Severe back pain from below, right and left: causes

Spinal pains - a fairly common symptom that was previously considered a privilege of older people Bent, as they say, in three deaths, grandparents are considered a fairly common occurrence and this does not surprise anyone, because for many years their back had to endure many loads. Only the pain syndrome in the cervical, thoracic and lumbar spine is getting younger every day, while severe back pain is an obstacle to normal life and work ability of a person.

[1]

Causes of severe back pain

In medical terminology, to denote back pain caused by diseases of the spine, there is a separate concept - dorsalgia. This is the so-called pain syndrome, the localization of which can be any part of the spine, so distinguish dorsalgia of the cervical, thoracic and lumbosacral spine. Each kind of dorsalgia has its own causes, and most of them are related to the spine and back muscles. Although it is impossible to exclude other pathologies in which there is an irradiating pain, which patients also respond as pains in the back.

Severe back pain, and any spinal pain, no matter what character it is, is perceived by patients as a rather painful symptom, most often a symptom of diseases of the spine. Pain syndrome of different intensity is characteristic for the following diseases:

• Osteochondrosis is a pathology of a chronic nature that can cover various parts of the spine. With this disease, degenerative processes occur in the spine, leading to compression of the spine and changes in the structure of the intervertebral discs. The majority of patients complain of severe pain in the back, neck or loin with osteochondrosis, especially if the disease has progressed for several years. At the beginning of the disease, it is more about the appearance of a feeling of fatigue in the back, which gradually becomes a pain syndrome.
• Spondylosis is another of the diseases of the spine, which has a degenerative character. But in this case, there is no compression of the vertebrae and a disc between them, but the appearance of bone growths on the tissues of the vertebrae, resembling thorns like a heel spur. The pain syndrome in this pathology can be quite strong if the growths begin to irritate the nerve endings.
• Herniated discs are a serious and rather dangerous disease of the spine, in which there is a rupture of the fibrous ring around the disc with a displacement of the disc itself. He begins to squeeze nearby soft tissues, nerve fibers, blood vessels. The bulging of the disc beyond the vertebral column is accompanied by severe spinal pains at the location of the damaged disc and along the course of the nerve irritated by it. In this case, such a displacement can be found in any part of the spine, but it usually arises against the background of already existing pathologies, for example, the same osteochondrosis.
• Disc protrusion, i.e. Their protrusion beyond the spinal column without rupturing the fibrous ring. Back pain in the area of the displaced disc is the main symptom of pathology. Symptom is caused by squeezing the nearby nerve roots, vessels, muscles, which become inflamed due to constant irritation.
• Spondylarthrosis of the spine is a fairly frequent chronic pathology, for which patients turn to the doctor only with the appearance of back pain. We are talking about degenerative changes in the vertebral joints, cartilage damage, articular bags, periarticular bones, as well as the appearance of various bone outgrowths that impair the mobility of the spine. Strong aching pain in this pathology is observed mainly in the neck and lower back, ie. The most mobile parts of the spine.
• Spondylolisthesis is a pathology consisting in the displacement of individual vertebrae forward or backward relative to the axis of the spinal column (ante and retrolistesis), as well as to the left or right side (laterolistesis). Usually patients complain of aching pains in the back, in the place where the displacement of the vertebra is observed. With physical exertion or the need to keep the same position for a long time, an unpleasant symptom increases. But depending on which of the vertebrae has changed its position, other types of pain may appear, such as earaches, neuralgia of different localization with attacks of acute pain, stitching pains in the abdomen, etc.
• Instability of the spine is a pathological condition in which increased mobility of vertebrae is observed in various parts of the spine. At the same time, they begin to irritate the nearby nerve roots, which causes the appearance of a rather intense pain syndrome, which reminds one more of itself with physical activity, slopes, and turning of the trunk in one direction or another. Most often occurs against the background of the above pathologies of the spine, with the weakness of the ligament apparatus or after trauma. Most often, vertebral instability is diagnosed in the lumbar and cervical parts. With instability of the lumbar region, pain can be irradiated in the leg.
• Osteoporosis of the spine. In this disease, the density of bone tissue in the vertebrae is reduced. Back pain appears, beginning with the second stage of the disease, and first have a aching nature, intensifying after physical exertion. But as the pathology develops, they acquire a high intensity and constant character. Moreover, osteoporosis can be complicated by compression fractures of the vertebrae, in which the pain is very severe and appears from the slightest movement or pressure on the back.
