Backache

Back pain is a common problem in middle-aged and older patients. Maybe due to improper lifestyle, diseases of the musculoskeletal system, diseases of the internal organs. Neurologists, orthopedists, nephrologists, and urologists can treat back pain, depending on its origin. It is difficult for patients to find the cause of their discomfort on their own and choose the right doctor. Therefore, it is necessary to contact the therapist at first, depending on your symptoms, history and results of studies performed, they will refer you to a specialist specialist.

Classify

Back pain can be:

• Myofascial.
• Non-sensitive.
• Neuropathy.
• Mental.

Neuropathic painobserved during the so-called formation. trigger points in the muscles of the back. Trigger points are pea-like knots that form when muscles are constantly tense (when they simply cannot relax). Furthermore, when one segment of a muscle fiber is compressed, the other stretches. This affects the ability of muscle fibers to move: it is restricted. The fibers themselves are shortened, becoming tighter.

Trigger points arise due to overactive muscles. Furthermore, excessive stress can occur not only from excessive physical activity but also from being in a position for too long (eg, sitting in front of a computer). In addition, trigger points often occur with bone necrosis.

Another factor that contributes to the formation of trigger points is over-stimulation of sarcomeres (basic contractile units are a complex of proteins). If there is excessive irritation of the sarcomeres, they are often in a state of spasticity.

The presence of trigger points does not allow the muscles to fully relax. She begins to get tired quickly even under light load, overworked on the go, and recovers very slowly. Its limited range of motion affected the entire fascist chain. Other muscles and even some joints become less mobile.

Blood flow in the tissues surrounding the trigger point is also affected. Hence, oxygen starvation is observed in this area. Decomposition products accumulate, causing irritation to the trigger point and pain develops due to this. In this case, the size of the organ does not matter, it all depends on the degree of irritation of the spot. Even the tiniest muscle with trigger points in it can cause a lot of discomfort.

A characteristic feature of myofascial pain is their reflection. This means the pain is reflected to other parts of the body. They can occur in areas very far from the trigger point. So, for example, pain below the shoulder blades or in the lower back may develop due to the presence of nodes in the abdominal muscles. In addition, the lower back may experience pain from trigger points in the calf area or in the buttocks.

Muscle pain is usually long lasting and dull. Sometimes they only happen while moving, sometimes they are at rest. They can vary in strength: from mild discomfort to intolerable pain.

Pain caused by sensation- the body's response to direct stimulation of pain receptors (nociceptor). In the case of the back, these are the receptors located in the disc ligament, muscles, tendons, as well as in the synovial sac of the disc joint and the outer 1/3 of the fibrous sheath of the disc. Patients may experience pain accompanied by muscle spasm reflexes, dystrophy or pathological processes in the facial joints. When moving, the pain gets worse.

Neuropathic paindevelopment in pathological processes in the nervous system: damage to the nerves or roots of the peripheral nervous system, central nervous system disruption. Such pain can be observed with osteoporosis, degenerative spine, herniation and spinal fracture. They intensify when bending, moving, straining, coughing, sneezing, and in most cases they are delivered to the limbs. Sometimes they are dull and painful, but often they are sharper, shoot out.

Psychological painoccurs due to muscle spasms caused by emotional stress, chronic stress, or an anxiety disorder.

In some cases varieties may be combined. For example, social sensations coexist with sensitive feelings.

In addition, back pain is divided into 3 categories:

• Acute (lasts less than 6 weeks).
• Semi-acute (6-12 weeks).
• Chronic (more than 3 months).

Acute / subacute painUsually develops as a result of tissue damage (deep, superficial) caused by cuts, wounds, inflammation. As a result, the body warns us that something is wrong. The pain goes away after the tissues are completely healed.

Chronic painIt occurs due to diseases of the organs and systems or an emotional disturbance. If so, a thorough medical examination is required.

According to location, the pain can be:

• Local.
• Reflected.
• Irradiation.

Local pain develops directly at the site of the development of the pathological process. Reflect - if there is a trigger point. Irradiation - with damage to internal organs, spreads along nerve fibers.

Why does my back hurt?

