Back pain is a symptom of a whole group of diseases, united by a common manifestation. More than 70% of the inhabitants of developed countries are regularly confronted with it: the annual incidence in adults is about 45%, people aged between 35 and 55 years being the most often affected. In most cases (90%), acute episodes of low back pain resolve within 6 weeks, but in 7% of patients the disease becomes chronic.
Back pain can be acute or chronic. Acute pain lasts four to six weeks, while chronic pain lasts for long periods, years, sometimes a lifetime. Sometimes those who suffer from chronic pain may experience severe pain. Back pain can take many forms. It can be both sharp and pointy, and dull, painful. Pain can occur when you move, even when you sneeze.
A problem in the lower back can be a consequence of diseases of the bone tissue of the spine, the lumbar discs between the vertebrae, ligaments around and the discs of the spine, spinal cord and nerves, muscles of thelower back, internal organs of the small pelvis and abdomen, as well as the skin covering the lumbar region. The upper back may be painful due to aortic disease, swelling of the breasts, or inflammation of the spine. Sudden short-term pain in the lower back is also called lumbago and gradually develops into chronic - lumbodynia. If the lower back (tailbone) hurts, it is called coccygodynia. Numbness in the arms or legs may also occur.<1_img_centerxx>
Causes of back pain
In most cases, the back hurts due to musculoskeletal disorders (microdamage to ligaments and joints of the spine after heavy loads, stretching or muscle spasms). Less often, more pronounced changes in the spine, such as herniated intervertebral discs or displacement of the vertebrae (spondylolisthesis), become the cause of the pain. Finally, in rare cases, back pain can be associated with serious diseases (tumors and inflammatory processes of the spine and spinal cord, diseases of internal organs - kidneys, heart, pancreas, pelvic organs).
Possible causes of back pain:
- Muscle spasms;
- Sprain (ligament injury);
- Muscle injury;
- Bleeding in the pelvis;
- Dissection of the aorta ;
- Infections of the spine and pelvis;
- Lumbar stenosis;
- Spinal metastases (cancer that has spread to the spine from other organs)
- Viral infections, including influenza;
Diseases for which the back hurts:
- Abdominal aortic aneurysm;
- Ankylosing spondylitis;
- Bone cancer;
- Degenerative diseases of the vertebral discs;
- Diffuse idiopathic skeletal hyperostosis;
- Kidney stones;
- Paget's disease;
- Pancreatitis, pancreatic cancer (girdle pain);
- Psoriatic arthritis;
- Reactive arthritis;
- Shingles (characteristic pain and rashes).
Why is back pain dangerous?
Typically, back pain is permanent, worsened by movement and physical exertion, and is accompanied by limited mobility of the spine and a feeling of stiffness in the back. In most cases, a recurrent course is characteristic, in which episodes of exacerbations, usually caused by intense physical exertion, prolonged uncomfortable posture or hypothermia, are replaced by more or less prolonged periods during which the pain isabsent or minimal.
In the overwhelming majority of cases, back pain does not pose a direct threat to human life and health and often goes away on its own (without treatment). However, sometimes back pain can be caused by serious diseases of the spine or internal organs.
Below are the characteristics of back pain that may be associated with serious pathology. If you experience any of these symptoms, you should seek medical advice immediately and under no circumstances self-medicate.
- Back pain is constant and localized to one place.
- Back pain is not relieved by lying down or occurs at night.
- Back pain is accompanied by an increase in body temperature.
- Back pain is accompanied by muscle tension in the limbs or is accompanied by prolonged stiffness in the morning.
Diagnosis of back pain
- Examination by a neurologist to assess the state of the nervous system, muscles, spine.
- A general test of blood and urine to rule out an inflammatory process in the kidneys.
- X-ray of the spine to rule out osteomyelitis, fractures and other diseases. To clarify the changes revealed during the x-ray, the doctor may additionally prescribe magnetic resonance or calculated imaging of the spine (the first allows you to assess in detail the condition of bone structures, the second - the spinal cordand intervertebral discs).
Very often, these studies reveal dystrophic changes in the intervertebral discs and vertebral bodies and diagnose osteochondrosis. It should be noted that osteochondrosis in itself is not a disease, but reflects age-related changes in the spine. Certain changes in the intervertebral discs (including hernias) are detected in almost all middle-aged people, including those who have never suffered from back pain. In other words, identifying signs of osteochondrosis on X-rays or herniated disc on magnetic resonance imaging does not yet suggest that back pain is associated with it (such a decision cannot be made. than by a doctor based on the results of a clinical examination).
Treatment of back pain
Back pain is often not completely cured, but exacerbations can be minimized with appropriate lifestyle choices and medications. Treatment for back pain depends on the underlying cause. Only a doctor can choose the treatment that is right for you.
