The effectiveness of the treatmentback paindirectly depends on how accurately it was delivereddiagnosis. . . However, the pain syndrome itself is not some 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 of them are associated with diseases of the musculoskeletal system.
When self-medicating, patients mistakenly believe that the most important thing is to cope with pain, and they lose sight of the fact that every pain has a cause. Taking painkillers is a symptomatic treatment that does not affect either the outcome of the disease or the cause of the pain.
The main causes of back pain
Consider the mainillnesscausingback pain. . . For the convenience of 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 is 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 movable complex articulation with the skull, which is responsible for turning and tilting the head; any disease that occurs at this level has the potential to cause serious neurological damage, since damage or even slight compression of the spinal cord in the cervical spine immediately leads to impaired motor and / or sensory function throughout the rest of the body.
Osteochondrosis of the cervical spine
Normally, intervertebral discs, joints, ligaments and tendons do not have their own blood vessels; their blood supply depends on how intensively the nearby muscles and bones are supplied with blood. If this process is disturbed, for example, in an office worker leading a sedentary and sedentary lifestyle, degenerative-dystrophic changes begin in them. The nutrition of the cartilage of the intervertebral discs and joints is impaired, 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. Despite the fact that degenerative-dystrophic processes are characteristic of the entire spine, it is osteochondrosis that is the most common cause of pain in the cervical spine. Moreover, 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 cause serious complications.
Trauma
Although spinal cord injury is more commonly diagnosed in the lumbar spine, nearly 50% of cases of spinal cord injury 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 frame and massive vertebral bodies, high mobility contribute to trauma even without direct physical impact (for example, in case of a sudden stop or a blow from behind during an accident, the so-called whiplash injury of the neck often occurs, caused by sharp bending followed by sharpextension of the cervical spine). Pain is a constant companion of any spinal injury.
Myositis
Myositis or inflammatory muscle diseases is a whole group of diseases characterized by muscle pain. The most common cause of banal muscle inflammation 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 on most of the load on the neck, which ultimately leads to overstrain, 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 roots of the spinal cord when they are pinched in the intervertebral space, muscle spasm, which disrupts the metabolism in the nerves passing through the spasmodic muscles. Unlike neuritis or inflammation of the nerve, with neuralgia, pain is periodic, there are no pathological changes in the nerve fibers themselves.
Heart diseases
Heart diseases such as angina pectoris, ischemic heart disease, atherosclerosis of the coronary vessels are often accompanied by pain radiating to the neck, lower jaw, shoulder and forearm on the left. Pain may be accompanied by numbness, tingling on the skin, simulating pain in osteochondrosis of the cervical spine with an intervertebral hernia. Often, patients receive massage, physiotherapy, 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. Together they provide protection for the chest organs. The size of the thoracic vertebrae gradually increases, starting from 1 thoracic vertebra and further to the beginning of the lumbar spine - this is explained by a gradual increase in the load on them. The mobility of the middle part of the back is significantly lower than the mobility of the neck, the 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 known exactly, the disease begins in childhood. Lack of physical activity, weakness of the back muscles, improper posture and organization of the workplace of schoolchildren are considered as contributing factors. Due to pronounced curvature, impaired distribution of loads and biomechanics of the spine, overexertion of muscles that compensate for part of the load,arisechronicback pain.
Arthritis (spondyloarthritis)
The intervertebral joints, together with the intervertebral discs, unite the spine into one whole. Each vertebra has 4 articular surfaces that form articulations 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 reflected pain 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 background for spondyloarthritis or osteochondrosis of the spine.
Most often, pain reflected back pain 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 every organ of the abdominal cavity. Part of the pain impulses perceived by them returns 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, which, as in the case of the abdominal organs, is intimately connected by nerves with 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 symptomscan occur with acute pyelonephritis, renal colic, kidney abscesses. A characteristic symptom is the tension of the muscles of the back in the projection of the kidneys, which occurs due to inflammation of the kidneys or with an abscess of the tissue surrounding them.
Pain in the lumbosacral spine
The lumbosacral spine has the greatest stress. Up to 60-70% of the adult population of developed countries complain of back pain. This is a favorite localization of intervertebral hernias. One 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 a long-term osteochondrosis of the spine. Whereas 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 compensate for any weight, due to the semi-fluid core, which acts as a hydraulic shock absorber. However, due to osteochondrosis, fibrous and strong cartilage (annulus fibrosus) running along the periphery of the intervertebral disc loses its elasticity and strength, and some of its parts can crack. With a sharp increase in load, for example, when lifting weights, the pressure inside the diseased disc increases, because of which its contents can actually "shoot" through the damaged cartilage, falling into the lumen of the spinal canal - this is how an intervertebral hernia is formed.
