Aching pain in the back: right, left side, lower back, under the shoulder blades

According to statistics, every second adult has had aching back pain at least once in their life: the intensity and localization of such pain can vary, as can the cause. Pain in the neck, chest or lower back is most often caused by osteochondrosis. In second place are injuries or other diseases affecting the spinal column, muscular corset, internal organs.

Most often, people with insufficient physical activity, obesity, or those who have to deal with lifting and carrying heavy objects seek help for constant aching back pain. The causes of pain are different, so the treatment for this condition is also always different.

Causes aching back pain

Perhaps the most common cause of aching back pain is osteochondrosis. In particular, the well-known radiculitis is nothing more than a consequence of osteochondrosis. The disease is characterized by structural disorders in the spine: cartilage tissue is affected, nerve roots are pinched. Such changes are most often associated with age, but heavy physical exertion and the specifics of professional activity also play a significant role in the painful process.

Another common cause of aching pain is instability of the spinal column. Lack of stability is not a diagnosis, but a condition in which a person begins to feel back pain when changing the position of the body: due to the weakness of certain muscles, individual vertebrae shift, pressing on the nerve roots, which causes acute or aching pain.

Lack of readiness for physical activity, muscle and spine overload also lead to back pain. No less dangerous are prolonged static loads - for example, prolonged sitting or standing in one position.

In addition, back pain can be caused by myositis, infectious and inflammatory or tumor processes.

Risk factors

Aching back pain can occur in almost any person. Most often, pain occurs under the influence of certain factors, which can act both immediately and gradually, over many years. Let's try to consider such factors in more detail.

• Age.

Intervertebral discs are subject to abrasion, or slow wear: over the years, the discs become dehydrated and are subject to constant and sometimes very strong weight impact.

• Hypodynamia, prolonged sitting position.

Low physical activity causes a number of negative changes:

1. muscles lose elasticity and become weak;
2. the load on the spinal column increases;
3. the abdominal muscles weaken, the shape of the pelvis changes, which further increases the load on the back;
4. excess weight appears, the belly grows, which leads to a forward bend of the spinal column and the occurrence of additional stress.

• Incorrect posture.

Improper back posture and sitting for many hours are also considered basic factors in the appearance of aching back pain.

• Features of genetics.

There are people who are more susceptible to back problems than others. There is such a thing as defects in the structure of the spine associated with a gene mutation. For example, the COL9A2 gene is responsible for the production of collagen, an important component that provides elasticity to cartilage and vertebral discs. With a lack of collagen, the process of disc wear occurs faster.

• Professional features.

Heavy work, carrying and lifting heavy objects, as well as work that involves frequent turns and bends of the body, increases the risk of developing constant back pain. Vibration is an additional damaging factor – for example, in tractor drivers.

• Incorrect biomechanics, injuries.

Incorrect performance of physical exercises, incorrect approaches to sports equipment and exercise machines, incorrect height of the bicycle seat and/or handlebars, gymnastic injuries and other similar factors increase the degree of wear of the intervertebral discs.

• Pregnancy period.

Aching back pain during pregnancy is caused by the displacement of internal organs, a change in the distribution of weight in the forward direction, and weakness of the ligamentous apparatus of the pelvic region. The uterus grows and increases in size, and a woman's body weight may also increase: the spinal column begins to overload, which manifests itself in pain of varying intensity.

• Unhealthy lifestyle, kidney problems.

Smoking, alcohol abuse, and poor nutrition can cause circulatory problems, kidney disease, which also manifests itself as back pain.

Symptoms

Back pain can be disturbing in different ways and in different places. Against the background of osteochondrosis, moderate aching back pain under the shoulder blades is more pronounced during physical activity, coughing fits, sneezing. In some patients, it radiates to the lower limb, or even to the heart area (which creates the impression of heart pain).

With an intervertebral hernia, there is a nagging pain in the back in the shoulder blades or along the spinal column, which intensifies when changing the position of the body, when trying to move and even while walking. Often, discomfort is felt in the legs: they go numb, freeze.

Aching pains in the back and legs are typical of radiculitis: patients complain of a feeling of numbness in one or two limbs, unpleasant painful sensations in the buttocks and thighs. The problem is especially aggravated when walking and bending the body.

