The effectiveness of treatmentback paindirectly depends on how exactly it is delivereddiagnosis. . . However, the pain syndrome itself is not a characteristic symptom - it is a general symptom, according to which it is impossible to determine the cause of the disease. There are many different pathologies that can causeback pain, and not all of them are associated with diseases of the musculoskeletal system.
When self-medicating, patients mistakenly believe that the most important thing is to deal with the pain and lose sight of the fact that every pain has a cause. Taking painkillers is a symptomatic treatment that does not affect the outcome of the disease or the cause of the pain.
The main causes of back pain
Think about the basicsdiseasecausingback pain. . . For the convenience of the diagnosis, doctors divide the back into upper (cervical spine), middle (thoracic spine) and lower (lumbosacral) parts.
Pain in the upper back
Pain in the cervical spine requires extreme care. The reason is in the unique anatomical features of the cervical vertebrae: the spinal artery passes through them, supplying blood to it from the brain; the first and second cervical vertebrae form a movable complex articulation with the skull, which is responsible for turning and tilting the head; any disease that occurs at this level has the potential to cause serious neurological damage, as damage or even slight compression of the spinal cord in the cervical spine immediately leads to impaired motor and / or sensory function in the rest of the body.
Osteochondrosis of the cervical spine
Usually the intervertebral discs, joints, ligaments and tendons do not have their own blood vessels; their blood supply depends on how intensively the nearby muscles and bones are supplied with blood. If this process is disrupted, for example, in an office worker who leads a sedentary and sedentary lifestyle, degenerative-dystrophic changes begin in them. The nutrition of the cartilage of the intervertebral discs and joints is disturbed, the ligaments and tendons become thicker, due to sclerotic changes the spinal canal narrows and the distance between the vertebrae decreases.
Among non-specialists, this disease is known as osteochondrosis of the spine. Despite the fact that degenerative-dystrophic processes are characteristic of the entire spine, osteochondrosis is the most common cause of pain in the cervical spine. In addition, as in other parts of the spine, this disease can be complicated by an intervertebral hernia. However, due to the anatomical features of the cervical spine, even a small hernia can cause serious complications.
Trauma
Although spinal cord injury is more commonly diagnosed in the lumbar spine, nearly 50% of cases of spinal cord injury occur with trauma to the cervical spine. This is due to the peculiarities of the anatomy of the neck: the lack of a developed muscular frame and massive vertebrae, high mobility contribute to trauma even without direct physical impact (for example, sudden stop or rear impact during an accident, often occurs so-called whiplash injuryneck caused by abrupt bending followed by abrupt elongation of the cervical vertebrae). Pain is a constant companion of any spinal cord injury.
myositis
Myositis or inflammatory muscle disease is a whole group of diseases characterized by muscle pain. The most common cause of banal muscle inflammation is forced posture when performing any work, hypothermia, currents. Muscle pain can be a consequence of osteochondrosis of the cervical spine, intervertebral hernia - the muscles take most of the load on the neck, which ultimately leads to overexertion, muscle spasm with impaired microcirculation and inflammation.
neuralgia
Neuralgia is a condition in which the nerve fibers themselves become a source of constant pain impulses. The pain is paroxysmal, may be exacerbated and provoked by turning or tilting the head, cold weather. The cause of neuralgia is associated with diseases of the spine - osteochondrosis, intervertebral hernia, scoliosis and others. The immediate cause of pain is irritation of the roots of the spinal cord when pinched in the intervertebral space, muscle spasm, which disrupts metabolism in the nerves passing through spasmodic muscles. Unlike neuritis or inflammation of the nerve, in neuralgia the pain is periodic, there are no pathological changes in the nerve fibers themselves.
Heart disease
Heart disease such as angina pectoris, ischemic heart disease, coronary atherosclerosis are often accompanied by pain radiating to the neck, lower jaw, shoulder and left forearm. The pain may be accompanied by tingling, numbness of the skin, simulating pain in osteochondrosis of the cervical spine with intervertebral hernia. Often patients receive massage, physiotherapy, visit other doctors, although the electrocardiogram is sufficient to diagnose the cause.
A characteristic feature of such pain is the ability of antianginal drugs, which improve blood flow through the coronary arteries (isoket, nitroglycerin), to relieve pain within minutes.
Pain in the middle of the back
The thoracic spine consists of 12 thoracic vertebrae, each of which has a pair of ribs attached. Together they provide protection to the thoracic organs. The size of the thoracic vertebrae gradually increases, starting from 1 thoracic vertebra and further to the beginning of the lumbar spine - this is explained by a gradual increase in the load on them. The mobility of the middle part of the back is significantly lower than the mobility of the neck, the ribs provide additional protection, due to which traumatic spinal cord injury in the thoracic spine is less common.
