Most people occasionally have back problems and pain in the lower back, neck or middle back. In fact, back pain is the most common physical complaint of the adult population and the leading cause of temporary disability. Back pain can be mild or severe, short-lived or chronic.
Back pain includes: muscle and tendon pain, herniated disc pain, fractures or other back problems. The reasons usually have a long history. Back pain is most often caused by spinal diseases.
The structure of the spine is designed for extreme loads. The structure of the spine is stable enough for a person to walk (stand) and flexible enough to perform body movements.
A healthy spine has an elongated S-shape when viewed from the side and has natural curves in the lumbar, thoracic and cervical spine. The spine is the main supporting supporting part of the torso. In addition, the spine protects the spinal cord and the roots of the spinal cord with its bone structure, thus ensuring normal innervation of organs and tissues.
Between each of the 24 vertebrae are intervertebral discs that perform a damping function.
Reasons
Back pain refers to problems that a person mostly creates for themselves. Back problems and back pain are most often caused by bad habits that have accumulated over a long period of time. These bad habits include:
- Poor posture
- Overvoltage during operation
- Improper posture or driving
- Repeated stretching or lengthening of the spine or abnormally sharp lifting of weights.
The results of habits rarely appear immediately, but more often their negative effects accumulate over time. One of the most common types of back pain is pain associated with tension in the muscles surrounding the spine. The most common back pain is related to tension, muscles occur in the lumbar and cervical spine. If muscle tension is associated with lifting heavy objects, then the pain can be excruciating.
Sometimes back pain occurs for no apparent reason. In such cases, they talk about non-specific back pain. Such pain can develop due to weakened muscles that cannot cope with everyday stress, such as walking, bending and stretching. In addition, such nonspecific pain can be caused by poor sleep, general fatigue, or exposure to stressful situations.
Chronic pain in myofascial pain syndrome is caused by localized muscle tension. Sometimes this localized muscle tension is the result of stress or other emotional problems.
Pregnancyis often the cause of the disease, and it is a consequence of both hormonal changes in the female body and weight gain and excessive stress on the spine and legs.
Contact sports injuries, accidents and falls can also cause back problems, ranging from less muscle strain to serious spinal cord injuries.
It is important to understand that back pain is one of the symptoms of the disease and is not a diagnosis. Medical conditions that can cause back pain include the following:
Mechanical problems: Mechanical problems are related to the movement of the spine or the sensations that a person feels when performing certain movements. The most common mechanical cause is degeneration of the intervertebral discs (osteochondrosis), when involuntary changes occur in the intervertebral discs and deterioration of the amortization functions of the discs, which leads to the appearance of pain. Another cause of back pain is degenerative changes in the joints of the spine (spondyloarthritis). Other mechanical causes include muscle cramps, muscle tension and disc herniation.
Injuries: Spinal injuries such as sprains and fractures can cause acute and chronic pain. Sprains, tears on the ligaments that support the spine can be caused by twisting the torso or improper lifting. Vertebral fractures are often the result of osteoporosis, a disease in which bone density is impaired. Less commonly, back pain can cause more serious injuries resulting from collisions and falls.
Acquired conditions and diseases. Many medical conditions can cause or contribute to pain. These include scoliosis, kyphosis, kyphoscoliosis, which usually have no pain until the middle of the year. Various types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), spinal canal stenosis, which affects the nerve roots of the spinal cord. Diseases like osteoporosis are painless in themselves, but can lead to vertebral fractures, which will manifest as severe pain. Other causes of back pain include pregnancy, kidney infections or urolithiasis, endometriosis, fibromyalgia, which is characterized by chronic fatigue and diffuse muscle pain.
Infections and tumors. Although infections are not common causes of disease, they can still cause pain. If the bone tissue is affected, then we are talking about osteomyelitis, if the infection affects the intervertebral discs, then we are talking about dyskitis. Tumors are also relatively rare in pain. Sometimes spinal tumors are primary, but most often they are metastatic and the primary focus is located in another part of the body.
Although the causes of back pain are usually physical, it is important to understand that emotional stress can play a role, both in the intensity of the pain and in the duration. In addition, stress and emotional state can affect skeletal muscle tone. Thus, in the presence of depression and anxiety, back pain may be more intense. In addition, insomnia or lack of sleep can also contribute to or worsen pain.
