Back pain is a symptom of a whole group of diseases, united by a common manifestation. More than 70% of people in developed countries face them regularly: the annual incidence among adults is about 45%, with people between the ages of 35 and 55 most often affected. In most cases (90%), acute episodes of 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 for four to six weeks, while chronic pain lasts for long periods, years, sometimes for a lifetime. It happens that chronic pain sufferers may experience acute pain. Back pain can take many forms. It can be both sharp and sharp, and dull, aching. Pain can occur when moving, even when sneezing.
A problem in the lower back can be a consequence of diseases of the bone tissue of the spine, lumbar discs between the vertebrae, ligaments around and discs of the spine, spinal cord and nerves, muscles of the lower back, internal organs of the little pelvis and abdomen, as well as the skin covering the lumbar region. The upper back may be sore due to aortic disease, breast swelling, or inflammation of the spine. Short-term pain that comes on suddenly in the lower back is also called low back pain and gradually develops chronic ones - low back pain. If the lower back (coccyx) hurts, this is coccygodynia. Numbness in the arms or legs may also occur.
Causes of back pain
In most cases, the back hurts due to musculoskeletal disorders (microdamage to the ligaments and joints of the spine after heavy loads, strains 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 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 the 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;
- Spinal and pelvic infections;
- Lumbar spinal stenosis;
- Spinal metastases (cancer that has spread to the spine from other organs)
- Viral infections, including the flu
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 (pain in the girdle);
- psoriatic arthritis;
- reactive arthritis;
- Shingles (pain and characteristic rashes).
Why is back pain dangerous?
As a rule, back pain is permanent, aggravated 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 pain is absent or minimal.
In the vast majority of cases, back pain poses no direct threat to human life and health and often goes away on its own (without treatment). However, back pain can sometimes be caused by severe diseases of the spine or internal organs.
The following are the characteristics of back pain that can be associated with serious conditions. If you have any of these symptoms, you should immediately consult a doctor and in no case self-medicate.
- Back pain is constant and localized in one spot.
- 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 combined with prolonged stiffness in the morning.
Back Pain Diagnosis
- Examination by a neurologist to assess the state of the nervous system, muscles, spine.
- A general blood and urine analysis 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 radiography, the doctor may additionally prescribe a computed or spine MRI (the first allows you to assess in detail the state of the bone structures, the second - the spinal cord and intervertebral discs).
Most often, these studies reveal dystrophic changes in the intervertebral discs and vertebral bodies and diagnose osteochondrosis. It should be noted that osteochondrosis itself is not a disease, but reflects age-related changes in the spine. Some changes in the intervertebral discs (including hernias) are detected in almost all people of mature age, including those who have never had back pain. In other words, identifying signs of osteochondrosis with X-rays or herniated disc with MRI still gives no reason to believe that back pain is associated with them (such a decision can only be made by a doctor based on the results of a clinical examination).
Back pain treatment
Back pain is often not completely cured, but exacerbations can be minimized with proper lifestyle choices and medications. Treatment for back pain depends on the underlying cause. Only a doctor can choose the course of treatment that is right for you.
The effect of therapeutic measures may not appear immediately, so you need to be patient and persevering. 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 your back hurts, you need to limit physical activity at this point, especially to avoid lifting weights and staying in one 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 make sure it is at rest, it is recommended to use a suitable belt or corset.
Back pain medications
Treatment depends on the cause of the back pain and is prescribed by the doctor after the examination. Non-steroidal anti-inflammatory drugs are used to relieve pain, available in the form of tablets, ampoules for injections, creams and gels, pain relievers or combination drugs. Drugs of both groups are prescribed in a short course (usually no more than 3-5 days). In addition, compresses with local anesthetic solutions and drug blocks (which can only be done by a doctor) are used to eliminate pain.
For pain associated with muscle tension, drugs that eliminate muscle spasm (centrally acting muscle relaxants - within 1-2 weeks) are used. You can only take these medications 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 spinal diseases has not been proven, the same can be said of numerous widely advertised food supplements (usually containing medicinal plants, biological products, vitamins) and homeopathic remedies. Although all of these products are available over the counter without a prescription, they should not be taken without first checking with your doctor.
Physiotherapy and physical therapy for back pain
To reduce the severity of pain, dry heat (but not deep warming) and other physiotherapy procedures can be used, but only after consulting a doctor. After the end of the acute period, physical therapy (physiotherapy exercises) in special complexes (strengthening the back muscles, abdominal muscles) and massage are useful.
Manual therapy for back pain
Manual therapy can be prescribed by a doctor only after radiography and / or MRI, which allow for an objective assessment of the condition of the spine and surrounding tissues. If done correctly, manual therapy (which affects the joints of the spine, ligaments and muscles) allows you to correct many local ailments (for example, muscle tension, subluxation of the joints), which sometimes allows you to quickly and effectively eliminate the pain. on the back.
Manual therapy has contraindications and limitations:
- With hernias or destruction of the intervertebral discs (displacement of fragments can lead to compression of the spinal cord, spinal roots and blood vessels).
- After suffering from myocardial infarction, stroke, with cancer, tuberculosis of the spine, dysfunction of the endocrine system, with severe osteoporosis.
- With a pronounced exacerbation, accompanied by a sharp limitation of the mobility of the spine due to pain and tension in the back muscles (probably increased symptoms).
- For vascular diseases and disorders of the blood coagulation system.
If performed incorrectly, manual therapy can lead to serious complications, therefore it should only be performed by a qualified specialist (a doctor of the corresponding specialty is a manual therapist). It is absolutely unacceptable to carry out 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 combined with psychoemotional 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 (even in the past).
- For diseases that require urgent surgery.
- In case of impaired renal and hepatic function.
- If you have a tendency to bleed or take medications that interfere with blood clotting.
- For acute infectious diseases.
- During pregnancy.
Back pain prevention
Preventive methods for preventing back pain include the following tips:
- Use a comfortable bed with a firm, firm mattress.
- Try to maintain correct posture when walking.
- Observe proper desk posture 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 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 on a subway train).
- If you wear high-heeled shoes, remember that you can walk non-stop for no more than 2 hours straight.
- Avoid sharp bends and curves of the torso, always seek support to perform such actions.
- If you need to lift something off the floor, squat down, but don't bend over.
- Do not lift or carry weights while carrying them in front of you, avoid jerking and try to keep your back straight.
- Strengthen your back muscles with physical therapy, swimming, gym workouts.
- Maintain a healthy body weight.