Severe upper, middle and lower back pain

Back pain is an unpleasant situation that has a negative impact on a person's well-being. And if we are talking about severe pain, then work capacity also suffers. Moreover, doctors hear such complaints almost every day, and try to figure out what causes the pain syndrome, if the types of severe back pain are as varied as their causes.

Upper back pain

Intense pain in the upper back is not considered a common complaint, however, people still seek medical attention for this reason. When examining the causes of the ailment, doctors first of all pay attention to the localization of pain. Thus, complaints that the upper back hurts a lot lead the doctor to the idea that the cause of such pain is most likely hidden in diseases of the cervical and thoracic spine.

The most popular cause of back pain is considered to be osteochondrosis of the spine, and with this localization of pain, we are most likely talking about degenerative changes in the vertebrae of the cervical and thoracic regions. However, due to the low mobility of the upper thoracic region, osteochondrosis of this area is diagnosed much less often than cervical (in 1 patient out of 100). And even if degenerative changes in this most stable area of the spine are still present, they extremely rarely lead to complications such as a herniated disc or protrusion of the intervertebral disc, stenosis of the spinal canal, spondylosis or spondyloarthrosis.

But osteochondrosis of the cervical spine is a fairly common disease, which is characterized by pain in the upper back. Most often, a person has severe pain in both the back and neck. Some patients note that along with the neck, their right or left shoulder hurts, the pain can radiate to the forearm and fingers, sometimes there is a decrease in skin sensitivity in the place where the back hurts.

Degenerative processes in the cervical vertebrae and injuries to the upper spine (of which there are 7) can cause various types of severe back pain. The cervical spine is considered the most mobile, so it is not surprising that it is more susceptible to injury than others, and poor posture, prolonged exposure to the computer, and an uncomfortable pillow are risk factors for muscle strain or uneven distribution of the load on the spine.

The displacement of the vertebrae and any degenerative changes in this area of the spine can lead to compression of the spinal cord, the nerve roots extending from it, and blood vessels. It is not surprising that against the background of osteochondrosis of the cervical spine, neuralgia (pinching) of the occipital nerve often develops, accompanied by sharp, piercing pains radiating to the head and shoulders.

People with cervical osteochondrosis often experience dizziness and headaches. These are already symptoms of brain hypoxia caused by circulatory disorders in this area if the vertebrae or the resulting intervertebral hernia begin to compress the blood vessels. Cervical osteochondrosis is often accompanied by blood pressure disorders.

But complaints about severe headaches and back pain can be caused by another problem. For example, scoliosis, a pathology in which the spine bends to the right or left. In this case, the shape of not only the spine itself changes, but also individual vertebrae. Curvature of the spine leads to the fact that the spinal cord, directly connected to the brain and central nervous system, begins to suffer. Due to this connection, a person can experience pain in both the back and the head at the same time.

Pain in the neck, back of the head and back in combination with migraine-like headaches can also occur with inflammation of the meninges (meningitis). And the cause of such widespread aching pain will again be the connection between the spinal cord and the brain.

As for muscle pain in the upper back, it can be caused by muscle strain or spasm, in which small painful seals form in the thickness of the muscle tissue. When pressing on these points, called trigger points, a strong sharp pain appears.

Another cause of muscle pain in the back and shoulder area may be hypothermia. Then the person says that his back and shoulders are blown, which is why severe pain has appeared. Such pains are usually aching in nature and are noticeably aggravated by pressure. When diagnosing neuritis of the brachial nerve, which is damaged by the muscles of the upper back that have become compacted due to hypothermia and inflammation, numbness of the arm tissues and deterioration of the functionality of the hand are also possible.

Severe pain in the middle of the back

Sometimes patients complain that their back and chest hurt at the same time. In this case, one should not exclude the above-mentioned scoliosis, the pain in which can be of a different nature, radiating to both the front and back of the body. Osteochondrosis of the thoracic spine behaves in an identical manner. Usually, we are talking about aching dull pain, although with radicular syndrome, a person may also experience acute pain in the back and chest.

Severe back and chest pains are also characteristic of intercostal neuralgia. Many people mistake the acute pains that occur with this disease for heart pains and rush to a cardiologist, who often fails to detect serious heart diseases and sends the patient to a neurologist. In fact, the pathology, provoked in most cases by hypothermia or lifting weights, does not pose a danger, although it does cause noticeable discomfort.

