Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know about back pain first hand. More than a third of all issued "sick leave" refers to this problem. The reason can be considered the weakness of fragile muscles and their rapid growth. In addition to visual inspection, hardware diagnostics (X-ray, myography, CT, etc. ), laboratory blood tests are performed to identify the problem. Treatment is prescribed only after diagnosis.

Why does my back hurt?

Spinal pain can occur immediately after injury, pathology 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 affect, for example, diseases of internal organs. To some extent, the back itself is vulnerable due to its structure.

It is based on the spine, which provides support, protection, motor and cushioning function. This is due to the cartilage of the intervertebral discs, muscles and ligaments, which wear out over time due to improper lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spinal cord is the spinal cord, its paired roots innervate almost all organs and tissues. Any disorder in this complex system can cause pain. More often than others, the cervical and lumbar regions suffer due to their greatest loads and mobility.

What to do with back pain?

An examination by a doctor is mandatory to determine the cause, especially if the pain is frequent. Only a specialist can make the correct diagnosis and prescribe treatment. You cannot engage in self-diagnosis.

First, you can contact a therapist who will identify a number of symptoms and refer you to a real 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 non-specific symptom that can have various 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 salesmen, street advertisers, surgeons, teachers;
• heavy physical activity combined with sharp body turns;
• overload in training;
• in postmenopausal women with a tendency to osteoporosis.

Pathological causes:

• diseases of the spine (osteochondrosis, spondylosis, ankylosing spondylitis, tumors, arthritis, osteomyelitis, Reiter's syndrome) and spinal cord;
• growth 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 may occur with disc protrusion, spondyloarthritis, spinal epiduritis, osteochondrosis, intervertebral hernia, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, stroke, men and women with appendages, men and women.

Types of disease by nature back pain

Causes of excruciating pain:

• hypothermia;
• Crick;
• myositis;
• prolonged uncomfortable posture during sleep or work;
• lumbago (childbirth becomes the cause);
• osteochondrosis;
• intervertebral hernia or displacement of intervertebral discs due to sharp lifting of weights or sharp turning of the body;
• kidney disease - cause back pain due to the proximity of the kidneys to the lower back;
• stomach diseases.

Causes of cracking pain:

• intervertebral hernia - their condition worsens with any physical stress;
• sciatica - such back pain often occurs on one side, radiates to the thigh or buttocks, causes numbness of the legs and depends on physical exertion;
• osteochondrosis - the patient may feel traction pain that radiates to the leg, and is aggravated by coughing, sneezing, straining, walking, bending.

Etiology of pulsating pain:

• osteochondrosis;
• intervertebral hernia;
• lumbago;
• spondylosis - are acute and cannot be alleviated with analgesics.

shooting back pain:

• ischemia;
• heart attack;
• BODIES;
• gallbladder inflammation;
• sudden increase in pressure;
• atherosclerosis.

Why does my back hurt after sleep?

Most people often experience back pain in the morning after sleeping, which can be caused by:

• overload the day before, if you have lifted weights and moved abruptly;
• weak back muscles;
• hypothermia;
• vertebral hernia or osteochondrosis;
• scoliosis - curvature of the spine leads to uneven muscle contraction;
• pregnancy - it moves the center of the body;
• 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, the person is forced to take an uncomfortable, non-physiological position during sleep, which causes the muscles to strain and not rest at night. 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 oncology).

Diseases related to the joints and spine

All pathologies in which back pain occurs have a common basis - uneven load on the spine. This includes:

1. Ankylosing spondylitis - permanent 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 suddenly disrupts the work of the spine.
2. Spondylolisthesis - 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. It affects the cervical spine more often.
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. The small muscles of the back are affected. More often typical for young people, it develops gradually. The pain is strong in the morning and decreases in the evening.
7. Spinal canal stenosis - 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 feet, and intensifies both at rest and when walking.
8. Facet syndrome is a lesion of the intervertebral (faceted) joints. The pain may be local, or radiate to the groin, occipital bone, thigh. Physically dependent. In the evening the condition worsens, after rest it improves. It is more common in the elderly.