Aching pain in the back above the waist can be a remote consequence of myositis - an inflammatory process in the muscular corset. The pathology is often provoked by strong excessive loads or strong (long-term) hypothermia.

When the sciatic nerve is inflamed, there is a nagging pain in the back below the waist: in the sacrum, buttocks, sometimes even in the ankle joint. The pain gradually increases, it becomes difficult for a person not only to sit, but also to stand and walk.

Aching pain under the left shoulder blade from the back often bothers with intercostal neuralgia: the disease affects the nerve endings located between the ribs. The pain of a aching nature gradually becomes strong, sharp on inhalation, other additional signs appear in the form of muscle twitching, paresthesia. Not always only the left side is affected: aching pain under the right shoulder blade from the back, with irradiation to the neck, lower back, can be observed. This lesion requires careful differential diagnostics, since such manifestations can easily be confused with diseases of the cardiovascular system.

Aching pain radiating to the back is observed in diseases of the heart and main vascular network. Increasing pain, which seems to descend along the spine downwards, is characteristic of a dissecting aortic aneurysm. Extensive aching pain in the middle of the back is typical of heart failure. In case of a heart attack, discomfort is localized mainly in the sternal region or in the center of the spine.

Aching pain in the back and lower abdomen is a common symptom of a gallbladder problem. In acute cholecystitis, irradiation to the abdominal area, right collarbone, right shoulder blade and/or spinal column is observed. In this case, the liver area may be slightly painful or completely painless.

Aching pain in the lower back of a girdle nature is found in acute or chronic pancreatitis (at the stage of exacerbation). It is easy to diagnose such a pathology if you pay attention to other existing symptoms (increased pain after eating sweets, alcoholic drinks, fatty foods, as well as nausea after eating). Aching pain in the stomach at night, radiating to the back, is typical for damage to the body and tail of the pancreas: tumor processes often become the cause of the problem, but painful manifestations are characteristic of them only in the late stages of the pathology.

Aching pain in the back on the right side often indicates heart problems. It is necessary to determine whether the discomfort is associated with a lesion of the spine. If there are problems with the heart, then other symptoms are usually of concern: changes in blood pressure and heart rate, increased sweating, pale skin, a state of fear, a feeling of one's own heartbeat. In such a situation, it is very important to conduct a cardiographic examination of the patient in a timely manner.

Aching pain in the back under the ribs often becomes a sign of kidney disease - for example, pyelonephritis or urolithiasis. The main sign: such pain is not associated with sudden physical activity, a change in body position, lifting weights, etc. During an attack of urolithiasis, the pain from aching quickly turns into sharp, with irradiation along the ureters to the lower abdomen, groin, inner thigh surface.

Aching pain in the sides of the back sometimes appears after intensive sports training: in track and field athletes, heavyweights, gymnasts. The cause of such sensations is myalgia, caused by muscle tension or excessive load on them. As a rule, the condition of the muscles normalizes after quality rest.

Aching pain in the back on the left side can be caused by trauma, prolonged stay in an uncomfortable and incorrect position. In most cases, such a problem is solved by several massage sessions using ointments or gels with a distracting or pain-relieving effect.

A nagging and aching pain in the back, radiating to the leg, often indicates spondyloarthrosis, a pathology that affects the small joints of the spinal column. Spondyloarthrosis is classified as an arthritic diathesis: the disease can be combined with varying degrees of obesity, diabetes and atherosclerosis. The pain syndrome in this disease is often blurred and manifests itself after a long stay in a motionless state (for example, in the morning, after rest), as well as after hypothermia or infectious processes. If such a disease lasts a long time, then the bone tissue grows, and the openings through which the nerves pass narrow: the so-called radicular syndrome is formed.

Aching pains in the chest and back occur with heart disease, spondylopathy, and tuberculous spondylitis. Hormonal spondylopathy is characterized by changes in posture, pronounced thoracic kyphosis, and pain in the bones of the legs. Tuberculous spondylitis is characterized not only by aching, but also by a peculiar drilling sensation in the spinal column.