Back pain can have many causes, including:

• Scoliosis curvature: scoliosis, hunchback of the spine.
• Neurological diseases: disc herniation, degenerative cervical vertebrae, cervical vertebra degeneration.
• Endocrine diseases: osteoporosis.
• Respiratory system diseases: pleurisy.
• Pathologies of the kidneys and urinary system: urolithiasis, pyelonephritis, glomerulonephritis.
• Tumors.

Short-term pain (often severe, burning) can be caused by many different things. Including:

• Injured.
• Excessive muscle activity (due to a monotonous posture or performing the same kind of repetitive movements).
• Hypothermia.

Pain caused by the degenerative process occurs with the following diseases:

• Bone tumors.
• Disc herniation.
• Convex disc.
• Degenerative vertebrae.
• Scoliosis degeneration.
• Arthritis.
• Spondylolisthesis.
• Degenerative vertebrae (no vertebral arch linking).
• Spinal stenosis.

Pain spreading to the spine can develop as a result of diseases:

• Heart and arteries: myocardial infarction, angina, aortic aneurysm.
• Lung: cancerous tumor, pleurisy.
• Stomach.
• Gallbladder and biliary tract: acute and chronic cholecystitis.
• Kidney and urinary tract.
• Pancreas.

Back pain in rare cases can be of infectious origin. For example, sometimes my back hurts from the flu. In addition, the infection can enter the spine from neighboring organs: the urinary tract, the kidneys.

Other reasons for the development of back pain may be changes in hormone levels (eg, age related, during or after menopause). In this case, degenerative hormonal spondylolisthesis occurs (degenerative changes in the spine).

Back pain a lot: what to do?

If you have severe pain attacks, see your doctor as soon as possible. However, if the sensation is so strong that any movement causes torment, immediate medical attention is needed. You need to lie on your back on a flat, hard surface (eg the floor). This will help relieve spasms, relax muscles and relieve pain.

Lie on a flat surface, do not change the back position. Lie on your back, try to roll over to the side. This will soothe the spine. When the pain subsides, get back on your back. Should put something under your feet, lift them up. Lie in this position for 10-15 minutes.

You also need to climb correctly: roll over your body first. From this position, walk on all fours. Then lean on something (if no support is nearby - crawl over it) and get up slowly. Only then carefully straighten your back.

To find out why your back hurts so badly, don't postpone a visit to your doctor. This will help avoid new attacks.

Diagnose

You should definitely make an appointment with a therapist if you have back pain:

• occurs during exertion, muscle tension;
• last for more than 3 days;
• is repeated in batches.

Need to see a doctor immediately in the following cases:

• constant back pain;
• increased body temperature, numbness of the limbs, limbs became more painful in the morning;
• pain in the supine position does not go away;
• The pain gets worse at night.

At the appointment, the doctor will collect a history, examine the patient (assess skin condition, position and balance of the body, gait, etc. ). He will then appoint studies:

• general analysis of blood and urine;
• X ray;
• Computerized tomography;
• magnetic resonance imaging.

If necessary, the therapist will refer the patient to a neurologist, orthopedist, urologist, gynecologist, or nephrologist.

Treatment of back pain

Treatment for back pain is comprehensive and may include:

• medications (anti-inflammatory, analgesic, restorative drugs);
• blockade (long-term pain relief);
• physiotherapy procedures;
• physical therapy exercises;
• Massage;
• manual therapy.

If conservative methods do not give the desired results, surgical treatment is indicated. Modern methods make it possible to perform precise maneuvers with less injury time with short rehabilitation times.

Prevention of back pain

Simple precautions can help prevent back pain. It is necessary:

• Track your posture.
• Sleep on a hard mattress.
• Participate in activities that involve long sitting (driving, working with computers), changing positions over time, and organizing breaks and warm-ups.
• When standing for a long time, lean against something.
• Do not wear heels for more than 2 hours in a row.
• Make time for moderate physical activity (swimming, exercising).
• Keep track of your weight - back pain can be caused by weight gain.
• Try not to lift weights.
• Do not turn or bend when moving suddenly.
• Timely treatment of urological and gynecological diseases.

Annual preventive visits to the therapist will also be beneficial. Pathologies identified in an early stage can be eliminated without waiting for the development of complications.