The effectiveness of the treatmentBack achedirectly depends on how accurately it was delivereddiagnostic. . . However, the pain syndrome itself is not a characteristic symptom - it is a general symptom, according to which it is impossible to establish the cause of the disease. There are many different conditions that can causeBack ache, and not all are associated with diseases of the musculoskeletal system.
In self-medication, patients mistakenly believe that coping with pain is most important, and they lose sight of the fact that every pain has a cause. The use of analgesics 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
Consider the mainsicknessprovokingBack ache. . . To aid in the diagnosis, doctors divide the back into upper (cervical spine), middle (thoracic spine), and lower (lumbosacral) parts.
Upper back pain
Pain in the cervical spine requires the utmost attention. The reason lies in the unique anatomical features of the cervical vertebrae: the vertebral artery passes through them, supplying blood to the brain; the first and second cervical vertebrae form a movable complex joint with the skull, which is responsible for the rotation and tilt of 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 results in impaired motor and / or sensory function throughout the rest of the body. body.
Osteochondrosis of the cervical spine
Normally, intervertebral discs, joints, ligaments and tendons do not have their own blood vessels; their blood supply depends on the intensity with which the neighboring muscles and bones are supplied with blood. If this process is disturbed, for example, in an office worker leading a sedentary and sedentary lifestyle, then degenerative-dystrophic changes begin in him. The nutrition of the cartilage of the intervertebral discs and joints is impaired, the ligaments and tendons thicken, due to sclerotic changes, the spinal canal narrows, and the distance between the vertebrae decreases.
In non-specialists, this disease is known as spinal osteochondrosis. Despite the fact that 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 peculiarities of the anatomy of the cervical spine, even a small hernia can lead to serious complications.
Trauma
Although spinal cord injury is most commonly diagnosed in the lumbar spine, almost 50% of spinal cord injury cases occur with trauma to the cervical spine. This is due to the peculiarities of the anatomy of the neck: the absence of a developed muscular frame and massive vertebral bodies, high mobility contribute to the trauma even without direct physical impact (for example, with a sudden stop or a blow from behind duringan accident, a so-called whiplash often occurs, caused by strong flexion followed by strong extension of the cervical spine). Pain is a constant companion of any spinal 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, drafts. 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 overstrain, muscle spasms with impaired microcirculation andinflammation.
Neuralgia
Neuralgia is a condition in which the nerve fibers themselves become a source of constant pain impulses. The pain is paroxysmal, may be intensified and caused by turning or tilting the head, in 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 pinched in the intervertebral space, muscle spasms, which disrupt the metabolism of the nerves passing through the spasmodic muscles. Unlike neuritis or inflammation of the nerve, with neuralgia the pain is periodic, there are no pathological changes in the nerve fibers themselves.
Heart disease
Heart disease such as angina, ischemic heart disease, atherosclerosis of the coronary vessels is often accompanied by pain radiating to the neck, lower jaw, shoulder and left forearm. The pain may be accompanied by numbness, tingling on the skin, simulating pain in osteochondrosis of the cervical spine with intervertebral hernia. Often, patients receive massage, physiotherapy, consult other doctors, although an EKG is enough to diagnose the cause.
A hallmark of this pain is the ability of antianginal drugs that improve blood flow in 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 with a pair of attached ribs. Together they protect the thoracic organs. The size of the thoracic vertebrae gradually increases, starting from 1 thoracic vertebra and until 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, which is why traumatic injuries of the spinal cord in the thoracic spine are less common.
Curvature of the spine or scoliosis
Scoliosis or scoliosis disease is a pathological curvature of the spine in several planes. The causes of scoliosis are not yet precisely known, the disease begins in childhood. Lack of physical activity, weak back muscles, poor posture and the work organization of schoolchildren are considered to be contributing factors. Due to a pronounced curvature, poor load distribution and biomechanics of the spine, overexertion of the muscles that compensate for part of the load,arisechronicBack ache.
Arthritis (spondylitis)
The intervertebral joints, along with the intervertebral discs, unite the spine as a whole. Each vertebra has 4 articular surfaces which form joints with adjacent vertebrae. Like any other joint, the intervertebral joints can become inflamed. This pathological condition is called spondylitis. 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 that occurs in response to increased loads of osteochondrosis, scoliosis and other pathologies of the spine. Inflamed joints lose their function: stiffness of movement, 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 thoughtful 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 cause spondylitis or osteochondrosis of the spine.
Most often, reflected back pain occurs with gastric ulcer and duodenal ulcer, with hiatus hernia, acute or chronic pancreatitis. This phenomenon results 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 they perceive 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, like the abdominal organs, is intimately connected by nerves to the roots of the spinal cord. In the presence of inflammation, stones or other pathologies of the urinary tract, part of the painful impulses reach the spinal cord, simulating a disease of the spine.Symptoms of back painmay occur with acute pyelonephritis, renal colic, renal abscesses. A characteristic symptom is the tension of the muscles of the back in the projection of the kidneys, due to inflammation of the kidneys or an abscess of the tissue around them.
Pain in the lumbosacral spine
The lumbosacral spine is the most stressed. Up to 60-70% of the adult population in developed countries complain of back pain. It is a preferred location for intervertebral hernias. A patient is most often diagnosed with 2-3 hernias in the lumbosacral spine. In addition, pain in the lower back and sacrum often occurs with gynecological and urological pathologies.
