Back pain: causes, diagnosis, treatment and prevention

According to statistics, 80% of people know firsthand about back pain.Of all sick leave issued, more than a third are related 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, CT, etc.) and laboratory blood tests are performed.Treatment is prescribed only 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 damage to soft tissues.It depends on the position of the body, the level of physical activity, but can also be reflected, for example, in diseases of the internal organs.To some extent, the back itself is vulnerable due to its structure.

Its basis is the spine, which provides supporting, protective, motor and shock-absorbing functions.This is due to the cartilage of the intervertebral discs, muscles and ligaments, which tend to wear out over time with the wrong lifestyle and cause degenerative diseases of the musculoskeletal system.

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

What to do if you have back pain?

A doctor's examination is required to determine the cause, especially if the pain has become frequent.Only a specialist can make the correct diagnosis and prescribe treatment.You can't do self-diagnosis.

First, 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 the prescribed therapy.Neurologists, orthopedists, and vertebrologists treat back problems.

Causes of back pain

Back pain is a nonspecific symptom that can be caused by a variety of reasons.

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 salespeople, street advertisers, surgeons, teachers;
• heavy physical activity combined with sudden 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's 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, spinal cord epiduritis, osteochondrosis, intervertebral hernias, atypical appendicitis and intestinal obstruction, kidney stones, fractures and sprains, spinal cord strokes, inflammation of the appendages in women and prostate cancer in men.

Types of diseases based on the nature of back pain

Causes of aching pain:

• hypothermia;
• muscle strain;
• myositis;
• prolonged uncomfortable posture during sleep or work;
• lumbago (caused by labor);
• osteochondrosis;
• intervertebral hernia or displacement of intervertebral discs due to sudden lifting of weights or sudden turning of the body;
• kidney diseases - cause back pain due to the close location of the kidneys to the lower back;
• stomach diseases.

Causes of shooting pains:

• 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 effort;
• osteochondrosis - the patient may experience nagging pain that radiates to the leg and intensifies when coughing, sneezing, straining, walking, bending.

Etiology of throbbing pain:

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

Bursting back pain:

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

Why does my back hurt after sleep?

Most people often feel back pain in the morning after sleep, the reasons may be:

• overload the day before, if you lifted weights and moved sharply;
• weak back muscles;
• hypothermia;
• vertebral hernia or osteochondrosis;
• scoliosis - curvature of the spine leads to 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 soft - in any case, a person is forced to take an uncomfortable, unphysiological position in sleep, which causes the muscles to overstrain and not rest at night.Posture is so important that even an orthopedic mattress cannot 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 the spinal column

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

1. Ankylosing spondylitis - persistent inflammation of the ligaments and joints causes chronic spasm of the surrounding muscles.The process is autoimmune; over time, the vertebrae begin to fuse together, which dramatically disrupts 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 - intervertebral discs become thinner, crack, and are replaced by bone tissue.Depreciation becomes impossible.
4. Rheumatoid arthritis is an autoimmune inflammation of the joints.Most often affects the cervical spine.
5. Osteomyelitis is inflammation of the bone marrow and surrounding soft tissue.Causes severe pain.
6. Reiter's disease is a rheumatic simultaneous 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 severe in the morning and decreases in the evening.
7. Spinal canal stenosis - the cause may be a herniated disc or protrusion (protrusion into the spinal canal).More 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 at rest and when walking.
8. Facet syndrome is a lesion of the intervertebral (facet) joints.The pain can be local or radiate to the groin, tailbone, or thigh.Physically dependent.In the evening the condition worsens, after rest it improves.Occurs more often in the elderly.

Muscle-related diseases

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

1. Fibromyalgia is a pain syndrome from the neck to the lower back.Neurological symptoms may occur: increased sensitivity when pressing certain points on the back, stiffness and stiffness.
2. Polymyositis - occurs due to hypothermia, injury, sprains or severe 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 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 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 acute pain.Neurologists know about this.Pain of this kind can be eliminated with warming ointments and a needle applicator.