The effect of therapeutic measures may not appear immediately, so you need to be patient and enduring. The main goal of treatment is not only to relieve acute pain, but also to prevent an exacerbation of the disease in the future.
How to relieve back pain
Bed rest can help transition from acute back pain to chronic back pain. With this in mind, with moderate pain there is no need for bed rest, and with severe pain you should limit its duration as much as possible (1-3 days).
If you have back pain, it is necessary to limit physical activity at this stage, in particular to avoid lifting weights and staying in the same position for a long time; it is important to perform the movements correctly without increasing the load on the spine. To unload the spine and ensure that it is at rest, it is advisable to use a special belt or corset.
Medicines for back pain
Treatment depends on the cause of the back pain and is prescribed by your doctor after examination. To relieve pain, nonsteroidal anti-inflammatory drugs are used, which are available in the form of tablets, ampoules for injections, creams and gels, and pain relievers or combination drugs. Drugs of both groups are prescribed for a short time (usually no more than 3-5 days). In addition, compresses with solutions of local anesthetics and drug blockages (which can only be done by a doctor) are used to eliminate pain.
For pain associated with muscle tension, drugs are used to eliminate muscle spasms (centrally acting muscle relaxers - within 1 to 2 weeks). You can only take these medicines as directed by your doctor.
Currently, for the treatment of back pain associated with dystrophic changes in the spine (osteochondrosis), it is proposed to use chondroprotectors - drugs that stimulate the production of the main components of cartilage tissue and thereby slow down its destruction. The effectiveness of chondroprotectors in diseases of the spine has not been proven, so are many widely advertised dietary supplements (usually containing herbal remedies, biologics, vitamins) and homeopathic remedies. Although all of these products are available over the counter without a prescription, they should not be taken without first consulting your doctor.
Physiotherapy and exercise therapy for back pain
To reduce the intensity of pain, dry heat (but not deep heating) and other physiotherapy procedures can be used, but only after consulting a doctor. After the end of the acute period, exercise therapy (physiotherapy exercises) in special complexes (strengthening of the back muscles, abdominal muscles) and massage are useful.
Manual therapy for back pain
Manual therapy can only be prescribed by a doctor after radiography and / or magnetic resonance imaging, which allows an objective assessment of the condition of the spine and surrounding tissues. If done correctly, manual therapy (affecting the joints of the spine, ligaments and muscles) corrects many local disorders (eg, muscle tension, subluxation of the joints), which sometimes helps to eliminateback pain quickly and effectively.
Manual therapy has contraindications and limitations:
- With hernias or destruction of the intervertebral discs (the displacement of fragments can lead to compression of the spinal cord, spinal roots and blood vessels).
- After suffering myocardial infarction, stroke, cancer, tuberculosis of the spine, endocrine dysfunction, with severe osteoporosis.
- With a pronounced exacerbation, accompanied by a strong limitation of the mobility of the spine due to pain and tension in the muscles of the back (possibly increased symptoms).
- For vascular diseases and disorders of the blood coagulation system.
If performed improperly, manual therapy can lead to serious complications. Therefore, it should only be performed by a qualified specialist (a doctor of the corresponding specialization is a manual therapist). It is absolutely unacceptable to practice manual therapy by paramedics and people without medical training!
Acupuncture (acupuncture) often has a positive effect on moderate back pain, especially caused by muscle tension and associated with psycho-emotional disorders. Although, according to traditional Chinese medicine, acupuncture can be used for any disease, it is generally accepted that acupuncture is contraindicated in the following cases:
- With diseases of the heart and blood vessels.
- In the presence of benign and malignant tumors (including in the past).
- For diseases requiring urgent surgery.
- In case of renal and hepatic insufficiency.
- If you have a tendency to bleed or take medicines that interfere with blood clotting.
- For acute infectious diseases.
- During pregnancy.
Prevention of back pain
Preventive methods for preventing back pain include the following tips:
- Use a comfortable bed with a firm, firm mattress.
- Try to maintain good posture when walking.
- Observe correct posture in the office when working with a computer. Pay attention to the fact that the forearms are not suspended during work, but are completely resting on the table. When working for a long time, use a chair with a backrest, headrest and armrests to rest and relax.
- Avoid staying in one position for a long time (at the computer, driving a car). If possible, try to stretch, stretch, move every half hour if possible.
- When standing for a long time, find a fulcrum for your back, arm, or head (for example, rest your back on a vertical surface in a subway train).
- If you wear high-heeled shoes, remember that you cannot walk for more than 2 hours at a time without a break.
- Avoid sharp turns and torso bends, always seek support when performing such actions.
- If you have to lift something off the ground, squat down, but don't bend down.
- Do not lift or carry weight while carrying them in front of you, avoid jerking, and try to keep your back straight.
- Strengthen your back muscles with exercise therapy, swimming, gym workouts.
- Maintain a healthy body weight.