Back pain is just a symptom and can be reflected. Many diseases of the peritoneum and pelvic organs can cause pain in the spine (appendicitis, aneurysms, kidney disease, bladder disease, infections and inflammatory diseases of the pelvis).
Risk factors
- Age over 40
- Male
- Family History
- Previous injuries
- Pregnancy
- Spinal surgeries in the past
- Congenital malformations of the spine.
- Lack of regular exercise
- Work or activity that requires prolonged sitting to lift weights.
- Smoking. People who smoke more often than people who do not smoke feel back pain.
- Overweight. Being overweight, especially with fat around the waist, can put more strain on the back and have weak muscles and limited mobility
- Poor posture. Impaired posture leads to a violation of the load vector distribution and to muscle tension, muscle spasms and pain.
- Stress. Stress and other emotional factors are believed to play an important role in back pain, especially chronic pain. Many people unknowingly tense their back muscles when under stress.
- Condition after a long period of depression.
- Long-term use of drugs (such as steroids) that weaken bone tissue.
- Pulmonary diseases leading to chronic cough.
Symptoms
Most people have experienced back pain during their lifetime. There are many reasons for back pain, some of which a person creates for themselves. Other causes include accidents, muscle sprains, sports injuries and various diseases. Although the causes may be different, they are most often marked by the same symptoms.
- Constant pain or stiffness in any part of the spine, from the bottom of the neck to the buttocks
- Acute, localized pain in the neck, upper back or lower back - especially after lifting heavy objects or performing strenuous activities. (Pain at the top can also be a sign of a heart attack or other life-threatening conditions. )
- Chronic pain in the middle or lower part, especially after prolonged sitting or standing.
- Low back pain radiating to the buttocks of the leg.
- Unable to stand upright.
But there are symptoms that justify seeking medical help
- Feeling numb, tingling, or weakness in your arms or legs, as this may indicate a spinal cord injury.
- Pain in the lower back radiates to the leg, which may be evidence of root compression (radiculitis).
- The pain is worse when coughing or leaning forward, which can be a sign of a herniated disc.
- Pain is accompanied by fever and a burning sensation when urinating, which can be a sign of a urinary tract infection.
- Bowel or bladder dysfunction
- History of Cancer
- Weight loss
- Long-term use of steroids
- History of trauma
- Increased weakness even after rest.
- Pain lasting more than a month
- Night pain
- No healing effect
- History of drug use
Diagnostics
Due to the fact that the cause of back pain can be different conditions, it is first of all important to carefully collect the doctor's anamnesis and symptoms. The localization of pain and the intensity and presence of radiation are also important. Physical examination includes careful examination of neurological status (reflex activity, muscle strength, sensitivity, etc. ). If you suspect pelvic organ disease, your doctor may prescribe a consultation with a gynecologist, a urologist.
Instrumental research methods
Radiography usually has little value in diagnosing spinal pain, especially if there are no significant symptoms. The use of radiography is indicated for acute significant injuries or minor injuries in patients older than 50 years, patients with osteoporosis or a history of long-term steroid use.
MRI is the most informative diagnostic method that enables high-quality visualization of bones and soft tissues and enables the diagnosis of both degenerative changes and tumors or infections.
CT can be recommended for clearer visualization of changes in bone tissue.
EMG and ENMG allow the determination of conduction along nerve fibers and muscles and, as a rule, are used in the diagnosis of chronic back pain.
Ultrasound examination of the abdominal organs or the organs of the small pelvis, kidneys is necessary when it is necessary to distinguish the source of pain.
Laboratory research methods are also used for the differential diagnosis of inflammatory diseases or infections.
Treatment
There is no universal treatment for back pain. The treatment of back pain in each individual case depends on the genesis of the manifestations of pain and on the individual characteristics of the person, because people's perception varies significantly.
Medical treatment includes the use of various medications, both conventional analgesics or NSAIDs, and muscle relaxants or antibiotics for infections. Antidepressants, tranquilizers or neuroleptics can be used for chronic pain syndrome.
Drug-free treatments such as physiotherapy, massage, manual therapy, acupuncture, and exercise therapy are widely used in the treatment of back pain. These methods of treatment are effective for both acute and chronic manifestations of pain associated with spinal diseases.