• Ankylosing spondylitis (Bechterew's disease) is a systemic chronic inflammatory-degenerative pathology, which mostly affects young men under 30 years old. Characterized by a gradual change in the properties of intervertebral structures and with progressive ossification. The pain syndrome usually appears on the 2nd stage of the disease and resembles the symptoms of the osteochondrosis of the lumbar spine. Characterized by night pains, increasing in the morning and decreasing during movement. As the disease develops, the pain spreads up the spine and is accompanied by a constant tension of the back muscles.
• Scoliosis - curvature of the spine in the right or left side, developing as early as childhood. In this case, the pains are not constant and arise mainly after loads on the spine (prolonged sitting, after a long walk or standing, weight transfer).
• Kyphosis of the spine is the bend of the upper part of the vertebral column posteriorly, which is more characteristic of the thoracic spine. The first symptoms of pathology appear usually in adolescence. First, we are talking about the rapid appearance of fatigue in the back, but as the stoop develops, the pain syndrome progresses. To back pain will be added and violations in the work of various organs, headaches caused by a violation of blood circulation in the cervical section, etc.
• The lordosis of the spine is a similar disease, in which there is a strong bending of the spine anteriorly. Such a curvature is more characteristic of the lumbar and cervical divisions, much less often - for the thoracic. One of the signs of the pathology is pain of varying intensity in the back, waist and cervical region, especially under static loads, as well as fatigue of the spine, caused by constant muscle tension due to incorrect load redistribution.
• Tuberculous spondylitis is the bone form of tuberculosis that afflicts the vertebrae. This pathology is of an infectious-inflammatory nature with localization in any of the departments of the spine. It can appear at any age if the mycobacterium tuberculosis enters the human body. A characteristic symptom of the pathology is just strong permanent pain in the back, which arise regardless of physical exertion.
• Spine osteomyelitis (spondylitis) is a serious and dangerous disease with a long course, also having an infectious and inflammatory nature. As a result of the inflammatory process, the vertebrae are destroyed, the density of bone tissue decreases, and the spine deforms. There are purulent foci in his tissues. The acute form of the disease debuts with back pain and fever. The chronic course of the disease is characterized by radicular syndrome (squeezing and irritation of the roots of the spinal nerves), one of the main manifestations of which is dorsalgia.
• Radiculitis is a pathology of the inflammatory plan, which is characterized by compression of the roots of the spinal cord. It usually occurs against the background of other pathologies of the spine with degenerative changes or spinal injuries. We are accustomed to scrawling down lumbar pains, although in fact the pain syndrome with this disease can also be localized in the back and neck. In fact, this term doctors do not mean a disease, but a syndrome that is characteristic of many diseases of the spinal column. The syndrome is a symptom complex, which includes back pain, and they can have a different character. It can be dull seldom arising pains, acute pain syndrome, or a constant exhausting symptom of a localized form or with the presence of irradiating pains that are delivered to the neck, shoulders, extremities along the course of the irritated nerve.
• Neuralgia of the back or squeezing of the intercostal nerves by the ribs, muscle tissue, modified vertebrae. Cervical and thoracic parts are affected. The pain syndrome can be either dull aching or acute, local (in the area of nerve compression) or reflected (along the course of nerve fibers).
• Spine arthritis / rheumatoid arthritis is a chronic inflammatory disease of the connective tissue of the spine. Back pain, cervical and lumbar injuries are one of the main symptoms of the disease, affecting mainly people over 30 years of age. Pain becomes stronger with an increase in the load on the spine or a long time in an uncomfortable position.
• Injuries of the spine (fractures, bruises, dislocations). Injuries often lead to the development of various diseases and syndromes, including pain in the back area. The cause of pain is inflammation and the displacement of bones, as a result of which the muscles, nerves, blood vessels are damaged.
• Tumor processes in the spine (benign and malignant, primary and metastatic). Tumors in the region of the spinal cord are characterized by a rapid appearance of symptoms, among which intense pain, not controlled by analgesics. Tumor processes outside the spinal cord can not be reminiscent of for a long time, but as the neoplasm grows, pain develops which are progressive. Usually the pains appear in the middle of the back and waist, can be localized and reflected, amplified after lying on the back, strains of the back muscles, coughing, sneezing, etc.
• Stenosis of the spinal canal is an age-related disease characterized by narrowing of the spinal canal, lateral pocket and intervertebral openings in the lumbar region. Further, the intervertebral disks are displaced, as a result of which the roots of the spinal cord are compressed, and pain arises that is most often localized in the lower back, waist, and legs.
• Congenital defects in the development of the spine. Some of the diseases listed above are congenital in nature, but back pain usually appears already in the school period, when the load on the spine increases due to a prolonged forced sitting position. It is in this position that the load on the spine is maximal.

The fact that severe back pains appear as a result of various pathologies of the spine is quite logical and does not surprise anyone. But the appearance of a similar symptom can provoke other diseases and conditions. And the diseases do not necessarily have to be connected with the spine.

