Back pain

Back pain is a broad category of symptoms that can indicate completely different diseases. Statistics say that almost 75% of the inhabitants of the planet are familiar with the pain in the back, the age category of those suffering from back pain is not limited by any numbers.

One of the reasons for such a wide spread of symptoms is a sedentary lifestyle, limited motor activity and excessive strain on the spine. In addition, the cause lies in the diet, unreasonable diet, insufficiency of calcium and the necessary vitamins reduce the stability of the spine, the tone and elasticity of the muscles adjacent to it. As a rule, primary acute pains in the back pass within a month, if the cause of the pain symptom is not eliminated, the disease turns into a chronic form.

Back pain is conditionally divided into such subjective indicators: 

• Sharp, sudden pain in the back; 
• Pain that grows quite quickly; 
• Dull, aching pain; 
• Back pain transient with relapses; 
• Pain with irradiation (in the arm, leg, in the heart area); 
• Pain causing reflex incontinence of urine, feces; 
• Pain with numbness in the cones of the fingers or toes; 
• Pain in the back, giving in the groin; 
• Severe pain up to a painful shock.

Painful sensations in the back may occur when sneezing, coughing, sharp bends, changing the position of the body, physical exertion - tilting, squats, lifting weights.

[1], [2], [3], [4], [5]

Back pain, what are they signaling, what diseases can I indicate?

The most common causes are the following pathologies:

• Premature wear, deformation of the intervertebral discs, which are regularly overloaded. The causes of wear can be different - from large body weight, excessive fullness to pathological changes in the structure of bone tissue. In principle, the change in the condition of the disk is a natural and age-related phenomenon.

Normally, after 30-35 years, the nucleus of the disc naturally begins to contract, losing its elasticity. There comes a time when the core dissolves completely and the height of the disk decreases, and the depreciation properties also decrease accordingly. During the reduction of the core mass, the fibrous ring begins to deform and become covered with cracks, into which the core is pressed. Nerve endings of the fibrous ring and longitudinal ligaments undergo additional load, hence painful sensations appear. Back pain initially occurs in the lumbar region, then begin to move downward - to the legs. The altered intervertebral disc can not provide a normal joint of the bodies of nearby vertebrae, they compensate, shift. When the pressure is shifted, the surrounding muscles are exposed, the nerve endings of which also react to deformation by pain. If the regular load does not stop, the vertebrae compensate for their deformation by building osteophytes (reactive processes). The terminal stage of this destructive process is a complete rupture of the fibrous ring, which leads to the loss of the nucleus beyond the boundaries of the disk. In this situation, the pain in the back becomes particularly acute, since one of the largest nerves is squeezed - the sciatic one. Ischialgic pain radiates to the leg, so, in addition to back pain, there is another problem - the impossibility of active movement. The most dangerous is the damage to the "horse tail" - a bundle of nerve endings in the coccyx. This may result in partial or complete paralysis of the legs, a violation of bowel movements and urination. Similar pathological changes sometimes progress and spread to other vertebrae. Osteophytes are growing, the spine deforms as a whole, spondylosis develops.

Back pain may be caused by other causes, including secondary deformation of the intervertebral discs. The spinous formations appear on the lateral parts of the vertebral body, as compensation for the compression of the front longitudinal ligaments by the disc. Deformed and intervertebral joints, there is a functional blockade. A consequence of this process is spondyloarthrosis.

Less common causes of back pain may be: 

• Defects, changes in the structure of the spine, associated with congenital pathology (deficiency, insufficient number of vertebrae); 
• Lumbarization of the sacral zone of the spine, when the first vertebra of the sacral region replaces the sixth vertebra of the lumbar region; 
• Sacralization, vertebral deficiency, when the fifth vertebra of the lumbar region replaces the first sacral vertebra; 
• Spondylolysis (spondylolisthesis) - complete disruption of interarticular archs or shift of the body of the deformed vertebra forward; 
• Bechterew's disease; 
• Osteoporosis; 
• Oncoprocess, metastasis; 
• Staphylococcal bone disease; 
• Tuberculosis; 
• Gynecological pathology; 
• Pathological diseases of the prostate, infection of the urethra; 
• Pathology of the kidneys, concrements; 
• Bleeding to the pelvic region; 
• Aneurysm of the abdominal aorta; 
• Herpes zoster.

[6], [7], [8], [9], [10]

How are back pain treated?

Treatment of back pain depends on the diagnosis and concomitant diseases. Typically, these are classic NSAIDs - non-steroidal anti-inflammatory drugs, in the dosage form that will be most effective - tablets or injections. It is mandatory to prescribe analgesic drugs, possibly applying anesthetic compresses, and novocain blockades. If the muscles are damaged, myelorelaxants are prescribed. It is also advisable to use chondroprotectors - drugs that activate the production of basic cartilage substances. Physiotherapy, acupuncture and other non-pharmacological methods are not basic, they are effective as an auxiliary, fixing the main therapeutic effect.

Back pain is a serious symptom that should not be ignored. The earlier the cause of pain in this area is clarified, the faster and more efficiently the therapeutic process is carried out, which means that the risk of serious complications is minimized.

How to recognize back pain?

• General examination and collection of anamnesis; 
• Laboratory tests - blood, urine, to determine the possible inflammatory process; 
• Radiography, CT, MRI;
• US of nearby organs; 
• Puncture (if necessary)