Back ache

23 December 2023

One in ten people worldwide suffer from back pain. This condition leads to a decrease in working capacity and significantly limits the usual way of life. In some cases, back pain can be a symptom of a serious illness, treatment of which is most effective with early diagnosis. Therefore, if unpleasant symptoms appear in the back area, especially in the lower parts, it is recommended to consult a doctor. The specialist will establish an objective diagnosis and develop a targeted treatment and rehabilitation plan.

The modern clinic employs highly qualified doctors and care is provided in accordance with international standards. You can make an appointment by phone or online. Reception of specialists is organized at a time convenient for the patient.

About the disease

Back pain, and especially in its lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists and orthopedists. Labor losses due to pathology of the musculoskeletal system occupy one of the first places, since, as a rule, the most active group of the population is affected, aged 20 to 60 years and themore often from 25 to 45 years old.

The spine carries a colossal mechanical load, but at the same time it is a complex anatomical formation in which circulatory, supporting and spinal structures innervating the entire human body are closely interrelated. That is why changes in the spine, leading to compression or irritation of the spinal elements, can manifest as pathology of any internal organ (headache, vascular dystonia, hypertension, arrhythmia, sexual dysfunction, etc. . ).

Types of back pain

Pain is an unpleasant sensory and emotional experience caused by existing or potential tissue damage. The duration of back pain can vary, so there are 3 types:

acute – lasts up to 6 weeks;
subacute – present for more than 6 weeks;
chronic – bothers a person for more than 3 months.

Considering the causes of pain in the back region, it can be specific or non-specific. The most common pain encountered in clinical practice is nonspecific pain, which can occur at any age. This condition is characterized by the absence of a clear cause-and-effect relationship between the existing symptoms and the objective data of the examination (physical and instrumental). Timely treatment can interrupt the pain impulse.

Doctors speak of specific back pain if one or more pathological processes were discovered during a thorough diagnostic research. In this case, the mechanisms leading to the development of pain syndrome can be:

compression of nerve structures;
inflammatory damage to the joints of the spine;
instability of different segments of the spine (the lumbar region suffers most often);
damage to muscles and fascia.

Depending on the underlying cause, specific back pain is classified as follows:

discogenic – the cause lies in damage to the intervertebral disc;
radicular – caused by compression of nerve roots emerging from the spinal cord through the intervertebral foramina;
myofascial – pain is due to damage to the muscles surrounding the spine and/or the connective tissue membranes covering them;
joint – pain is caused by facet-articular osteoarthritis.

Spontaneous back pain, which occurs for no apparent reason, is a separate category.

Back Pain Symptoms

The disease can begin with sharp pain in any part of the back, which intensifies with active movements and bending. But most often, it all starts with a feeling of "tolerable" discomfort in the interscapular, lumbar and shoulder girdle areas. The discomfort intensifies in the evening, with weakness of the paraspinal muscles, or in the morning, due to poor sleeping conditions.

Depending on the mechanism of development of pain, it may be accompanied by other symptoms:

numbness in an arm or leg;
decreased muscle tone;
pathological sensitivity: crawling sensation, burning sensation, etc. ;
dysfunction of the pelvic organs: incontinence of urine, gas or stools, intimate disorders in men, etc.

Most Common Causes of Back Pain

According to observations and retrospective studies, the most common causes of back pain in patients visiting a medical center are the following conditions:

herniated disc, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative lesions of the intervertebral joints (spondyloarthrosis), increased mobility of the spinal segments (vertebral instability) and slippage of the vertebrae (degenerative spondylolisthesis);
simple traumatic injuries of the spine;
pathological fractures of the vertebrae occurring against the background of osteoporosis (a minor external impact is enough to disrupt the integrity of the bone);
aggressive hemangioma - a tumor arising from blood vessels that can compress nearby tissues;
primary and metastatic tumors affecting the spine.

Diagnosis of back pain

To identify possible causes of pain, doctors at the medical center conduct a complete examination of the patient. The diagnostic program is developed individually for each patient.

In addition to an objective neurological examination, the following diagnostic procedures may be prescribed:

CT scan of the spine. In the clinic, the examination is carried out using a high-precision device which makes 128 cuts of the anatomical area. This makes it possible to detect various abnormalities in the structure of the spine, incl. at the initial stage of development. Computed tomography is informative for identifying developmental abnormalities and degenerative-dystrophic lesions of the vertebrae, foci of inflammation, bone tumors, fractures and displacements of the vertebrae, narrowing of the spinal canal, hemorrhages in the spinal cord, which are associated with rupture of the arteriovenous canal. malformation.
Computer densitometry of the spine. The study makes it possible to objectively measure bone mineral density, which is important for the early diagnosis of latent osteoporosis. The sooner this pathology is detected, the sooner your doctor can prescribe treatment to strengthen your bones.
Magnetic resonance imaging of the spine. Most professional centers have a modern tomograph that generates a magnetic field of 1. 5 Tesla, which allows you to obtain detailed images with high precision. Magnetic resonance imaging makes it possible to detect not only bone pathologies, but also soft tissue lesions. The method is informative for detecting various forms of osteochondrosis (hernias and intervertebral protrusions, arthrosis of the joints), spinal injuries and deformities, vascular anomalies, inflammatory diseases of the spinal cord, tumors of varying density, etc.
Spinal x-ray. A robotic 3D x-ray complex allows you to examine various parts of the spine in one procedure, while computer software carries out digital "stitching" of images. This significantly increases the diagnostic value of the method. The clinic is equipped with computers and magnetic resonance imaging scanners with numerous functionalities, which make it possible to examine patients even with significant weight (up to 200 kg).

