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

According to statistics, every second adult has a aching backache at least once in his life: the intensity and localization of such pain may be different, as well as the cause. Soreness in the neck, chest or lower back is most often caused by osteochondrosis. In second place are injuries or other diseases affecting the spine, muscular system, and internal organs.

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

Causes of the aching back pain

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

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

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

In addition, back pain can be caused by myositis, infectious-inflammatory or neoplastic processes.

Risk factors

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

• Age.

Intervertebral discs are prone to abrasion, or slow wear: over the years, the discs become dehydrated, they have a constant and sometimes very strong weight effect.

• Hypodynamia, long sitting position.

Low physical activity causes a number of negative changes:

1. muscles lose elasticity, weaken;
2. increases the load on the spine;
3. weakens the muscles of the abdomen, changes the shape of the pelvis, which further increases the load on the back;
4. excess weight appears, the abdomen increases, which leads to the deflection of the spinal column anteriorly and the appearance of additional stress.

• Wrong posture.

Disturbed position of the back, sitting for many hours are also considered to be the basic factors for the appearance of aching back pain.

• Features of genetics.

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

• Professional features.

Hard work, carrying and lifting weights, as well as work that is associated with frequent turning and bending of the body, increases the risk of constant back pain. An additional damaging factor is vibration — for example, for tractor drivers.

• Incorrect biomechanics, injuries.

Improper exercise, improper approaches to sports equipment and exercise equipment, incorrect height of the bicycle seat and / or handlebars, gymnastic injuries and other similar factors increase the degree of wear of the intervertebral discs.

• Gestation period

Aching pains in the back during pregnancy are caused by a shift in the internal organs, a change in the distribution of weight towards the front, weakness of the ligaments of the pelvic region. The uterus grows and increases in size, the woman can also increase body weight: the spinal column begins to overload, which is manifested by pains of varying intensity.

• Unhealthy lifestyle, kidney problems.

Smoking, alcohol abuse, poor diet can cause poor circulation, kidney disease, which is also manifested by back pain.

Symptoms

Back pain can bother in different ways and in different places. Against osteochondrosis, moderate aching back pain under the shoulder blades is more pronounced during physical exertion, coughing, sneezing. In some patients, it gives to the lower limb, or even to the region of the heart (which creates the impression of heart pain).

In case of intervertebral hernia, aching pain in the back appears in the shoulder blades or along the spinal column, which increases with changing body position, when trying to move and even while walking. Often, discomfort is felt in the legs: they are numb, cold.

The aching pain in the back and legs is inherent in radiculitis: patients complain of numbness of one or two limbs, unpleasant painful sensations in the buttocks, thighs. A particularly worsening of the problem is observed during walking and when the body bends.

Aching pain in the back above the waist is a long-term consequence of myositis - an inflammatory process in the muscle corset. Pathology is often triggered by strong excessive loads or strong (long) supercooling.

When inflammation of the sciatic nerve appears aching pain in the back below the waist: in the area of the sacrum, buttocks, sometimes even in the ankle joint. Soreness gradually increases, it becomes difficult for a person not only to sit, but also to stand and walk.

The aching pain under the left shoulder blade is often disturbed by intercostal neuralgia: the disease affects the nerve endings located between the ribs. The aching character gradually becomes strong, sharp on inhalation, other additional signs appear in the form of muscle twitches, paresthesias. Only the left side is not always affected: a aching pain can be observed under the right shoulder blade from the back, radiating to the neck and lower back. This lesion requires a thorough differential diagnosis, since such manifestations can easily be confused with diseases of the cardiovascular system.

The aching pain extending to the back is observed in diseases of the heart and the main vascular network. Increasing pain, which as it descends along the spinal column downwards, is characteristic of dissecting aortic aneurysm. Extensive aching in the middle of the back is typical for heart failure. In case of a heart attack, discomfort is localized mainly in the retrosternal region or in the center of the spine.

Aching pain in the back and lower abdomen is a frequent manifestation of a malfunction on the part of the gallbladder. In acute cholecystitis, irradiation is observed in the abdominal region, in the right collarbone, right scapula and / or spine. At the same time, the liver area may be not very painful, or generally painless.

