Back pain has been one of the most common patient complaints in emergency medicine and outpatient appointments in recent years. This pain is not a single disease unit, but a clinical manifestation of many diseases. Of particular importance to this symptom is that, often accompanied by acute pain, motor activity is significantly restricted and people are less able to work.
The main cause of back pain is spinal disease, in addition to this clinical manifestation may be caused by pathological changes of internal organs, occupational characteristics (sitting at a table or driver's seat for long periods of time, physical labor), trauma or pregnancy. In most cases, the cause of the pain can be found by careful examination of the patient, and sometimes additional tests are required to confirm the diagnosis. Relief of pain syndrome depends on the underlying disease and characteristics of its course, and treatment is selected individually for each case.
Medical statistics show that more than half of the world's population suffers from back pain. Moreover, this symptom is a manifestation of visceral disease in childhood, which is relatively rare. With the increase of age, low back pain is more common, and almost everyone will encounter it in old age. Only about 25% of people suffer from this disease. Seek doctor's adviceOpinion.
What are the risks of back pain?
In most cases, back pain treatment that is not started in time or that is not prescribed adequately results in a chronic course. Chronic back pain is a very common cause of performance decline in people aged 40 to 55 and is characterized by:
- of a permanent nature;
- increased during exercise and physical activity;
- restricted movement activities;
- Development of stiffness in the back.
The chronic process is characterized by recurrent, frequent episodes, caused by prolonged periods of hypothermia, physical activity, or being in one posture. Exacerbations are replaced by periods of remission, in which there is no or minimal pain at all. In most cases, back pain does not pose an immediate threat to a person's health or life, but severe lesions of the spine and internal organs can manifest this symptom and require immediate medical attention.
Back pain in general disorders
Common conditions that present with back pain include sciatica and herniated discs.
The severity of pain syndromes in these disorders depends on the stage of its course and the patient's sensitivity threshold.
radiculitis
Radiculopathy, or radiculitis, is a symptom complex that develops as a result of compression of the spinal cord root, manifesting as motor and autonomic disturbances on a background of severe pain. Assign cervical, thoracic, and lumbar (lumbosacral) sciatica.
clinical manifestations
It presents as a marked pain syndrome, localized and exacerbated by movement and coughing (even mildly). Pain may be of different nature (painful, dull, or severe), recurring or persistent. In most cases, the pain radiates to the upper or lower extremities. In addition to pain, the disease is also characterized by muscle weakness and impaired sensitivity in the extremities.
herniated disc
A fragment of an intervertebral disc that protrudes or protrudes into the spinal canal is called a herniated disc. Most of the time, the disease occurs in people between the ages of 25 and 50, and risk groups include drivers, people who sit for long periods of time and people who are forced to lift weights every day.
clinical manifestations
The main symptom is pain, which is dull and intermittent at the onset of the disease and worsens with physical exertion, coughing, and prolonged exposure to one position. As the pain progresses, it increases and radiates to the arm, buttock, or thigh, depending on the location of the hernia.
Causes of pain in people over 50
Almost every older person experiences spinal pain, and the most common causes of this symptom are:
Osteoporosis
clinical manifestations
The disease is characterized by asymptomatic or barely noticeable flare-ups with symptoms similar to osteochondrosis. Often, the pathology that characterizes its damage has been detected, or rather, fractures can occur with minimal load or minor bruising.
The disease is difficult to detect early on, and it usually presents with the following symptoms:
- Lumbar or thoracic spine pain, which occurs with prolonged static loads and dramatic changes in weather conditions;
- brittle hair and nails;
- May develop non-inflammatory periodontal disease;
- Postural changes and decreased height;
- Leg cramps at night.
Spondylosis
Chronic degenerative dystrophic lesions of the spine caused by deformed vertebrae and the appearance of bony outgrowths and spikes (osteophytes) on their surfaces.
clinical manifestations
In the early stages, it manifests as a slight limitation of spinal mobility. As the disease progresses due to immobilization of the overloaded area, a pronounced pain syndrome develops. Acute, excruciating pain is accompanied by muscle tension and limited mobility due to the gradual straightening of the physiological curve of the spine.
