A large number of people experience back problems from time to time and experience pain in the lower back, neck or back. In fact, back pain is the most common physical complaint in adults and a major cause of temporary disability. Back pain can be mild or severe, pain can occur in the short term or chronic.
Back pain includes: muscle and tendon pain, disc herniation, fractures or other back problems. Often, the reason has a long history. Often, back pain is caused by back pain.
The spinal structure is designed for extreme loads. The structure of the spine is stable enough for a person to walk (stand) and flexible enough to perform the movement of the trunk.
A healthy S-shaped spine when viewed from the side and has a natural indentation in the lumbar, thoracic and cervical spine. The spine is the main bearing part of the torso. In addition, the spine protects the spinal cord and spinal cord roots with its bone structure, thus ensuring the normal preservation of organs and tissues.
Between each of the 24 vertebrae there is an intervertebral disc that performs a cushioning function.
Reason
Back pain refers to a problem that a person often causes for themselves. Back problems and back pain are most often caused by bad habits that accumulate over a long period of time. These bad habits include:
- Poor posture
- Excessive tension while working
- Improper posture on the table or driving
- Repeated stretching or lengthening of the spine or abnormal weight gain.
The results of habits rarely appear immediately, but more often the negative effects accumulate over time. One of the most common types of back pain is pain associated with tension in the muscles around the spine. Often, back pain is associated with tension, muscles occurring in the lumbar spine and in the 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 nonspecific back pain. Such pain can arise due to weak muscles and inability to cope with daily stress, such as walking, bending, and stretching. In addition, nonspecific pain like this can be triggered by poor sleep, general fatigue, or exposure to stressful situations.
Chronic pain in myofascial pain syndrome is caused by local muscle tension. Sometimes this localized muscle tension is caused by stress or other emotional problems.
Pregnancyis often the cause of this disease and this is due to both hormonal changes in the female body and weight gain and excessive pressure on the spine and legs.
Injuries in contact sports, accidents and falls can also cause back problems, ranging from mild muscle tension to serious injuries to the spine and spinal cord.
It is important to understand that back pain is one of the symptoms of the disease and not a diagnosis. Medical conditions that can cause back pain include the following:
Mechanical Problems: Mechanical problems related to spinal movements or sensations experienced by a person while performing certain movements. The most common mechanical cause is degeneration of the intervertebral disc (osteochondrosis), when changes do not occur in the intervertebral disc and deterioration of the amorphous function, leading to the onset of pain. Another cause of back pain is degenerative changes in the spinal joint (spondyloarthrosis). Other mechanical causes include muscle cramps, muscle tension, and herniated discs.
Injuries: Spinal injuries such as sprains and fractures can cause acute pain and chronic pain. Sprains, tears in the ligaments that support the spinal space, can occur as a result of trunk rotation or improper lifting. Spinal fractures are often caused by osteoporosis, a disorder in which bone density is disrupted. Less commonly, back pain can be caused by more serious injuries due to accidents and falls.
Suffering from conditions and diseases. Many medical conditions can cause or contribute to pain. These include scoliosis, kyphosis, kyphoscoliosis, where there is usually no pain until middle age. Various types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), stenosis of the spinal canal, which affects the roots of the spinal cord. Diseases such as osteoporosis are not painful on their own, but can cause fractures of the spine, which will manifest itself as severe pain. Other causes of back pain include pregnancy, kidney infection or urolithiasis, endometriosis, fibromyalgia, which are characterized by chronic fatigue and diffuse muscle pain.
Infections and tumors. Although infection is not a common cause of illness, infection can cause pain. If bone tissue is affected, then we are talking about osteomyelitis, if the infection affects the intervertebral disc, then we are talking about discitis. Tumors are also relatively rare. Sometimes spinal tumors are primary, but often tumors are metastatic and the primary focus is on other parts of the body.
