The effectiveness of the treatmentback paindepends directly on how exactly it was delivereddiagnosis. . . But 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 musculoskeletal disorders.
When self-medicating, patients mistakenly believe that the most important thing is to cope with pain, and they lose sight of the fact that every pain has a cause. Taking pain medication is a symptomatic treatment that does not affect either the outcome of the disease or the cause of the pain.
The main causes of back pain
Consider the most important thingdiseasecausesback pain. . . To facilitate diagnosis, doctors divide the back into the upper (cervical spine), middle (thoracic spine) and lower (lumbosacral) parts.
Upper back pain
Pain in the cervical spine requires the greatest attention. The reason is the unique anatomical features of the cervical vertebrae: the vertebral artery passes through them and supplies blood to ⅓ of the brain; the first and second cervical vertebrae form a movable complex articulation with the skull, which is responsible for rotating and tilting the head; any disease that occurs at this level has the potential to cause severe 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, intervertebral discs, joints, ligaments and tendons do not have their own blood vessels; their blood supply depends on how intensely the nearby muscles and bones are supplied with blood. If this process is disrupted, for example, by an office worker leading a sedentary and sedentary lifestyle, degenerative-dystrophic changes begin in them. The nutrition of the cartilage in the intervertebral discs and joints is reduced, 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 spinal osteochondrosis. Although degenerative-dystrophic processes are characteristic of the entire spine, it is osteochondrosis that 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 special conditions of the anatomy 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, almost 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 absence of a developed muscle frame and massive vertebral bodies, high mobility contributes to trauma even without direct physical impact (for example, with a sudden stop or a blow from behind during an accident often occurs so-called whiplash injury in the neck, caused bysharp bending followed by sharp elongation of the cervical spine). Pain is a constant companion of any spinal cord injury.
Myositis
Myositis or inflammatory muscle diseases are a whole group of diseases characterized by muscle pain. The most common cause of banal muscle inflammation is a forced posture when performing any work, hypothermia, pulling. Muscle pain can be a consequence of osteoporosis in the cervical spine, intervertebral hernia - the muscles take on most of the load on the neck, which eventually leads to overload, muscle spasms with decreased 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, can be intensified and induced by turning or tilting the head, cold weather. The cause of neuralgia is associated with diseases of the spine - osteochondrosis, intervertebral hernia, scoliosis, etc. The immediate cause of pain is irritation of the roots of the spinal cord when they get pinched in the intervertebral space, muscle spasms that disrupt the metabolism in the nerves that pass throughthe spastic muscles. Unlike neuritis or inflammation of the nerve, with neuralgia, pain is periodic, there are no pathological changes in the nerve fibers themselves.
Heart disease
Heart diseases such as angina pectoris, ischemic heart disease, atherosclerosis of the coronary arteries are often accompanied by pain radiating to the neck, lower jaw, shoulder and forearm to the left. Pain may be accompanied by numbness, tingling of the skin, simulation of pain in osteochondrosis of the cervical spine with an intervertebral hernia. Often patients receive massage, physiotherapy, visit other doctors, even if an electrocardiogram is enough to diagnose the cause.
A characteristic feature of such pain is the ability of antianginal medication that improves blood flow through the coronary arteries (isoket, nitroglycerin) to relieve pain within a few minutes.
Pain in the middle of the back
The thoracic spine consists of 12 thoracic vertebrae, each with a pair of ribs attached. Together, they provide protection to the breast organs. The size of the thoracic vertebrae increases gradually, starting from 1 thoracic vertebra and on to the beginning of the lumbar vertebra - this is explained by a gradual increase in the load on them. The mobility in the middle part of the back is significantly lower than the mobility of the neck, the ribs provide additional protection, which is why traumatic injuries to the spinal cord in the thoracic spine are less common.
Spinal curvature or scoliosis
Scoliosis or scoliotic disease is a pathological curvature of the spine in several planes. The causes of scoliosis are still not known exactly, the disease begins in childhood. Lack of physical activity, weakness in the back muscles, incorrect posture and organization of school children's workplace are considered contributing factors. Due to pronounced curvature, reduced load distribution and biomechanics in the spine, overexertion of muscles that compensate for part of the load,arisechronicback pain.
Gout (spondyloarthritis)
The intervertebral joints, together with the intervertebral discs, unite the spine into one whole. Each vertebra has 4 joint surfaces that form joint connections 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 in the intervertebral joints. These are systemic rheumatic diseases (such as rheumatoid arthritis or ankylosing spondylitis) or reactive inflammation that occur in response to increased strain 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 the background of spondyloarthritis or osteochondrosis of the spine.
Most often, pain-reflected back pain occurs with stomach ulcers and duodenal ulcers, with hiatal hernia, acute or chronic pancreatitis. This phenomenon stems from the peculiarities of the sympathetic and parasympathetic systems, whose nerve fibers are present in every organ of the abdominal cavity. Some of the pain impulses perceived by them return to the roots of the spinal cord and simulate pain in the spine and back.
Kidney disease and back pain
The kidneys are a paired organ located in the retroperitoneal space that, as in the case of abdominal organs, is intimately connected by nerves with the roots of the spinal cord. In the presence of inflammation, stones or other pathologies of the urinary tract, part of the pain impulses reach the spinal cord, simulating a disease of the spine.Symptoms of back painmay occur with acute pyelonephritis, renal colic, renal abscess. A characteristic symptom is the tension of the muscles of the back in the projection of the kidneys, which occurs due to inflammation of the kidneys or with an abscess of the tissue around them.