The aching pain in the lower back of the shingles is found in acute or chronic pancreatitis (in the acute stage). It is easy to diagnose such pathology if you pay attention to other existing symptoms (increased pain after eating sweets, alcoholic drinks, fatty foods, as well as nausea after eating). Night aching pain in the stomach, radiating to the back, is typical for lesions of 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 of the right often indicates heart problems. Be sure to determine whether the discomfort is associated with lesions of the spine. If there are heart problems, other symptoms usually bother you: changes in blood pressure and heart rate, increased sweating, blanching of the skin, a state of fear, a feeling of your own heartbeat. In such a situation it is very important to conduct a cardiographic examination in a timely manner for the patient.

Aching pain in the back under the ribs is often a sign of kidney disease - for example, pyelonephritis or urolithiasis. The main symptom: such pain is not associated with abrupt physical activity, change in body position, weight lifting, etc. When urolithic attack, the pain quickly passes into a sharp, radiating along the ureters to the lower abdomen, groin, internal femoral surface.

The aching pain in the sides of the back sometimes appears after intense sports training: in athletes, heavyweights, gymnasts. The cause of such sensations is myalgia due to muscle tension or excessive stress on them. As a rule, the state of the musculature is normalized after a quality rest.

The aching back pain in the left side of the left can be caused by trauma, a long stay in an uncomfortable and wrong position. This problem is in most cases solved by several massages with the use of ointments or gels of a distracting or analgesic effect.

Stretching and aching pain in the back, extending to the leg, often speaks of spondyloarthrosis, a pathology that affects the small joints of the spine. Spondyloarthrosis belongs to the category of arthritic diathesis: the disease can be combined with varying degrees of obesity, diabetes and atherosclerosis. Pain syndrome in this disease is often blurred and manifests itself after a long stay in a fixed state (for example, in the morning, after a rest), as well as after hypothermia or infectious processes. If such a disease goes on for a long time, then the bone tissue grows, and the holes through which the nerves pass are narrowed: the so-called radicular syndrome is formed.

The aching pains in the chest and back occur in heart disease, in spondylopathies, in tuberculous spondylitis. Hormonal spondylopathies are characterized by a change in posture, severe chest kyphosis, pain in the bones of the legs. Tuberculous spondylitis is distinguished not only by the aching, but also by the peculiar boring sensations in the spinal column.

The aching back pain in the thoracic region is more often associated with impaired intervertebral disc structure. The problem can occur against the background of intervertebral hernia, protrusions, and spinal compressor injuries. Discomfort may increase after sleeping on an uncomfortable bed, after prolonged standing, sitting, or physical activity. Many patients have tingling in the limbs, numbness, cold feet.

Aching pain in the muscles of the back is often associated with their physical overstrain, however, it can also be caused by osteochondrosis, as there is an excessive tension of the muscles that support the spine. Muscles are in a state of hypertonus. As a result, the nerves and blood vessels are clamped by tight muscles, which is manifested by aching pain syndrome.

Aching back pain in women

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

• sedentary lifestyle, lack of motor activity, weakness of the muscular system, fragility of the bone tissue, tendency to osteoporosis after 45 years;
• frequent adherence to diets, restriction of food intake, insufficient intake of useful vitamin and mineral substances in the body;
• carrying a child, carrying children frequently, lifting and carrying heavy objects;
• frequent stresses, anxiety, mood changes, feelings and fears.

Many women, even feeling a clear discomfort in the back, do not rush to see a doctor because of their permanent employment: unfortunately, “in itself” in most cases does not have enough time. However, we must not forget that the cause of the pain can be quite serious, and a small but neglected pathology in a few years can transform into a disability. You should not hope that the disease "will pass by itself."

Aching pain in the lower back in men

According to statistics, men are slightly more likely to experience back pain 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 uneven distribution of the load on the spine. Additional factors may also be:

• the presence of bad habits (smoking, alcohol abuse), occupational hazards;
• improper poor nutrition (preferential use of convenience foods, fast food, lack of vitamins and minerals, lack of dairy products in the diet);
• overload of the back, frequent and prolonged physical activity, weight lifting;
• excessive body weight, excessive accumulation of fat in the abdominal area;
• the lack of a good quality rest.

