Almost everyone during a lifetime, 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. Have
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 distinctive characteristics that help people to understand that with his health problems and it's time to consult a doctor.
The probable causes of back pain:
- lesions of the spine, its ligaments and muscles;
- the denial of roots and other diseases of the spinal cord;
- diseases of the internal organs;
- connective tissue disease;
- depression and psychogenic disorders.
Proven that back pain often occur in low physical activity, obesity, Smoking, heavy physical work, stay in an uncomfortable position, prolonged action of vibration, and sharp turns of the torso.
Diseases of the spine, its ligaments and joints
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 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 are given the so-called syndrome of the joints with "small face" — private form of osteoarthritis affecting 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 re-increased after load for 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 bending, use of the 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 awkward position and provoke excess stress on the joints and cause pain, discomfort and gradual destruction of cartilage. Therefore, office workers are advised to regularly do exercises, and they need funds in protecting and regenerating cartilage.
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, the age of 50 years. Metastases most often affects the thoracic spine.
Another reason for back pain related to cancer is myeloma. Rarely, but there are benign and primary malignant tumors of the spine, for example, a benign tumor produced from bone tissue, Ewing's sarcoma.
Ankylosing spondylitis should be suspected in a young patient age, morning stiffness of the spine and large joints, improvement after 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 appear for other symptoms that are observed in the following 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 long courses of the drug-a total of 20 injections 2 times a year. Supplement they the treatment of back pain allows to reduce the dosage and duration of use of NSAIDs.
Osteomyelitis of the spine or spondylitis need to assume prolonged fever, intravenous medications or drugs, previous 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 younger than 20 and older than 55 years;
- recent back injury;
- the probability of infection (inflammation in the urogenital tract, taking immunosuppressive agents, acquired immunodeficiency syndrome);
- moved cancer;
- unexplained weight loss and fever;
- incontinence of urine or faeces;
- gait disturbance;
- progressive neurological disorders.
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, during 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 is a fairly common disease, often occurring 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 the spinal roots emerging through the holes between the vertebrae, is a more rare cause of pain in every 10th patient. However, this pain syndrome stronger and longer, and the treatment lasts about 2 months.
Compression (compression) of the roots of the cause:
- hernia of the intervertebral 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:b
- 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).
For back pain, particularly arising suddenly 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.
The transition of pain in the chronic form contribute to social and behavioural factors:
- financial difficulties;
- emotional stress;
- confidence in the inevitability of pain because of her apparent connection with everyday work;
- thoughts about a possible serious illness and disability;
- 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.