Aching back pain in the thoracic region is often associated with disorders of the structure of the intervertebral discs. The problem can occur against the background of intervertebral hernias, protrusions, compression injuries of the spine. Discomfort can increase after sleeping on an uncomfortable bed, after prolonged standing, sitting or physical activity. Many patients experience tingling in the limbs, numbness, cold feet.

Aching pain in the back muscles is often associated with their physical overexertion, but can also be caused by osteochondrosis, as there is excessive tension in the muscles that support the spine. The muscles are in a state of hypertonicity. As a result, the nerves and blood vessels are pinched by tense muscles, which manifests itself as aching pain syndrome.

Aching back pain in women

Women may have back problems for various reasons. Doctors note that most often problems occur under the influence of such factors:

• sedentary lifestyle, lack of physical activity, weakness of the muscular corset, brittle bone tissue, tendency to osteoporosis after 45 years;
• frequent dieting, restriction of food intake, insufficient intake of beneficial vitamins and minerals;
• carrying a child, frequently carrying children in one's arms, lifting and carrying heavy objects;
• frequent stress, anxiety, mood swings, worries and fears.

Many women, even having felt obvious discomfort in the back, are in no hurry to see a doctor due to their constant busyness: unfortunately, in most cases, there is not enough time “for yourself”. However, we must not forget that the cause of the pain can be quite serious, and a small but neglected pathology can transform into disability in a few years. Do not hope that the disease will “go away on its own”.

Aching pain in the lower back in men

According to statistics, men experience back pain somewhat more often than women. This is mainly due to the fact that men are more physically active, sometimes they have to work for a long time in a tense, uncomfortable and asymmetrical position, with an uneven distribution of the load on the spine. Additional factors can also be:

• the presence of bad habits (smoking, alcohol abuse), occupational hazards;
• improper, irrational nutrition (predominant consumption of semi-finished products, fast food, lack of vitamins and minerals, absence of dairy products in the diet);
• back strain, frequent and prolonged physical activity, lifting weights;
• excess body weight, excessive accumulation of fat deposits in the abdominal area;
• lack of proper, quality rest.

Nature of pain

Back pain can differ not only in the cause of its occurrence, localization, but also in the nature of the sensations. For example, patients at a doctor's appointment often voice the following descriptions of the pain syndrome:

• Dull aching pain in the back - they are a symptom of many pathologies, and not only of the spinal column, but also of internal organs. Dull pain sensations can be primary (associated with problems in the spine) or secondary (associated with diseases of internal organs, tumor processes, curvature of the spine, etc.).
• Constant aching back pain is often attributed to overwork, hypothermia, and women associate it with the beginning of a new menstrual cycle. However, constant discomfort can have deeper roots: for example, this is observed with hernias, deformations in the spine, with ankylosing spondylitis, neuritis, pyelonephritis. The exact cause can only be determined after diagnostic measures.
• Severe aching back pain can be periodic, constant, long-term or short-term. It may or may not depend on a person’s activity, and may or may not go away after a long period of rest. Sharp pain in any part of the back requires urgent medical consultation.
• Nagging aching pains in the back never appear "out of the blue". In infectious processes, they are accompanied by signs of intoxication and inflammatory reaction, while degenerative processes, pinching and deformations of the spine cause neurological symptoms (headaches, dizziness, sleep disturbances, changes in sensitivity, impaired motor abilities, etc.).

Usually, a medical specialist can make a preliminary diagnosis after listening to the patient's complaints. However, a full-scale diagnosis should dot all the i's.

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Diagnostics aching back pain

Aching back pain requires careful and competent diagnosis, because the main goal is to find the cause of the disorder.

First of all, the doctor will interview and examine the patient. He may be interested in the following questions:

• how often the pain occurs, how intense it is, where it is localized;
• what is the cause of such pain, in the patient’s opinion;
• when and under what circumstances did the first painful sensations appear;
• does the pain increase when walking, sitting, coughing, etc.;
• does the pain get better after rest;
• have there been any previous injuries to the back or spinal column;
• what other symptoms appeared against the background of pain.

After the survey and examination, the doctor prescribes laboratory and instrumental diagnostics.

The patient takes blood and urine tests (to determine the inflammatory process in the body, anemia, kidney disease).

