Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people experience back pain.Of all sick leave issued, more than a third are linked to this problem.The reason can be considered the weakness of fragile muscles and their rapid growth.To identify the problem, in addition to a visual examination, hardware diagnostics (x-ray, myography, computed tomography, etc.) and laboratory blood tests are carried out.Treatment is only prescribed after a diagnosis has been established.

Why does my back hurt?

Pain in the spine can occur directly after injuries, pathologies of the vertebrae, ligaments and discs, or soft tissue damage.It depends on the position of the body, the level of physical activity, but can also result, for example, in diseases of the internal organs.To some extent, the back itself is vulnerable due to its structure.

Its base is the spine, which provides support, protection, motor skills and cushioning functions.This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time due to poor lifestyle and cause degenerative diseases of the musculoskeletal system.

Inside the spine is the spinal cord, its paired roots innervate almost all organs and tissues.Any disruption to this complex system can cause pain.The cervical and lumbar regions suffer most often due to their greater loads and mobility.

What to do if you have back pain?

A medical examination is necessary to determine the cause, especially if the pain has become frequent.Only a specialist can make the correct diagnosis and prescribe treatment.You cannot self-diagnose.

As a first step, you can contact a therapist, who will identify a set of symptoms and refer you to the right specialist.If the cause is known and obvious, you can continue with the prescribed treatment.Neurologists, orthopedists and vertebrologists treat back problems.

Causes of back pain

Back pain is a non-specific symptom that can be caused by various reasons.

Physiological causes (common):

• increased weight;
• recent childbirth or pregnancy;
• hypodynamic work - in the office, at the computer, behind the wheel of a car;
• standing work - hairdressers, waiters and sellers, street announcers, surgeons, teachers;
• intense physical activity combined with sharp turns of the body;
• overload during training;
• postmenopausal with a tendency to osteoporosis.

Pathological reasons:

• diseases of the spine (osteochondrosis, spondylosis, ankylosing spondylitis, tumors, arthritis, osteomyelitis, Reiter syndrome) and spinal cord;
• growth diseases – 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, epiduritis of the spinal cord, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, strokes of the spinal cord, inflammation of the appendages in women and prostate cancer in men.

Types of diseases depending on the nature of back pain

Causes of aching pain:

• hypothermia;
• muscle tension;
• myositis;
• prolonged uncomfortable posture while sleeping or working;
• lumbago (caused by work);
• osteochondrosis;
• intervertebral hernia or displacement of the intervertebral discs due to sudden lifting of weight or sudden rotation of the body;
• kidney diseases - cause back pain due to the proximity of the kidneys to the lower back;
• stomach diseases.

Causes of shooting pain:

• intervertebral hernia - with them the condition worsens with any physical stress;
• radiculitis - this type of back pain often occurs on one side, radiates to the thigh or buttock, causes numbness in the legs and also depends on physical exertion;
• osteochondrosis - the patient may experience shooting pain that radiates down the leg and intensifies when coughing, sneezing, straining, walking or bending.

Etiology of shooting pain:

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

Breaking back pain:

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

Why does my back hurt after sleeping?

Most people often experience back pain in the morning after sleeping, the reasons may be:

• overload the day before, if you lifted weights and moved suddenly;
• weak back muscles;
• hypothermia;
• spinal hernia or osteochondrosis;
• scoliosis – curvature of the spine causes uneven muscle contraction;
• pregnancy - when the center of the body shifts;
• obesity - the load on the spine is also uneven.

Sleeping conditions are also important.The bed should not be too hard or too soft - in any case, a person is forced to take an uncomfortable and unphysiological position during sleep, which causes excessive tension of the muscles and does not rest at night.Posture is so important that even an orthopedic mattress can't help.It is recommended to sleep on your back with your legs elevated.

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 spine

All pathologies that cause back pain have a common basis: uneven load on the spine.These include:

1. Ankylosing spondylitis – persistent inflammation of ligaments and joints causes chronic spasms of surrounding muscles.The process is autoimmune;over time, the vertebrae begin to fuse, significantly disrupting the functioning of the spine.
2. Spondylolisthesis – the vertebrae are in an abnormal position.They are displaced and affect the brain or roots.
3. Osteochondrosis - the intervertebral discs become thin, crack and are replaced by bone tissue.Amortization becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammation of the joints.Most often affects the cervical spine.
5. Osteomyelitis is an inflammation of the bone marrow and surrounding soft tissues.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 of young people, it develops gradually.The pain is intense in the morning and diminishes in the evening.
7. Spinal stenosis – the cause may be a herniated disc or 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, intensifying both when resting and walking.
8. Facet syndrome is an injury to the intervertebral (facet) joints.The pain may be local or radiate to the groin, coccyx or thigh.Physically dependent.In the evening the condition worsens, after rest it improves.Occurs more often in older people.