Diseases associated with the musculature

Muscle tissue is affected secondarily, on the background of pathology of bone tissue or joints. Painful cramps and contractions appear in the muscles, mobility is impaired:

1. Fibromyalgia is a syndrome of pain from the neck to the lower back. Neurological symptoms may also join: increased sensitivity to pressure on certain points of the back, stiffness and stiffness.
2. Polymyositis - occurs with hypothermia, trauma, sprains or heavy physical exertion. Muscle weakness occurs, 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 nerve roots.
5. Polymyalgia rheumatica is the negativity of the environment in the form of hypothermia, overload, uncomfortable posture and the like. It leads to spasms of certain muscles and the appearance of pain. The so-called trigger points appear, with the pressure to which the muscle reacts with acute pain. Neurologists know about it. This type of pain is relieved with warming ointment and a needle applicator.

Spinal cord pathologies

This includes damage to the spinal cord, which has 31 pairs of branches, where each nerve is responsible for innervating its place. This condition occurs when:

• trauma (spinal fracture);
• tumors;
• osteochondrosis or herniated disc;
• inflammation as a result of abscess, hematoma;
• cerebral hemorrhage;
• myositis;
• mineral and vitamin deficiencies;
• complications of HIV or neurosyphilis;
• sclerosis.

Back pain due to psychosomatics

In recent years, back pain has begun to manifest in psychosomatics. In this case, with complaints of back pain, the examination does not reveal pathology. This condition occurs with chronic stress, depression, lack of libido. The result can be not only pain, but also changes in gait, worsening of the lumbago and sensory disorders.

Causes of back pain by localization

Pain can occur in various 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 cause pain in this area:

• formation of stones in the organs of the urinary system;
• appendicitis (appendicitis);
• gallbladder inflammation;
• nephritis;
• ovarian inflammation;
• salpingitis.

Pain in the left side

This back area can hurt when:

• splenitis;
• ICD;
• root pinching;
• 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 because it has a huge load. This part becomes inflamed due to nerve root damage, osteochondrosis or hernial protrusion. Less common causes may be tuberculosis of the spine, arthritis, lumbosciatica, 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 in 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 ache after physical exertion. The condition improves after rest. Also, pain can occur in diabetes, pinching the roots. If it does not disappear at rest, the reasons may be:

• scoliosis;
• osteochondrosis (with a sedentary lifestyle or improper posture);
• vertebral infections;
• circulatory disorders.

Tight nerve

The sciatic nerve - sciatica - is more often compressed. In this case, its myelin sheath is not disturbed. This is usually due to osteochondrosis. When pinched, there is a sharp and sharp pain that spreads to the leg, sacrum, lower back.

In compression radiculopathy, the roots of the spinal nerves are also compressed due to a herniated disc or a reduction in its height and, as a result, the distance between the vertebral bodies. This pain feels "superficial", intensified by coughing, exertion or sneezing.

Intervertebral hernia

Hernia is the extrusion of the nucleus of the intervertebral disc into the spinal canal. It is more often the result of untreated osteochondrosis. The central part protrudes towards the spinal cord, squeezing it. Even a small load in such cases leads to a reduction 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

The characteristic of the pain may indicate the diagnosis:

1. Gastric ulcer - growing dull pain. It is eliminated by drugs.
2. Intercostal neuralgia - the disease is characterized by acute pain with any physical exertion.
3. Osteochondrosis - dizziness, changes in pressure, numbness of the hands.
4. Exacerbation of angina pectoris - pain is localized in the left shoulder blade, radiating to the chest and below the collarbone.

Pain along the spine and back

They most often occur when the nerve endings are tight. Exacerbations are associated with curvature of the spine. If the pain is not pronounced, we can talk about protrusion. With increased pain, you may think of osteochondrosis. Spinal pain 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 commonly associated with osteochondrosis and spondyloarthritis. Less often, such feelings may occur when:

• diseases of the genital area in women (endometritis, adnexitis, vulvitis, cervicitis, oophoritis);
• pregnancy;
• menstruation;
• ulcerative colitis;
• appendicitis;
• prostate or bladder diseases - in men.