Next, extended instrumental diagnostics are carried out:

• X-ray examination (helps to assess the condition of the skeletal system, detect foci of bone degeneration, tumors, traumatic injuries).
• Magnetic resonance imaging (helps to detect soft tissue pathologies, hernias, inflammatory processes).
• Osteoscanning (determines the presence of tumor processes, compression fractures, etc.).
• Nucleography (used primarily before surgical interventions to clarify the location of the damaged disc).
• Myelography (helps in the diagnosis of intervertebral hernia and other injuries of the spinal column).
• Electrodiagnostics (electromyography, allows to evaluate nerve conductivity, detect pinched nerves, diabetic neuropathy, etc.).

Differential diagnosis

Differential diagnostics is carried out taking into account the following factors:

• Age.

In older patients, the risk of developing aching back pain is always higher, and the connection is most often traced to osteochondrosis and osteoarthrosis. In addition, with age, the risk of developing malignant tumors increases significantly.

In young people, back pain is most often associated with injuries, physical overexertion. In addition, spondyloarthropathy is a common cause.

• Previous injury.

There is a connection with trauma even in the development of osteochondrosis.

• The side of aching pain.

Pain on only one side of the back is typical for osteochondrosis, and pain on both sides is typical for osteochondropathy.

• Pain relief or increase with changes in position, at rest or during activity.

Osteochondrosis is characterized by increased pain in a sitting position and during movements, and relief in a lying position. With spondyloarthropathy, aching pain increases in a calm state and is relieved during movements.

During diagnostics, it is important to exclude the following pathologies:

• degenerative processes (such as osteochondrosis, spondyloarthrosis, spondylosis);
• metabolic disorders (gout);
• infectious and inflammatory processes (psoriatic joint disease, osteomyelitis, etc.);
• internal diseases (liver and kidney diseases);
• malignant processes (prostate cancer, thyroid cancer);
• soft tissue diseases (myalgia, tendinitis).

In many cases, a final diagnosis requires consultation with specialists (oncologist, surgeon, vertebrologist, therapist, neurologist).

Treatment aching back pain

Treatment measures for pain are not always the same, as they depend on the underlying cause that led to the problem. The most common are physiotherapy, exercise therapy, and medications, the action of which is aimed at stopping the inflammatory process and relieving the pain syndrome.

For most diseases, complex therapy is used. Taking pain-relieving medications does not solve the problem completely: it is also necessary to relieve muscle spasms, improve blood circulation and trophism in the affected area, and accelerate regeneration. In combination with medication, vitamin therapy is prescribed, in which B vitamins play a leading role. They potentiate the effectiveness of non-steroidal anti-inflammatory drugs, optimize metabolism in nerve roots, and improve the passage of nerve impulses.

During the recovery stage, it is recommended to undergo a course of massage therapy and physiotherapy.

Medicines for aching pain

The use of medications includes a complex of various drugs. In case of severe pain and radicular syndrome, a novocaine blockade is performed, non-steroidal anti-inflammatory drugs, muscle relaxants and glucocorticoids are prescribed. Some patients are recommended to take drugs with restorative properties (Rumalon, Osteochondrin, Chondroxide, etc.).

Ibuprofen	Adult patients take 1-2 tablets every 5 hours, but no more than six tablets per day. It is not advisable to take the drug for more than five days in a row. Long-term use may negatively affect the digestive system (increases the risk of ulcerative and inflammatory processes).
Ortofen	Adult patients take 75-150 mg per day, divided into two or three doses, preferably before meals. Ortofen can cause nausea, abdominal pain, allergic reaction.
Meloxicam	Patients are administered 15 mg intramuscularly daily for 2-3 days. Treatment may be accompanied by dyspeptic symptoms, increased blood pressure. The development of an allergy to the drug is not excluded.
Mydocalm	The drug is used only for the treatment of adult patients, in the form of intramuscular injections, 100 mg in the morning and evening. Slow intravenous administration of 100 mg once a day is allowed. Redness and slight swelling may be observed at the injection site.
Chondroxide	This drug is available as an external agent (gel) or tablets. The ointment is used for rubbing into painful areas on the back and joints. The tablets are taken 500 mg twice a day. Treatment with Chondroxide is always long-term, at least 3-6 months. Side effects are rare and manifest themselves mainly in the development of an allergy to the drug.

