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Backache

A woman is worried about back pain

In recent years, back pain has been one of the most common complaints among patients in emergency medicine and outpatient visits.Such pain is not a separate nosological unit, but a clinical manifestation of a number of diseases.What makes this symptom particularly serious is that often, in cases of acute pain, physical activity is significantly limited and people's ability to work is reduced.

The main cause of back pain is spinal diseases;furthermore, this clinical manifestation can be caused by pathologies of the internal organs, professional characteristics (long sitting at the table or in the driving seat, heavy physical work), injury or pregnancy.In most cases it is possible to discover the cause of the pain by carefully examining the patient;Sometimes additional tests are needed to establish a diagnosis.Relief from pain syndrome depends on the underlying disease and the characteristics of its course;treatment is selected individually for each case.

Medical statistics indicate that more than half of the world's population suffers from back pain.Also, in childhood, such a symptom indicates diseases of the internal organs and is quite rare;with advancing age, back pain occurs more and more often and in old age almost everyone experiences it and only around 25% of those suffering from this pathology turn to the doctor.

What are the dangers of back pain?

In most cases, premature or inadequate therapy for back pain leads to the chronicity of the process.Chronic back pain is a very common cause of decreased performance in people between the ages of 40 and 55 and is characterized by:

  • permanent nature;
  • increased during movements and physical activity;
  • limitation of physical activity;
  • development of a feeling of stiffness in the back.

The chronic process is characterized by a relapsing course with frequent episodes of exacerbations provoked by prolonged hypothermia, physical activity or staying in one position.Flares are followed by periods of remission, during which no pain is felt or is minimally expressed.In most cases, back pain does not pose a direct threat to a person's health or life, but there are serious pathologies of the spine and internal organs manifested by this symptom, which require immediate consultation with a specialist.

Back pain due to common diseases

Common diseases that manifest as back pain include sciatica and herniated spinal discs.

The severity of pain in these diseases depends on the stage of their progression and the patient's sensitivity threshold.

Radiculitis

Radiculopathy or radiculitis is a complex of symptoms that develops as a result of compression of the roots of the spinal cord and manifests itself with motor and autonomic disorders against the background of severe pain.There are cervical, thoracic and lumbar (lumbosacral) radiculitis.

Clinical manifestations

It manifests itself as a pronounced painful syndrome localized at the site of the violation and intensified by movements and coughing (even with light cough).Pain can be of different nature (aching, dull or sharp), appear periodically or be constant.In most cases, the pain radiates to the upper or lower extremities.In addition to pain, the disease is characterized by muscle weakness and loss of sensation in the limbs.

Herniated disc

The protrusion or prolapse of fragments of intervertebral discs into the spinal canal is called disc herniation.Most often, the disease occurs in people between the ages of 25 and 50;Motorists, people who spend long periods of time sitting and those who are forced to lift heavy objects every day are included in the risk group.

Clinical manifestations

The main symptom is pain, which at the beginning of the disease is dull and intermittent and intensifies with physical exertion, coughing and prolonged stay in the same position.As the hernia progresses, the pain increases and radiates to the arm, buttock, or thigh, depending on the location of the hernia.

Causes of pain in people over 50 years old

Almost every elderly person experiences pain in the spine;the most common causes of this symptom are the following diseases:

Osteoporosis

Clinical manifestations

The disease is characterized by an asymptomatic or almost imperceptible onset, with symptoms similar to osteochondrosis.Often the pathology is detected already with characteristic injuries, or rather fractures, which can occur with minimal load or slight bruising.

It is very difficult to notice the disease at an early stage;It usually manifests itself with the following signs:

  • pain in the lumbar or thoracic spine, appearing during prolonged static load and during sudden changes in weather conditions;
  • hair and nails become brittle;
  • the development of non-inflammatory periodontal diseases is possible;
  • changes in posture and reduction in height;
  • the appearance of leg cramps at night.

Spondylosis

Chronic degenerative-dystrophic lesion of the spine, caused by the deformation of the vertebrae and the appearance of bony growths and spines (osteophytes) on their surface.

Clinical manifestations

In the initial stages it manifests itself with a slight limitation in the mobility of the spine.As the disease progresses, a pronounced painful syndrome develops due to fixation of the area subjected to overload.The acute and unbearable pain is accompanied by muscle tension and limited mobility due to the progressive straightening of the physiological curves of the spine.

Causes of pain in people under 50 years of age

Most often, the cause of pain in the lumbar or thoracic spine that occurs at a young age or in middle age are the following pathologies:

  • sacroiliitis;
  • spinal osteomyelitis;
  • spondylolisthesis;
  • fibrositis.

Sacroiliitis

The inflammatory process localized in the sacroiliac joint is called sacroiliitis.The cause of the development of this disease can be an injury, an increased load on the joint for a long time (during pregnancy, work associated with heavy lifting or constant sitting), congenital developmental anomalies, metabolic disorders, neoplasms.

Clinical manifestations

The pain is localized in the pelvic area and spreads along the sciatic nerve on the affected side;it can intensify with pressure on the wing of the ilium and flexion of the limbs.In case of severe pain, the patient assumes a forced position with bent knees.In addition to pain, an increase in body temperature, the development of purulent abscesses and severe intoxication syndrome can be observed.The disease is usually treated in surgical departments.

