Back pain: causes and treatment

Almost every person throughout life is at least one long episode of back pain, and one-third of adults these unpleasant sensations are repeated regularly. The urgency of the problem is illustrated by at least the fact that for the treatment of back pain every year spent three times more money than on therapy for cancer patients.

The duration of the episode of pain is usually about 2 weeks, but in many patients, residual symptoms persist for months or longer. In

part of these patients are diagnosed herniated discs, spinal canal disease, disease of the kidneys, ovaries and other internal organs, and sometimes malignant tumors or their metastases.

In our article, we briefly describe the main causes of back pain and their distinguishing characteristics help a person to understand that his health problems have arisen and it is time to consult a doctor.

Possible causes of back pain:

  • lesions of the spine, its ligaments and muscles;
  • trapped by the roots and other diseases of the spinal cord;
  • diseases of the internal organs;
  • connective tissue disease;
  • depression and psychogenic disorders.

Proven that back pain most often occur with low physical activity, obesity, Smoking, heavy physical work, stay in an uncomfortable position, prolonged vibration, and sharp turns of the torso.

Diseases of the spine, its ligaments and joints

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Most people with complaints of back pain they occur because of lesions of the intervertebral discs, joints between processes, as well as themselves the bone of the vertebral body. With age the discs between the vertebrae lose water, decreasing their thickness. As a result of increased mobility of individual spinal segments, which irritate pain receptors of the intervertebral joints. It should be said that often even in people with pronounced "age-related changes of the spine back pain no. Often a herniated disc combined with pain randomly.

In recent years, a growing importance in the development of persistent back pain is the so-called syndrome of the joints with "small face" — private form of osteoarthritis that affects the articular apparatus of the spine.

The pain in this syndrome may be unilateral, bilateral, localized near the spine, most often in lumbar region extending into the thigh. The pain often appears in the morning, but during the day and again after exercise until the evening. It first appears usually after a sharp awkward turn or torso. The pain is worse in standing and extension of the back is decreased in the sitting position or lying down, with a light flexion, the use of support. Syndrome joints with "small face" often recurs.

Often cause back pain in lesions of the spine the following state:

  • spondylolisthesis – displacement of vertebrae relative to each other;
  • spinal stenosis;
  • ankylosing spondylitis (Bechterew's disease);
  • osteoporosis fractures of the vertebral bodies (often in the elderly, especially in women);
  • a large disc herniation (more than 5 mm);
  • disease of the cervical spine.

Lack of physical activity during the working day is a distinctive feature of work in the office. Lack of movement, long stay in an uncomfortable position provoke undue stress on the joints and cause pain, discomfort and gradual destruction of cartilage. Therefore, office workers are advised to do regular exercises and therapy tools that protect and regenerate the cartilage tissue.

More rare but dangerous causes of pain syndrome is a tumor, most often it is the metastases to the spine. The risk increases if the patient has any cancer (often lung cancer, breast cancer and prostate cancer), weight loss, fever, duration of complaints more than a month, at the age of 50 years. Metastases most often affects the thoracic spine.

Another reason for back pain that is related to cancer is myeloma. Rarely, but there are benign and primary malignant tumors of the spine, for example, a benign tumor composed of bone tissue, Ewing's sarcoma.

Ankylosing spondylitis should be suspected in a young patient age, morning stiffness of the spine and large joints, improve the condition after the warm-up. The pain often appears in the gluteal region. Characterized by its gain night, so sick in the morning can not sleep due to discomfort.

Back pain there are other symptoms that are observed in such diseases:

  • psoriatic arthritis;

  • rheumatic disease;
  • juvenile rheumatoid arthritis;
  • Crohn's disease, Whipple's, ulcerative colitis;
  • shigellosis, salmonellosis.

An important component of comprehensive treatment is the administration of drugs, the effectiveness of which is aimed at preserving and improving the condition of joints and cartilage. Injection provides maximum bioavailability and speed of action of the drug, which helps to stop the progression of destruction of cartilage, reduces inflammation and stimulates the synthesis of hyaluronic acid. Due to the rapid onset of effect no need for lengthy courses of the drug-a total of 20 injections 2 times a year. Application treatment of back pain allows to reduce the dosage and duration of use of NSAIDs.