The diagnostic program for patients with back pain also includes laboratory tests. They allow you to take a comprehensive approach to assess the clinical situation and select the most optimal solution to the problem.

Expert opinion

Back pain is common among people over 60 years old, and many people attribute it to "age", deliberately depriving themselves of the pleasure of active movement. Meanwhile, the problem can occur at any age. Late diagnosis, as well as inappropriate treatment, often prolongs the disease for several months, requiring patients to be referred to establish a disability group, and premature surgical treatment often permanently disables patients. The number of disabled people due to so-called osteochondrosis of the spine has reached alarming proportions.

Which doctor should I consult for back pain?

General practitioners deal with general back pain problems. If highly specialized treatment is required, the patient is referred to a neurologist, and if there are indications for surgical treatment, to a neurosurgeon.

Back pain treatment

Conservative treatment

Nonsteroidal anti-inflammatory drugs, corticosteroid therapy, and local anesthetic blockades may be used to relieve pain. As part of a comprehensive treatment, physical exercise, massage, physiotherapy, reflexology, etc. are useful.

The further nature of conservative treatment is determined by the cause of the pain syndrome. So, for osteoarthritis, anti-inflammatory drugs are used, for osteoporosis, drugs that block the activity of cells that destroy bone tissue, etc. Certain pathologies initially require surgical intervention, because. . . conservative measures appear a priori ineffective.

Surgery

Surgical treatment of patients with back pain in the clinic can be carried out using different methods. In some cases, a minimally invasive procedure is performed, in others, traditional surgery is necessary.

Depending on the cause of back pain, doctors use different surgical options.

The main types of surgical care are:

Nucleoplasty. In the event of protrusion or intervertebral hernia, a puncture is made in the projection of the affected disc. Using an electrode (cold plasma or radiofrequency method), the deformed part of the nucleus is "evaporated", which reduces the pressure on the nerve root. As a result, the pain disappears. Rehabilitation is short - about 2 weeks.
Microdiscectomy. This microsurgical operation is performed for fairly large intervertebral hernias. After removing the prolapsed part of the nucleus pulposus, the pain syndrome is eliminated.
Radiofrequency denervation of the facet joints. The operation is indicated for back pain of myofascial origin and severe spondyloarthrosis. Under the influence of a high-frequency current, thermocoagulation of the nerve endings occurs, irritation of which causes pain. This is a one-day minimally invasive operation with a short rehabilitation period (1-2 days).
Spinal stabilization. A stabilizing structure is installed on the problem area, which firmly fixes the position of the vertebrae. Transpedicular screw fixation systems, interbody cages, laminar hook systems, and ventral plates can be used as stabilizers.
Decompression of the spinal canal. The surgeon removes compressive fragments and structures. In case of increased mobility of individual segments of the spine, additional stabilization surgery can be performed.
Vertebroplasty. Sterile medical bone cement is injected into the diseased vertebra using a special needle. As a result, the stability and functionality of the spine are restored.

Back pain prevention

Preventive measures are relevant both for people who have never experienced pain and for those who have already encountered unpleasant symptoms. Neurologists and orthopedists recommend:

regularly perform exercises aimed at strengthening the back muscles;
avoid physical inactivity;
keep body weight under control;
avoid lifting weights or do it correctly, without putting pressure on the spine;
promptly treat and correct postural disorders, bone and joint diseases;
undergo regular checkups and follow all doctor's recommendations.

Rehabilitation

The duration and characteristics of the rehabilitation period depend on the type of surgical intervention. After minimally invasive operations, the patient is recommended to start walking from the first day; after more extensive operations, the patient becomes more active after a few days. Restriction of physical activity can also range from 1-2 days to 1. 5 months. Your attending physician will inform you of the specifics of the rehabilitation period.

It is important, after relieving acute pain and restoring tissues, to pay attention to strengthening the muscular corset of the back. This will stabilize the spine and reduce stress on the vertebrae. A set of physical exercises should be developed by a specialist, taking into account the initial state of the musculoskeletal system.

Questions and answers

Why does my back hurt?

The causes of pain can be varied. In some cases, compression of the nerve roots occurs, in others, muscles and fascia are damaged, in others, the intervertebral joints suffer. Sometimes the cause of pain is related to functional conditions.

What to do when you have back pain?

First of all, go to the doctor. As first aid, you can apply creams or gels based on non-steroidal anti-inflammatory drugs to the sore spot.

Does surgery help me get back to my normal lifestyle?

Before surgery, the patient is examined in detail in order to select the optimal surgical technique that will break the "vicious circle". In most cases, surgical treatment reliably relieves pain and restores mobility to the spine.