Intervertebral hernia
An intervertebral hernia is the result of long-term 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 tremendous pressure. A healthy disc is able to compensate for any weight, thanks to the semi-fluid core, which acts as a hydraulic shock absorber. However, due to osteochondrosis, the fibrous and solid cartilage (annulus fibrosus) that runs along the periphery of the intervertebral disc loses elasticity and strength, and some of its parts may crack. With a sharp increase in the load, for example, when lifting weights, the pressure inside the diseased disc increases, due to which its contents can actually "pull" through the damaged cartilage, falling into the lumen. spinal canal - this is how an intervertebral hernia is formed.
The fragments of the nucleus that have fallen from the disc compress the spinal cord and the spinal roots. As a result, there is swelling of nerve tissue and impaired blood circulation, which is accompanied by severe pain and protective muscle spasms. The pain can be unbearable, including the need to use narcotic pain relievers. A characteristic feature is the irradiation of pain in the lower extremities. There may be altered sensitivity to pain, tingling, and numbness of the skin on the lower leg and thigh.
Protrusion of the intervertebral disc
The main difference between the protrusion of an intervertebral disc and a herniation is the preservation of the integrity of the fibrous ring. The cause of pain is compression of the spinal cord and its roots by protruding 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 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 herniation.
Spondylosis of the spine
Excessive loads 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 growths or growths that arise along 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 together, the spine loses flexibility and elasticity. The pain is due to irritation of the spinal cord and its roots, reactive inflammation, and dystrophy of the soft tissues, ligaments, and muscles surrounding the spine.
Radiculitis
Radiculitis is called severe pain resulting from circulatory disturbances and ischemia of the roots of the spinal cord, strangled by a hernia or protrusion with osteochondrosis of the spine. Various disorders of skin sensitivity in the buttocks, perineum, thighs and lower legs are possible. Onset sciatica causes muscle atrophy and weakness. A characteristic symptom is stabbing pain along the sciatic nerve, aggravated by movement, weight lifting and in cold weather. This condition is called sciatica or sciatica.
Spine 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 decomposition of bone tissue is accompanied by necrosis - this picture is also typical of spinal tuberculosis. Pain can occur both from irritation of nerve endings, and from pathological compression fractures of the spine, weakened by inflammation.
Gynecological and urological diseases
Pathologies such as cancer of the cervix, endometriosis or adnexitis (inflammation of the uterine appendages) in women, prostatitis or prostate cancer in men are often accompanied by severe pain in the body. of 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 nerve trunks by a tumor.
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 additionally stabilizes the spine. In chronic diseases of the spine, the muscles are subjected to excessive loads, which weak and atrophied muscles are not able to withstand. As a result, muscle spasms occur and are caused by metabolic disturbances in the muscles and pain. This condition is called myofascial syndrome, which is characteristic of osteochondrosis of the spine, hernias and protuberances of the intervertebral discs.
Postoperative pain
Spine surgeries are usually accompanied by significant trauma - to stabilize and restore the integrity of the vertebrae, doctors may resort to installing metal structures, screwing screws into the vertebrae, and removingnon-viable tissue. The pain in this case is due not only to the disease itself, but also to the surgery. With proper rehabilitation and postoperative care, the pain will gradually subside. However, if in the postoperative period you neglect the instructions of doctors and ignore compulsory exercises, the pain can become chronic.
How are the causes of back pain diagnosed?
To diagnose pain in the back and spine, it is necessary to visit a qualified neurologist in time. At the first stage, a neurological examination, a survey of patients, a study of reflexes and symptoms are carried out. An experienced and knowledgeable doctor is well acquainted with diseases of the back and spine for certain reasons and characteristics.
Back pain for no apparent reason should be especially vigilant. It can be with reflected pains of other organs and systems, with tumors and diseases of the spinal cord.
To find out why the back and spine hurt, a neuropathologist may order magnetic resonance imaging. It is the safest and most effective 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 spinal pain
To relieve, but not treat, back pain, take analgesics for several days, which is necessary to wait for a consultation with a specialist. Most often, nonsteroidal anti-inflammatory drugs or NSAIDs are used for this purpose. However, it is important to remember that this group of drugs can cause dangerous side effects, the probability of which increases with prolonged use. That is why it is important not to postpone the visit to the doctor and the examination until later. processingdiseasesspineand the reasonsBack ache.
Treatment of pain in the spine
As stated at the very beginning, the effectiveness of treatment for back pain depends on how accurately the diagnosis is made. Despite the evidence, many patients "cure" the 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, for some diseases of the spine, such procedures are not only contraindicated, but also dangerous.
There are effective and scientifically proven treatments for variousspeciesdiseases causingBack ache. . . Many of them require the patient's perseverance and perseverance 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 it, with hard training and physical exercises that a neurologist will show you.
Which doctor should I contact for pain in the spine?
Back pain is one of the most common neurological symptoms that occurs due to the involvement of the nerves and spinal cord in the pathological process. Therefore, the first specialist, whom it is necessary to receive the consultation with in case of pain in the spine, will be a neurologist. Based on the results of the exam and magnetic resonance imaging, you may need to see 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 precisely with the pathology of the spine.