Although the cause of back pain is usually physical, it is important to understand that emotional stress can play a role, both in the intensity of the pain and at all times. In addition, stress and emotional states can affect skeletal muscle tone. Therefore, if there is depression and anxiety, the back pain may be more intense. In addition, insomnia or lack of sleep can also contribute to or exacerbate pain.
Back pain is just a symptom and may be noticeable. Many diseases of the peritoneum and pelvic organs can cause spinal pain (appendicitis, aneurysms, kidney disease, bladder disease, infections, and pelvic inflammatory disease).
Risk Factors
- Over 40
- Gender
- Family history
- Previous injuries
- Pregnancy
- Surgical intervention on the spine in the past
- Congenital spinal deformity.
- Lack of regular exercise
- Jobs or activities that require prolonged weight gain.
- Smoking. People who smoke more often than non-smokers suffer from back pain.
- Overweight. Being overweight, especially those with fat at the waist, can put pressure on the back and tend to have weak muscles and limited movement
- Poor posture. Disrupted posture causes disruption in vector distribution of muscle load and tension, muscle spasm and pain.
- Pressure. Stress and other emotional factors are thought to play an important role in back pain, especially chronic pain. Many people unknowingly tighten their back muscles when they are under stress.
- Conditions after prolonged depression.
- Long-term use of drugs (such as steroids) that weaken bone tissue.
- Lung disease that causes chronic cough.
Symptoms
Most people have experienced back pain in their lifetime. There are many causes for back pain, some of which are created by a person for himself. Other causes include accidents, muscle spasms, sports injuries, and various ailments. Although the cause can be different, it is often marked by the same symptoms.
- Persistent pain or stiffness in any part of the spine, from the base of the neck to the sternum . (Pain in the upper body can also be a sign of a heart attack or other life-threatening condition. )
- Chronic pain in the middle or lower back, especially after a long sitting or standing.
- Lower back pain radiates to the back of the foot.
- Inability to stand upright.
But there are symptoms that require medical treatment
- Numbness, tingling, or weakness in the arms or legs, as this may indicate spinal cord injury.
- Lower back pain radiates to the feet, which may be evidence of root compression (radiculitis).
- Pain increases when coughing or leaning forward, which may be a sign of a herniated disc.
- Pain is accompanied by fever and burning sensation during urination, which may be a sign of a urinary tract infection.
- Disorders of bowel or bladder function
- History of cancer
- Weight Loss
- Long-term use of steroids
- History of trauma
- Increased pain even after rest.
- Pain that lasts more than a month
- Night Pain
- No treatment effects
- Drug use history
Diagnostics
Since the causes of back pain can be a variety of conditions, then, first of all, the collection of anamnesis and doctor's symptoms is important. Good localization of pain and intensity, presence of irradiation is 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, urologist.
Instrumental research methods
Radiography is usually of no value in diagnosing spinal pain, especially if there are no severe symptoms. The use of radiographs 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 and allows high quality visualization of both bone and soft tissue and makes it possible to diagnose degenerative changes and tumors or infections.
For a clearer visualization of bone changes, CT may be recommended.
EMG and ENMG make it possible to determine conduction along nerve and muscle fibers and, as a rule, are used in the diagnosis of chronic back pain.
Ultrasound examination of the abdominal organs or small pelvic organs, kidneys is required if necessary to differentiate the source of pain.
Laboratory research methods are also used to differentiate the diagnosis of inflammatory diseases or infections.
Treatment
There is no universal treatment for back pain. The treatment of back pain in each case depends on the genesis of the pain manifestations and the individual characteristics of a person, as people's perceptions differ significantly.
Medical treatment includes the use of a variety of medications, either conventional analgesics or NSAIDs, as well as muscle relaxants or antibiotics for infections. With chronic pain syndrome, the use of antidepressants, sedatives or neuroleptics is possible.
Non-drug treatments such as physiotherapy, massage, manual therapy, acupuncture and exercise therapy have been widely used in the treatment of back pain. This method of treatment is effective for the manifestation of acute and chronic pain associated with spinal diseases.