Most people experience back problems from time to time and experience pain in the lower back, neck or lower back. 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, short-term or chronic pain.
Back pain includes: muscle and tendon pain, disc herniation pain, fracture or other back problems. Most often, the reasons have a long history. Most often, back pain is caused by back diseases.
The backbone structure 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 has an elongated S shape when viewed from the side, and has natural curves in the lumbar spine, thorax and cervix. The spine is the main supporting part of the body. In addition, the spine protects the spinal cord and spinal cord roots with its bone structure, thus ensuring the normal innervation of organs and tissues.
Between each of the 24 vertebrae there are intervertebral discs that perform a cushioning function.
Reasons
Back pain refers to problems that a person mainly creates for themselves. Back problems and back pain are most often caused by bad habits that have accumulated over a long period of time. These bad habits include:
- Poor attitude
- Overvoltage at work
- Improper table standing or driving
- Repeated stretching or extension of the spine or abnormally sharp weight lifting.
The results of habits rarely appear immediately, but more often their negative effects accumulate over time. One of the most common types of back pain is tension-related pain in the muscles surrounding the spine. Most often, back pain accompanied by tension, muscles occur in the lumbar spine and in the cervical spine. If muscle tension is accompanied by the lifting of heavy objects, then 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 can not cope with daily stress, such as walking, bending and stretching. In addition, such nonspecific pain can be caused by poor sleep, general fatigue, or exposure to 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 and it is associated with both hormonal changes in a woman's body and weight gain and excessive stress on the spine and legs.
Injuries in contact sports, accidents and falls can also cause back problems, ranging from minor muscle strain to serious spinal and spinal cord injuries.
It is important to understand that back pain is one of the symptoms of the disease and is not a diagnosis. Medical conditions that can cause back pain include the following:
Mechanical problems: Mechanical problems are related to the movements of the spine or the sensations that a person experiences when performing certain movements. The most common mechanical cause is degeneration of the intervertebral discs (osteochondrosis), when involutional changes occur in the intervertebral discs and deterioration of the damping functions of the discs, which leads to the appearance of pain. Another cause of back pain are degenerative changes in the joints of the spine (spondyloarthritis). Other mechanical causes include muscle spasms, muscle tension and disc herniation.
Injuries: Spinal cord injuries such as sprains and fractures can cause acute pain and chronic pain. Distortions, tears in the ligaments that support the spine, can occur from torso twisting or improper lifting. Vertebral fractures are often the result of osteoporosis, a disorder in which bone density is impaired. Rarely, back pain can be caused by more severe injuries that come from collisions and falls.
Acquired conditions and diseases. Many medical conditions can cause or contribute to pain. These include scoliosis, kyphosis, kyphoscoliosis, in which there is usually no pain until middle age. Different types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), spinal canal stenosis, which affects the nerve roots of the spinal cord. Diseases such as osteoporosis are painless in themselves, but can lead to vertebral fractures, which will manifest with severe pain. Other causes of back pain include pregnancy, kidney infections or urolithiasis, endometriosis, fibromyalgia, which is characterized by chronic fatigue and diffuse muscle pain.
Infections and tumors. Although infections are not common causes of the disease, infections can still cause pain. If the bone tissue is affected, then we are talking about osteomyelitis, if the infection affects the intervertebral discs, then we are talking about discitis. Tumors are also relatively rare in pain. Sometimes spinal tumors are primary, but more often the tumors are metastatic and the primary focus is on another part of the body.
While the causes of back pain are usually physical, it is important to understand that emotional stress can play a role in both pain intensity and duration. In addition, stress and emotional state can affect skeletal muscle tone. So in the presence of depression and anxiety, back pain can be stronger. In addition, insomnia or lack of sleep can also contribute to or worsen the pain.
Back pain is just a symptom and can be reflected. Many diseases of the peritoneum and pelvic organs can cause spinal pain (appendicitis, aneurysm, kidney disease, bladder disease, infections, and pelvic inflammatory disease).
Risk Factors
- Age over 40
- Male gender
- Family history
- Previous Injuries
- Pregnancy
- Spinal Surgeries in the Past
- Congenital malformations of the spine.
- Lack of regular exercise
- Work or activity that requires prolonged weight lifting.
- Smoking. People who smoke more often than people who do not smoke experience back pain.
- Mbipesha. Being overweight, especially those with fat around the waist, can put more strain on the back and tend to have weak muscles and limited mobility
- Poor attitude. Impaired posture leads to a violation of the distribution of load vectors and to muscle tension, muscle spasm and pain.
- Stress. Stress and other emotional factors are believed to play an important role in back pain, especially chronic pain. Many people unconsciously strain 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 leading to chronic cough.
Symptoms
Most people have experienced back pain in their lifetime. There are many reasons for back pain, some of which a person creates for themselves. Other causes include accidents, muscle cramps, sports injuries and various diseases. Although the causes may be different, more often they are marked with the same symptoms.
- Persistent pain or stiffness in any part of the spine, from the base of the neck to cancer
- Acute pain, localized in the neck, upper back or lower back - especially after lifting heavy objects or performing strenuous activities. (Upper back pain can also be a sign of a heart attack or other life-threatening condition. )
- Chronic pain in the middle or lower back, especially after sitting or prolonged stay.
- Pain in the lower back radiating to the buttocks.
- Inability to stand up straight.
But there are symptoms that require seeking medical attention
- Nausea, tingling or weakness in the arms or legs, as this may indicate spinal cord injury.
- Low back pain radiates to the legs, which may be evidence of root (radicle) oppression.
- The pain increases when you cough or bend forward, which can be a sign of a disc herniation.
- Pain is accompanied by fever and burning sensation when urinating, which may be a sign of a urinary tract infection.
- Disorders of bowel or bladder function
- History of cancer
- Weight Loss
- Long-term steroid use
- History of trauma
- Increased despair even after rest.
- Pain lasting more than a month
- Night Pain
- No treatment effect
- History of drug use
Diagnosis
Due to the fact that the cause of back pain can be different conditions, then, first of all, careful collection of the doctor's anamnesis and symptoms is important. Localization of pain and intensity, presence of radiation are important. Physical examination involves a careful examination of the 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, urologist.
Instrumental search methods
Radiography is usually of little value in diagnosing back pain, especially if there are no severe symptoms. The use of radiography is indicated for significant acute injuries or minor injuries in patients over 50 years of age, patients with osteoporosis, or a history of long-term steroid use.
MRI is the most informative diagnostic method and allows high quality visualization of both bone and soft tissue and allows the diagnosis of degenerative changes and tumors or infections.
For clearer visualization of bone changes, CT may be recommended.
EMG and ENMG allow the determination of conduction along nerve fibers and muscles and, as a rule, are used in the diagnosis of chronic back pain.
Ultrasound examination of the abdominal or pelvic organs, kidneys is necessary in case it is necessary to differentiate the source of pain.
Laboratory research methods are also used for the differential diagnosis of inflammatory diseases or infections.
Treatment
There is no universal treatment for back pain. The treatment of back pain in each individual case depends on the genesis of the manifestations of pain and the individual characteristics of a person, as people's perception varies considerably.
Medical treatment involves the use of various medications, such as conventional analgesics or NSAIDs, as well as muscle relaxants or antibiotics for infections. With chronic pain syndrome, it is possible to use antidepressants, sedatives or neuroleptics.
Non-medical treatments such as physiotherapy, 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 spinal diseases.