Osteomyelitis of the spine or spondylitis should be considered when prolonged fever, intravenous medications or drugs preceding infectious disease or trauma, administration of immunosuppressants. Inflammatory diseases of the spine can have a specific nature, originating from syphilis, tuberculosis.

Defined by so-called indicators of serious problems requiring a thorough examination of the patient:

  • suddenly, for the first time, emerged a pain;
  • very severe pain;
  • no correlation of pain from the position of the body;
  • the pain is stronger at night than during the day;
  • patient age 20 years and older 55 years;
  • recent back injury;
  • the probability of infection (inflammation of the urinary tract, taking immunosuppressive agents, acquired immunodeficiency syndrome);
  • moved cancer;
  • unexplained weight loss and fever;
  • weakness;
  • incontinence of urine or faeces;
  • gait disturbance;
  • progressive neurological disorders.

Muscle damage

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Lose back muscles can be secondary: in diseases of the spine, the muscles tense, creating a "protective system" that holds our vertebral column, but from the constant tension and spasm are the cause of the pain. Often a muscle spasm occurs initially, for example, with a long stay in an uncomfortable position or increased anxiety. This pain syndrome has a relatively benign course and responds well to medical therapy.

Some systemic diseases of muscles is also present with back pain. These include:

  • the rheumatic polymyalgia;
  • fibromyalgia.

Fibromyalgia is a fairly common disease, more common in middle-aged women. It is characterized by diffuse pain in the muscles of the body, weakness, sleep disturbances, changes in skin sensation, anxiety, unstable chair.

Pathology of the spinal cord and its roots

Compression of spinal roots that exit through openings between the vertebrae, are a rare cause of pain in every 10th patient. However, this pain syndrome stronger and longer treatment lasts about 2 months.

Compression (compression) of the roots of the cause:

  • herniated disc;
  • hypertrophy of the yellow ligament;
  • bone growth;
  • the narrowing of the spinal canal (eg, due to injury).

The picture of the destruction of roots (radiculopathy): the sharp "shooting" pain, disturbance of sensation in the area of innervation of the spine, decreased reflexes, weakness of the corresponding muscles. If compression of the spine proven by modern research methods and drug treatment is ineffective, sometimes resort to surgery.

Diseases of the internal organs

Back pain occurs not only in diseases of the spine or spinal cord, but also accompanies many diseases of internal organs:

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  • heart disease (myocardial infarction, stable and unstable angina, infective endocarditis, aortic aneurysm);
  • lung disease (pulmonary embolism, pneumothorax, pleurisy);
  • pathology of the esophagus and stomach (peptic ulcer, esophageal spasm, esophagitis);
  • inflammatory processes in the kidney, liver, pancreas, gall bladder.

Usually distinguish these diseases allow two things:

  • sudden and very intense pain in the back;
  • signs of damage to the relevant authorities (shortness of breath, rales in the lungs, pain on palpation of the abdomen, and so on).

With back pain, especially was unexpected and is not accompanied by signs of disease of the spine, it is always necessary to register an electrocardiogram to exclude acute myocardial infarction. Especially this atypical localization of pain in ischemic heart disease typical of the elderly.

Psychogenic disorders

The transition of pain in the chronic form contribute to social and behavioural factors:

  • financial difficulties;
  • emotional stress;
  • confidence in the inevitability of pain for her apparent connection with everyday work;
  • thoughts about a possible serious illness and disability;
  • depression;
  • dependence on other people;
  • the strategy of avoidance of disease, in which the patient takes no action to diagnose and treat your condition.

To what doctor to address

So the causes of back pain are varied. Often they are associated with diseases of the spine and spinal cord, when they occur, you should consult a neurologist. Additionally, you may need to consult other specialists: neurosurgeon, oncologist, gastroenterologist, cardiologist, surgeon, and psychologist. To choose the right specialist, you can first contact the therapist after the initial examination to establish a provisional diagnosis.

24.07.2018