Fragments of the nucleus that have fallen out of the disc squeeze the spinal cord and spinal roots. As a result, there is swelling of the nerve tissues and impaired blood circulation, which is accompanied by severe pain and protective muscle spasm. The pain can be unbearable, up to the need for the use of narcotic analgesics. A characteristic feature is the irradiation of pain in the lower extremities. There may be impaired sensitivity to pain, tingling and numbness of the skin of the lower leg and thigh.
Intervertebral disc protrusion
The main difference between protrusion of an intervertebral disc 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 protrusion can easily turn into a hernia. Symptoms and pains are similar to those of a herniated disc, since the severity of the pain syndrome depends not only on the size, but also on the location of the protrusion or hernia.
Spondylosis of the spine
Excessive loads and degenerative-dystrophic processes in the spine can lead to ossification of cartilage tissue, which is saturated with calcium salts and turns into sharp coracoid bone outgrowths or growths that arise along the periphery of the vertebral bodies. With the progression of the process, these outgrowths can merge with the same growths on the body of adjacent vertebrae. Over time, all vertebrae grow together with each other, the spine loses its flexibility and elasticity. The pain occurs due to irritation of the spinal cord and its roots, reactive inflammation and dystrophy of the soft tissues, ligaments and muscles surrounding the spine.
Radiculitis
Radiculitis is called intense 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 in the area of the buttocks, perineum, thighs and lower legs are possible. Launched sciatica leads to muscle atrophy and weakness. A characteristic symptom is shooting pains along the sciatic nerve, aggravated by movement, lifting weights and in cold weather. This condition is called sciatica or sciatica.
Spine 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. The gradual decay of bone tissue is accompanied by necrosis - this picture is also typical for spinal tuberculosis. Pain can occur both due to irritation of the nerve endings, and due to 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 nerves caught in the area of inflammation, or by the growth of nerve trunks by a tumor.
Back muscles ache along the spine
Well-developed back muscles are a sign of a healthy spine, since the muscle corset relieves some of the stress and additionally stabilizes the spine. In chronic diseases of the spine, the muscles are subject to excessive loads, which weak and atrophied muscles are not able to withstand. As a result, muscle spasm occurs, and due to metabolic disorders in muscles and pain. This condition is called myofascial syndrome, which is characteristic of osteochondrosis of the spine, hernias and protrusions of the intervertebral discs.
Postoperative pain
Spine surgeries are usually accompanied by extensive trauma - to stabilize and restore the integrity of the vertebrae, doctors can resort to installing metal structures, screwing screws into the vertebrae and removing nonviable tissue. The pain in this case is due not only to the disease itself, but also to the surgery. With proper rehabilitation and postoperative care, the pain will gradually disappear. However, if in the postoperative period you neglect the instructions of doctors and ignore the obligatory 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. At the first stage, a neurological examination, a patient survey, a study of reflexes and symptoms are carried out. An experienced and competent doctor knows well what diseases the back and spine pain has for certain reasons and characteristic features.
Back pain for no apparent reason should be especially vigilant. This can be with reflected pains of other organs and systems, with tumors and diseases of the spinal cord.
To find out why the back and spine hurt, a neuropathologist may prescribe magnetic resonance imaging. It is the most effective and safest method for diagnosing almost all possible causes of back pain. The procedure is based on the ability of magnetic fields and radio waves to give clear and detailed images of the spine and spinal cord without the use of X-rays and other harmful factors.
How to relieve spinal pain
To relieve, but not treat, back pain, let us take analgesics 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 likelihood of which increases with prolonged use. That is why it is important not to postpone the visit to the doctor and examination for later.treatmentdiseasesspineand reasonsback pain.
Spine pain treatment
As stated at the very beginning, the effectiveness of back pain treatment depends on how accurately the diagnosis was made. Despite the obviousness, many patients "cure" pain for years, but not the disease itself, each time postponing a visit to a doctor, turning to traditional healers, osteopaths, and chiropractors. Moreover, for some diseases of the spine, such procedures are not only contraindicated, but also dangerous.
There are effective and scientifically proven treatments for variousspeciesdiseases causingback pain. . . Many of these require the patient's perseverance and perseverance 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 this, with hard training and physical exercises that a neurologist will show you.
Which doctor should I contact for pain in the spine?
Back pain is one of the most common neurological symptoms that occurs due to the involvement of the nerves and 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. Based on the results of the examination and magnetic resonance imaging, you may need to consult another doctor. If back pain is caused by heart disease, the patient is referred to a cardiologist, if the problem is in the digestive tract, to a gastroenterologist. But most often the pain syndrome is associated precisely with the pathology of the spine.