Nature of pain

Back pain may differ not only the cause of the appearance, localization, but also the nature of sensations. For example, patients at a doctor’s appointment often sound the following descriptions of pain syndrome:

• Dull aching pain in the back - they are a symptom of many pathologies, and not only the spinal column, but also the internal organs. Dull painful sensations are 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 "written off" on fatigue, hypothermia, and women associate it with the beginning of a new menstrual cycle. However, permanent discomfort can also have deeper roots: for example, this is observed with hernias, spinal deformities, ankylosing spondylitis, neuritis, pyelonephritis. The exact cause can be found only after diagnostic measures.
• Severe aching back pain can be intermittent, permanent, long-lasting or short-term. May or may not depend on the activity of a person, to pass or not to pass after a prolonged state of rest. A sharp pain in any part of the back requires urgent medical advice.
• Pulling aching backache never occur "on level ground". During infectious processes, they are accompanied by signs of intoxication and an inflammatory reaction, with degenerative processes, injuries and deformities of the spine, neurological symptoms occur (pain in the head, dizziness, sleep disturbances, changes in sensitivity, impaired motor abilities, etc.).

Usually, a medical specialist can make a preliminary diagnosis after hearing the patient's complaints. However, full-length diagnostics should put all the dots on “i”.

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Diagnostics of the aching back pain

Aching pain in the back requires a thorough and competent diagnosis, because the main goal is to find the cause of the violation.

First of all, the doctor will conduct a survey and examination of the patient. He may be interested in the following questions:

• how often pain occurs, how intense they are, where they are located;
• what causes such pain, in the opinion of the patient;
• when and under what circumstances the first painful sensations appeared;
• Does the pain increase when walking, sitting, coughing, etc.;
• is pain relieved after resting;
• whether there were any injuries to the back or spinal column;
• what other symptoms appeared on the background of pain.

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

The patient is tested for blood, urine (to determine the inflammatory process in the body, anemia, kidney disease).

Next is the extended instrumental diagnostics:

• X-ray examination (helps to assess the state of the skeletal system, detect foci of bone degeneration, tumors, traumatic injuries).
• Magnetic resonance imaging study (helps to detect the pathology of soft tissues, hernia, inflammatory processes).
• Osteoscanning (determines the presence of tumor processes, compressor fractures, etc.).
• Nucleography (used primarily before surgery to clarify the location of the damaged disk).
• Myelography (helps in the diagnosis of intervertebral hernia and other injuries of the spinal column).
• Electrodiagnostics (electromyography, allows to evaluate the conductivity of the nerves, detect pinching, diabetic neuropathy, etc.).

Differential diagnosis

Differential diagnosis is carried out taking into account such factors:

• Age.

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

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

• Previously injured.

There is a connection with injury even with the development of osteochondrosis.

• The side of aching pain.

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

• Relief or increased pain when changing position, at rest or activity.

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

During the diagnosis it is important to exclude such pathologies:

• degenerative processes (by the type of osteochondrosis, spondyloarthrosis, spondylosis);
• metabolic disorders (gout);
• infectious and inflammatory processes (psoriatic joint damage, osteomyelitis, etc.);
• internal diseases (diseases of the liver, kidneys);
• malignant processes (prostate cancer, thyroid gland);
• soft tissue diseases (myalgia, tendinitis).

In many cases, the final diagnosis requires consultation of narrow specialists (oncologist, surgeon, spine, neurologist).

Treatment of the aching back pain

Therapeutic measures in case of pain are not always the same, as they depend on the root cause, which led to the problem. The most common use of physiotherapy, exercise therapy, as well as medicines, the action of which is directed to stop the inflammatory process and relieve painful syndrome.

