Almost in every person during life happens that at least one longer episode of pain in the back and a third of adults these unpleasant sensations are repeated regularly. The urgency of the issue is illustrated by the fact that the treatment of back pain annually spends three times more funding than treatment in cancer patients.Length episodes of pain is usually around 2 weeks, but in many patients no residual effects persist even in the course of a month and longer. In
of these patients, diagnosed herniation of the intervertebral disc, disease спинномозгового canal, diseases of the kidneys, ovaries and other internal organs, and sometimes even malignant tumors or their metastases.
In our article, we briefly describe the main causes of back pain and their characteristic properties, which help one to understand that with his health problems, and it is time to see a doctor.
Likely causes of back pain:
- the defeat of the spine, its ligaments and muscles;
- pinched nerve roots and other diseases of the spinal cord;
- diseases of the internal organs;
- disease of the connective tissue;
- depression and psychogenic disorders.
It is shown that back pain often arise when small mobility, obesity, smoking, heavy physical work, stay in an uncomfortable position, prolonged action of vibration, and also the sharp turns of the torso.
Diseases of the spine, its ligaments and joints
In most people with complaints of back pain that arise due to lesions of the intervertebral discs, joints between branches, as well as the bones of the vertebral bodies. With age the disks between the vertebrae lose water, shrinking their thickness. As a result, increases the mobility of the individual elements of the spinal pillar, which irritates the pain receptors межпозвонковых joints. It should be said that often even for people with distinctive "age" changes of the spine back pain no. Often and a herniated disk in combination with pain happen.
In recent years, still greater importance in the development of constant back pain associated so-called синдрому joints with "small face" — a private form of joint arthrosis that affects the articular apparatus of the spine.
The pain in this syndrome may be both one-sided and two-sided, локализуется around the spine, most often in the lumbar region with spread to the thigh. Pain often occurs in the morning, but during the day passes and again they get worse after load into the evening. First appear usually after a sharp improper rotation or tilt of the torso. Pain is amplified in the in the standing position and when разгибании back pain decreases with sitting or lying down, in the light сгибании, the use of the support. Syndrome the joints with "small face" often рецидивирует.
Often cause pain in the back when damage to the spine following conditions:
- spondilolistezom – displacement of the vertebrae relative to each other;
- spinal stenosis;
- ankylosing spondylitis (Bechterew's);
- osteoporosis fractures of the vertebral bodies (often in the elderly, especially in women);
- a large herniated disk (more than 5 mm);
- disease of the cervical spine.
Lack of physical activity during the workday — is a characteristic feature of the work in the office. The lack of movements, a prolonged stay in an uncomfortable position provoke an excessive burden on the joints and they become the cause of pain, discomfort and gradual destruction of cartilage. So workers office it is advisable to regularly do the exercises, and also them it is necessary to receive funds, roll-over protection and settlement хрящевую fabric.
More rare, but dangerous reasons болевого of the syndrome include swelling, most often it is the metastases in the spine. The risk increases in the presence of a patient of any cancer (most commonly lung cancer, breast cancer and prostate cancer), weight loss, fever, duration of complaints more months, over the age of 50 years. Метастазами more often than others поражается department of thoracic spine.
Another cause of back pain, related to онкологическим diseases, include миелома. Rarely, but they are benign and primary malignant tumors of the spine, for example, a benign tumor, a form of bone tissue, sarcoma Юинга.
Bechterew's is a must have at the young age of the patient, morning stiffness of the spine and large joints, improve the condition after heating. Pain often occurs in the medius area. Typical is its amplification in the night, so that is sick in the morning already cannot sleep because of the discomfort.
Back pain will occur other symptoms that are observed in the following diseases:
- psoriatic arthritis;
- ревматическое disease;
- juvenile rheumatoid arthritis;
- Crohn's disease, Уиппла, ulcerative colitis;
- шигеллез, сальмонеллез.
An important part of a comprehensive treatment is the administration of drugs, whose effectiveness is focused on the preservation and normalization of the condition of joints and cartilage. Fuel injection ensures maximum bioavailability and speed of action of the drug, which helps stop the progression of the destruction of cartilage, relieves inflammation, and stimulates the synthesis of hyaluronic acid. Due to the rapid onset of action, no need long courses of preparation-a total of 20 injections 2 times per year. In addition, they treat pain in the back allows you to reduce the dosage and duration of use of NSAIDS.
