Almost all people during life happens, at least, a long episode of back pain, and one-third of adults these sensations are repeated regularly. Relevance of the problem illustrated at least by the fact that the treatment of back pain annually spent three times more to finance than to the therapy of patients with cancer.
The duration of an episode of pain is usually about 2 weeks, but many patients residual are retained for more than a month and for a longer time. Ipart of such patients are diagnosed to herniated intervertebral disc, disease спинномозгового canal, diseases of the kidneys, ovaries and other internal organs, and sometimes malignant of a tumor or its metastases.
In our article, we briefly describe the main causes of back pain and their distinguishing characteristics, help the person to realize that his health is having problems at the time to consult with your doctor.
Probable causes of back pain:
- the defeat of the spinal column, ligaments and muscles;
- pinching the nerve root and other diseases of the spinal cord;
- disease of the internal organs;
- diseases of the connective tissue;
- depression and psychogenic violation.
It is proven that back pain most often occur with low motility, obesity, smoking, heavy physical work, stay in the posture problems, the prolonged action of vibration, as well as closed curves trunk.
Diseases of the vertebral column, its ligaments, and joints
The majority of people with complaints of back pain, they occur due to injury of the intervertebral disc, the joints between отростками, as well as the bones of the bodies of the vertebrae. With age, the disks between the vertebrae lose water, decreasing its thickness. The result is the increase of mobility of the individual elements of the vertebral column, which are irritating to the pain receptors in the joints and intervertebral. It must be said that often, even in people with pronounced "ages" of changes in the spine, pain in the back. Many times the herniated disc combines with the pain by chance.
In the last years a growing importance in the development of persistent pain in the back, attributed to the so-called syndrome of the joints with the "little person" — a private form of osteoarthritis attacks the joint unit of the vertebral column.
The pain with this syndrome can be as unilateral and bilateral, is located near the spine, most often in the lumbar region with the dissemination of the thigh. The pain often appears in the morning, but during the day goes by and again it is enhanced after the load for the night. For the first time, she usually appears after a strong discomfort of the rotation or the tilt of the trunk. The pain intensifies in the standing position and extension of thin strands, decreases in the position of sitting or lying down, when the light-bending, the use of brackets. The syndrome of the joints for the "little guy" often reappears.
Often, cause pain in the back injuries to the spine in the following states:
- spondylolisthesis – displacement of vertebrae to each other;
- the stenosis of the spinal canal;
- the ankylosing spondylitis disease Spondylitis);
- osteoporosis with fractures of the vertebral bodies (often in the elderly, especially in women);
- a large hernia of the hard disk (more than 5 mm);
- diseases of the cervical spine.
The lack of physical activity during the work day — a distinctive feature of the work in the office. The lack of movements, the long-lasting presence in an uncomfortable posture cause excess load on the joints and cause pain, discomfort and the progressive destruction of the cartilage. Therefore, workers in offices, it is recommended to do gymnastics, as well as a need for tools that protect and straightening хрящевую fabric.
The more rare, but dangerous reasons starting point of the pain syndrome refers to a tumor, the most common is the metastasis to the vertebral column. Risk increases when the patient has any cancer (especially cancer of lung, breast and prostate), weight loss, fever, duration of complaints more than a month, with more than 50 years old. Metastases are most frequently affect the thoracic department of vertebral column.
Another cause of back pain is related to patients with cancer diseases, applies the multiple myeloma. It is rare, but there are benign tumors and malignant tumors primary vertebral column, for example, a benign tumor, образующееся of the bone tissue, a sarcoma of Ewing.
The disease Ankylosing need be suspected when a young patient, morning stiffness of the spine and large joints, improve the state after the exercise. The pain often appears in the gluteus medius area. It is typical of his gain of the night, so that the patient under the morning already can't sleep because of unpleasant sensations.
Back pain appear and other symptoms, that occur when the following diseases:
- the psoriatic arthritis;
- disease rheumatic;
- ювенильный rheumatoid arthritis;
- Crohn's disease, Уиппла, ulcerative colitis;
- шигеллез, salmonella infection.
An important component of integrated treatment is the reception of medicines, the effectiveness has as goal to preserve and normalization of the state of the joints and tissue of cartilage. The injection ensures maximum bioavailability and speed of action of the drug, which helps stop the progression of the destruction of cartilage, relieves inflammation, and stimulates the synthesis of hyaluronic acid. Thanks to the fast onset of effect: there is no need for lengthy courses of medicine only 20 injection of 2 times per year. In addition to them the treatment of back pain enables you to reduce the dose and duration of use of NSAIDS.