In most diseases, complex therapy is used. Taking pain-relieving drugs does not fully solve the problem: it is also necessary to remove muscle spasms, improve blood circulation and trophism in the affected area, and speed up the regeneration. In conjunction with taking medication, vitamin therapy is prescribed, in which the B-group vitamins play a leading role. They potentiate the effectiveness of nonsteroidal anti-inflammatory drugs, optimize the metabolism in the roots of nerves, improve the passage of nerve impulses.

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

Medications for aching pain

The use of medicines includes a complex of diverse medicines. In case of severe pain and radicular syndrome, the procaine blockade is performed, nonsteroidal anti-inflammatory drugs, muscle relaxants and glucocorticoid drugs are prescribed. Individual patients are recommended to take medications that have restorative properties (Roumalon, Osteochondrin, Hondroxid, etc.).

Ibuprofen	Adult patients take 1-2 tablets every 5 hours, but not more than six tablets per day. It is undesirable to take the drug for more than five days in a row. Prolonged use may adversely affect the state of the digestive system (the risk of developing ulcerative and inflammatory processes increases).
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 intramuscularly in a dose of 15 mg daily for 2–3 days. Treatment may be accompanied by dyspeptic symptoms, increased blood pressure. The development of allergy to the drug is not excluded.
Midocalm	The drug is used only for the treatment of adult patients, in the form of intramuscular injections, 100 mg each morning and evening. Slow intravenous administration in the amount of 100 mg once a day is allowed. Redness and slight swelling may be observed at the injection site.
Chondroxide	This drug is produced in the form of an external agent (gel) or tablets. Ointment is used for rubbing in painful places on the back and joints. Tablets take 500 mg twice a day. Treatment with Hondroxide is always long, at least 3-6 months. Side effects are rare and occur mainly due to the development of allergy to the drug.

[2], [3]

Vitamins

For additional support of the body during the treatment of aching back pain, many doctors advise taking vitamins - and especially the emphasis should be placed on vitamin B. This group helps to eliminate basic neurological problems, accelerates pain relief, relieves numbness and stiffness in joints and the spine..

It is recommended to pay special attention to such vitamin substances:

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

Physiotherapy

Physiotherapy treatment with the appearance of aching back pain is used in all clinics of the relevant profile. Such therapy has repeatedly proved its effectiveness, accelerating the recovery of the body and facilitating rehabilitation.

Procedures improve muscle tone, relieve spasm from excessive tension, regenerate damaged tissue, have a complex positive effect on the body. Sessions may include exposure to high and low temperatures, ultrasonic vibrations, a magnetic field, electric current, a laser, etc.

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

Among the most common methods that are used for aching back pain, we can distinguish the following:

• electromyostimulation;
• electro and phonophoresis;
• UHF-therapy;
• paraffin wax;
• ultrasound exposure;
• magnetotherapy.

Specific therapeutic effects have radon baths. 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 in pain in the back.

Alternative treatment

Alternative remedies for aching back pain include decoctions, tinctures, and herbal extracts. Such treatment can be initiated only after the appropriate recommendation of the doctor has been received.

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

• Mustard bath. Take mustard powder (200 g), fall asleep in a hot bath. The patient is immersed in the bath for 15 minutes, then wipes well and puts on the warmth. The procedure is best carried out at night.
• Honey-acetic compress. Take 2 tsp. Honey, stirred with 2 tsp. Table vinegar. The resulting mass is spread on a fresh leaf of cabbage and applied to the painful area on the back. The compress is fixed with a warm shawl or towel and left overnight.
• A bag of salt. Warm up the salt in a dry pan, pour it into a canvas bag and apply it to the painful area on the back for warming up. To avoid burns, the bag is not placed directly on the skin, but through a towel or a thick scarf. The procedure is carried out before bedtime.

