Backache

23 December 2023

Every tenth person in the world experiences back pain. This condition leads to a decrease in the ability to work and greatly limits the usual way of life. In some cases, back pain can be a symptom of a serious disease, the treatment of which is more 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 make an objective diagnosis and draw up a targeted treatment and rehabilitation plan.

The modern clinic employs highly qualified doctors and care 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. Loss of work due to the pathology of the musculoskeletal system occupies one of the main places, since, as a rule, it affects the most active group of the population, from 20 to 60 years old, and more often - 25-45 years old.

The spinal column carries a colossal mechanical load, but at the same time it is a complex anatomical formation in which the blood circulation, supporting and spinal structures that innervate the entire human body are closely intertwined. This is why changes in the spine, which lead 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 area, 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 existing symptoms and objective examination data (physical and instrumental). Timely treatment can interrupt the pain impulse.

Doctors talk about specific back pain if one or more pathological processes are detected during a complete diagnostic research. In this case, the mechanisms leading to the development of the pain syndrome may be:

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

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

discogenic - the cause lies in the damage of the intervertebral disc;
radicular - caused by compression of the nerve roots exiting the spinal cord through the intervertebral foramen;
myofascial – pain occurs due to damage to the muscles surrounding the spine and/or the connective tissue membranes that cover them;
articular – pain is provoked by fasto-articular osteoarthritis.

Spontaneous back pain, which appears for no apparent reason, is a category of its own.

Back pain symptoms

The disease can begin with acute pain in any part of the back, which intensifies with active movement and bending. But most often everything starts with a "tolerable" feeling of discomfort in the interscapular, waist and shoulder girdle areas. Discomfort intensifies in the evening, with weakening of the paravertebral muscles, or in the morning, as a result of poor sleeping conditions.

Depending on the mechanism of pain development, 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 feces, intimate disorders in men, etc.

The 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:

disc herniation, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative damage to the intervertebral joints (spondyloarthrosis), increased mobility of the spinal segments (instability of the spine) and slipping of the vertebrae (degenerative spondylolisthesis);
uncomplicated traumatic injuries of the spine;
pathological fractures of the vertebrae that occur against the background of osteoporosis (a small external impact is enough to disrupt the integrity of the bone);
aggressive hemangioma - a tumor originating 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 perform a comprehensive examination of the patient. The diagnostic program is compiled individually for each patient.

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

Computed tomography of the spine. In the clinic, the examination is performed using a high-precision device that makes 128 sections of the anatomical area. This makes it possible to detect various abnormalities in the structure of the spine, including. in the initial stage of development. CT is informative in identifying developmental abnormalities and degenerative-dystrophic lesions in the vertebrae, foci of inflammation, bone tumors, fractures and dislocations of the vertebrae, narrowing of the spinal canal, hemorrhages in the spinal cord, which are associated with arteriovenous rupture. malformation.
Computed densitometry of the spine. The study allows you to objectively measure bone mineral density, which is important for the early diagnosis of latent osteoporosis. The sooner this condition 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 get very accurate detailed images. Magnetic resonance imaging can detect not only bone pathologies, but also soft tissue lesions. The method is informative for the detection of various forms of osteochondrosis (hernias and intervertebral protrusions, joint arthrosis), injuries and deformations of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of different densities, etc.
X-ray of the spine. A 3D X-ray robotic complex allows you to examine different parts of the spine in one procedure, while computer software performs digital "stitching" of the images. This greatly increases the diagnostic value of the method. The clinic is equipped with a computer and a magnetic resonance scanner with wide functionality, which allow the examination of patients even with a large 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 assessing the clinical situation and choosing the most optimal solution to the problem.

Expert opinion

Back pain is common in people over 60 and many people attribute it to "age", deliberately depriving themselves of the joy of active movement. Meanwhile, the problem can arise at any age. Delayed diagnosis, as well as improper treatment, often prolongs the disease for many months, which forces patients to be referred to create a disability group, and premature surgical treatment often disables patients forever. The number of people with disabilities due to the so-called spinal osteochondrosis has reached alarming proportions.

Which doctor should I contact for back pain?

General practitioners deal with general back pain issues. If highly specialized treatment is necessary, 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 blocks may be used to relieve pain. As part of a comprehensive treatment, physical exercises, massage, physiotherapy, reflexology, etc. are useful.

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

Surgery

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

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

The main types of surgical care are as follows:

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

Back pain prevention

Preventive measures are important both for those 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 exerting stress on the spine;
immediately treat and correct postural disorders, bone and joint diseases;
perform regular examinations and follow all the doctor's recommendations.

reHabiLitatiON

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

It is important, after relief of acute pain and tissue restoration, to pay due 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.

Question and answer

Why does my back hurt?

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

What should you do when your back hurts?

First of all, go to the doctor. As a first aid, you can apply cream or gel based on non-steroidal anti-inflammatory drugs to the injured area.

Will the surgery help me return to my normal lifestyle?

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