Should we blame patients who mistake neuralgia pain for heart problems? Probably not, because cardiovascular pathologies can also cause severe chest and back pain. Thus, with angina, the patient can feel burning pain both in the chest and in the middle of the back, and sometimes it even radiates to the lumbar region.

During a myocardial infarction, severe squeezing pain is felt in the chest, shoulders, back, and even in the arms. During inflammation of the cardiac membranes, the pain is more of an obsessive, aching nature, but it radiates to the sternum and back, accompanied by breathing problems, changes in body temperature, and general weakness.

Severe back and chest pain is a characteristic symptom of a thoracic aortic aneurysm. In this case, patients complain of a pulsating, aching pain inside the aortic arch. Pain is also felt in the chest and back, accompanied by shortness of breath, cough, difficulty swallowing, and snoring. When the aneurysm dissects, the pain becomes sharp, abrupt, which patients describe as burning and tearing.

The appearance of severe back pain can also be caused by various types of respiratory diseases, because the trachea, lungs, and pleura are located in the middle of the back, which can become inflamed under the influence of cold, infections, and other irritants. Back and chest pain is typical for almost all diseases accompanied by a cough: colds, flu, bronchitis, tracheitis, pneumonia, tuberculosis of the lungs, etc.

But with bronchitis and a strong cough, the chest and upper back along the bronchi usually hurt. The pain syndrome appears at the height of the disease. With a cold, acute respiratory viral infection and flu, back pain usually occurs after other symptoms of the disease have subsided. They are considered a complication of infectious diseases of the respiratory system and are caused by intoxication of the body, exacerbation of existing osteochondrosis, the development of myositis (local inflammation of the muscles), when the back muscles hurt badly, pyelonephritis, inflammation of the appendages, etc. In this case, both the muscles and even the skin on the back can hurt, suffering from circulatory disorders caused by the redistribution of blood flow in this area.

Tracheitis, inflammation and tuberculosis of the lungs, pleurisy are characterized by severe back pain in the shoulder blade area, which is aching in nature, characteristic of the inflammatory process inside the body. If the disease arose as a result of hypothermia, the pain can spread to the upper back, shoulders, neck.

People with serious cardiovascular diseases may also complain of severe back pain between the shoulder blades, since the heart is located at this level. In this case, severe back pain on the left may periodically appear, which is typical for attacks of angina pectoris, myocardial infarction, coronary heart disease and some other pathologies.

Severe back pain on the right side often occurs with liver and gallbladder diseases. But damage to the esophagus and upper stomach can be accompanied by pain in the upper back and sternum on the left. Although this is not a fact, because most diseases of internal organs manifest themselves in combined pain, for example, in the back and chest or in the back and abdomen. In this case, they talk about girdle pain.

Acute pain between the shoulder blades is a common symptom that occurs with intercostal neuralgia on the side where the nerve is pinched. The back may hurt in the shoulder blade area with myositis caused by muscle strain or hypothermia, osteochondrosis of the thoracic spine, spondyloarthritis and other inflammatory-degenerative pathologies of the spine. But in this case, if the spinal roots are not affected, the pain will be more of a dull, aching nature.

Lower back pain

9 thoracic vertebrae are considered a low-mobility section of the spine, while the remaining 3 vertebrae and the structures of the lumbar region are already responsible for the turns and bends of the torso. Well, where else, if not in this area, do different types of severe back pain manifest themselves especially often and clearly.

Severe back pain above the waist is most often associated with kidney disease, and in particular with pyelonephritis. Since the kidneys are a paired organ, parts of which are located on both sides of the back, the localization of pain can be different. With inflammation of the right kidney, patients complain of severe pain on the right side of the back. But pain in diseases of the liver, gallbladder, duodenum and pancreas can radiate to the same area.

Severe pain on the left side of the back is typical for ulcerative lesion of the stomach and inflammation of the left kidney. But it should be taken into account that on the left side of the body there are also some parts of the liver and pancreas, so it is not surprising that with diseases of these organs, patients can complain of severe girdle pain in the back, which is typical for acute periods of the disease.

And again, difficulties with diagnosis arise, because girdle pain above the waist can also occur with inflammation of the gallbladder (cholecystitis), duodenal ulcer, a viral disease called "shingles" (although in this case there are specific skin manifestations). Sometimes girdle pains remind of myocardial infarction and aortic aneurysm. The intensity of the symptom can be used to understand how serious the situation is, while severe pain is characteristic of acute forms of diseases or exacerbation of chronic ones (the intensity is somewhat lower).

