In recent years, back pain is one of the most common patient complaints in emergency rooms and outpatient clinics. Such pain is not a separate nosological unit, but a clinical manifestation of a number of diseases. Of particular importance for this symptom is the fact that often with acute pain, motor activity is significantly limited and people's ability to work is reduced.
The main cause of low back pain are diseases of the spine, in addition, such a clinical manifestation can be caused by pathologies of internal organs, occupational characteristics (sitting at a table or in the driver's seat for a long time, heavy physical work). trauma or pregnancy. In most cases, it is possible to find out the cause of pain by carefully examining the patient, and sometimes additional tests are required to make a diagnosis. The elimination of pain syndrome depends on the underlying disease and the characteristics of its course, the treatment is selected individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain. In addition, such a symptom in childhood indicates diseases of the internal organs, and is very rare, back pain becomes more frequent with age, and in old age almost everyone encounters it, and only 25% of those who suffer from this pathology. Seek medical advice.
What is the risk of back pain?
In most cases, untimely or inadequately prescribed treatment for low back pain leads to a chronic process. Chronic low back pain is a very common cause of decreased performance in people aged 40-55 years and is characterized by:
- permanent character;
- increased during movement and physical activity;
- restriction of motor activity;
- development of a feeling of stiffness in the back.
The chronic process is characterized by a recurrent course with frequent exacerbation episodes triggered by prolonged hypothermia, physical activity, or being in one position. Exacerbations are replaced by periods of remission in which there is no pain or minimal expression. 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 that show this symptom and require urgent medical attention.
Back pain in common diseases
Common diseases that present with low back pain include sciatica and herniated discs.
The severity of pain syndrome in these diseases depends on the stage of their course and the patient's sensitivity.
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 in motor and autonomic disorders against the background of severe pain. Distinguish cervical, thoracic and lumbar (lumbosacral) sciatica.
Clinical manifestations
It manifests itself as an overt pain syndrome with localization at the site of disruption and intensification during movements and coughing (even with a mild cough). The pain may be of a different nature (painful, dull or sharp), may appear intermittent or may be permanent. In most cases, the pain spreads to the upper or lower extremities. In addition to pain, the disease is characterized by muscle weakness and impaired sensitivity in the extremities.
Herniated disc
The passage or exit of fragments of intervertebral discs into the canal of the spine is called a herniated disc. The disease most often occurs in people between the ages of 25 and 50, and the risk group includes drivers, people who sit for long periods of time, and those who are forced to lift weights daily.
Clinical manifestations
The main symptom is pain, which is dull and intermittent at the onset of the disease and increases with physical strength, coughing and prolonged stay in one position. As the pain progresses, it increases depending on the location of the hernia and spreads to the arm, hip, or thigh.
Causes of pain in people over 50 years
Almost every elderly person suffers from back pain, the most common causes of such symptoms are the following diseases:
Osteoporosis
Clinical manifestations
The disease is characterized by asymptomatic or almost imperceptible onset, similar in symptoms to osteochondrosis. Often, the pathology is detected by injuries that are already characteristic of it, or rather by fractures that can occur with minimal load or light bruising.
It is very difficult to see the disease at an early stage, usually manifested by the following symptoms:
- pain in the lumbar region or thoracic spine caused by prolonged static load and abrupt changes in weather conditions;
- hair and nails become brittle;
- possible development of non-inflammatory periodontal diseases;
- change in posture and decrease in height;
- night leg cramps.
Spondylosis
It occurs as a result of chronic degenerative-dystrophic damage to the spine, deformation of the vertebrae and the appearance of bone protrusions and spikes (osteophytes) on their surface.
Clinical manifestations
In the early stages, this manifests itself as a slight restriction of spinal mobility. An obvious pain syndrome develops with the development of the disease due to the fixation of the area exposed to overload. Acute, unbearable pain is accompanied by muscle tension, limited mobility due to the gradual correction of the physiological curves of the spine.
Causes of pain in people under 50 years
Very often the following pathologies are the cause of low back or thoracic back pain that occurs in young or middle age:
- sacroiliitis;
- osteomyelitis of the spine;
- spondylolisthesis;
- fibrosis.
sacroiliitis
The localized inflammatory process in the sacroiliac joint is called sacroiliitis. The development of this disease can be trauma, long-term (during pregnancy, work associated with lifting weights or constant sitting), congenital anomalies, metabolic disorders, neoplasms.
Clinical manifestations
The pain is localized in the pelvic region and spreads along the sciatic nerve on the affected side, which may increase with pressure on the iliac crest and flexion of the limbs. With severe pain, the patient assumes a forced position with legs bent at the knees. In addition to pain, there may be an increase in body temperature, the development of purulent abscesses and an open intoxication syndrome. The disease is usually treated in surgical departments.
Spinal osteomyelitis
Osteomyelitis is a purulent infectious disease that affects the bone tissue, periosteum and bone marrow. It can be acute (first seen) or chronic (characterized by periods of exacerbation and remission).
