Almost every person in the course of life occurs at least a long episode of pain in the back, but in a third of the adults of these unpleasant sensations are repeated regularly. The relevance of the problem illustrates well the fact that on the treatment of back pain each year is spent three times more funds than on the treatment of patients with cancer.
The duration of the episode of pain is usually about 2 weeks, but in many patients, the residual effects persist for a month or more. Ofa portion of these patients are diagnosed with the herniated disc, disease spinal canal, disease of the kidney, ovary and other internal organs, and sometimes malignant tumors, or their metastases.
In our article, we briefly describe the main causes of back pain and their distinguishing characteristics, helping the person to understand that health problems and it is time to consult a doctor.
The likely causes of pain in the back:
- the defeat of the spine, its ligaments and muscles;
- damage to roots and other diseases of the spinal cord;
- the diseases of the internal organs;
- connective tissue disease;
- depression and psychogenic of the offence.
There is evidence that back pain occur more frequently in the case of low mobility, obesity, smoking, heavy physical work, stay in an uncomfortable position, prolongs the action of vibrations, as well as the tight turns of the torso.
The disease of the spine, its ligaments, and joints
Most of the people complaining of pain in the back they are due to lesions of the intervertebral discs, the joints between the spine and the bones of the vertebrae. With age, the discs between the vertebrae lose water, decreasing their thickness. Results in an increase in the mobility of the individual elements of the spinal column which irritate the rcepteurs painful spinal joints. It must be said that often, even in people with severe "age" of the change in the spine pain in the back non. Often, the herniated disc is combined with the pain by chance.
In recent years, more and more importance in the constant evolution of back pain attached to what is called the syndrome of the joints with the "small face" private to the form of osteoarthritis that affects the joint of the device of the spinal column.
The pain in this syndrome may be both unilateral and bilateral, localized near the spine, most often in the lumbar region of the spread in the thigh. The pain often appears in the morning, but in the course of the day passes again amplified after the load of the evening. The first time it appears, usually after the twisting rotation, or tilt of the trunk. The pain is worse in standing and extension of the back, decreases in sitting or lying position with a slight flexion, the use of media. The syndrome of the joints with the "small face" often happen again.
Often cause pain in the back during the defeat of the spine, states the following:
- spondylolisthesis – slippage of a vertebra relative to the other;
- stenosis of the spinal canal;
- ankylosing spondylitis (Ankylosing spondylitis);
- osteoporosis with fractures of the vertebral bodies (often in the elderly, especially elderly women);
- a herniated disc extensive (more than 5 mm);
- disease of the cervical spine.
The lack of physical activity during the work day is a characteristic of office work. The lack of movement, extended in an awkward position causing an excessive load on the joints and become the cause of the pain, discomfort, and the gradual destruction of cartilage. Therefore, workers in offices, it is recommended to do regular exercise, as well as, they need a receipt of funds and the protection and recovery хрящевую the fabric.
More rare, but dangerous causes of the pain is a part of the tumor, the more often metastases in the spinal column. The risk increases if the patient has a type of cancer (most commonly lung cancer, breast and prostate cancer), weight loss, fever, duration of complaints of more than a month, over the age of 50 years. Metastases most frequently affect the thoracic spine.
Another cause of pain in the back, related to cancer, reports the myeloma. Rarely, but there are benign tumors and malignant tumors of the spine, for example, a benign tumor, formed from bone tissue, Ewing's sarcoma.
Ankylosing spondylitis need to suspect when the patient's young age, morning stiffness of the spine and large joints, the improvement of the state after the workout. The pain is often appears in the buttocks. The characteristic of its the strengthening of the night, so that the patient in the morning can not sleep due to the discomfort.
The pain in the back appear, and if other symptoms occur with the following diseases:
- the psoriatic arthritis;
- rheumatism;
- juvenile rheumatoid arthritis;
- Crohn's disease, Whipple, ulcerative colitis;
- shigellosis, salmonellosis.
An important element of the overall treatment is taking these medications, the effectiveness of which is focused on the maintenance and the normalization of the status of joints and cartilage. The injection allows a maximum of bioavailability and speed of action of the drug which helps to stop the progression of the destruction of cartilage, relieves inflammation, and stimulates the synthesis of hyaluronic acid. Thanks to the offensive of the effect does not need long preparation course 20 injection 2 times per year. Most of their pain in the back can reduce the dosage and duration of NSAIDS.
