Almost everyone during a lifetime, at least one long episode of back pain, and one-third of the adults of these unpleasant sensations are repeated periodically. The urgency of the problem is illustrated by, at least, the fact that for the treatment of back pain each year spends three times more money than in the therapy for patients with cancer.
The duration of the episode of pain is usually around 2 weeks, but in many patients, residual symptoms persist for months or more. Havepart of these patients are diagnosed with herniated discs, spinal canal disease, the disease of the kidneys, ovaries and other internal organs, and sometimes malignant tumors or their metastasis.
In our paper, we briefly describe the main causes of back pain and its distinctive characteristics that help people to understand that with his health problems and it is time to consult a doctor.
The probable causes of back pain:
- injuries 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 diseases;
- the depression and psychogenic disorders.
Shown that back pain often occur in the low physical activity, obesity, Smoking, heavy physical work, staying in an awkward position, prolonged action of vibration, and sharp turns of the torso.
Diseases of the spine, its ligaments and joints
The majority of people with complaints of back pain that 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 its thickness. As a result of the increase of the mobility of the individual spinal segments, which irritates the pain receptors of the intervertebral joints. It must be said that often, even in people with pronounced age changes of the spine back pain not. Often a herniated disc combined with pain at random.
In recent years a growing importance in the development of persistent back pain are given the so-called syndrome of the joints with "small faces" — a private form of osteoarthritis affects the joint apparatus of the spine.
The pain in this syndrome can be unilateral, bilateral, localized near the spine, most often in the lumbar region extends to the thigh. The pain often appears in the morning, but during the day and again increased after load for the night. Appears for the first time in general after a strong uncomfortable turn or torso. The pain is worse in standing and extension of the back is the decrease in the sitting position or lying down, with a slight inflection, the use of the support. The syndrome of the joints with "small faces" are often repeated.
Often the cause of back pain in injuries of the spine the following state:
- spondylolisthesis – displacement of vertebrae relative to each other;
- stenosis spinal;
- ankylosing spondylitis (Bechterew's disease);
- osteoporosis, fractures of the bodies vertebral (often in the elderly, especially in women);
- a large herniated disk (over 5 mm);
- diseases of the cervical spine.
The lack of physical activity during the working day is a distinctive feature of the work in the office. The lack of movement, long stay in an awkward position and cause excess tension in the joints and the cause of the pain, discomfort and the progressive destruction of cartilage. Therefore, the office workers are advised to regularly do exercises, and they need funds for the protection and regeneration of cartilage.
More rare, but dangerous causes of the 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, at the age of 50 years. Metastasis most often affects the spine thoracic.
One of the reasons for the back pain related to cancer is myeloma. A few times, 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 that the age of the patient, morning stiffness of the spine and large joints, improves after warm-up. The pain often appears in the gluteal region. It is characterized by its gain night, so sick in the morning can not sleep due to discomfort.
Back pain appear other symptoms that are observed in the following diseases:
- psoriatic arthritis;
- rheumatic diseases;
- juvenile rheumatoid arthritis;
- Crohn's disease, Whipple, ulcerative colitis;
- shigellosis, salmonellosis.
An important component of comprehensive treatment is the administration of drugs, the effectiveness of which is intended to preserve and improve the state of the joints and cartilage. Injection provides the maximum bioavailability and speed of action of the drug, which helps to stop the progression of the destruction of cartilage, reduces inflammation and stimulates the synthesis of hyaluronic acid. Due to the rapid appearance of the effect without the need for long courses of the drug-a total of 20 injections of 2 times a year. Supplement which the treatment of back pain helps reduce the dose and duration of use of Nsaids.
Osteomyelitis of the spine or spondylitis need to take fever prolonged, intravenous medications or drugs, previous infectious disease or trauma, the administration of immunosuppressants. Inflammatory diseases of the spine can have a specific nature, the origin of 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;
- there is 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 injury to the back;
- the probability of infection (inflammation of the treatment of urogenital, taking immunosuppressive agents, acquired immunodeficiency syndrome);
- he moved to the cancer;
- processes of loss of weight and fever;
- weakness;
- incontinence of urine or faeces;
- the motion disturbance;
- progressive neurological disorders.
Lose muscle
Lose muscles of the back can be secondary: in diseases of the spine and the muscles tense, the creation of a "protection system" that is our spine, 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 the muscles is also present with back pain. These include:
- the rheumatic polymyalgia;
- the symptoms of fibromyalgia.
Fibromyalgia is a fairly common disease, often occur in middle-aged women. It is characterized by diffuse pain in the muscles of the body, weakness, sleep disturbances, changes in skin sensations, 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 rare cause of pain in each 10 patient. However, this pain syndrome more strong and more, and the treatment lasts about 2 months.
Compression (compression) of the roots of the cause:
- herniated intervertebral disc;
- the hypertrophy of the ligament yellow;
- the bone growth;
- the narrowing of the spinal canal (for example, due to an injury).
The image of the destruction of the roots (radiculopathy): the sharp "shooting" pain, altered sensation in the area of innervation of the spine, decreased reflexes, weakness of the corresponding muscles. If the compression of the spine demonstrated the modern methods of research and treatment of drugs is ineffective, sometimes, resorting to the surgery.
Diseases of internal organs
Back pain occurs not only in diseases of the spine or the spinal cord, but also accompanies many diseases of internal organs:
b- heart disease (myocardial infarction, stable and unstable angina, infective endocarditis, aortic aneurysm);
- pulmonary disease (pulmonary embolism, pneumothorax, pleurisy);
- pathology of the esophagus and the stomach (peptic ulcer, esophageal spasm, esophagitis);
- inflammatory processes in the kidney, liver, pancreas, gallbladder.
Usually distinguish these diseases allow two things:
- sudden and very intense pain in the back;
- signs of damage to the competent authorities (shortness of breath, rales in the lungs, the pain in the palpation of the abdomen, etc.).
For back pain, especially that arising suddenly and is not accompanied by signs of disease of the spine, it is always necessary to register an ecg to exclude myocardial acute infarction. Especially this atypical localization of pain in ischemic heart disease typical of the elderly.
Psychogenic disorders
The transition of pain in the chronic form of contributing to social and behavior factors:
- financial difficulties;
- emotional stress;
- confidence in the inevitability of pain because of its apparent connection with the work of every day;
- thoughts about a possible serious illness and disability;
- depression;
- dependency on other people;
- the strategy of avoidance of the disease, in which the patient takes no action to diagnose and treat your illness.
To what doctor to address
Thus, the causes of back pain are very varied. Are often associated with diseases of the spine and spinal cord, when they occur, you should consult a neurologist. In addition, it may be necessary to consult other specialists: neurosurgeon, oncologist, gastroenterologist, cardiologist, surgeon, psychologist. Choosing the right specialist, the first contact with the professional after the first exploration to establish a diagnosis provisional.