The effectiveness of the treatment.Back paindirectly depends on the precision with which it was delivereddiagnosis. . . 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 pathologies that can causeBack pain, and not all are associated with diseases of the musculoskeletal system.
By self-medicating, patients mistakenly believe that the most important thing is to cope with pain and lose sight of the fact that all 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
Consider the maindiseasecausingBack 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 utmost attention. The reason lies in the unique anatomical features of the cervical vertebrae: the vertebral artery passes through them, supplying blood to ⅓ of the brain; the first and second cervical vertebrae form a complex mobile joint with the skull, which is responsible for turning and tilting the head; any disease occurring 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.
Normally, intervertebral discs, joints, ligaments, and tendons do not have their own blood vessels; its blood supply depends on how strongly blood is supplied to nearby muscles and bones. If this process is disturbed, 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 the joints is altered, the ligaments and tendons thicken, 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, osteochondrosis is the most common cause of pain in the cervical spine. Also, 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 often diagnosed in the lumbar spine, nearly 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 framework 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 a accident, so-called whiplash injury often occurs, caused by sharp flexion followed by abrupt extension of the cervical spine). Pain is a constant companion to any spinal injury.
Myositis
Myositis or inflammatory diseases of the muscles is a whole group of diseases characterized by muscle pain. The most common cause of inflammation of the banal muscles is a 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 eventually 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, can be intensified 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, etc. The immediate cause of pain is irritation of the spinal cord roots when they are pinched in the intervertebral space, muscle spasm, which disrupts the metabolism of the nerves that pass 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 diseases
Heart diseases such as angina pectoris, ischemic heart disease, and atherosclerosis of the coronary vessels are often accompanied by pain that radiates to the neck, lower jaw, shoulder, and left forearm. Pain may be accompanied by numbness, tingling of the skin, simulating pain in osteochondrosis of the cervical spine with an intervertebral hernia. Often patients receive massages, physical therapy, visit other doctors, although an electrocardiogram is enough to diagnose the cause.
A characteristic feature of such pain is the ability of antianginal drugs that improve 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 of which has a pair of ribs attached to it. Together they provide protection to the organs of the chest. The size of the thoracic vertebrae gradually increases, starting from 1 thoracic vertebra and then to the beginning of the lumbar spine; This is explained by a gradual increase in the load on them. Mid-back mobility is significantly less than neck mobility, ribs provide additional protection, which is why traumatic damage to the spinal cord 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 causes of scoliosis are still not exactly known, the disease begins in childhood. Lack of physical activity, weak back muscles, improper posture and organization of the workplace of schoolchildren are considered contributing factors. Due to the pronounced curvature, the poor distribution of loads and the biomechanics of the spine, the overexertion of the muscles that compensate part of the load,increasechronicBack pain.
Arthritis (spondyloarthritis)
The intervertebral joints, together with the intervertebral discs, unite the spine as a whole. Each vertebra has 4 articular surfaces that form joints 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 that occurs in response to increased loads 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 pain reflected 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 origin of spondyloarthritis or osteochondrosis of the spine.
Most often, reflected pain in the back occurs with gastric ulcer and duodenal ulcer, with hiatal hernia, acute or chronic pancreatitis. This phenomenon arises from the peculiarities of the sympathetic and parasympathetic systems, the nerve fibers of which are present in all organs 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 that, as in the case of 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 pain impulses reaches the spinal cord, simulating a disease of the spine.Back pain symptomsIt can occur with acute pyelonephritis, renal colic, kidney abscess. A characteristic symptom is the tension of the back muscles in the projection of the kidneys, which is produced by inflammation of the kidneys or by an abscess of the tissue that surrounds them.
Lumbosacral spine pain
The lumbosacral spine has the most stress. Up to 60-70% of the adult population in developed countries complain of back pain. This is one of the favorite locations for intervertebral hernias. A patient is most often diagnosed with 2-3 hernias in the lumbosacral spine. Also, 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 enormous pressure. A healthy disc is able to offset any weight thanks to the semi-fluid core, which acts as a hydraulic shock absorber. However, due to osteochondrosis, the strong, fibrous cartilage (annulus fibrosus) that runs along the periphery of the intervertebral disc loses its elasticity and strength, and some of its parts may crack. With a sharp increase in load, for example, when lifting weights, the pressure inside the diseased disc increases, due to which its contents can actually "shoot" through the damaged cartilage, falling into the lumen of the spinal canal; This is how an intervertebral hernia forms.