Muscle-related diseases

Muscle tissue is affected secondarily, in the context of bone tissue or joint pathology. Painful spasms and tightness appear in the muscles, mobility is impaired:

1. Fibromyalgia is a pain syndrome extending from the neck to the lower back.Neurological symptoms may occur: increased sensitivity to pressure on certain points of the back, aches and pains.
2. Polymyositis - occurs due to hypothermia, injury, sprain or heavy physical exertion.Muscle weakness appears, in which even turning to the side is painful and problematic.
3. Dermatomyositis is a chronic disease of the muscles, organs and skin, often autoimmune in nature.
4. Charcot disease is an inflammation of the peripheral nerves that run through the spine.This leads to changes in gait, muscle weakness, and increased sensitivity of the nerve roots.
5. Polymyalgia rheumatica is the negativity of the environment in the form of hypothermia, overload, uncomfortable posture, etc.Leads to spasms in individual muscles and the appearance of pain.So-called trigger points appear;when pressed, the muscle reacts with sharp pain.Neurologists know this.Pain of this type can be eliminated with warming ointments and a needle applicator.

Spinal cord pathologies

These include damage to the spinal cord, which has 31 paired branches, where each nerve is responsible for the innervation of its area. This condition occurs when:

• injuries (spine fracture);
• tumors;
• osteochondrosis or herniated disc;
• inflammation resulting from 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 appear due to psychosomatics.In this case, if there are complaints of back pain, the examination does not reveal pathology.This condition occurs in cases of chronic stress, depression and 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 location

The pain can occur in various places on the back.Then they talk about its location.

Right side pain

The right side of the back may be painful due to curvature of the spine, kyphosis, lordosis, myositis, displaced intervertebral disc, and obesity.

Somatic pathologies can also cause pain in this area:

• formation of stones in the organs of the urinary system;
• inflammation of the vermiform appendix of the cecum (appendix);
• inflammation of the gallbladder;
• nephritis;
• inflammation of the ovaries;
• salpingitis.

Left side pain

This area of the back can hurt in the following cases:

• splenite;
• ICD;
• root pinching;
• duodenitis;
• oophoritis.

Pain located above the lower back may be associated with inflammation of the serous membranes covering the lungs, damage to the bronchi, intercostal neuralgia and ischemia.

Pain in the lumbar region

The lower back often suffers because it supports a colossal load.This section becomes inflamed when the nerve roots are damaged, in cases of osteochondrosis or hernia protrusion.More rarely, the cause may be tuberculosis of the spine, arthritis, lumboischialgia, a decrease in density and disruption of the structure of bone tissue, Reiter's syndrome - a combination of urethritis and prostatitis.

Pain in the lumbar region is usually chronic.

In the lumbar area on the right

Pain in the lumbar region occurs in scoliosis, tuberculosis, myositis, neuralgia, tumor, osteomyelitis, spondyloarthritis.An acute attack can be caused by urolithiasis or pyelonephritis.

Turning is typical for diseases of the lower back with frequent damage to the spinal roots (radiculitis).Constant pain, dull and monotonous, is more typical for an organ such as the liver.

Left lumbar region

Most often, the left side begins to hurt after physical activity.The condition improves after rest.Pain can also occur in cases of diabetes or pinched roots. If it does not disappear upon rest, the reasons may be:

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

Pinched nerve

Most often, the sciatic nerve is pinched - sciatica.Its myelin sheath is not damaged.It is usually a consequence of osteochondrosis.When pinched, a sharp, sharp pain appears, radiating to the leg, sacrum and 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, therefore, the distance between the vertebral bodies.This pain is felt as “superficial”, it is strongly intensified when coughing, exercising or sneezing.

Intervertebral hernia

A herniation is an extrusion of the core of the intervertebral disc into the spinal canal.Most often it becomes a consequence of untreated osteochondrosis.The central part protrudes towards the spinal cord, compressing it.Even a small load in such cases leads to a decrease in the height of the cartilage and even greater protrusion of the hernia.The pain is sharp and sharp, radiating towards the arm or leg.