Severe encircling pain in the lower back can also occur with radicular syndrome, because the lower part of the thoracic and lumbar spine are considered mobile structures that tend to shift and change with injuries and increased loads. Only in this case the pain will be sharp and piercing, and its appearance is always associated with a change in body position. During pregnancy, in addition to the above-described pathologies and typical gastrointestinal tract failures during this period, encircling pain in the lumbar region may indicate a threat of miscarriage.

A distinctive feature of the pain syndrome in gastrointestinal diseases is the fact that the pain occurs against the background of other symptoms of digestive disorders. Thus, nausea, heaviness in the stomach and severe back pain are characteristic of the clinical picture of acute pancreatitis, which intensify some time after eating (usually after 1.5-2 hours). With an exacerbation of chronic pancreatitis, pancreatic diarrhea with its characteristic abdominal cramps may occur.

In acute cholecystitis, in addition to nausea and pain, bitterness in the mouth and bowel disorders may occur. In case of gastric and duodenal ulcers, pain is strictly tied to the time of food intake and occurs within half an hour or a little more after eating. The patient may experience dyspeptic symptoms, bowel disorders, vomiting, headaches. In the presence of acute pain, ulcer perforation and the development of peritonitis may be suspected.

Exacerbation of gastrointestinal diseases may be accompanied by an increase in temperature, but it rarely rises to febrile levels. In case of myocardial infarction, the temperature rises on the 2nd-3rd day, and digestive disorders are usually not observed.

But with a cold, severe back pain may occur, which is characterized as aching, and a temperature, indicating that the body has begun to fight the infection. In this case, both the back between the shoulder blades and the lower back may hurt. Other symptoms will be a runny nose, nasal congestion, coughing, sneezing, headaches.

Inflammatory diseases of the lower respiratory tract may also occur against the background of elevated temperature. Thus, with pneumonia, the patient's body temperature may rise to 40 degrees and above.

But pain above the waist can also be caused by various diseases of the spine. Unlike the slightly mobile 9 vertebrae of the upper thoracic region, the 3 lower vertebrae are already quite mobile. With instability of the spine, caused by weakness of the muscular-ligamentous apparatus of the back, injuries of the spinal column and inflammatory-degenerative processes in it, pinching of the nerves of blood vessels can occur, accompanied by severe pain in the back above the waist.

The lumbar spine is no less mobile than the cervical spine, so severe back pain in the lumbar region is considered a very common symptom. It is this section that bears the maximum load, and thanks to the modern fashion for low-waist tops and jeans, it is most often exposed to hypothermia.

Drivers and people working at a computer most often suffer from lower back pain, as well as those engaged in heavy physical labor, whose work involves standing or sitting for a long time, women who are fond of high heels. Weightlifters are also at risk. Although sometimes the cause of lower back pain is excessive strain during training or hypothermia of the lower back.

A sedentary lifestyle, poor nutrition and metabolic disorders, heavy loads on the spine and poor posture lead to the development of diseases that are considered the primary cause of lower back pain: osteochondrosis of the lumbar region, lumbosacral radiculitis, intervertebral hernias and protrusions, spondyloarthrosis, osteoporosis, etc. And already against the background of these diseases, pains appear associated with overstrain of the muscles of the lumbar region, caused by improper distribution of the load, and pinching of nerve fibers and blood vessels by deformed musculoskeletal structures.

Sometimes a person's back hurts so much that he complains of the following: I can't walk, move, sit, lie down. Such a strong pain syndrome is typical for pain in the lumbosacral region, especially if it is affected by osteochondrosis or radiculitis, which is an inflammation of the spinal roots.

Doctors themselves call osteochondrosis a punishment for an unhealthy lifestyle. And the fact that the disease worsens, leading to a violation of the motor ability of the spine, only indicates that the person has not drawn the necessary conclusions. As a punishment, he receives severe acute or aching pain, which most often occurs in the neck and lower back. If during remission of osteochondrosis they are felt in the form of discomfort and fatigue of the spine, having a low intensity, then during an exacerbation of the pathology there are already strong stabbing or aching pains, depending on which tissues were affected by the deformed vertebrae.

Acute lower back pain, called lumbago, can be caused by hypothermia of this area and lifting weights, when the pressure increases both on the diseased spine itself and on the tissues surrounding it, including the spinal nerve roots that pass between the bone structures of the spine.

