Back pain is a symptom that occurs in various diseases and conditions. Most commonly, back pain is a reflection of bone pathology, changes in the joints of the spine and periarticular tissue, muscles, nerve trunks, and skin across the spine. Back pain can be accompanied by other diseases, including diseases of internal organs.
Symptoms of back pain
Depending on the cause, back pain can have its own characteristics. In rheumatic diseases, the following symptoms are distinguished:
- pain occurs in the lumbar spine, buttocks, gives in the thigh;
- pain increases at rest and decreases with movement;
- the pain is accompanied by morning stiffness in the lumbar spine;
- the defeat of the spine is bilateral.
With infectious processes:
- sharp pain in the spine;
- with a lesion in the lumbar region, the pain radiates to the buttocks, leg;
- the pain increases by pressing on the affected area;
- swelling and redness of the skin in the affected area are often noticed;
- the process is often one-sided (on one side of the spine).
With muscle pathology:
- in fibromyalgia the pain is constant, widespread, covering both the right and left halves of the body above and below the waist. It is exacerbated by emotional and mental overload, the effects of low temperatures, sudden climate change. Pain points appear in various anatomical areas, which are detected by pressing on them;
- tension of the affected muscle;
- decreased muscle strength.
Disc herniation (osteochondrosis), spondyloarthritis:
- back pain caused by the load on the spine (for example, prolonged standing in an upright position), intensified by turning and bending backwards, passes at rest;
- discomfort may occur during prolonged stay in one position;
- possible nerve compression by hernia or subluxation in the joint. In such cases, the pain may be in the arm, occipital region (with damage to the cervical spine), in the leg (with damage to the lumbar spine), followed by numbness, tingling and muscle weakness in the leg or arm;
- subluxation of the joints in the cervical spine can constrict the vertebral artery, causing headaches, dizziness, impaired coordination of movement, vision, hearing;
- the stiffness of the spine disappears after heating.
With damage to internal organs:
- with kidney pathology, in addition to back pain, abdominal pain, frequent urination may also occur;
- in diseases of the pancreas - the surrounding nature of pain;
- with lung disease - pain in the back and chest behind or in front, under the shoulder blade, intensified by cough.
Causes
The causes of the disease are very diverse.
- Back pain caused by pathology of the spine (bones, ligaments, tendons, intervertebral discs):
- osteomyelitis (an infectious and inflammatory process that affects the site of the bone marrow and then the elements of bone tissue);
- tumors of the spine and metastases ("screening" of tumors of any organ that have spread to the spine with the formation of a new focus);
- disc herniation (osteochondrosis);
- osteoporosis (a disease characterized by increased bone fragility);
- spondylolisthesis (displacement of one vertebra relative to the other);
- scoliosis (curvature of the spine);
- spondyloarthritis (a disease based on the defeat of all components of the joint, primarily articular cartilage);
- fractures;
- spinal canal stenosis (obstruction).
- Back pain due to muscle abnormalities:
- fibromyalgia (a complex of symptoms, manifested by chronic generalized (spreading to many muscles) muscle pain, depression, sleep disturbance, morning stiffness, rapid fatigue);
- muscle cramps;
- muscle stretching.
- Back pain due to other conditions:
- pelvic bleeding;
- purulent hematoma (accumulation of spilled blood) of the retroperitoneal space;
- diseases of the pelvic organs;
- aortic dissection;
- kidney disease;
- diseases of the abdominal organs;
- rheumatic diseases (ankylosing spondylitis (a disease characterized by an inflammatory process in the spine and joints), reactive arthritis (inflammatory diseases of the joints of an infectious nature), psoriatic arthritis (inflammation of the joints, combined with the appearance of scaly plaques on the skin));
- herpes zoster, herpes zoster.
- Provocative factors can be:
- injury;
- weightlifting;
- unprepared movements;
- prolonged stay in an unphysiological (uncomfortable) position;
- hypothermia.
- Analysis of complaints (back pain, back discomfort with prolonged exposure to one position, morning stiffness; numbness, tingling, muscle weakness in the arm or leg).
- Analysis of the anamnesis (history of development) of the disease - the question of how the disease began and how it developed.
- General examination (examination and palpation of the spine, determining the extent of movement in the spine).
- General blood and urine tests to identify the infectious process and kidney pathology.
- X-ray of the spine - allows you to detect pathological changes in the spine.
- Computed tomography, magnetic resonance imaging of the spine - allows you to determine in more detail the nature of the lesion of the spine and surrounding tissues.
- Electromyography - to detect muscle pathology.
- Radioisotope bone scintigraphy is a contrast study, which is based on the observation of the characteristics of the distribution of the contrast agent introduced into the body in the bones. Focuses of excessive accumulation indicate the presence of a pathological process.
- Densitometry - determination of bone density. It is performed to detect osteoporosis (a disease characterized by increased bone fragility).
- Consultations with a neurologist, vertebrologist, rheumatologist, orthopedist.
- Treatment of the underlying disease that causes back pain.
- Rest for a few days (2 to 5).
- Wearing a bandage (corset) to relieve the spine.
- Nonsteroidal anti-inflammatory drugs (oral, in the form of injections, in the form of local means - ointments, gels) - to reduce pain.
- Muscle relaxants are muscle relaxants.
- Surgical treatment depending on the cause of the pain - for example, removal of a purulent focus in the spine; implantation of a prosthesis between the vertebrae to establish a normal distance between them with narrowing of the intervertebral cleft and compression of the nerve trunks.
- After the disappearance of acute pain - physiotherapy procedures (consultation with a physiotherapist is required), massage, physiotherapy exercises.
- It depends on the cause and severity of the disease that caused the pain.
- The transition of the disease into a chronic form (osteochondrosis) is possible.
- In severe cases, disability (trauma, rheumatic diseases).
- Treatment of the underlying disease.
- Elimination of injuries, physical overload, hypothermia.
- Proper posture.
- Proper arrangement of places for work and sleep (to exclude the non-physiological position of the spine in which it is subjected to curvature).
- Correction of excess body weight.