Related symptoms

Manifestations of back pain vary depending on the location. With the defeat of the cervical spine, migraines and dizziness, weakness and numbness of the hands, jumps in pressure, flies and flashes in the eyes will be noticed. When the chest is affected, there is tingling and stiffness in the chest, difficulty breathing, pain in the shoulder blades.

Situations requiring urgent medical attention

An urgent visit to the doctor requires back pain, which occurs in the following cases:

• injury;
• neurological symptoms in the form of tingling and numbness in the limbs;
• fever is combined with back pain;
• numbness in the hands and feet, weakness and a burning sensation;
• gait changed or legs taken away;
• history of cancer;
• weight loss for no apparent reason;
• impaired urination and defecation - a person cannot control these processes;
• back pain radiating to chest, jaw and neck;
• consciousness is confused and dizzy;
• genital numbness and weakness, "cottoniness" in the legs;
• leg cramps;
• problems with conception or erection;
• problems with the gastrointestinal tract, in which the treatment of a gastroenterologist does not help;
• pain in the back of the head, small pelvis, exacerbated by a change in body position;
• increased pain when sitting or standing for long periods of time.

Experts will help you discover the cause of the pain.

Diagnosis

To determine the cause of back pain, a neurologist prescribes a comprehensive examination:

1. Blood tests. They help to recognize the presence of infection and inflammation in the form of leukocytosis and increased ESR. Decreased hemoglobin will indicate anemia, which can have several causes, and one of the possible ones is cancer.
2. MRI. . .Visualizes the condition of all components of the spine. It helps to differentiate the type and nature of the tumor, to determine the distance between the vertebrae and the degree of root compression.
3. CT. Identifies fractures, allows you to find the smallest fragments after injury. All this is in 3D.
4. Radiography. The most cost-effective way to diagnose back pain and determine the condition of bone tissue. It is prescribed for suspected fracture, arthritis, scoliosis, osteoporosis, spondyloarthritis.
5. Electromyography (EMG). Determines indicators of bioelectrical activity of muscles and peripheral nerve endings.
6. Ultrasound of blood vessels of the neck and brain. In triplex or duplex mode, it is used to assess the patency of blood flow through arteries and vessels. Their condition is checked - wall thickness, permeability, etc.

Treatment of back pain

There are several treatments for back pain. The neurologist will choose the optimal treatment for you, taking into account the patient's age, lifestyle, level of physical mobility and clinical manifestations.

NSAIDs, analgesics, muscle relaxants, B vitamins are most often used in the treatment of back pain. Physiotherapy, exercise, IRT, massage, spinal traction, muscle relaxation are prescribed along the way.

In case of back pain, in order for the treatment to be of good quality, it is recommended to visit one doctor.

Prophylaxis

Preventive measures:

• learn to hold your posture and stand properly;
• do not bend;
• keep your back straight while sitting, put a stand under your feet;
• properly organize a place to sleep;
• do not jump abruptly after waking up - slowly stretch, do simple exercises with arms and legs;
• spread weights on both hands - don’t carry everything in one hand, bounce the bag over your shoulder - a backpack is better;
• do not carry a child in your arms with your back bent;
• lift weights by squatting;
• do not wash floors without a cloth, bending forward or kneeling;
• balance your diet with enough minerals and vitamins;
• quit smoking and alcohol;
• do not forget about physical exercises - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• protects the liver, produces collagen for the ligaments of the spine and vertebrae;
• strengthen immunity;
• weight control;
• it is recommended to undergo a course of manual therapy of 5-10 sessions every 6 months (according to the recommendation of a specialist);
• avoid stress;
• don’t forget about medical checkups.

If you get back pain, see a doctor who can help you. Remember, any disease is easier to treat in the initial stages.