The vertebral osteomyelitis or ankylosing need to take over the long term, fever, внутривенном introduction of medicines or drugs, previous infectious disease or the injury, the intake of immunosuppressive drugs. Inflammatory diseases of the vertebral column can have a specific nature, arose when сифилисе, tuberculosis.
Defined the so-called indicators of serious problems, which require a careful examination of the patient:
- suddenly, for the first time in my life that came the pain;
- very strong pain;
- the lack of agreement with the pain of the position of the body;
- the pain is stronger at night than in the day;
- the age of the patient with age below 20 years and with over 55 years of age;
- recently transferred trauma back;
- the probability of infection (inflammation of the urinary ways, the intake of immunosuppressive drugs, acquired immune deficiency syndrome);
- suffered from cancer of the disease;
- unexplained, decrease in the mass of the body, and fever;
- general weakness;
- incontinence of urine or the stool;
- violation of gait;
- prognosis of neurological disorders.
The defeat of the muscles
The defeat of the muscles of the back can be secondary: in diseases of the spinal column, muscles tighten, creating a "protective corset", it keeps your spinal column, but from a constant tension and spasm become the cause of the pain. Many times, the muscle spasm occurs is primary, for example, the prolonged stay in posture problems or increased anxiety. This pain caused a relatively benign during and responds well to pharmacological treatment.
Some systemic diseases muscle also manifest pain in the back. These include:
- ревматическая полимиалгия;
- fibromyalgia.
Fibromyalgia – is common enough disease, it is more a practice common in middle-aged women. It is characterized by leakage of muscle pain in body, weakness, sleep disturbances, changes in tactile sensitivity, anxiety, unstable chair.
Pathology of the spinal cord and of the
Compression of the nerve root of the spinal cord are entering through the holes between отростками the vertebrae, is more a rare cause of pain that each 10 patients. However, when this pain caused stronger and longer lasting, the treatment lasts about 2 months.
Compression (compression) of the cause:
- the hernia межпозвонкового disk;
- hypertrophy of the yellow ligament;
- bone and expansion;
- narrowing of the spinal canal (for example, due to an injury).
Painting the defeat of the nerve root (radiculopathy): acute "shooting" pain in the back, the violation of sensitivity in the zone of the nerve supply корешка, the decrease of the reflection of a weakness of the corresponding muscle. If the compression корешка proven through modern research techniques and treatment inefficient, sometimes, resort to a surgical operation.
Disease of the internal organs
The back pain comes not only to diseases of the vertebral column or the spinal cord, but and accompanies many diseases of the internal organs:
b- heart diseases (myocardial infarction, stable and unstable angina, infective endocarditis, aneurysm-aortic);
- lung disease (pulmonary embolism, pneumothorax, pleural effusion);
- pathology of the esophagus and of the stomach (peptic ulcer, spasm of the esophagus, esophagitis);
- inflammatory processes in the kidneys, liver, pancreas, gall bladder.
Usually distinguish these diseases allow for two points:
- instant and very intense pain in the back;
- signs of injury of organs (shortness of breath, wheezing in the lung, pain during palpation of the abdomen, and so on).
When the pain in the back, especially came unexpectedly, and not сопровождающейся signs of diseases of the spinal column, it is always necessary to register an electrocardiogram (ecg) for exclusion of acute myocardial infarction. Especially such нетипичная location of the pain when the coronary heart disease is common to the elderly.
Psychogenic violation
The transition from the starting point of the pain syndrome, chronic in a way to contribute to social and behavioural factors:
- financial difficulties;
- the emotional tension;
- confidence in the inevitability of pain because of its apparent connection with the daily work;
- thoughts about the possibility of serious illness and loss of work capacity;
- depression;
- dependence of other persons;
- the strategy to prevent the illness, while the patient takes no action for the diagnosis and treatment of your state.
Why doctor search
Thus, the causes of back pain varied. As well as most of the time they are related to diseases of the vertebral column and the spinal cord, when you appear you should consult a neurologist. In addition, it may be necessary to the consultation of other professionals: a neurosurgeon, a radiation oncologist, gastroenterologist, cardiologist, surgeon, and a psychologist. To choose a specialist, you can first consult a doctor, who after the primary search is able to set the provisional diagnosis.