Back pain

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

One of the reasons for such a widespread symptomatology is a sedentary lifestyle, limited physical activity and excessive load on the spine. In addition, the reason lies in nutrition, an unreasonable diet, lack of calcium and essential vitamins reduce the stability of the spine, tone and elasticity of the muscles adjacent to it. As a rule, primary acute back pain goes away within a month, if the cause of the pain symptom is not eliminated, the disease becomes chronic.

Back pain is conventionally divided into the following subjective indicators:

• Sharp, sudden back pain;
• Pain that increases quite quickly;
• Dull, aching pain;
• Back pain is transient and recurrent;
• Pain with irradiation (to the arm, leg, to the heart area);
• Pain causing reflex incontinence of urine and feces;
• Pain with numbness in the tips of the fingers or toes;
• Back pain radiating to the groin;
• Severe pain, even to the point of pain shock.

Painful sensations in the back area can occur when sneezing, coughing, turning sharply, changing body position, physical activity - bending, squatting, lifting weights.

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Back pain, what does it signal, what diseases can it indicate?

The most common causes are the following pathologies:

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

Normally, after 30-35 years, the disc nucleus naturally begins to shrink, losing elasticity. There comes a time when the nucleus completely dissolves and the height of the disc decreases, and accordingly, the shock-absorbing properties are reduced. During the period of reduction of the mass of the nucleus, the fibrous ring begins to deform and become covered with cracks, into which the nucleus is pressed. The nerve endings of the fibrous ring and longitudinal ligaments are subjected to additional stress, therefore, pain appears. Back pain initially occurs in the lumbar region, then begins to move down - to the legs. The altered intervertebral disc cannot provide a normal junction of the bodies of nearby vertebrae, they, compensating, shift. When shifting, the surrounding muscles are subjected to pressure, the nerve endings of which also react to the deformation with pain. If regular loads do not stop, the vertebrae compensate for their deformation by building up osteophytes (reactive processes). The terminal stage of this destructive process is a complete rupture of the fibrous ring, which leads to the nucleus falling out of the disk. In this situation, back pain becomes especially acute, since one of the largest nerves is compressed - the sciatic nerve. Sciatic pain radiates to the leg, so, in addition to back pain, another problem appears - the impossibility of active movement. The most dangerous is considered to be damage to the "horse's tail" - a bundle of nerve endings in the coccyx area. This can end in partial or complete paralysis of the legs, impaired defecation and urination. Such pathological changes sometimes progress and spread to other vertebrae. Osteophytes build up, the spine is deformed as a whole, spondylosis develops.

Back pain can be caused by other reasons, including secondary deformation of the intervertebral discs. Spinous formations appear on the lateral parts of the vertebral body as compensation for the compression of the anterior longitudinal ligaments by the disc. The intervertebral joints are also deformed, and a functional block occurs. The consequence of this process is spondyloarthrosis.

Less common causes of back pain may include:

• Defects, changes in the structure of the spine associated with congenital pathology (deficiency, insufficient number of vertebrae);
• Lumbarization of the sacral region of the spine, when the first vertebra of the sacral region replaces the sixth vertebra of the lumbar region;
• Sacralization, a deficiency of vertebrae, when the fifth lumbar vertebra replaces the first sacral;
• Spondylolysis (spondylolisthesis) is a complete failure of the interarticular arches to close or a forward shift of the body of the deformed vertebra;
• Bechterew's disease;
• Osteoporosis;
• Oncologic process, metastases;
• Staphylococcal bone infection;
• Tuberculosis;
• Gynecological pathologies;
• Pathological diseases of the prostate, infection of the urethra;
• Kidney pathology, stones;
• Bleeding into the pelvic area;
• Abdominal aortic aneurysm;
• Herpes zoster.

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How is back pain treated?

Treatment of back pain depends on the diagnosis and concomitant diseases. As a rule, these are classic NSAIDs – non-steroidal anti-inflammatory drugs, in the dosage form that will be most effective – tablets or injections. Prescription of analgesics is mandatory, possibly application of pain-relieving compresses, novocaine blockades. If muscles are damaged, muscle relaxants are prescribed. It is also advisable to use chondroprotectors – drugs that activate the production of basic cartilage substances. Physiotherapy, acupuncture and other non-drug methods are not the main ones, they are effective as auxiliary ones, consolidating the main therapeutic effect.

Back pain is a serious symptom that should not be ignored. The sooner the cause of pain in this area is identified, the faster and more effective the therapeutic process is, which means the risk of serious complications is minimized.

How to recognize back pain?

• General examination and anamnesis;
• Laboratory tests – blood, urine, to determine a possible inflammatory process;
• X-ray, CT, MRI;
• Ultrasound of nearby organs;
• Puncture (if necessary)