Nucleus fragments that have fallen off the disc squeeze the spinal cord and spinal roots. As a result, there is swelling of nerve tissues and impaired blood circulation, which is accompanied by severe pain and protective muscle spasm. The pain can be excruciating, even requiring the use of narcotic pain relievers. A characteristic feature is the radiation 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.
Bulging of the intervertebral disc
The main difference between an intervertebral disc bulge 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 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 loads and degenerative-dystrophic processes in the spine can lead to ossification of cartilaginous tissue, which is saturated with calcium salts and turns into acute coracoid bone outgrowths or growths that arise along the periphery of the bodies. vertebral. With the progression of the process, these growths can merge with the same growths on the body of the adjacent vertebrae. Over time, all the vertebrae grow together, the spine loses its flexibility and elasticity. Pain occurs due to irritation of the spinal cord and its roots, reactive inflammation, and dystrophy of the soft tissues, ligaments, and muscles that surround the spine.
Radiculitis
Radiculitis is called severe pain arising from circulatory disorders and ischemia of the roots of the spinal cord, strangulated by a hernia or protrusion with osteochondrosis of the spine. Various disorders of skin sensitivity are possible in the area of the buttocks, perineum, thighs, and lower legs. Thrown sciatica leads to muscle wasting and weakness. A characteristic symptom is shooting pains along the sciatic nerve, aggravated by movement, weight lifting, and in cold weather. This condition is called sciatica or sciatica.
Spinal 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. Gradual breakdown of bone tissue is accompanied by necrosis; this image 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 cervical cancer, endometriosis or adnexitis (inflammation of the uterine appendages) 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 trapped nerves in the area of inflammation or by the growth of the nerve trunks by a tumor.
The back muscles ache along the spine.
Well-developed back muscles are a sign of a healthy spine, as the muscle brace relieves some of the stress and also stabilizes the spine. In chronic diseases of the spine, the muscles are subjected to excessive loads, which the weak and atrophied muscles cannot bear. As a result, muscle spasm occurs due to metabolic disorders in the muscles and pain. This condition is called myofascial syndrome, which is characteristic of osteochondrosis of the spine, hernias, and bulging 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 frameworks, 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 surgery. With proper post-operative care and rehabilitation, the pain will gradually subside. However, if in the postoperative period you neglect the instructions of the doctors and ignore the mandatory 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 seek medical help from a qualified neurologist in time. In the first stage, a neurological examination, a survey of the patient, a study of reflexes and symptoms is carried out. An experienced and competent doctor knows well what diseases back and spine pain have for certain reasons and characteristic features.
Back pain for no apparent reason should be especially attentive. This can occur with reflected pain from other organs and systems, with tumors and diseases of the spinal cord.
To find out why your back and spine hurt, a neuropathologist may prescribe an MRI. It is the most effective and safest method for diagnosing almost all possible causes of back pain. The procedure relies on the ability of magnetic fields and radio waves to provide clear, 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 painkillers for several days, which is necessary to wait for the 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 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 exam until later. treatmentdiseasesspineand reasonsBack pain.
Treatment of spinal pain
As stated at the beginning, the effectiveness of back pain treatment depends on the precision with which the diagnosis has been made. Despite the obvious, many patients "cure" the pain for years, but not the disease itself, each time postponing a visit to the doctor and 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 that causeBack pain. . . Many of these require the 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 it, with hard training and physical exercises that a neurologist will show you.
Which doctor should I contact if I have pain in my spine?
Back pain is one of the most common neurological symptoms that occurs due to the involvement of the nerves and the 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. Depending on the results of the exam and MRI, 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 - a gastroenterologist. But most often, the pain syndrome is associated precisely with the pathology of the spine.