Остеомиелит of the spine or spondylitis it is necessary to assume in long-term illness, внутривенном the introduction of drugs or narcotics, by means of supporting инфекционном disease or injury, the use of immunosuppressive drugs. Inflammatory diseases of the spine may have a specific nature, arises when сифилисе, туберкулезе.
They are defined by so-called indicators of serious problems, which require careful examination of the patient:
- suddenly for the first time in my life resulting from the pain;
- very severe pain;
- the lack of dependence of the head from the position of the body;
- the pain is greater at night than in the day;
- the age of patients is under 20 years of age and older 55 years;
- recently transferred back injury;
- the likelihood of infection (inflammation in the мочеполовых ways, the intake of immunosuppressive drugs, acquired immune deficiency syndrome);
- перенесенное cancer disease;
- unexplained weight loss and fever;
- general weakness;
- incontinence of urine or feces;
- breach of walking;
- progressive neurological disorders.
The defeat of the muscles
The defeat of the back muscles can be secondary: in diseases of the spine muscles tense up, creating a "protective corset", holding the spine, but from the constant tension and cramps, themselves become the cause of the pain. Often there is a spasm of the muscles occurs in the first place, for example during a long stay in an uncomfortable position, or increased anxiety. Such a painful has a relatively доброкачественное time and lends itself well to medical therapy.
Some systemic diseases of the muscles is also manifested by pain in the back. These include:
- ревматическая полимиалгия;
Fibromyalgia – a fairly common disease, often encountered in middle-aged women. It is characterized by spilled pain in the muscles of the torso, weakness, sleep disorders, changes in skin sensitivity, anxiety disorders, unstable chair.
Pathology of the spinal cord and its roots
Compression of the nerve roots of the spinal cord, entering through the holes between the branches of the vertebral, is a rare cause of pain for every 10-th patient. However, at this painful stronger and длительнее, the treatment lasts about 2 months.
Compression (compression) root cause:
- hernia of the intervertebral disc;
- hyperplasia of yellow ligament;
- bone growths;
- narrowing of the spinal canal (for example, due to injury).
The image of the lesion of the root (радикулопатии): acute "стреляющая" back pain, disorder of sensitivity in zone of innervation of the корешка, reduced reflex, weakness of the relevant muscles. If compression корешка shown that with the help of modern methods of investigation and treatment treatment is inefficient, sometimes resort to surgery.
Diseases of the internal organs
Back pain occurs not only in diseases of the spine or spinal cord, but also brings many diseases of the internal organs:b
- heart disease (myocardial infarction, stable and unstable angina pectoris, infectious эндокардит, aortic aneurysm);
- lung disease (тромбоэмболия the pulmonary artery, pneumothorax, pleural effusion);
- pathology of the esophagus and the stomach (gastric ulcer, spasm of the esophagus, esophagitis);
- inflammatory processes in the kidneys, the liver, the pancreas, the gallbladder.
Usually distinguish these diseases allow for two points:
- sudden and very intense pain in the back;
- signs of the destruction of the competent authorities (shortness of breath, wheezing in the lungs, pain during palpation of the abdomen, and so on).
When pain in the back, especially when unexpectedly and is not сопровождающейся the symptoms of diseases of the spine, it is always necessary to register the электрокардиограмму for the exclusion of acute myocardial infarction. In particular, such atypical localization of pain in ischemic heart disease is typical for older people.
The transition болевого syndrome in chronic forms contribute to the social and behavioral factors:
- financial difficulties;
- emotional stress;
- confidence in the inevitability of pain, because of her apparent connection with everyday work;
- thoughts about a possible serious illness and loss of working capacity;
- dependence on others;
- strategy of avoidance of the disease in which the patient has not taken any measures for the diagnosis and treatment of your condition.
The doctor turn
So, the causes of back pain are diverse. Because most often they are associated with diseases of the spine and spinal cord, at the time of their occurrence it is necessary to turn to a neurologist. In addition, it may be necessary advice to other professionals: нейрохирурга, онколога, a gastroenterologist, a cardiologist, a surgeon, but also a psychologist. To correctly choose a specialist, you can first contact with the therapist after the initial survey to be able to set a preliminary diagnosis.