Pathologies that can lead to severe back pain:

• Stretching of the muscles and ligaments of the back. Pathology, which refers to the category of injuries, most often occurs during weight training and lifting weights by untrained people. Although sometimes the cause of this situation are violations of posture and prolonged immobilization, accompanied by muscle atrophy. The main symptoms of the pathology are severe back pain and limitation of mobility, because any movements and loads on the affected muscle or ligament cause the appearance of piercing, tearing pain. The cause of pain is considered microfractures of soft tissue fibers and their inflammation.
• Inflammation of the back muscles (myositis) with the formation of painful seals on the muscles. Pathology is characterized by swelling of the tissues and aching pains of mild and moderate intensity that do not pass after rest. But with muscle strain, sudden movements, pressure on painful seals, lying on the back on a hard surface, changing weather, under the influence of cold, and affect the quality of life of patients.
•  Fibromyalgia is a disease whose causes are not known to doctors. Symmetric chronic muscular, tendon and joint pains in the back and body are characteristic for pathology. The pains are diffuse (that is, the patient feels all the back, including the spine, and all the pains) and different intensity, tend to intensify when the weather changes, under the influence of cold and stress.
• Myofascial syndrome, in which there is spasmodic muscles with the formation of point-like painful seals (trigger points). The development of pathology is facilitated by trauma, sudden movements, stress, low physical activity, chronic muscle fatigue due to the implementation of monotonous movements, etc. Pain in this syndrome can be of high intensity, especially when exposed to trigger points. Characteristic reflective pain.
• Muscular-tonic syndrome caused by degenerative changes in the spine and increased strain on the muscles of the back. The pains are aching and moderate intensity, can worsen during movement and exposure to cold. Most often it's about pain, limited to a specific area of the back.
• Inflammatory diseases of the kidneys (pyelonephritis, glomerulofeprite), in which patients can experience quite severe pain in the lower back. Especially painful are renal colic in renal stone disease.
• Diseases of the liver and gallbladder, when there are reflected back pain.
• Problems with the intestines, which often breaks the lower back, and sometimes hurts the entire lower half of the back.
• Heart pathologies, pain at which can be noted both behind the breastbone on the left, and in the field of scapulas on the back.
• An ulcer of the stomach and duodenum, the pain in the aggravation of which is often irradiated in the back.
• Pancreatitis or inflammation of the pancreas with characteristic girdling pains, which, when exacerbating the pathology, are of rather high intensity.
• Diseases of the lungs and pleura (pneumonia, pleurisy, pulmonary tuberculosis). They are characterized by pain in the thoracic region of the back and especially between the shoulder blades.

If we are talking about diseases of internal organs and reflected pain in the back, their characteristic feature can be considered that they practically do not depend on the change in body position, physical loads, temperature effects. Back pain in this case is an additional symptom that may or may not appear.

When it comes to the diseases of the spine and back muscles, the appearance of the pain syndrome can contribute to various points. Consider the main risk factors for the appearance of spinal pain:

• Subcooling the body, contributing to a decrease in immunity and the development of infectious and inflammatory diseases, including diseases of soft tissues and back bones.
• Infections of a bacterial and viral nature (patients can complain about tangible back pain even with respiratory infections: influenza, acute respiratory viral infection, angina, etc.).
• Any chronic diseases that weaken the body and negatively affect many of the processes in it.
• Heavy physical work, implying a load on the spine.
• Classes in weightlifting.
• Raising and carrying heavy weights are especially untrained people.
• Sharp movements in the spine, which can lead to pinching of the roots of the spinal nerves.
• Diseases of the pelvic organs, which can provoke the appearance of quite severe aching pain in the lumbar region.
• Diseases of the digestive organs (isofagitis, esophagospasm) and heart diseases (cardiac ischemia, aortic aneurysm, pericardial inflammation of the heart, pulmonary artery thromboembolism, etc.)
• Enhanced training in the gym without preliminary training or unauthorized trainer increased loads.
• Work activity, implying a long stay in a sitting or standing position.
• Excessive enthusiasm for the computer, as a result of which people spend hours at the monitor, forgetting to relieve the tension of the muscles of the back and watch their posture. This factor is especially relevant in our time and is one of the main reasons for the occurrence of severe back pain in adolescents and young people.
• An uncomfortable bed that does not help relaxation, but muscle tension and can be a factor leading to the curvature of the spine.
• Unprofessionally performed back massage.
• Epidural anesthesia, i.e. Injection of anesthetics into the space between the vertebrae, which is used to relieve severe pain during labor and perform various operations.
• Pregnancy, in which back pain can be caused as physiological (the growth of the abdomen changes the woman's posture, which leads to an incorrect distribution of the load on the spine and its rapid fatigue), and pathological causes (for example, popular in pregnancy pyelonephritis).
• Excess weight, which creates increased stress not only on the legs, but also on the spine.
• Metabolic disorders that make the bones weaker, and the muscles and ligaments are less elastic.
• Stress, which is considered a risk factor for the development of most human diseases and significantly increases their number during periods of psycho-emotional upheavals.