Pain in the lumbosacral spine
The lumbosacral spine has the greatest stress. Up to 60-70% of the adult population in developed countries complain of back pain. This is a favorite localization of intervertebral hernia. A patient is most often diagnosed with 2-3 hernias in the lumbosacral spine. Pain in the lower back and sacrum also often occurs with gynecological and urological pathologies.
Intervertebral hernia
An intervertebral hernia is the result of a prolonged osteochondrosis of the spine. While in the cervical region relatively small loads are placed on the intervertebral discs, in the lumbosacral region each disc has an enormous pressure. A healthy disc is able to compensate for any weight, due to the semi-liquid core that acts as a hydraulic shock absorber. However, due to osteochondrosis, fibrous and strong cartilage (annulus fibrosus) that runs along the periphery of the intervertebral disc loses its elasticity and strength, and some of its parts may rupture. With a sharp increase in the load, for example when lifting weights, the pressure inside the diseased disc increases, due to which the contents can actually "shoot" through the damaged cartilage and fall into the lumen of the spinal canal - this is how an intervertebral is formedcomplaining.
Fragments of the nucleus that have fallen out of the disc squeeze the spinal cord and the spinal roots. As a result, there is swelling of the nerve tissues and decreased blood circulation, which is accompanied by severe pain and protective muscle spasms. The pain can be unbearable, up to the need for the use of narcotic analgesics. A characteristic feature is the irradiation of pain in the lower extremities. There may be decreased sensitivity to pain, tingling and numbness in the skin of the lower leg and thigh.
Intervertebral disc protrusion
The major difference between protrusions of an intervertebral disc and a hernia is the preservation of the integrity of the annulus fibrosus. The cause of pain is compression of the spinal cord and its roots by protrusion along the periphery of the intervertebral disc. However, if the process continues, the protrusion can easily turn into a hernia. 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 protrusion or hernia.
Spondylosis of the spine
Excessive strain and degenerative-dystrophic processes in the spine can lead to ossification of cartilage tissue, which is saturated with calcium salts and turns into sharp coracoid bone outgrowths or growths that occur along the periphery of the vertebral bodies. With the progression of the process, these outgrowths can fuse with the same growths on the body of adjacent vertebrae. Over time, all the vertebrae grow together, 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 the soft tissue, ligaments and muscles around the spine.
Radiculitis
Radiculitis is called intense pain due to circulatory disorders and ischemia in the roots of the spinal cord, suffocated by a hernia or protrusion with osteochondrosis of the spine. Various disorders of skin sensitivity in the area of buttocks, perineum, thighs and lower legs are possible. Launched sciatica leads to muscle atrophy and weakness. A characteristic symptom is shooting pain along the sciatic nerve, aggravated by movement, lifting of weights and in cold weather. This condition is called sciatica or sciatica.
Spine infection
The vertebrae are composed 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 decay of bone tissue is accompanied by necrosis - this picture is also typical of 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 cervix) 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 trapped in the area of inflammation or by the growth of nerve trunks of a tumor.
The back muscles ache along the spine
Well-developed back muscles are a sign of a healthy spine, as the muscle corset relieves some of the stress and also stabilizes the spine. In chronic diseases of the spine, the muscles are exposed to excessive loads, which weak and atrophied muscles are unable to withstand. As a result, muscle spasms occur, and due to metabolic disorders in muscles and pain. This condition is called myofascial syndrome, which is characteristic of osteochondrosis of the spine, hernia and protrusion 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 the surgery. With proper rehabilitation and postoperative care, the pain will gradually disappear. However, if you neglect the doctors' instructions during the postoperative period and ignore the mandatory exercises, 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 attention from a qualified neurologist in a timely manner. In the first phase, a neurological examination, a patient examination, an examination of reflexes and symptoms are performed. An experienced and competent doctor knows well what diseases back and back pain have for certain causes and characteristic features.
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 find out why the back and spine hurt, a neuropathologist may prescribe magnetic resonance imaging. It is the most effective and safest method to diagnose almost all possible causes of back pain. The procedure is based on the ability of magnetic fields and radio waves to provide 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 relieve, but not treat, back pain, let's take analgesics for several days, which is necessary to wait for a consultation of a specialist. Most often, non-steroidal anti-inflammatory drugs or NSAIDs are used for this purpose. However, it is important to remember that this group of medicines can cause dangerous side effects, the likelihood of which increases with prolonged use. Therefore, it is important not to postpone doctor visits and examination until later. treatmentdiseasesspineand causesback pain.
Back pain treatment
As mentioned in the beginning, the effectiveness of treatment for back pain depends on how exactly the diagnosis was made. Despite the obvious, many patients "cure" pain for years, but not the disease itself, each time postponing a visit to a doctor, turning to traditional healers, osteopaths and chiropractors. Moreover, such procedures for some diseases of the spine are not only contraindicated but also dangerous.
There are effective and scientifically proven treatments for variousarterdiseases causeback pain. . . Many of these require patient persistence and persistence 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 physical exercises that a neurologist will show you.
Which doctor should I contact in case of pain in the spine?
Back pain is one of the most common neurological symptoms that occurs due to involvement of nerves and spinal cord in the pathological process. Therefore, the first specialist whose consultation it is necessary to receive in case of pain in the spine, will be a neurologist. Based on the results of the examination and magnetic resonance imaging, it may be necessary to consult another physician. If back pain is due to 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 precisely with the pathology of the spine.