Most people experience back problems from time to time and feel pain in the back, neck or middle of the waist. In fact, back pain is the most common physical complaint in the adult population and is a major cause of temporary disability. Back pain can be mild or severe, the pain can be short-term or chronic.
Low back pain includes: muscle and tendon pain, disc herniation, fracture or other back problems. Often the reasons have a long history. Often, back pain is caused by spinal diseases.
The spine structure is designed for extreme loads. The structure of the spine is stable so that a person can walk (stand) and be flexible enough to perform trunk movements.
A healthy spine has an elongated S-shape when viewed from the side and has natural curves at the waist, chest and neck. 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 normal innervation of organs and tissues.
Between each of the 24 vertebrae are intervertebral discs that perform a cushioning function.
Reasons
Back pain is one of the main problems that people create for themselves. Back problems and back pain are most often caused by bad habits accumulated over a long period of time. These bad habits include:
- Weak posture
- Excessive stress during operation
- Wrong posture at the table or while driving
- Repeated stretching or stretching of the spine or abnormally sharp lifting of weights.
The consequences of habits rarely appear immediately, but more negative effects accumulate over time. One of the most common types of back pain is pain associated with tension in the muscles around the spine. Tension-related low back pain often occurs in the lower back and cervical spine. If muscle tension is associated with lifting heavy objects, the pain may be tolerable.
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 are unable to cope with daily stress such as walking, bending and stretching. In addition, it can cause non-specific pain, 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 caused by stress or other emotional problems.
Pregnancyis often the cause of the disease, which is caused by hormonal changes in a woman's body, as well as weight gain, excessive stress on the spine and legs.
Injuries, accidents and falls in contact sports can also cause back problems, from minor muscle strains to spinal cord and spinal cord injuries.
It is important to understand that back pain is one of the symptoms of the disease and is not diagnosed. Medical 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 performing certain movements. The most common mechanical cause is degeneration of the intervertebral discs (osteochondrosis), which occurs when involutional changes occur in the intervertebral discs and the deterioration of the amortization functions of the discs causes pain. Another cause of back pain is degenerative changes in the spinal joints (spondyloarthritis). Other mechanical causes include muscle spasm, muscle tension, and herniated discs.
Injuries: Spinal injuries such as nose and fractures can cause both acute and chronic pain. Hernias, hernias, in the ligaments that support the spine can occur without bending the body or lifting it properly. Vertebral fractures are often the result of osteoporosis, a disease in which bone density is compromised. Less commonly, back pain can lead to more serious injuries resulting from accidents and falls.
Acquired conditions and diseases. Many medical conditions can cause or cause pain. These include scoliosis, kyphosis, kyphoscoliosis, which are generally painless until middle age. Different types of arthritis (osteoarthritis, rheumatoid arthritis, ankylosing spondylitis) affecting the spinal nerve roots, stenosis of the spinal canal. Diseases such as osteoporosis are painless in themselves, but can cause vertebral fractures that present with severe pain. Other causes of back pain include pregnancy, kidney infections, or fibromyalgia characterized by urolithiasis, endometriosis, chronic fatigue, and diffuse muscle pain.
Infections and tumors. Although infections are not a common cause 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 during pain. Sometimes spinal tumors are primary, but in most cases the tumors are metastatic and the primary focus is on another part of the body.
Although the causes of back pain are generally physical, it is important to understand that emotional stress can play a role in both the intensity and duration of the pain. In addition, stress and emotional state can affect skeletal muscle tone. Thus, back pain may be more intense when there is depression and anxiety. In addition, insomnia or lack of sleep can cause or worsen pain.
Back pain is just 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
- Over 40 years old
- Male
- Family history
- Previous injuries
- Pregnancy
- Past spinal surgeries
- Congenital defects of the spine.
- Lack of regular exercise
- A job or activity that requires you to sit for a long time and lift weights.
- Smoking. People who smoke are more likely to have back pain than non-smokers.
- Overweight. Those who are overweight, especially those with fat on their backs, can put more strain on their backs and have weak muscles and limited mobility.
- Poor posture. Posture disorders cause disruption of the distribution of load vectors and cause muscle tension, muscle spasm and pain.
- Stress. Stress and other emotional factors are thought to play an important role in back pain, especially chronic pain. Many people unknowingly strain their back muscles when they are under stress.
- The situation after a long depression.
- Long-term use of bone-weakening drugs (such as steroids).
- Lung diseases that cause chronic cough.
symptoms
Most people have experienced back pain throughout their lives. There are many causes for back pain, some of which are caused by the person himself. Other causes include accidents, muscle cramps, sports injuries, and various illnesses. Although the causes may be different, in most cases they are marked by the same symptoms.
- Persistent pain or stiffness in any part of the spine, from the base of the neck to the coccyx
- Acute, localized pain in the neck, upper back, or lower back - especially after lifting heavy objects or strenuous activity. (Pain in the upper extremity may be a sign of a heart attack or other life-threatening condition. )
- Chronic pain in the middle or lower extremities, especially after sitting or standing for long periods of time.
- Back pain spreading to the back of the foot.
- It is impossible to stand up straight.
But there are symptoms that require medical attention
- Feeling of numbness, tingling, or weakness in the arms or legs, as this may indicate spinal cord injury.
- Low back pain spreads to the leg, which may be evidence of radiculitis.
- Pain increases when coughing or leaning forward, which can be a sign of a herniated disc.
- Pain is accompanied by a fever and burning sensation during urination, which may be a sign of a urinary tract infection.
- Impaired bowel or bladder function
- History of cancer
- Weight Loss
- Long-term steroid use
- Trauma history
- Increased fatigue after rest.
- Pain lasting more than a month
- Night Pain
- No effect of treatment
- History of drug use
Diagnostics
Since the cause of back pain can be a variety of conditions, it is important that the doctor first carefully collects the anamnesis and symptoms. Both the location and intensity of the pain and the presence of radiation are important. Physical examination involves careful examination of the nervous condition (reflex activity, muscle strength, sensitivity, etc. ). If you suspect a disease of the pelvic organs, your doctor may prescribe a consultation with a gynecologist, urologist.
Instrumental research methods
Radiography is generally of little importance in the diagnosis of back pain, especially in the absence of any symptoms. The use of radiography is indicated in patients older than 50 years, in patients with osteoporosis, or for acute injuries or minor injuries with a long history of steroid use.
MRI is the most informative diagnostic method and allows high-quality imaging of both bone and soft tissues, and allows the diagnosis of both degenerative changes and tumors or infections.
CT may be recommended to make bone changes more visible.
EMG and ENMG allow the determination of conduction along nerve fibers and muscles and are commonly used in the diagnosis of chronic low back pain.
Ultrasound examination of the abdomen or small pelvis, kidneys is necessary when it is necessary to identify 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 low back pain in each individual situation depends on both the genesis of the pain manifestations and the individual characteristics of a person, because people's perceptions change significantly.
Medical treatment involves the use of various traditional analgesics or NSAIDs and muscle relaxants or antibiotics for infections. It is possible to use antidepressants, tranquilizers or neuroleptics with chronic pain syndrome.
Non-drug therapies such as physiotherapy, massage, manual therapy, acupuncture and sports therapy have been widely used to treat low back pain. These treatments are effective for both acute and chronic pain associated with spinal diseases.