[4], [5], [6]

Herbal medicine

• The rhizome of horseradish is rubbed on a grate, the resulting mass is evenly distributed over a piece of cotton fabric, applied to the sore back area. Turn on the hair dryer and gently warm the compress for 3 minutes. Next, the compress is removed, and fresh and clean leaves of horseradish are applied to the back, fixed with a woolen scarf or towel, left for at least 30 minutes. The procedure is best performed at bedtime.
• Freshly picked dandelion flowers are poured into a glass container of 1 l, 0.5 l of vodka is poured. The container is covered with a lid and kept in the dark for 10 days, sometimes mixing the contents. Tincture is used for rubbing with aching pain in the back or joints, up to 4 times per day.
• Inflate a rubber glove on a hand, take 3-4 shoots of freshly picked stinging nettle. Whip the affected area of skin no less than five or six times, before the formation of characteristic traces. The procedure is repeated once a day. You should first check whether the patient is allergic to nettles.
• Take fresh birch leaves, apply them to the back and fix with a bandage or a scarf. Additionally, you can warm 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 drugs are Cel-T and Traumel C.

Traumel is prescribed in the presence of inflammation in the tissues, with gout, traumatic injuries of the bones or muscles.

Goal-T is used in osteochondrosis, spondyloarthrosis, scapulohumeral periarthritis.

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 advise any of the monotherapy drugs:

• Akonitum napelus - will help with lumbago, sciatica.
• Esculeus hippocastanum - eases long aching pains in the lumbar region and sacrum, with the transition to the thigh.
• Agaricus muscarius - is used for back pain, which is aggravated by touching.
• Berberis vulgaris - helps with pain in the lumbar region, with increased discomfort in a sitting or lying position.
• Kaustikum Khanemani - used for aching pain and stiffness in the lumbar region, sacrum.
• Valerian officinalis - is used for pain in the coccyx, aching lumbar pain.

Treatment with homeopathy is considered relatively safe: the only contraindication to use is the presence of an allergy to the selected drug.

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Surgery

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

The cause of the pain syndrome is different, so often the intervention of the surgeon is required in such cases:

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

If the disease progresses, the soreness becomes more intense, neurological disorders appear, then a planned operation can be scheduled, the essence of which depends on the original cause of the problem.

Complications and consequences

What can happen if you do not heal a aching back pain and do not consult a doctor? In this situation, the pathology will progress, which will lead to deterioration, aggravation of pain, loss of ability to work.

The consequences of ignoring pain may be the most unfavorable:

• the problem will become chronic, spread to other tissues, and further treatment will be more difficult and costly;
• a disease that previously could have been resolved with medication, may require surgical intervention;
• in case of loss of working ability, disability and permanent lying position of the patient (loss of motor ability) may follow;
• the disease can affect the internal organs (urinary problems often appear, sexual dysfunctions occur, limb sensitivity is affected).

We should not expect that the aching back pain will pass on its own - it is better to consult a doctor, and the sooner this is done, the better.

Consultation with a medical professional should be urgent in such situations:

• if the aching pain lasts more than 2-3 days;
• if the aching pain gradually increases;
• if the pain becomes a hindrance to the performance of domestic and professional duties;
• if there are additional problems in the limbs, in the groin;
• if there are problems with urination, bowel movements;
• if the temperature rises;
• if the aching back pain is not very worried, however, the loss of body weight has become noticeable.

[9], [10]

Prevention

Prevention of aching back pain is not specific, however, it can effectively prevent the problem in both young and old age.

• To ease the load on your back in life, it is advisable to move as actively as possible, do not sit in one place for a long time, 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.
• Simultaneously with the back muscles, the abdominal muscles should be strengthened.
• It is necessary to improve the quality of night rest: for the prevention of aching back pain, it is better to sleep on a hard orthopedic mattress. The correct mattress will help the spine to relax during sleep.
• Women need to wear shoes with high heels or platform as rarely as possible. If back pain already exists, then you should pay attention to special orthopedic shoes.

Human nutrition is also of considerable importance. A diet enriched with vitamins and minerals will help the body to quickly restore tissue, strengthen the immune defense.

[11], [12]

Forecast

The prognosis for pain in the back is most often favorable. However, the quality of the forecast is directly dependent on the original root cause of the problem. According to statistics, nine out of ten patients have a primary recovery already within a couple of weeks: the pain subsides. Only less than 5% of cases have to apply surgery.

For chronic pain is characteristic wave-like course, with periods of exacerbation and improvement.

Constant aching pain in the back can cause a deterioration in the ability to work, a decrease in sensory and motor activity. Individual patients may develop depression.

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