Back pain: causes and treatment

Almost every person in the course of life happen to at least one long episode of back pain, and one-third of adults these unpleasant sensations are repeated regularly. The importance of the problem illustrated by at least the fact that for the treatment of back pain every year spent three times more to finance therapy for cancer patients.

The duration of an episode of pain is usually about 2 weeks, but many patients residual phenomena persist for a month or longer. The

part of these patients are diagnosed hernia of the intervertebral discs, the disease of the spinal canal, diseases of the kidney, ovary and other internal organs, and sometimes malignant tumors, or their metastases.

In this article we describe briefly the main causes of back pain and their distinguishing characteristics, to help the person to understand that with his health problems and it is time to consult a doctor.

The likely causes of back pain:

• the defeat of the spine, ligaments and muscles;
• breach roots, and other diseases of the spinal cord;
• diseases of the internal organs;
• diseases of the connective tissue;
• depression and disorders psychogenic.

It is shown that the back pain often occur when the small mobility, obesity, smoking, heavy physical work, stay in an uncomfortable position, prolonged action and vibration, and also the curves of the trunk.

Diseases of the spinal column, ligaments and joints

Most people with back pain that occur because of a lesion of the intervertebral disc, the joints between the peaks and the same bone of the vertebral bodies. With age the discs between the vertebrae lose water, decreases their thickness. Thus increases the mobility of the individual elements of the spinal column, which irritate pain receptors of the joints and intervertebral. I have to say that often even in people with severe "age" changes in the spinal column and the back pain is not. Often the herniated disc merges with the pain of the event.

In recent years more and more importance in the development of a constant back pain has been attributed to the so-called syndrome of the joints with "small faces", a form of osteoarthritis that affects the gastrointestinal of motion of the spine.

The pain with this syndrome can be unilateral and bilateral, is localized near the spine, most often in the lumbar region with the diffusion in the thigh. The pain often appears in the morning, but during the day passes, and still more after loading in the evening. For the first time usually appears after the strong discomfort of the rotation or inclination of the trunk. The pain increases in standing position and when you wind back, the decreases in sitting or lying position, with a slight decline, the use of media. The syndrome of the joints with "small face" is often used.

Often cause the back pain to the defeat of the spine the following states:

• spondylolisthesis – displacement of vertebrae with respect to one another;
• stenosis of the channel;
• ankylosing spondylitis (ankylosing Spondylitis);
• osteoporosis with fractures of the vertebral bodies (often in the elderly, especially in women;
• a large disc herniation (more than 5 mm);
• diseases of the cervical spine.

The lack of physical activity during the work day is a characteristic of the work in the office. The lack of movement, the long stay in an uncomfortable position will cause excess stress on the joints and become the cause of pain, disability and progressive destruction of the cartilage. Therefore, the employees of the offices it is recommended that you do gymnastics, and need to receive funds, the protection and repair of the cartilage tissue.

More rare, but dangerous reasons of the pain has a cancer, often the metastases in the vertebral column. The risk increases if the patient has had any cancer (most often the cancer of the lung, breast and prostate), weight loss, fever, duration of complaints more than a month, over the age of 50 years. Metastases most frequently affect the thoracic spine.

Another cause of back pain is related to cancer diseases, has multiple myeloma. Rarely, but there are benign and primary malignant tumors of the spine, for example, a benign tumor, it can be produced from bone tissue, Ewing's sarcoma.

Ankylosing Spondylitis is necessary to suspect when the young age of the patient, morning stiffness of the spine and large joints, improve the state after the warm-up. The pain often appears in the gluteal region. Characteristic the gain of the night, so that the sick person under the morning not able to sleep because of unpleasant sensations.

Back pain appear and other symptoms that are observed in the following diseases:

• the psoriatic arthritis;

• a rheumatic disease;
• juvenile rheumatoid arthritis;
• Crohn's disease, Whipple's, ulcerative colitis;
• dysentery, salmonellosis.

An important component of a comprehensive treatment is the intake of drugs, the effectiveness of which focuses on conservation and the normalization of the state of the joints and cartilage. A single injection ensures maximum bioavailability and speed of action of the drug, which helps to stop the progression of the destruction of the cartilage, reduces inflammation and stimulates the synthesis of hyaluronic acid. Thanks to the rapid onset of the effect there is no need for the long courses of the drug for a total of 20 injection 2 times a year. In addition to their the treatment of back pain, you can reduce the dosage and duration of use of NSAIDS.