Spinal cord pathologies

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

• injuries (spinal fracture);
• tumors;
• osteochondrosis or disc herniation;
• inflammation as a result of 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 with 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

Pain can occur in a variety of places in the back.Then they talk about its localization.

Pain on the right side

The right side of the back may hurt due to spinal curvature, kyphosis, lordosis, myositis, intervertebral disc displacement, 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.

Pain on the left side

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

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

Pain localized 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 suffers very often, as it bears a colossal load.This section becomes inflamed when the nerve roots are damaged, osteochondrosis or hernial protrusion.Less commonly, the cause may be spinal tuberculosis, arthritis, lumboischialgia, decreased 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 with scoliosis, tuberculosis, myositis, neuralgia, tumor, osteomyelitis, spondylitis.An acute attack can be caused by urolithiasis or pyelonephritis.

Shooting is typical for diseases of the lower back with frequent involvement of the spinal roots (radiculitis).Constant dull and monotonous pain 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 with diabetes or root pinching. If it does not go away at rest, the reasons may be:

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

Pinched nerve

Most often, the sciatic nerve is pinched - sciatica.Its myelin sheath is not damaged.This is usually a consequence of osteochondrosis.When pinched, a sharp and acute pain occurs, 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, as a result, the distance between the vertebral bodies.Such pain is felt as “superficial”, it sharply intensifies when coughing, exertion or sneezing.

Intervertebral hernia

A herniation is an extrusion of the core of the intervertebral disc into the spinal canal.More 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 an even greater protrusion of the hernia.The pain is sharp and sharp, radiating to the arm or leg.

In the area of the shoulder blades

Pain characteristics may indicate a diagnosis:

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

Pain along the spine and in the back

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

Causes of pain below the lower back

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

• diseases of the genital area in women (endometritis, adnexitis, vulvitis, cervicitis, oophoritis);
• pregnancy;
• menses;
• ulcerative colitis;
• appendicitis;
• diseases of the prostate or bladder - 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, pressure surges, spots and flashes in the eyes will be noted.When the thoracic region is involved, 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:

• injury;
• neurological symptoms in the form of tingling and numbness in the limbs;
• temperature is combined with back pain;
• numbness in the 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 in the genitals and weakness, “wooliness” in the legs;
• leg cramps;
• problems with conception or erection;
• problems with the gastrointestinal tract, for which treatment by a gastroenterologist does not help;
• pain in the coccyx and pelvis area, 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.

Diagnostics

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

1. Blood tests.They help identify the presence of infection and inflammation in the form of leukocytosis and increased ESR.A decrease in hemoglobin will indicate anemia, which can have many causes, and one of the possible reasons is oncology.
2. MRI. Visualizes the condition of all components of the spine.Helps 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. Radiography.The most inexpensive 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 patency of blood flow through arteries and vessels.Their condition is checked - wall thickness, permeability, etc.

Treatment for back pain

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, analgesics, 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 ensure quality treatment, it is advisable to see one doctor.

Prevention

Prevention measures:

• learn to maintain posture and stand correctly;
• don't slouch;
• keep your back straight when sitting, place a stand under your feet;
• organize your sleeping area correctly;
• do not jump up suddenly after waking up - stretch slowly, do simple exercises with your arms and legs;
• distribute weights on both hands - do not carry everything in one hand, refuse a bag over your shoulder - a backpack is better;
• do not carry the child in your arms bending backwards;
• lift weights by squatting;
• do not wash floors without a mop, leaning forward or kneeling;
• balance your diet with a sufficient amount of minerals and vitamins;
• give up smoking and alcohol;
• do not forget about physical exercise - swimming, Nordic walking, yoga;
• take a contrast shower in the morning;
• take care of the liver, it produces collagen for the spinal ligaments and vertebral bodies;
• strengthen immunity;
• control weight;
• It is advisable to undergo a course of manual therapy every 6 months for 5-10 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 appropriate assistance.Remember, any disease is easier to treat in the initial stages.