Back pain is a symptom of various diseases and conditions. Back pain most often reflects bone pathology, changes in the joints of the spine and periarticular tissues, muscles, nerve trunks, and skin above the spine. Back pain can be accompanied by other diseases, including diseases of the internal organs.
Symptoms of back pain
Depending on the cause, back pain has its own characteristics. In rheumatological diseases, the following symptoms are distinguished:
- pain in the lumbar spine, buttocks, thighs;
- the pain increases at rest and decreases with movement;
- pain is accompanied by morning stiffness in the lumbar spine;
- the defeat of the spine is bilateral.
Infectious processes:
- sharp pain in the spine;
- as the lumbar region changes, the pain radiates to the buttocks and legs;
- the pain increases with pressure in the affected area;
- swelling and redness of the skin in the affected area is often observed;
- the process is often one-sided (on one side of the spine).
With muscle pathology:
- in fibromyalgia, the pain is constant, extensive, covering both the right and left sides of the body above and below the waist. It is exacerbated by emotional and mental overload, cold temperatures, and sudden climate change. Painful spots appear in different anatomical areas that reveal when pressed;
- the tension of the affected muscle;
- decreased muscle strength.
Disc herniation (osteochondrosis), spondyloarthrosis:
- back pain resulting from strain on the spine (such as prolonged vertical standing), aggravated by turning and leaning back at rest;
- discomfort may occur during prolonged stay in one position;
- possible compression of nerves due to hernia or subluxation in the joint. In such cases, pain may occur in the arm, the occipital region (with damage to the cervical spine), the foot (with damage to the lumbar spine), accompanied by numbness, tingling, and muscle weakness in the leg or arm;
- subluxation of the joints of the cervical spine can compress the vertebral artery, causing headache, dizziness, coordination of movement, vision, hearing;
- the spinal stiffness disappears after warming up.
With damage to internal organs:
- with kidney pathology, in addition to back pain, abdominal pain and 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, aggravated by a cough.
Cause
The causes of the disease are very varied.
- Back pain caused by spinal cord pathology (bones, ligaments, tendons, intervertebral discs):
- osteomyelitis (an infectious and inflammatory process that affects part of the bone marrow and then parts of the bone tissue);
- spinal tumors and metastases ("screening" for a tumor in any organ that has spread to the spine);
- disc herniation (osteochondrosis);
- osteoporosis (a disease characterized by increased fragility of bone tissue);
- spondylolisthesis (displacement of one vertebra relative to the others);
- scoliosis (curvature of the spine);
- spondyloarthrosis (a disease based on the defeat of all the components of the joint, especially the articular cartilage);
- fractures;
- narrowing of the spinal canal.
- Back pain due to muscle disorders:
- fibromyalgia (a syndrome characterized by chronic generalized muscle pain, depression, sleep disturbance, morning stiffness, and rapid tiredness);
- muscle cramps;
- stretching the muscles.
- Back pain due to other conditions:
- pelvic bleeding;
- purulent hematoma (accumulation of shed blood) in the retroperitoneal space;
- diseases of the pelvic organs;
- aortic dissection;
- kidney disease;
- diseases of the abdominal organs;
- rheumatological diseases (ankylosing spondylitis (a disease characterized by an inflammatory process in the spine and joints), reactive arthritis (inflammatory diseases of the joints), psoriatic arthritis (combined with the appearance of scaly plaques on the skin));
- herpes zoster, herpes zoster.
- Provocative factors may include:
- injury;
- weight-lifting;
- unprepared movements;
- prolonged stay in a non-physiological (uncomfortable) situation;
- hypothermia.
- Analysis of complaints (spinal pain, prolonged back discomfort in one position, morning stiffness; numbness, tingling, muscle weakness in the arm or leg).
- Analysis of the history (developmental history) of the disease - we ask how the disease started and went.
- General examination (examination and palpation of the spine, determination of the range of motion of the spine).
- General blood and urine test to identify the infectious process and pathology of the kidney.
- Spine X-ray - allows the detection of abnormalities in the vertebrae.
- Computerized magnetic resonance imaging of the spine - allows more detailed determination of the lesion of the spine and surrounding tissues.
- Electromyography - for the detection of muscle pathologies.
- Radioisotope bone scintigraphy is a contrast test based on the observation of the characteristics of the distribution of contrast medium into the bone. The foci of excessive accumulation indicate the presence of a pathological process.
- Densitometry - determination of bone density. Osteoporosis (a disease characterized by increased fragility of the bones) is performed.
- Neurologist, vertebrologist, rheumatologist, orthopedic consultation.
- Treatment of the underlying disease that causes back pain.
- Rest for a few days (2-5).
- Wearing a bandage (corset) to relieve the spine.
- Non-steroidal anti-inflammatory drugs (oral, in the form of injections, topical ointments, gels) - to reduce pain.
- Muscle relaxants are muscle relaxants.
- Surgical treatment depending on the cause of the pain - for example, removal of the purulent focus in the spine; insertion of a prosthesis between the vertebrae to restore the normal distance between them by narrowing the intervertebral cleft and compressing the nerve trunks.
- After the cessation of the acute pain - physiotherapy procedures (consultation with a physiotherapist required), massage, physiotherapy exercises.
- It depends on the cause and severity of the pain-causing disease.
- It is possible for the disease to progress to a chronic form (osteochondrosis).
- In severe cases, disability (trauma, rheumatological diseases).
- Treatment of the underlying disease.
- Elimination of injuries, physical overload, hypothermia.
- Correct posture.
- Proper arrangement of the workplace and sleeping area (exclusion of the non-physiological position of the spine in which it is exposed to curvature).
- Overweight correction.