Osteomyelitis spine or spondylitis is necessary to assume long fever, intravenously administered drugs or narcotic substances, previous infectious disease, or injury, intake of immunosuppressive drugs. Inflammatory diseases of the spinal column can have and the specific nature, which comes from syphilis, tuberculosis.

Defined the so-called indicators of serious problems, which require a careful examination of the patient:

• suddenly, for the first time in life born of pain;
• very strong pain;
• the lack of second pain from the position of the body;
• the pain is stronger at night and during the day;
• the age of the patient under age 20 years and over the age of 55 years;
• recently suffered a back injury;
• the probability of infection (inflammation in the urinary tract ways, the intake of immunosuppressive drugs, acquired immunodeficiency syndrome);
• moved to the cancer;
• unexplained weight loss and fever;
• general weakness;
• incontinence of urine or faeces;
• the gait;
• acronym of neurological disorders.

The defeat of the muscles

The defeat of the muscles of the back may be a secondary: disease of the spinal column muscles, the creation of a "protective corset keeps the spine, but from the constant tension and spasm, they themselves become the cause of the pain. Often a muscle spasm occurs the primary, for example, in the case of a long stay in an uncomfortable position or increased anxiety. The syndrome is relatively benign course and lends itself well to medical therapy.

Some systemic diseases muscles also occur back pain. These include:

• polymyalgia rheumatica;
• fibromyalgia.

Fibromyalgia is a common disease, more common in middle-aged women. It is characterized paid the pain in the muscles of the trunk, weakness, sleep disturbances, changes in skin sensitivity, anxiety, chair unstable.

The pathology of the spinal cord and its roots

The compression of the roots of the spinal cord, emerge through the holes between the peaks of the vertebrae, is the most rare cause of pain for every 10 ° of the patient. However, the pain more sharp and long, the treatment lasts about 2 months.

Compression (compression) roots call:

• herniated intervertebral disc;
• hypertrophy of the yellow ligament;
• bone proliferation;
• narrowing of the spinal canal (for example, due to an injury).

The framework defeat roots (radiculopathy): acute toxicity "filming" the back pain and disorders of sensitivity in zone of innervation of the spine, reduction of glare, the relative weakness of the muscle. If the compression of the margin has been demonstrated with the help of modern research methods, and drug treatment is inefficient, sometimes resorting to surgery.

Diseases of the internal organs

The back pain occurs not only to the diseases of the vertebral column or the spinal cord, but and accompanies many diseases of the internal organs:

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• heart disease (myocardial infarction, stable and unstable angina pectoris, infective endocarditis, aneurysm of the aorta);
• lung disease (pulmonary embolism, pneumothorax, pleural effusion);
• pathology of the esophagus and of the stomach (peptic ulcer, esophageal spasm, esophagitis);
• inflammatory processes in the kidneys, liver, pancreas, gall bladder.

Usually distinguish these diseases allow two points:

• sudden and very intense pain in the back;
• signs of lesions of the competent bodies (shortness of breath, wheezing in the lungs, pain on palpation of the abdomen, and so on).

When the back pain, especially has occurred suddenly and is not accompanied by signs of disease of the spinal column, it is always necessary to record an electrocardiogram for the elimination of acute myocardial infarction. In particular, this atypical localization of pain in coronary artery disease it is typical for the elderly.

Disorders psychogenic

Transition to chronic pain syndrome contribute to the social and behavioural factors:

• financial difficulties;
• the emotional tension;
• confidence in the inevitability of pain because of its apparent relationship with the daily work;
• thoughts of a possible serious illness and disability;
• depression;
• the dependence on other people;
• the strategy of avoidance of the disease, where the patient does not perform any action, for the diagnosis and treatment of the condition.

To what doctor to address

Then, the causes of back pain are many. As is very often associated with diseases of the spine and spinal cord, with their appearance of consult a neurologist. In addition, you can seek the advice of other specialists: a neurosurgeon, an oncologist, a gastroenterologist, a cardiologist, a surgeon, and a psychologist. To choose the right specialist, the first contact a therapist, who, after the first survey able to establish a preliminary diagnosis.