Spinal curvature or scoliosis
Scoliosis or scoliotic disease is a pathological curvature of the spine in several planes. The exact causes of scoliosis are still unknown, the disease begins in childhood. Contributing factors include lack of physical activity, weakness of the back muscles, poor posture and the organization of students' workplace. Due to the pronounced curvature, impaired load distribution and biomechanics of the spine, muscle strain that compensates for part of the load,arisechronicback pain.
Arthritis (spondyloarthritis)
The intervertebral joints, together with the intervertebral discs, unite the spine. Each vertebra has 4 articular surfaces that form articulations with adjacent vertebrae. Like any other joint, the intervertebral joints can become inflamed. This pathological condition is called spondyloarthritis. There are two main causes of inflammation of the intervertebral joints. These are systemic rheumatic diseases (such as rheumatoid arthritis or ankylosing spondylitis) or reactive inflammation, which occurs in response to increased stress in osteochondrosis, scoliosis and other pathologies of the spine. Inflamed joints lose their function: stiffness of movements, stiffness of the spine, prolonged back pain.
Diseases of the gastrointestinal tract and back pain
Diseases of the abdominal organs are often the cause of reflected pain in the back and spine. There is also a direct link between pathologies of the gastrointestinal tract and diseases of the musculoskeletal system. Diseases such as chronic colitis or gastroenteritis are a background for spondyloarthritis or osteochondrosis of the spine.
The most common back pain occurs in gastric and duodenal ulcers, hiatal hernia, acute or chronic pancreatitis. This phenomenon arises from the peculiarities of the sympathetic and parasympathetic systems, whose nerve fibers are located in each organ of the abdominal cavity. Some of the pain impulses perceived by them return to the roots of the spinal cord, simulating pain in the spine and back.
Kidney disease and back pain
The kidneys are a paired organ located in the retroperitoneal space, which, as in the case of the abdominal organs, is closely connected by nerves to the roots of the spinal cord. In the presence of inflammation, stones or other pathologies of the urinary tract, some of the pain impulses reach the spinal cord, simulating a disease of the spine.Symptoms of back painmay occur in acute pyelonephritis, renal colic, renal abscesses. A characteristic symptom is the tension of the back muscles in the projection of the kidneys, which occurs due to inflammation of the kidneys or an abscess of the surrounding tissue.
Pain in the lumbosacral spine
The lumbosacral spine has the greatest tension. Up to 60-70% of the adult population in developed countries complain of back pain. This is a favorite location for intervertebral hernias. One patient is most often diagnosed with 2-3 hernias in the lumbosacral spine. Also, pain in the lower back and sacrum often occurs in gynecological and urological pathologies.
Intervertebral hernia
Intervertebral hernia is the result of prolonged osteochondrosis of the spine. While in the cervical region the intervertebral discs are relatively light, in the lumbosacral region each disc has a huge pressure. The solid disk is able to compensate for any weight, thanks to the semi-liquid core, which acts as a hydraulic shock absorber. However, due to osteochondrosis, fibrous and healthy cartilage (annulus fibrosus) passing along the periphery of the intervertebral disc loses its elasticity and strength, and some parts of it can crack. With a sharp increase in load, for example, when lifting weights, the pressure inside the diseased disc increases, so its contents can actually "shoot" through the damaged cartilage, falling into the lumen of the spinal canal - thus forming an intervertebral hernia.
Fragments of the nucleus that have fallen out of the disc compress the spinal cord and spinal roots. This results in swelling of the nervous tissues and impaired blood circulation, which is accompanied by severe pain and protective muscle spasm. The pain can be unbearable, up to the need to use narcotic analgesics. A characteristic feature is the irradiation of pain in the lower extremities. There may be impaired sensitivity to pain, tingling and numbness of the skin of the lower leg and thigh.
Protrusion of the intervertebral disc
The main difference between a protrusion of the intervertebral disc and a hernia is the preservation of the integrity of the fibrous ring. The cause of the pain is compression of the spinal cord and its roots by protrusion on the periphery of the intervertebral disc. However, if the process continues, the bulge can easily turn into a hernia. The symptoms and pain are similar to those of a herniated disc, as the severity of the pain syndrome depends not only on the size but also on the location of the bulge or hernia.
Spondylosis of the spine
Excessive stress and degenerative-dystrophic processes in the spine can lead to ossification of cartilage tissue, which is saturated with calcium salts and turns into acute coracoid bone growths or growths that occur on the periphery of the vertebral bodies. As the process progresses, these growths may merge with the same growths on the body of adjacent vertebrae. Over time, all vertebrae grow with each other, the spine loses its flexibility and elasticity. The pain occurs due to irritation of the spinal cord and its roots, reactive inflammation and dystrophy of soft tissues, ligaments and muscles around the spine.