Causes of pain in people under 50
Many times, the following conditions can be the cause of lumbar or thoracic spine pain in young or middle age:
- sacroiliitis;
- spinal osteomyelitis;
- Spondylolisthesis;
- Fibritis.
sacroiliitis
The inflammatory process located in the sacroiliac joints is called sacroiliitis. The cause of the development of this disease can be trauma, increased stress on the joints over a prolonged period of time (during pregnancy, work related to weightlifting or sedentary periods), congenital abnormalities, metabolic disorders, tumors.
clinical manifestations
Pain is localized to the pelvic region and spreads along the sciatic nerve from the affected side, and may increase with pressure on the ilium wing and flexion of the extremities. Due to severe pain, the patient takes a forced position with both legs bent at the knees. In addition to pain, elevated body temperature, purulent abscesses, and a marked toxic syndrome may also occur. The disease is usually treated in the surgical department.
spinal osteomyelitis
Osteomyelitis is a purulent infectious disease affecting bone tissue, periosteum, and bone marrow. It can be acute (first appearance) or chronic (long-term, characterized by periods of exacerbation and remission).
clinical manifestations
It starts with chills, fever (usually as high as 40. 0), and increased heart rate. After 2-4 days, localized pain at the lesion site, localized edema and hyperemia (redness) of the tissue, and limited motor activity. In chronic osteomyelitis, there are traces of fistula passages (circular wounds with purulent discharge) on the skin. If the development of osteomyelitis is suspected, medical help is urgently needed. Surgeons handle the treatment of this pathology.
Spondylolisthesis
Spondylolisthesis is the forward displacement of the vertebrae due to a congenital arch that does not unite with the body or degenerative dystrophic changes in the intervertebral disc. In most cases, it occurs when the fifth lumbar vertebra is displaced.
clinical manifestations
It mainly presents as chronic pain in the lumbar region due to spondylolisthesis and damage to nerve endings. The pain usually radiates to the buttock area and intensifies when trying to straighten. Leg pain, muscle weakness, and numbness in the extremities may be present.
fibrosis
Fibritis is a nonspecific inflammatory process characterized by fibrosis and fatty degeneration of fibrous connective tissue. The exact cause of the disease has not been determined. More common in middle-aged women.
clinical manifestations
- Moderate or severe persistent back pain;
- headache;
- neck and shoulder pain;
- Spine pain and stiffness in the morning;
- sleep disorder;
- irritability.
Outdoors in the cold season, after excessive exercise, after emotional stress, the soreness in the morning can be exacerbated.
Pain of musculoskeletal origin
The musculoskeletal system allows you to keep your body in space and move, with space 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, and displacement of the articular processes of the vertebrae lead to an inflammatory process in the spinal tissue that causes pain.
Pain radiating to the back and lumbar spine (stenosis)
Due to the stenosis (stenosis of the spinal canal or the opening of the exit of the spinal nerve root), which causes compression of nerve fibers, the pain occurs in the back and then radiates to the legs, while the patient's gait changes and he limps.
The pain is dull and constant. The cause of the disease is age-related changes, so it is not easy to occur in young adults. For treatment, a surgical method called decompression surgery is used, in which the vertebral arches are dissected.
back pain after trauma
Back injuries can be caused by:
- Heavy lifting often causes muscle fibers or ligaments to stretch or tear;
- autumn;
- hit or hurt;
- mechanical shock.
Spasms of muscle fibers develop as pain sets in at the time of the injury, and it goes away within a few hours to a few days, depending on the severity of the injury. In severe injuries, muscle spasms can last for weeks. The pain is severe immediately after the injury and is replaced by pain after a while.
back pain during pregnancy
In some women, persistent pulling pain in the lumbar spine area begins during the first few months of pregnancy and does not go away until after delivery. The cause of the pain is the increased secretion of relaxin, a hormone responsible for preparing the birth canal for the passage of the child, which softens the ligamentous organs in the sacral region. Because relaxin acts on all ligaments and increases the load on the spine of pregnant women, chronic pain in the lumbar region may occur.
How to relieve the symptoms of back pain during pregnancy:
- Do not wear high heels;
- All movements must be smooth;
- you cannot lift weights;
- When it is urgent to lift heavy objects, try to distribute the weight on your hands, do not bend over, do not yank;
- Do not bend over to the floor, you need to kneel;
- No need to remove high objects.
Causes of pain above the lower back
The main causes of pain above 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. Assign cervical, thoracic, and lumbosacral osteochondrosis. The disease is often accompanied by disc herniation and herniation.
clinical manifestations
The symptoms of the disease are characterized by their localization:
- Cervical osteochondrosis manifests as pain and stiffness with neck and arm movement, headache, compression of the vertebral arteries, dizziness, hearing impairment, and fainting.
- In the thoracic form of the disease, there is acute pain in the back and chest (a woodpile feeling), heart pain, and difficulty breathing.
- The lumbosacral localization is characterized by low back pain that radiates to the legs and aggravates during exercise, and may present with back pain, numbness of the extremities, and urogenital disorders.
myofascial syndrome
Myofascial syndrome is a disorder characterized by excessive tension and severe pain in the muscles of the spine. The main cause of development is prolonged static overloading of the spinal musculature (in an uncomfortable position).
clinical manifestations
Pain on one or both sides of the spine that is aggravated by stress, overwork, injury, or sudden hypothermia. The pain can vary in severity, from mild discomfort that is barely noticeable to severe pain lasting several days.
One of the most effective ways to relieve back pain istherapeutic blockade.