Clinical manifestations
It begins with chills, fever (often up to 40. 0) and an increase in heart rate. After 2-4 days, local pain at the lesion site, local tissue edema and hyperemia (redness), limited motor activity develop. In chronic osteomyelitis, there are traces of fistulae in the skin (rounded wounds with purulent discharge). If the development of osteomyelitis is suspected, it is necessary to seek medical help immediately. The surgeon treats such a pathology.
Spondylolisthesis
Spondylolisthesis is a congenital misalignment of the arch with the body or forward movement of the vertebrae as a result of degenerative-dystrophic changes in the intervertebral disc. In most cases, it develops during the displacement of the fifth vertebra.
Clinical manifestations
The main manifestation is chronic pain in the lower back due to slipping of the vertebrae and damage to the nerve endings. The pain often spreads to the gluteal region and intensifies as you try to bend. It can be accompanied by pain in the legs, muscle weakness and numbness of the limbs.
Fibrosis
Fibrosis is a non-specific inflammatory process characterized by fibrous and fatty degeneration of fibrous connective tissue. The exact cause of the disease has not yet been clarified. It is more common in middle-aged women.
Clinical manifestations
- moderate or severe persistent, aching lower back pain;
- headaches;
- pain in the neck and shoulders;
- morning pain and stiffness of the spine;
- sleep disorders;
- irritation.
The pain intensifies in the mornings in the cold season, outside, after excessive exercise, after emotional stress.
Musculoskeletal pain
The musculoskeletal system, which allows you to keep your body in space and move, has spatial and pain sensitivity. Damage to any, even the smallest element of this system by injury or disease can lead to the development of pain. Various injuries, excessive physical activity, as well as displacement of articular processes in the vertebrae lead to the development of an inflammatory process that causes pain in the tissues of the spine.
Pain in the back and lumbar region (stenosis)
With stenosis (narrowing of the spinal canal or openings of the roots of the spinal nerves), resulting in compression of the nerve fibers, the pain in the back then spreads to the legs, while walking. The sick man changes, he stumbles.
The pain is dull and constant. The reason for the development of this disease is age-related changes, so young and middle-aged people are not susceptible to its occurrence. For treatment, an operative method called decompression surgery, in which the vertebral arches are broken, is used.
Post-traumatic back pain
Can cause back injuries:
- abrupt lifting of weights often leads to the development of stretching or tearing of muscle fibers or ligaments;
- autumn;
- blow or injury;
- mechanical impact.
In addition to the appearance of pain during injury, depending on the severity of the injury, spasms of muscle fibers develop that disappear within a few hours to several days. In severe injuries, muscle spasms can last for several weeks. Immediately after the injury, the pain becomes sharp, and after a while it is replaced by pain.
Low back pain during pregnancy
In some women, persistent back pain is already visible in the first months of pregnancy and does not go away until birth. 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, ie softening the garden apparatus of the sacral region. Because relaxation affects all ligaments and places an increasing load on a pregnant woman's spine, chronic back pain can develop.
How to relieve the symptoms of back pain during pregnancy:
- do not wear high heels;
- all actions must be carried out smoothly;
- you can't lift weights;
- when there is an urgent need to lift something heavy, try to distribute the weight to both hands, do not bend and do not bend;
- do not bend to the ground, you need to kneel;
- there is no need to remove highly placed objects.
Causes of lower back and upper back pain
The main causes of localized pain in the lower back are:
- osteochondrosis;
- myofascial syndrome.
Osteochondrosis
The degenerative-dystrophic process that causes changes in the normal structure of the cartilage tissue of the spine is called osteochondrosis. Distinguish cervical, thoracic and lumbosacral osteochondrosis. Often the disease is accompanied by a protrusion of the vertebral disc and an intervertebral hernia.
Clinical manifestations
The characteristics of the symptoms of the disease depend on its localization:
- Cervical osteochondrosis is characterized by pain and stiffness in the neck and arms, headaches, constriction of the vertebral arteries, dizziness, hearing impairment, and fainting.
- In the thoracic form of the disease there is a sharp pain in the back and chest (feeling of pain), heart pain, difficulty breathing.
- Lumbo-sacral localization is characterized by pain in the lumbar region, spreads to the legs and worsens during movement, back pain, numbness of the extremities, disorders of the genitourinary system may appear.
Myofascial syndrome
Myofascial syndrome is a disease characterized by severe painful overexertion of the muscles of the spine. The main reason for the development is the long-term (restless state) static overload of the muscular frame of the spine.
Clinical manifestations
The pain is localized on one or both sides of the spine and is aggravated by pressure, overwork, injury, or sudden hypothermia. The pain can range in severity from a mild discomfort that is almost imperceptible to severe unbearable pain for several days.
One of the most effective ways to relieve back paintherapeutic blockades.