Most people experience back problems from time to time and experience pain in the lower back, neck, or middle 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.
Back pain includes: muscle and tendon pain, herniated disc, fracture, or other back problems. Most of the time, the reasons have a long history. Most often, back pain is caused by diseases of the spine.
The column 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, thoracic, and cervical spine. The spine is the main supporting part of the torso. In addition, the spine protects the spinal cord and the roots of the spinal cord with its bone structure, thus ensuring the normal innervation of organs and tissues.
Between each of the 24 vertebrae are intervertebral discs that perform a cushioning function.
Reasons
Back pain refers to problems that a person creates primarily for themselves. Back problems and back pain are often caused by bad habits that have built up over a long period of time. These bad habits include:
- Bad posture
- Overvoltage during work
- Wrong posture at desk or while driving
- Repeated stretching or extension of the spine or abnormal weight lifting.
The results of habits rarely appear immediately, but more often their negative effects add up over time. One of the most common types of back pain is pain associated with tension in the muscles that surround the spine. Most often, back pain associated with tension, muscles occur in the lumbar spine and cervical spine. If 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 speak of non-specific back pain. Such pain can develop due to weakened muscles that cannot cope with daily stress such as walking, bending, and stretching. Also, this nonspecific pain can be caused by lack of 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 problems.
Pregnancyis often the cause of the disease and this is due both to hormonal changes in the woman's body and to weight gain and excessive stress on the spine and legs.
Injuries from contact sports, accidents and falls can also cause back problems, ranging from mild muscle strain to severe spinal cord and spinal cord injuries.
It is important to understand that back pain is one of the symptoms of the disease and 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 the degeneration of the intervertebral discs (osteochondrosis), when involutive changes occur in the intervertebral discs and deterioration of the amortization functions of the discs, leading to the appearance of pain. Another cause of back pain is degenerative changes in the joints of the spine (spondyloarthrosis). Other mechanical causes include muscle spasms, muscle tension, and herniated disc.
Injuries: Spinal injuries, such as sprains and fractures, can cause both acute pain and chronic pain. Sprains, tears in the ligaments that support the spine, can occur from a torso twist or incorrect elevation. Fractures of the vertebrae are often the result of osteoporosis, a disorder in which bone density deteriorates. Less commonly, back pain can be caused by more serious injuries that result 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. Various types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis), stenosis of the spinal canal, affecting the nerve roots of the spinal cord. Diseases such as osteoporosis are painless in themselves, but they can cause vertebral fractures, which will manifest as 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 illness, infections can 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 terms of pain. Sometimes tumors of the spine are primary, but most of the time the tumors are metastatic and the main focus is elsewhere in the body.
Although the causes of back pain are often physical, it is important to understand that emotional stress can influence both the intensity and duration of pain. Also, stress and emotional state can affect skeletal muscle tone. So, in the presence of depression and anxiety, back pain can be more intense. Additionally, insomnia or lack of sleep can also contribute to or exacerbate 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 sex
- Family history
- Previous injuries
- Pregnancy
- Past surgery on the spine
- Congenital malformations of the spine.
- Lack of regular exercise
- Work or activity that requires prolonged sitting while lifting weights.
- Smoking. People who smoke more often than non-smokers experience back pain.
- Overweight. Being overweight, especially those with fat around the waist, can put more pressure on the back and they tend to have weak muscles and limited mobility
- Bad posture. 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 a role in back pain, especially chronic pain. Many people unknowingly tense their back muscles when under stress.
- Condition after a long period of depression.
- Long-term use of medicines (such as steroids) that weaken bone tissue.
- Lung diseases that cause chronic coughing.
Symptoms
Most people have experienced back pain in their lifetime. There are many reasons for back pain, some of them are self-created. Other causes include accidents, muscle sprains, sports injuries, and various diseases. Although the causes may be different, most of the time they are marked with the same symptoms.
- Persistent pain or stiffness in any part of the spine, from the base of the neck to the coccyx
- Sharp, localized pain in the neck, upper back, or lower back, especially after heavy lifting or strenuous activities. (Pain in the upper body can also be a sign of a heart attack or other life-threatening conditions. )
- Chronic pain in the middle or lower part, especially after prolonged sitting or standing.
- Low back pain radiating to the buttocks of the leg.
- Inability to stand up straight.
But there are symptoms that warrant seeking medical attention
- Numbness, tingling, or weakness in the arms or legs, as this may indicate a spinal cord injury.
- Low back pain radiates to the leg, which may be evidence of root compression (radiculitis).
- Pain is worse when coughing or bending forward, which may be a sign of a herniated disc.
- The pain is accompanied by a fever and a burning sensation when urinating, which may be a sign of a urinary tract infection.
- Bowel or bladder function disorders
- History of cancer
- Weight loss
- Long-term steroid use
- Trauma history
- Increased discomfort even after the break.
- 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 various conditions, then first of all it is important for the doctor to carefully collect the anamnesis and symptoms. Both the location of the pain and the intensity, the presence of radiation are important. The physical examination 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, urologist.
Instrumental Research Methods
Radiography is often of little value in diagnosing spinal pain, especially if there are no significant symptoms. The use of radiography is indicated for significant acute injuries or minor injuries in patients older than 50 years, patients with osteoporosis, or a history of long-term steroid use.
Magnetic resonance imaging is the most informative diagnostic method and allows a high-quality visualization of both bone and soft tissue and allows the diagnosis of degenerative changes as well as 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 are generally used in the diagnosis of chronic back pain.
Ultrasound examination of the abdominal organs or organs of the small pelvis, the kidneys is necessary when 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 are no universal treatments for back pain. The treatment of back pain in each individual case depends both on the genesis of the manifestations of pain and on the individual characteristics of a person, since the perception of people varies significantly.
Medical treatment includes the use of various medications, both conventional pain relievers or NSAIDs, as well as muscle relaxants or antibiotics for infections. With chronic pain syndrome, it is possible to use antidepressants, tranquilizers, or neuroleptics.
Non-drug treatments such as physical therapy, massage, manual therapy, acupuncture, and exercise therapy have been widely used in the treatment of back pain. These treatment methods are effective for both acute and chronic pain manifestations associated with diseases of the spine.