When any soft tissue is injured, it tends to become inflamed, especially if the injury is repeated regularly. When a nerve root is compressed, a strong piercing pain occurs, preventing a person from straightening up or bending over, i.e. making a movement that causes even greater injury to the affected nerve. If the injury is prolonged or repeated frequently, the nerve becomes inflamed and the pain becomes constant, aching, but strong, turning into a sharp, piercing pain when moving the lower back.

It turns out that radiculitis is a consequence of osteochondrosis of the spine, which is confirmed by statistics. Only 5% of cases of radiculopathy development are associated with injuries, herniated discs and age-related changes in the bone structures of the spinal column.

It is osteochondrosis and radiculitis of the lumbosacral spine that are characterized by severe back pain when walking and bending the body. If the disease affects the thoracic spine, then the entire back and chest hurt, and with cervical radiculitis, there are great difficulties with turning and bending the head, again due to severe pain syndrome.

Moreover, osteochondrosis, hernia and protrusion of intervertebral discs in the lumbar region often become the reason why a person has severe back and leg pain. Complaints boil down to the fact that a person cannot stand on his feet for a long time, stand, walk, his legs get tired and start to hurt, although there seems to be no reason for this.

The nature of reflected pain can be used to judge the pathologies that may cause it. If the lower back and upper thigh hurt, the cause may be a protrusion and hernia of the spine, tumors in the sacrum area, including metastases from other organs, tumors of the spinal cord, bursitis of the gluteal tendons, vasculitis. When the nerve roots of the upper lumbar vertebrae are compressed, the pain spreads along the outer side of the thigh.

When the 3rd and 4th lumbar vertebrae are affected, the pain may radiate to the front of the leg, and problems with flexion and extension of the hip and knee joints are also observed.

When a person complains of constant dull pain in the back and lower back, radiating to the back of the leg all the way to the foot, it is most likely an inflammation of the sciatic nerve.

Lower back and knee pain may occur with lesions of the hip joint (traumatic or inflammatory-degenerative), with oncology of the genitals, fractures of the pelvic bones. If we are talking about a violation of the integrity of the bone, such symptoms as numbness of the limb, pain in the sacrum at the site of the obturator nerve, a sensation of crawling ants, etc. are also possible.

Sometimes severe back pain radiating to the leg is caused by anticoagulant treatment or complications of diabetes, spinal stenosis, which occurs against the background of various pathologies of the spinal column. The cause may also be the growth of osteophytes on the lumbosacral vertebrae, which press on the muscles and nerves passing nearby, and the pain spreads along the nerve fibers, i.e. it can radiate to both the back and the leg.

Pain in the ribs

A special case of spinal pain is severe back pain in the ribs. It can occur for various reasons. This symptom is typical for traumatic injuries of the ribs (severe bruises, fractures). With rib fractures, depending on whether there was a displacement and whether nearby soft tissues and nerves were affected, the pain can be weak or sharp, intense, increasing when walking, taking a horizontal position, getting out of bed, bending, etc. The pain can radiate to the chest and be accompanied by tissue swelling at the site of injury. With rib contusions, the pain is sharp, but less intense, gradually turning into aching.

Sometimes, with a small fracture or crack of the rib, the patient may not even suspect such an outcome, because there is no severe pain, which means one can suspect a bruise. But if a person complains that his back hurts a lot when taking a deep breath, the traumatologist may well suspect a rib fracture or damage to the intercostal cartilage. The pain may also increase with any stress caused by even minor physical exertion, coughing, sneezing.

The pain syndrome is especially pronounced when a rib fragment damages lung tissue - pneumothorax (the situation is identical with a penetrating wound). The pain in this case is very deep, piercing, stabbing. It can radiate not only to the back, but also to the chest, shoulder, neck and becomes stronger with any physical exertion. Young men are sometimes diagnosed with spontaneous pneumothorax, which occurs as a result of weakness of the pleura.

Intense back pain in the rib area may also occur with the following diseases: intercostal neuralgia, pericardial syndrome, dry form of pleurisy or pericarditis, tumor processes in the tissues of the back. Usually in these cases we are talking about a strong pain syndrome, which sometimes subsides, then intensifies under the influence of coughing, sneezing, physical activity, and also during inhalation or exhalation.

A symptom such as severe pain in the ribs, similar to the pain syndrome of angina pectoris, is sometimes observed with inflammation of the intercostal cartilages (Tietze's syndrome), when the pain intensifies when pressing on the affected rib.