If you carefully look at the factors and reasons that provoke back pain, it becomes clear that our whole life contributes to this. It is not surprising that the prevalence of such a symptom as severe back pain approaches to such violations as headaches and fatigue, which can be called almost the characteristics of modern man.

Pathogenesis

Regardless of the location of pain syndrome localization, it always affects the quality of a person's life. Usually we notice even minor pain sensations, and what to say about strong pains that are able to constrain movement and bring a person into a stupor. From back pain of varying intensity, 80 to 90% of patients with pathologies of the spine suffer from different estimates. Almost half of apparently healthy people complain about spinal pains. But do they know why such a symptom arises at all?

The appearance of severe pain in the back is associated with the development of various pain syndromes: radicular, myofascial, muscular-tonic. It is through pain that we learn about various disorders in the body, i.e. It can be regarded as a conditioned reflex of a protective nature.

If tissues are damaged, for example, if they become inflamed due to aggressive mechanical action, which causes hematomas (strokes), rupture of the fibers (excessive physical exertion), areas of chronic irritation (bone fragments, spiny outgrowths, protruding vertebrae, infections), pain receptors become activated , giving a signal about the problem in the brain. Not surprisingly, any inflammatory processes are accompanied by pain of greater or lesser intensity, and the more inflammation, the stronger we feel it.

It is a question of physiological pain, which can be coped with the help of medicines and removing the cause of irritation. A somewhat different character is caused by pain caused by disturbances in the work of the nervous system. Such pains can be provoked by serious diseases of the brain or spinal cord, but they can also be caused by a negative effect on the peripheral nerves. A variety of such pains is the radicular syndrome, which occurs when the roots of the spinal cord are damaged (squeezed or irritated) in the lumen of the vertebral column when the vertebrae are displaced.

Severe back pain can also be caused by increased muscle tone. With muscle spasms, blood supply to soft tissues is impaired, which leads to trophic disorders, which the body regards as trauma. In addition, strained back muscles, which become dense and inelastic, are more prone to microfractures of fibers.

Moreover, they, like protruding bones and cartilages, can squeeze the nearby nerve fibers. That will be accompanied by painful sensations and a decrease in the sensitivity of tissues.

Muscle pain is well removed by massage. But it must be done by a specialist. If after the massage the back hurts badly, it means that it is done incorrectly. Perhaps, due to the careless non-professional actions of the masseur, even some structures in the back area were damaged. Proper massage helps to relax the muscles of the back and remove pain, and not vice versa. Strengthen pain only during the procedure, and at the end of the session, there should be relief.

Of interest are pains after pain treatment. From the outside it looks like an incident. Nevertheless, patients often complain that their back aches strongly after epidural anesthesia. The pain appears after the action of the anesthetic passes. Gradually it should weaken and pass for several days. If this does not happen, then during the procedure there were some violations: an infection was entered or the puncture was done inaccurately or in the wrong place, as a result of which the needle injured muscles and nerve fibers. Although in this case it is impossible to exclude the patient's psychoemotional mood.

In some cases, severe back pain can be psychogenic. So they say about the pain syndrome, which arises on the basis of strong experiences and stresses. In contrast to physiological and neuropathic pain, such sensations are not associated with organic lesions of the tissues of the back. It's just that in too sensitive people, strong emotions cause disturbances in the work of the nervous system, which begins to misinterpret impulses coming to her, perceiving most of them as painful. In this case, analgesics can not help much, unlike sedatives and psychotherapy sessions.

Statistics

Statistics say that the most popular cause of back pain is osteochondrosis, which affects about 80 percent of the population. Scoliosis, which is more or less diagnosed in most students and students, as well as regular sitting behind computer games are the most common causes of spinal pain in the younger generation. But most often from the pain in the back, old people still suffer, who during their lifetime have accumulated a decent baggage of various diseases and physiological changes in the body that do not contribute to the health of the back have begun.

It is necessary to understand that often people simply do not suspect about their pathologies. Therefore, the appearance of a pain syndrome in the back area for them is some kind of surprise. Even if the pain was caused by an uncomfortable position of the body or by sleeping on a too hard or soft bed, the fact that it does not pass for two or more days indicates that the person is not all right with the back.