leg (with injury to the lumbar spine), accompanied by numbness, tingling, and muscle weakness inleg or arm;
- subluxation of the joints of the cervical spine can compress the vertebral artery, causing headache, dizziness, impaired coordination of movements, vision, hearing;
- the stiffness of the spine disappears after warming up.
With damage to internal organs:
- with kidney pathology, in addition to back pain, abdominal pain, frequent urination may occur;
- in diseases of the pancreas - the surrounding nature of pain;
- with lung diseases - pain in the back and chest behind or in front, under the scapula, worse with coughing.
Causes
The causes of the disease are very diverse.
- Back pain due to pathology of the spine (bones, ligaments, tendons, intervertebral discs):
- osteomyelitis (an infectious and inflammatory process that affects one site in the bone marrow, then parts of bone tissue);
- spinal tumors and metastases ("screenings" for a tumor from any organ that has spread to the spine with the formation of a new focus);
- herniated disc (osteochondrosis);
- osteoporosis (a disease characterized by increased fragility of bone tissue);
- spondylolisthesis (displacement of one vertebra in relation to others);
- scoliosis (curvature of the spine);
- spondylarthrosis (a disease based on the defeat of all components of the joint, mainly the articular cartilage);
- fractures;
- spinal stenosis (obstruction).
- Back pain due to muscle abnormalities:
- fibromyalgia (symptomatic complex, manifested by generalized chronic muscle pain (spreading to many muscles), depression, sleep disturbances, morning stiffness, rapid fatigue);
- muscle cramps;
- stretch 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;
- Dissection of the aorta;
- kidney disease;
- diseases of the abdominal organs;
- rheumatological diseases (ankylosing spondylitis (a disease characterized by an inflammatory process of the spine and joints), reactive arthritis (inflammatory diseases of the joints of an infectious nature), psoriatic arthritis (inflammation of the joints, associated with the appearance of scaly patches on theskin));
- shingles, shingles.
- The provoking factors can be:
- injury;
- lifting weights;
- unprepared movements;
- prolonged stay in a non-physiological (uncomfortable) position;
- hypothermia.
Diagnostic
- Analysis of complaints (pain in the spine, back pain with prolonged exposure to a position, morning stiffness; numbness, tingling, muscle weakness in the arm or leg).
- Analysis of the anamnesis (history of development) of the disease - asking how the disease started and proceeded.
- General examination (examination and palpation of the spine, determination of the range of motion of the spine).
- General tests of blood and urine to identify the infectious process and renal pathology.
- X-ray of the spine - allows you to detect pathological changes in the vertebrae.
- Computer, magnetic resonance imaging of the spine - allows you to determine in more detail the nature of the damage to the spine and surrounding tissues.
- Electromyography - to detect muscle pathology.
- Radioisotope bone scintigraphy is a contrast study, which is based on observing the characteristics of the distribution of a contrast agent introduced into the body into the bones. Foci of excessive accumulation indicate the presence of a pathological process.
- Densitometry - determination of bone density. It is performed to detect osteoporosis (a disease characterized by increased fragility of the bones).
- Consultation with a neurologist, vertebrologist, rheumatologist, orthopedist.
Treatment of back pain
- Treatment of the underlying disease causing back pain.
- Rest for several days (2 to 5).
- Wearing a bandage (corset) to relieve the spine.
- Nonsteroidal anti-inflammatory drugs (taken by mouth, in the form of injections, in the form of local 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 focus in the spine; placement of a prosthesis between the vertebrae to restore the normal distance between them with narrowing of the intervertebral slit and compression of the nerve trunks.
- After the acute pain subsides - physiotherapy procedures (consultation of a physiotherapist is required), massage, physiotherapy exercises.
Complications and consequences
- Depends on the cause and severity of the disease that caused the pain.
- The transition of the disease to a chronic form (osteochondrosis) is possible.
- In severe cases, handicap (trauma, rheumatological diseases).
Prevention of back pain
- Treatment of the underlying disease.
- Elimination of injuries, physical overload, hypothermia.
- Correct posture.
- Correct arrangement of the workplace and sleep (to exclude the non-physiological position of the spine, in which it is subjected to a curvature).
- Correction of excess body weight.