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Vitamins

For additional support of the body during the treatment of aching back pain, many doctors recommend taking vitamins - and especially the B vitamin group. It is this group that helps eliminate the main neurological problems, accelerates the relief of pain syndrome, eliminates numbness and stiffness in the joints and spine.

It is recommended to pay special attention to the following vitamin substances:

• Thiamine, or B ₁ – improves the quality of nerve tissue and helps relieve back pain.
• Pyridoxine, or B ₆ – optimizes the function of the nervous system.
• Cyanocobalamin, or B ₁₂ – accelerates the restoration of damaged tissues.
• Vitamin D – facilitates the assimilation and absorption of minerals necessary for the body: calcium, magnesium, phosphorus.
• Ascorbic acid – stops oxidative processes in damaged tissues, helps to slow down inflammation, optimizes metabolism, helps to synthesize collagen fibers. Ascorbic acid is best taken in combination with vitamins A and E: the production of collagen, necessary for the bone and cartilage system, will be even more intense.

Physiotherapy treatment

Physiotherapy treatment for aching back pain is used in all clinics of the corresponding profile. Such therapy has repeatedly proven its effectiveness, accelerating the recovery of the body and facilitating rehabilitation.

The procedures improve muscle tone, relieve excess spasm tension, regenerate damaged tissue areas, and have a complex positive effect on the body. Sessions may include exposure to high and low temperatures, ultrasound vibrations, magnetic fields, electric current, lasers, etc.

Physiotherapeutic methods have a multifaceted effect on the human body, almost never cause complications or side effects, and also consolidate the effect of drug treatment.

Among the most common methods used for aching back pain, the following can be distinguished:

• electrical myostimulation;
• electro and phonophoresis;
• UHF therapy;
• paraffin applications;
• ultrasonic action;
• magnetic therapy.

Radon baths have a specific therapeutic effect. The essence of such procedures is as follows. During the decay of radon gas, α-radiation affects protein chemical activity, which has a calming effect on the nervous system.

Salt and pine baths, hydrogen sulphide and sulphide baths, and contrast douches are considered useful for back pain.

Folk remedies

Folk remedies for aching back pain include decoctions, infusions and herbal extracts. You can start such treatment only after receiving the appropriate recommendation from a doctor.

The following recipes are excellent for warming up the painful area of the back:

• Mustard bath. Take mustard powder (200 g), pour it into a hot bath. The patient is immersed in the bath for 15 minutes, then wipes himself well and dresses warmly. It is better to do the procedure at night.
• Honey and vinegar compress. Take 2 teaspoons of honey, mix with 2 teaspoons of table vinegar. Spread the resulting mass on a fresh cabbage leaf and apply to the painful area on the back. Fix the compress with a warm shawl or towel, leave overnight.
• A bag of salt. Heat the salt in a dry frying pan, pour it into a canvas bag and apply it to the painful area on the back to warm it up. To avoid burns, the bag is not placed directly on the skin, but through a towel or thick scarf. The procedure is carried out before bedtime.

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Herbal treatment

• Horseradish rhizome is grated, the resulting mass is evenly distributed over a piece of cotton fabric and applied to the sore area of the back. Turn on the hair dryer and gently warm the compress for 3 minutes. Then remove the compress and apply fresh and clean horseradish leaves to the back, fix with a woolen scarf or towel, and leave for at least 30 minutes. It is better to perform the procedure before going to bed.
• Freshly picked dandelion flowers are poured into a 1 liter glass container and 0.5 liters of vodka are added. The container is covered with a lid and kept in the dark for 10 days, occasionally stirring the contents. The tincture is used for rubbing for aching pain in the back or joints, up to 4 times a day.
• Inflate a rubber glove on your hand, take 3-4 shoots of freshly picked stinging nettle. Whip the affected area of skin at least five or six times until characteristic marks form. Repeat the procedure once a day. First, check whether the patient is allergic to nettles.
• Take fresh birch leaves, apply them to the back and secure with a bandage or scarf. Additionally, you can warm up the affected area with a hair dryer or a warm bag of salt.