In case of tumor processes in the back and spine, a person complains of severe back pain in a lying position. The pain is chronic, can be both constant and occur under certain conditions. When palpating the back, a lump in the form of a bump can be felt.

Rib pain often occurs with osteoporosis. When bone tissue weakens, the risk of rib fracture increases, which can break even with minor loads and be accompanied by acute pain. Severe compression of the vertebrae with osteoporosis can lead to the development of radicular syndrome, one of the manifestations of which is considered to be sharp pain in the back between the ribs or under them.

Patients with osteochondrosis or herniated disc, intercostal neuralgia, inflammatory pathologies of the muscles and nerves of the back, fibromyalgia, inflammation (dry form) and pleural tumors may complain of intense back pain in the ribs. Psychogenic pains, which are experienced by suspicious people and patients with mental disorders, should be noted separately.

Pain in the sacrum and coccyx

It is osteochondrosis that can cause severe back pain in the sacrum. The sacrum is a wedge-shaped bone in the lower part of the spine, which itself cannot hurt, because the bones do not have nerve endings. Pain usually occurs at the junction of the last vertebra and the sacrum.

With osteochondrosis of the lumbosacral spine with deformation of the vertebrae in this area, the pain usually covers both the lumbar and sacral regions. A person begins to experience tension in this area, and movements in the spine are limited by severe pain syndrome. Even in a sitting position, the pain does not subside, because in this case the load on the lower spine only increases.

With sudden movements, lifting weights or starting movements after a long stay in an uncomfortable static position, the pain syndrome in the sacrum increases. If we are talking about an intervertebral hernia, pressing on the nerve endings, then severe pain in the back appears, radiating to the leg, which is characterized by intensification in the first half of the day and weakening in the evening.

If the pain in the cross is localized on the right or left side, then it is possible that we are talking about pathologies of the sacroiliac joint. Injuries and inflammatory processes in it can remind of themselves with pain syndrome on the right or left side of the spine. Other symptoms include limping, muscle cramps in the lower limb on the side of the diseased joint, swelling at the site of inflammation.

The types of severe back pain in the lumbosacral region also depend on what tissues are affected and what happens to them. When nerves and muscles are compressed with subsequent spasms, the pain becomes sharp, piercing, burning, while the inflammatory process is more characterized by a dull, aching pain, the intensity of which depends on the extent of the pathological process and the structures involved in it.

Also, aching pain in the sacrum can appear with tumor processes in this area. And it is not always about tumors developing from the tissues of the spinal cord or the muscles of the lower back. Often, metastases from other nearby organs (kidneys, pancreas, prostate, intestines, ovaries) manifest themselves in this way. And sometimes the tumor comes from the lungs, stomach or thyroid gland, and the person does not even suspect that the sacrum can hurt for such an unusual reason.

If a person complains of severe back pain in the coccyx area, then the pain is usually suspected to be of a traumatic nature. This could be a fracture, bruise, or crack in the lowest immobile section of the spine, a rudimentary organ left to us by our tailed ancestors. Most often, severe acute pain occurs immediately after an injury, although in some cases it may appear much later, after several months or even years. Both the coccyx itself and the tissues around it can hurt. In this case, the pain syndrome intensifies when a person walks or sits.

Athletes involved in horse riding or cycling often complain of pain in the tailbone while sitting. Microtraumas of bones and nearby tissues are considered to be the cause of such unpleasant sensations. But, oddly enough, people who prefer to sit on a soft surface also seek medical help with the same symptom. It is believed that in such a situation, there is a higher risk of circulatory disorders due to the incorrect position of the organ, and this in turn is fraught with stagnation and metabolic disorders in the tissues of the tailbone.

Pain while sitting can also be caused by a cystic formation in the coccyx area (dermoid cyst), as well as damage to the organ during childbirth.

People with adhesions in the pelvis may also experience pain in the coccyx when standing up. But pain when bending is typical for a chronic inflammatory process in the pelvic organs. This may be dysbacteriosis or inflammation of the mucous membrane of the small intestine and sigmoid colon, inflammation of the bladder (cystitis), inflammation of the appendages or the inner layer of the uterus, etc. In this case, the pain is lower in intensity and is aching, dull or pulling. Severe back pain in the pelvic area, not associated with spinal diseases, is more typical for injuries and acute inflammatory processes.

The same pains are typical for osteochondrosis of the lumbosacral spine, but in this case they are combined with pains in the lower back and sacrum. But with hemorrhoids and the habit of sitting on the toilet for a long time, they can also occur independently.