At the level of the shoulder blades

Pain characteristics may indicate a diagnosis:

1. A stomach ulcer is a dull, growing pain.Eliminated with medication.
2. Intercostal neuralgia is a disease characterized by acute pain with any physical exertion.
3. Osteochondrosis - dizziness, pressure changes, numbness of the hands.
4. Exacerbation of angina - the pain is localized in the left shoulder blade, radiating to the chest and below the clavicle.

Pain along the spine and back

Most often they occur when nerve endings are pinched.Exacerbations are associated with curvature of the spine.If the pain is not pronounced, we can speak of protrusion.With increasing pain, you can think about osteochondrosis.Pain along the spine is characteristic of myositis, fractures, thinning and wear of the intervertebral discs, and spondyloarthritis.They are always lively and constant.

Causes of pain below the lower back

Such pain is often associated with osteochondrosis and spondyloarthrosis. More rarely, such sensations may appear when:

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

Associated symptoms

The manifestations of spinal pain vary depending on the location.If the cervical spine is affected, migraines and dizziness, weakness and numbness of the hands, water hammer, spots and flashes in the eyes will be noted.When the thoracic region is affected, there is a burning sensation and stiffness in the chest, difficulty breathing and pain in the shoulder blades.

Situations requiring urgent medical attention

Urgent consultation with a doctor requires back pain that occurs in the following cases:

• bruise;
• neurological symptoms in the form of tingling and numbness in the limbs;
• temperature is associated with back pain;
• numbness of arms and legs, weakness and tingling sensation;
• gait has changed or legs are lost;
• there is a history of cancer;
• weight loss for no apparent reason;
• urination and defecation are impaired - a person cannot control these processes;
• back pain radiates to the chest, jaw and neck;
• consciousness is confused and dizzy;
• numbness of the genitals and weakness, “wooly” in the legs;
• leg cramps;
• problems with conception or erection;
• problems of the gastrointestinal tract, for which treatment by a gastroenterologist does not help;
• pain in the coccyx and pelvis region, intensifying with changes in body position;
• increased pain when sitting or standing for a long time.

Experts will help you find out the cause of the pain.

Diagnosis

To identify the cause of back pain, the 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 level will indicate anemia, which can have many causes, and one of the possible reasons is oncology.
2. MRI. Visualizes the condition of all spinal components.Helps to differentiate the type and nature of the tumor, determines the distance between the vertebrae and the degree of compression of the roots.
3. CT. Detects fractures and allows you to find the smallest fragments after injuries.All this in three dimensions.
4. X-ray.The cheapest way to diagnose back pain and identify the condition of bone tissue.Prescribed for suspected fractures, arthritis, scoliosis, osteoporosis, spondyloarthrosis.
5. Electromyography (EMG).Determines indicators of bioelectrical 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 permeability of blood flow in arteries and vessels.Their condition is checked - wall thickness, permeability, etc.

Back pain treatment

There are several methods for treating 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 drug treatment of back pain, NSAIDs, painkillers, muscle relaxants and B vitamins are usually used. Physiotherapy, exercise therapy, IRT, massage, spinal traction and muscle relaxation are also prescribed.

For back pain, to guarantee quality treatment, it is advisable to consult a doctor.

Prevention

Prevention measures:

• learn to maintain posture and carry yourself correctly;
• don't slouch;
• keep your back straight when sitting, place support under your feet;
• organize your sleeping area correctly;
• do not jump suddenly after waking up - stretch slowly, do simple exercises with your arms and legs;
• distribute the weights on both hands - do not carry everything in one hand, refuse a bag on your shoulder - a backpack is better;
• do not carry the child in your arms leaning back;
• lifting weights while squatting;
• do not wash floors without mopping, bending forward or kneeling;
• balance your diet with a sufficient amount of minerals and vitamins;
• stop smoking and drinking alcohol;
• don't forget physical exercise - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• take care of the liver, it produces collagen for spinal ligaments and vertebral bodies;
• strengthen immunity;
• control weight;
• It is recommended to follow a course of manual therapy every 6 months for 5 to 10 sessions (on the recommendation of a specialist);
• avoid stress;
• Don't forget about medical examinations with a doctor.

If you experience back pain, consult a doctor who will provide you with appropriate assistance.Remember that any disease is easier to treat in the early stages.