Homeopathy

Of the complex homeopathic remedies for back pain, the most widely used are Ziel-T and Traumeel S.

Traumeel is prescribed for inflammation in tissues, gout, traumatic injuries to bones or muscles.

Ziel-T is used for osteochondrosis, spondyloarthrosis, and scapulohumeral periarthritis.

The drugs are available in the form of injections and ointments, so they can be alternated with each other: this will only increase the effectiveness of the treatment.

In addition, a homeopathic doctor may also recommend one of the following mono-drugs:

• Aconitum napellus – helps with lumbago and sciatica.
• Aesculus hippocastanum – relieves prolonged aching pain in the lumbar and sacral region, moving to the hip.
• Agaricus muscarius - used for back pain that gets worse when touched.
• Berberis vulgaris - helps with pain in the lumbar region, with increased discomfort in a sitting or lying position.
• Causticum Hanemani - used for aching pain and rigidity in the lumbar and sacral regions.
• Valeriana officinalis - used for pain in the coccyx, aching lumbar pain.

Homeopathic treatment is considered relatively safe: the only contraindication to use is an allergy to the chosen drug.

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Surgical treatment

Surgical intervention may be recommended in situations where conservative and drug therapy methods do not produce the desired result, and constant aching back pain leads to a deterioration in the patient’s quality of life.

The cause of pain syndrome can be different, so most often surgical intervention is required in the following cases:

• for chronic aching back pain caused by intervertebral hernia, spinal canal stenosis, spondylolisthesis, traumatic damage to nerve fibers;
• for chronic aching pain caused by degenerative processes in the intervertebral discs.

If the disease progresses, the pain becomes more intense, and neurological disorders appear, then a planned operation may be prescribed, the essence of which depends on the underlying cause of the problem.

Complications and consequences

What can happen if you do not treat aching back pain and do not consult a doctor? In such a situation, the pathology will progress, which will lead to a deterioration in the condition, worsening pain, and loss of ability to work.

The consequences of ignoring pain can be very unfavorable:

• the problem will become chronic, spread to other tissues, and further treatment will be more complex and costly;
• a disease that could previously be treated with medication may now require surgical intervention;
• loss of ability to work may be followed by disability and permanent recumbent position of the patient (loss of motor ability);
• the disease can affect internal organs (problems with urination often appear, sexual disorders arise, sensitivity of the extremities suffers).

Don't expect your aching back pain to go away on its own - it's better to see a doctor, and the sooner it's done, the better.

Consultation with a medical specialist should be urgent in the following situations:

• if the aching pain continues for more than 2-3 days;
• if the aching pain gradually intensifies;
• if pain becomes an obstacle to performing everyday and professional duties;
• if additional problems appear in the limbs, in the groin area;
• if problems with urination or defecation begin;
• if the temperature rises;
• if the aching pain in the back does not bother you much, but weight loss has become noticeable.

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Prevention

Prevention of aching back pain is non-specific, but can effectively prevent the problem in both young and old age.

• To ease the strain on your back at home, it is advisable to move as actively as possible, not to sit in one place for a long time, to do exercises - in particular, you should pay special attention to exercises to strengthen the muscles of the back and lumbar spine. Walking and swimming are also recommended.
• Along with the back muscles, you should also strengthen the abdominal muscles.
• It is necessary to improve the quality of night rest: to prevent aching back pain, it is better to sleep on a firm orthopedic mattress. A properly selected mattress will help the spine relax during sleep.
• Women should wear high-heeled shoes or platforms as little as possible. If back pain already exists, then special orthopedic shoes should be considered.

Human nutrition is also of great importance. A diet enriched with vitamins and minerals will help the body to restore tissues faster and strengthen the immune system.

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Forecast

The prognosis for back pain syndrome is usually favorable. However, the quality of the prognosis directly depends on the initial root cause of the problem. According to statistics, nine out of ten patients experience primary recovery within a couple of weeks: the pain subsides. In less than 5% of cases, surgical intervention is required.

Chronic pain is characterized by a wave-like course, with periods of exacerbation and improvement.

Constant aching back pain can cause a deterioration in work capacity, decreased sensory and motor activity. Some patients may develop depression.

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