Radiculitis
Radiculitis is called intense pain arising from circulatory disorders and ischemia of the spinal cord roots, suffocated by hernia or bulge with osteochondrosis of the spine. Various skin sensitivity disorders in the buttocks, perineum, thighs and lower legs are possible. Started sciatica leads to muscle atrophy and weakness. A characteristic symptom is shooting pains along the sciatic nerve, intensified by movement, weight lifting and cold weather. This condition is called sciatica or sciatica.
Spinal cord infection
The vertebrae are made up of spongy bone tissue rich in bone marrow. When an infection enters the bloodstream in the body of the vertebrae, an inflammatory process can occur - osteomyelitis. The gradual disintegration of bone tissue is accompanied by necrosis - this picture is typical for spinal tuberculosis. Pain can occur both due to irritation of the nerve endings and due to pathological compression fractures of the spine, weakened by inflammation.
Gynecological and urological diseases
Pathologies such as cervical cancer, endometriosis or adnexitis (inflammation of the appendages of the uterus) in women, prostatitis or prostate cancer in men are often accompanied by severe pain in the lumbosacral spine. The nature of the pain is explained by irritation of the nerves caught in the area of inflammation, or by the growth of the nerve trunks by a tumor.
The muscles of the back ache along the spine
Well-developed back muscles are a sign of a healthy spine, as the muscular corset relieves some of the stress and further stabilizes the spine. In chronic diseases of the spine, the muscles are subjected to excessive loads that weak and atrophied muscles are unable to withstand. As a result, muscle spasm occurs due to metabolic disorders in the muscles and pain. This condition is called myofascial syndrome, which is characterized by osteochondrosis of the spine, hernias and protrusions of the intervertebral discs.
Postoperative pain
Spinal surgeries are usually accompanied by extensive trauma - to stabilize and restore the integrity of the vertebrae, doctors may resort to installing metal structures, screwing screws into the vertebrae and removing non-viable tissue. The pain in this case is due not only to the disease itself, but also to the operation. With proper rehabilitation and postoperative care, the pain will gradually disappear. However, if in the postoperative period you ignore the instructions of doctors and neglect mandatory exercise, the pain can become chronic.
How are the causes of back pain diagnosed?
To diagnose back and spine pain, it is necessary to seek medical help in time from a qualified neurologist. At the first stage, a neurological examination, examination of the patient, examination of reflexes and symptoms are performed. An experienced and competent doctor knows well what diseases have back and spine pain due to certain reasons and characteristics.
Back pain for no apparent reason should be especially vigilant. This can be with reflected pain in other organs and systems, with tumors and diseases of the spinal cord.
To understand why the back and spine hurt, the neurologist may prescribe magnetic resonance imaging. This is the most effective and safest method for diagnosing almost all possible causes of back pain. The procedure is based on the ability of magnetic fields and radio waves to give clear and detailed images of the spine and spinal cord without the use of X-rays and other harmful factors.
How to relieve back pain
To alleviate, but not treat back pain, let's take analgesics for a few days, which is necessary to wait for consultation with a specialist. Non-steroidal anti-inflammatory drugs or NSAIDs are most commonly used for this purpose. However, it is important to remember that this group of drugs can cause dangerous side effects, the likelihood of which increases with prolonged use. That is why it is important not to postpone the visit to the doctor and the examination. treatmentdiseasesthe spineand reasonsback pain.
Treatment of back pain
As mentioned at the outset, the effectiveness of treating back pain depends on how accurately the diagnosis is made. Despite the obvious, many patients "cure" pain for years, but not the disease itself, each time postponing a visit to the doctor, turning to traditional healers, osteopaths and chiropractors. In addition, in some diseases of the spine such procedures are not only contraindicatedbut also dangerous.
There are effective and scientifically proven treatments for variouskindsdiseases causingback pain. . . Many of them require perseverance and perseverance of the patient in the fight against the disease. It is important to remember that there are no pills or injections that can cure osteochondrosis - only you can do this, with hard training and exercise that the neurologist will show you.
Which doctor should I see for back pain?
Back pain is one of the most common neurological symptoms that occur due to the involvement of nerves and spinal cord in the pathological process. Therefore, the first specialist whose consultation is necessary in case of back pain will be a neurologist. Based on the results of the examination and magnetic resonance imaging, you may need to consult another doctor. If the back pain is caused by heart disease, the patient is referred to a cardiologist, if the problem is in the digestive tract, to a gastroenterologist. But most often the pain syndrome is associated with the pathology of the spine.