Most people have back problems and pain in their lower back, neck, or middle back from time to time. In fact, back pain is the most common physical complaint in the adult population and the leading cause of temporary disability. Back pain can be mild or severe, and the pain can be temporary or chronic.
Back pain includes: muscle and tendon pain, herniated disc, fracture, or other back problems. Most of the time the reasons have a long history. The most common back pain is caused by diseases of the spine.
The structure of the spine is designed for extreme loads. The structure of the spine is stable enough for a person to walk (stand) and flexible enough to perform trunk movements.
A healthy spine, when viewed from the side, has an elongated S-shape and natural curves in the lumbar, thoracic and cervical spine. The spine is the main support part of the torso. In addition, the spine with its bone structure protects the spinal cord and the roots of the spinal cord and thus ensures normal innervation of organs and tissues.
Between each of the 24 vertebrae there are intervertebral discs that perform a damping function.
reasons
Back pain refers to problems that a person mostly causes for themselves. Back problems and back pain are mostly caused by bad habits that have accumulated over a long period of time. These bad habits include:
- Bad posture
- Overvoltage while working
- Incorrect posture at the desk or while driving
- Repeated stretching or stretching of the spine, or abnormally sharp lifting of weights.
Habit results seldom occur immediately, but more often their negative effects accumulate over time. One of the most common types of back pain is pain associated with tension in the muscles surrounding the spine. Most commonly, back pain is associated with tension and muscles in the lumbar and cervical spine. When muscle tension is associated with lifting heavy objects, the pain can be excruciating.
Sometimes back pain occurs for no apparent reason. In such cases, they talk about non-specific back pain. Such pain can develop due to weakened muscles that cannot cope with everyday stress, such as: B. Walking, bending and stretching. In addition, such unspecific pain can be triggered by poor sleep, general fatigue or stressful situations.
Chronic pain in myofascial pain syndrome is caused by localized muscle tension. Sometimes this localized muscle tension is due to stress or other emotional issues.
Pregnancyis often the cause of the disease. This is due to both hormonal changes in the woman's body, and weight gain and excessive stress on the spine and legs.
Injuries from contact sports, accidents, and falls can also cause back problems, ranging from minor muscle strain to severe injuries to the spine and spinal cord.
It is important to understand that back pain is one of the symptoms of the disease and is not a diagnosis. Conditions that can cause back pain include:
Mechanical problems: Mechanical problems are related to the movements of the spine or the sensations a person experiences when making certain movements. The most common mechanical cause is the degeneration of the intervertebral discs (osteochondrosis), when involutional changes in the intervertebral discs and a deterioration in the amortization functions of the intervertebral discs occur, which leads to the appearance of pain. Another cause of back pain are degenerative changes in the spinal joints (spondyloarthrosis). Other mechanical causes are muscle spasms, muscle tension, and herniated discs.
Injuries: Injuries to the spine such as sprains and fractures can cause both acute and chronic pain. Sprains, tears in the ligaments that support the spine can occur from twisting the trunk or improper lifting. Vertebral body fractures are often the result of osteoporosis, a disease in which bone density is compromised. Less commonly, back pain can be caused by more severe injuries caused by falls and falls.
Acquired conditions and diseases. Many medical conditions can cause or contribute to pain. These include scoliosis, kyphosis, kyphoscoliosis, which usually doesn't experience pain until midlife. Different types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), stenosis of the spinal canal, which affects the nerve roots of the spinal cord. Diseases such as osteoporosis are painless in and of themselves, but can lead to vertebral body fractures which are manifested in severe pain. Other causes of back pain are pregnancy, kidney infections or urolithiasis, endometriosis, fibromyalgia, which is characterized by chronic fatigue and diffuse muscle pain.
infections and tumors. Although infections are not a common cause of illness, infections can still cause pain. If the bone tissue is affected then we talk about osteomyelitis, if the infection affects the intervertebral discs we talk about discitis. Tumors are relatively rare even with pain. Sometimes tumors of the spine are primary, but most often the tumors are metastatic and the primary focus is in a different part of the body.
While the causes of back pain are usually physical, it's important to understand that emotional stress can play a role in both the intensity of the pain and its duration. In addition, stress and emotional state can affect the tone of the skeletal muscles. With depression and anxiety, the back pain can be more severe. In addition, insomnia or lack of sleep can also make or worsen pain.