Spinal osteomyelitis

Osteomyelitis is a purulent infectious disease that affects bone tissue, periosteum and bone marrow.It can be acute (occurs for the first time) or chronic (long-term and characterized by periods of exacerbation and remission).

Clinical manifestations

It begins with chills, increased body temperature (often up to 40.0), and increased heart rate.After 2-4 days, local pain develops at the site of the lesion, local swelling and hyperemia (redness) of the tissues and limitation of motor activity.In chronic osteomyelitis there are traces of fistulous tracts on the skin (round wounds with purulent discharge).If you suspect the development of osteomyelitis, you should urgently seek help from a doctor.This pathology is treated by a surgeon.

Spondylolisthesis

Spondylolisthesis is the forward displacement of a vertebra due to congenital failure of fusion of the arch with the body or degenerative changes in the intervertebral disc.In most cases, it develops when the fifth lumbar vertebra is displaced.

Clinical manifestations

The main manifestation is chronic pain in the lumbar region, caused by spinal slippage and pinching of nerve endings.The pain often radiates to the gluteal region and intensifies when trying to straighten.It may be accompanied by leg pain, muscle weakness and numbness in the limbs.

Fibrositis

Fibrosis is a nonspecific inflammatory process characterized by fibrous and fatty degeneration of fibrous connective tissue.The exact cause of the disease has not yet been clarified.More common in middle-aged women.

Clinical manifestations

  • moderate or severe, constant, aching back pain;
  • heachache;
  • neck and shoulder pain;
  • pain and stiffness of the spine in the morning;
  • sleep disorders;
  • irritability.

The pain intensifies in the cold season, when outdoors, after excessive physical exertion, after emotional stress, in the morning.

Pain of musculoskeletal origin

The musculoskeletal system, which allows you to maintain the body in space and move, has spatial and pain sensitivity.Damage to any, even the smallest, element of this system caused by injury or disease causes the development of pain.Various injuries, excessive physical activity and displacement of the articular processes of the vertebrae lead to the development of an inflammatory process in the tissues of the spine, which becomes the cause of pain.

Pain radiating to the back and lower back (stenosis)

With stenosis (narrowing of the spinal canal or exit holes of the spinal nerve roots), as a result of which compression of the nerve fibers occurs, the pain that appears in the back then radiates to the leg, while the patient's gait changes, limps.

The pain is dull and constant.The cause of the development of this disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence.For treatment, a surgical method called decompression surgery is used, in which the vertebral arches are dissected.

Post-traumatic back pain

The causes of back injuries can be:

  • suddenly lifting heavy weights often causes sprains or tears in muscle fibers or ligaments;
  • fall;
  • bump or bruise;
  • mechanical impact.

Along with the appearance of pain in the event of an injury, a spasm of the muscle fibers develops, which disappears in a period ranging from a few hours to several days, depending on the severity of the injury.In severe injuries, muscle spasms can last several weeks.Immediately after the injury, the pain is sharp, which after a while is replaced by pain.

Back pain during pregnancy

In some women, constant and annoying pain in the lumbar region appears already during the first months of pregnancy and does not disappear until childbirth.The cause of the pain is the increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the baby, i.e. for softening the ligament system of the sacral region.Since relaxin acts on all ligaments and a greater load is applied to the spine of a pregnant woman, chronic pain in the lumbar region may develop.

How to relieve back pain during pregnancy:

  • Do not wear high-heeled shoes;
  • all movements must be performed smoothly;
  • you cannot lift weights;
  • if it is urgent to lift something heavy, try to distribute the weight on both hands, do not bend or jerk;
  • You should not bend down to the ground, you need to get on your knees;
  • There is no need to remove overhead items.

Causes of pain above the lower back

The main causes of pain localized above the lower back are:

  • osteochondrosis;
  • myofascial syndrome.

Osteochondrosis

The degenerative-dystrophic process leading to a change in the normal structure of the cartilaginous tissue of the spine is called osteochondrosis.There are cervical, thoracic and lumbosacral osteochondrosis.Often the disease is accompanied by protrusion of the vertebral disc and intervertebral hernia.

Clinical manifestations

The characteristics of the symptoms of the disease depend on its location:

  1. Cervical osteochondrosis is manifested by pain and stiffness in neck and arm movements, headaches;when the vertebral artery is compressed, dizziness, hearing loss, and fainting may occur.
  2. In the thoracic form of the disease, sharp pain in the back and chest (feeling like a stake), pain in the heart and difficulty breathing appear.
  3. Lumbosacral localization is characterized by pain in the lumbar region, which radiates to the legs and intensifies during movement;low back pain, numbness of the extremities and disorders of the genitourinary system may appear.

Myofascial syndrome

Myofascial syndrome is a disease characterized by acute, painful excessive tension in the muscles of the spine.The main reason for development is static overload of the muscular structure of the spine for a long time (being in an uncomfortable position).

Clinical manifestations

The pain is localized on one or both sides of the spine, intensifying with pressure, overwork, injury, or sudden hypothermia.Pain sensations can range in intensity from mild, almost imperceptible discomfort to intense, stabbing pain for several days.

One of the most effective ways to relieve back pain istherapeutic blocks.