Vertebral osteomyelitis or ankylosing spondylitis it must be assumed in the long term, the fever, the intravenous administration of drugs or medicine, from preconstruction of an infectious disease, or injury, receipt of immunosuppressive medications. Inflammatory disease of the spine may have and the particular nature of, arising from syphilis, tuberculosis.
Identified the so-called witnesses of serious problems, which require in-depth examination of the patient:
- suddenly, for the first time in life, born out of the pain;
- a very strong pain;
- the absence of the function of the pain of the position of the body;
- the pain is stronger at night than in the day;
- the age of patients under 20 years of age and over 55 years of age;
- recently transferred from a back injury;
- the probability of infection (inflammation in the urinary tract, the receipt of immunosuppressive drugs, acquired immunodeficiency syndrome);
- history of cancer;
- inexplicable, a reduction in body weight, and fever;
- the general weakness;
- incontinence of urine or faeces;
- the violation of the process;
- exponential neurological disorders.
The defeat of the muscles
The defeat of the muscles of the back may be secondary: in diseases of the spine, tense muscles, creating a "protective brace", maintains the spine, but the stress and spasms become themselves the cause of the pain. Often a muscle spasm occurs first, for example during a prolonged stay in an uncomfortable position or increased anxiety. This pain syndrome has relatively mild and lends itself well to the drug therapy.
Certain systemic diseases, of the muscles of the perception of pain in the back. These include:
- polymyalgia rheumatica;
- fibromyalgia.
Fibromyalgia – a fairly common disease more common in middle-aged women. It is characterized by poured out the pain in the muscles of the trunk, the weakness, sleep disturbances, changes in skin sensitivity, the anxiety, the insecurity of a chair.
The pathology of the spinal cord and its roots
The compression of the nerve roots of the spinal cord, out through the holes between the spines on the spine, is more rare because of the pain in 10 patients. However, the syndrome of the pain is stronger and more durable, the treatment continues for about 2 months.
Compression (compression) root cause:
- a herniated disc;
- hypertrophy of the yellow ligament;
- bone expansion;
- narrowing of the spinal canal (for example, due to an injury).
The painting of root lesions (radiculopathy): acute "pull" back pain, sensitivity disorders in the area of innervation of the binding, a decrease in the reflex, weakness corresponding to your muscles. If the compression of the nerve root is proven with the help of modern methods of research and addiction treatment ineffective, may use a surgical operation.
The diseases of the internal organs
The pain in the back occurs not only in diseases of the vertebral column and the spinal cord, but accompanies many diseases of internal organs:
b- heart disease (myocardial infarction, stable and unstable angina, infective endocarditis, aneurysm of the aorta);
- lung diseases (pulmonary embolism, pneumothorax, pleural effusion);
- the pathology of the esophagus and of the stomach (peptic ulcer, esophageal spasm, esophagitis);
- the inflammatory process in the kidneys, the liver, the pancreas, the gallbladder.
Usually, to distinguish them from those of the disease allows the two points:
- sudden and very intense pain in the back;
- signs of the defeat of the competent authorities (dyspnoea, wheezing in the lungs, pain on palpation of the abdomen, and so on).
When the pain in the back, in particular the problem of unexpectedly, and is not accompanied by signs of disease of the spine, it is always necessary to record the ecg for exclusion of acute myocardial infarction. In particular, this atypical localization of pain in coronary artery disease is characteristic for the elderly.
Psychogenic violation
The transition of the syndrome of chronic pain contribute to the social and behavioural:
- of financial difficulties;
- the emotional tension;
- the certainty of the pain because of his apparent communication with the daily work;
- thoughts on the possible severe disease and loss of working capacity;
- depression;
- addiction to other people;
- the strategy of avoidance of the disease, when the patient is not taking any measures for the diagnosis and treatment of this condition.
Which doctor to consult
Thus, the causes of back pain are varied. Because often, they are linked to diseases of the spine and spinal cord, when their appearance should consult a neurologist. In addition, you can consult with other professionals: a neurosurgeon, an oncologist, gastroenterologist, cardiologist, surgeon, and a psychologist. To choose the right specialist, you can first ask your general practitioner, who, after an initial survey can establish the diagnosis.