Back pain is only a symptom and can be reflected. Many diseases of the peritoneum and pelvic organs can cause back pain (appendicitis, aneurysm, kidney disease, bladder disease, infections, and pelvic inflammatory disease).
Risk factors
- Age over 40
- Male gender
- Family history
- Previous injuries
- pregnancy
- Surgical interventions on the spine in the past
- Congenital malformations of the spine.
- Lack of regular exercise
- A job or activity that involves sitting and lifting weights for extended periods of time.
- smoking. People who smoke more often than people who don't smoke have back pain.
- overweight. Obesity, especially those with fat around the waist, can put more strain on the back and tend to have weak muscles and limited range of motion
- Bad posture. An impaired posture leads to a violation of the distribution of the load vectors, as well as muscle tension, muscle cramps and pain.
- stress. It is believed that stress and other emotional factors play an important role in back pain, especially chronic pain. Many people unknowingly tighten their back muscles when they are under stress.
- Condition after a long period of depression.
- Long-term use of drugs (such as steroids) that weaken bone tissue.
- lung diseases that lead to a chronic cough.
Symptoms
Most people have had back pain during their lifetime. There are many reasons for back pain, some of which a person creates for himself. Other causes include accidents, muscle sprains, sports injuries, and various illnesses. Although the causes can be different, most of the time they are characterized by the same symptoms.
- Persistent pain or stiffness in any part of the spine, from the base of the neck to the tailbone
- Acute, localized pain in the neck, upper or lower back area - especially after lifting heavy objects or doing strenuous activities. (Pain on the tip can also be a sign of a heart attack or other life-threatening condition. )
- Chronic pain in the middle or lower part, especially after long periods of sitting or standing.
- Pain in the lower back that radiates to the buttocks of the leg.
- Inability to stand upright.
However, there are symptoms that warrant a visit to the doctor.
- Feeling numb, tingling, or weak in your arms or legs as these may indicate a spinal cord injury.
- Lower back pain radiates to the leg, which may indicate root compression (radiculitis).
- The pain increases when coughing or leaning forward, which can be a sign of a herniated disc.
- The pain when urinating is accompanied by a fever and burning sensation, which can be a sign of a urinary tract infection.
- Disorders of the bowel or bladder function
- Cancer story
- weight loss
- Long-term use of steroids
- History of the trauma
- Increased discomfort even after rest.
- Pain that lasts longer than a month
- Night pain
- No effect of the treatment
- History of drug use
Diagnosis
Due to the fact that back pain can be caused by various conditions, it is important that the doctor carefully records the anamnesis and symptoms. Both the location of the pain and the intensity and presence of radiation are important. The physical exam includes a careful examination of neurological status (reflex activity, muscle strength, sensitivity, etc. ). If you suspect a disease of the pelvic organs, the doctor may prescribe a consultation with a gynecologist or urologist.
Instrumental research methods
Radiography is usually of little value in diagnosing back pain, especially in the absence of severe symptoms. The use of radiography is indicated for acute significant or minor injury in patients over the age of 50, patients with osteoporosis, or a history of long-term steroid use.
MRI is the most informative diagnostic method and enables high-quality visualization of bones and soft tissues as well as the diagnosis of degenerative changes and tumors or infections.
A CT can be recommended for a clearer representation of bone changes.
EMG and ENMG enable the determination of conduction along nerve fibers and muscles and are usually used to diagnose chronic back pain.
Ultrasound examination of the abdominal organs or organs of the small pelvis, kidneys is necessary if the source of pain needs to be differentiated.
Laboratory research methods are also used for the differential diagnosis of inflammatory diseases or infections.
Treatment
There is no one universal treatment for back pain. Treatment of back pain in an individual case depends on both the emergence of the manifestations of pain and the individual characteristics of a person, since people's perception varies significantly.
Medical treatment includes the use of various drugs, both traditional analgesics or NSAIDs, as well as muscle relaxants or antibiotics for infections. For chronic pain syndrome, antidepressants, sedatives or neuroleptics can be used.
Non-drug treatments such as physical therapy, massage, manual therapy, acupuncture, and exercise therapy are widely used in the treatment of back pain. These methods of treatment are effective for both acute and chronic manifestations of pain associated with diseases of the spine.