Backache

23 December 2023

Every tenth person in the world suffers from back pain. This condition leads to a decrease in the ability to work and severely limits the normal way of life. In some cases, back pain can be a symptom of a serious illness, the most effective treatment with early diagnosis. Therefore, if unpleasant symptoms appear in the back area, especially in the lower part, it is recommended to consult a doctor. The specialist will establish an objective diagnosis and formulate a targeted treatment and rehabilitation plan.

Modern clinics use highly qualified doctors. Care is provided according to international standards. You can make an appointment by phone or online. Specialist reception is organized at a convenient time for the patient.

About the disease

Back pain, and especially in the lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists and orthopedists. Loss of labor due to pathology of the musculoskeletal system occupies one of the main places, because, as a rule, the most active population group is affected, aged 20 to 60 years, and most often - 25-45 years.

The spinal column bears a great mechanical load, but at the same time it is a complex anatomical formation in which blood circulation, support, and the spinal structure that surrounds the entire human body are closely interconnected. That 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 longer than 6 weeks;
chronic - bothers a person for more than 3 months.

Considering the cause of pain in the back area, it can be specific or non-specific. The most common pain encountered in clinical practice is non-specific 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 found during a comprehensive diagnostic search. In this case, the mechanism leading to the development of pain syndrome may be:

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

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

discogenic - the cause lies in damage to the intervertebral disc;
radicular - due to the compression of the nerve roots emerging from the spinal cord through the intervertebral foramina;
myofascial – pain occurs as a result of damage to the muscles surrounding the spine and/or the connective tissue membrane that covers it;
articular - pain 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 acute pain in any part of the back, which increases with active movement and bending. But more often it all starts with "tolerable" discomfort in the interscapular, lumbar, and shoulder girdle areas. Discomfort increases in the evening, with paravertebral muscle weakness, or in the morning, as a result of poor sleep.

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

numbness in the arms or legs;
reduce muscle tone;
pathological sensitivity: crawling sensation, burning sensation, etc. ;
pelvic organ dysfunction: incontinence of urine, gas or stool, intimate disorders in men, etc.

The most common cause of back pain

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

herniated disc, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative damage to the intervertebral joints (spondyloarthrosis), increased mobility of spinal segments (instability of the spine) and slipping of vertebrae (degenerative spondylolisthesis);
uncomplicated traumatic injury to the spine;
vertebral pathological fractures occurring on the background of osteoporosis (external impact small enough to disrupt bone integrity);
aggressive hemangioma - a tumor originating from a blood vessel that can compress nearby tissue;
primary and metastatic tumors affecting the spine.

Diagnosis of back pain

To identify the possible cause of the pain, the doctor at the medical center conducts a thorough examination of the patient. The diagnostic program is prepared 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 carried out 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, includingin the early stages of development. CT is informative in identifying developmental anomalies and degenerative-dystrophic lesions in the vertebrae, inflammatory foci, bone tumors, fractures and vertebral displacement, narrowing of the spinal canal, bleeding in the spinal cord, associated with arteriovenous rupture. disability.
Computer densitometry of the spine. This 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 modern tomographs that generate a magnetic field of 1. 5 Tesla, which allows you to get very accurate detailed images. Magnetic resonance imaging can detect not only bone pathology, but also soft tissue lesions. This method is informative for detecting various forms of osteochondrosis (intervertebral hernia and protrusion, joint arthrosis), injuries and deformities of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of varying density, etc.
X-ray of the spine. The robotic 3D X-ray complex allows you to examine multiple parts of the spine in one procedure, while computer software performs digital image "stitching". This greatly increases the diagnostic value of the method. The clinic is equipped with a computer and a magnetic resonance imaging scanner with a wide range of functions, which allows 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 assess the clinical situation and choose the most optimal solution for the problem.

Expert opinion

Back pain is common in people over the age of 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. Late diagnosis, as well as improper treatment, often prolong the disease for several months, which forces the patient to be referred to establish a disability group, and premature surgical treatment often disables the patient permanently. The number of disabled people due to the so-called osteochondrosis of the spine has reached alarming proportions.

Which doctor should I contact for back pain?

General practitioners deal with general back pain problems. If very specific 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 blocks may be used to relieve pain. As part of comprehensive treatment, physical exercise, massage, physiotherapy, reflexology, etc. useful

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

Surgery

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

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

The main types of surgical care are as follows:

Nucleoplasty. In the case of intervertebral protrusion or hernia, a puncture is performed in the projection of the affected disc. Using an electrode (cold plasma method or radio frequency), the defective part of the nucleus "evaporates", which reduces the pressure on the nerve roots. As a result, the pain disappears. Recovery is short - about 2 weeks.
Microdiscectomy. This microsurgical operation is performed for relatively large intervertebral hernias. After removing the prolapsed part of the nucleus pulposus, the pain syndrome is eliminated.
Decreased radio frequency in the facet joints. This surgery is indicated for the myofascial origin of back pain and severe spondyloarthrosis. Under the influence of high-frequency current, thermocoagulation of nerve endings occurs, irritation that causes pain. This is a minimally invasive one-day operation with a short recovery period (1-2 days).
Spinal stabilization. A stabilizing structure is attached to the problem area, which firmly fixes the position of the vertebrae. Screw transpedicular fixation systems, interbody cages, systems with laminar hooks, and ventral plates can be used as stabilizers.
Spinal canal decompression. The surgeon removes the debris and compressed structures. If there is increased mobility of individual segments of the spine, additional stabilization surgery can be performed.
Vertebroplasty. Sterile medical bone cement is injected into the diseased vertebrae through a special needle. As a result, stability and functionality are restored to the spine.

Prevention of back pain

Preventive measures are relevant for those who have never experienced pain, and for those who have experienced unpleasant symptoms. Neurologists and orthopedics recommend:

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

Restoration

The duration and characteristics of the recovery period depend on the type of surgical intervention. After a minimally invasive operation, patients are recommended to start walking within the first day; after a more extensive operation, the patient becomes more active in a few days. Physical activity restrictions can also range from 1-2 days to 1. 5 months. Your treating doctor will inform you about the specifics of the recovery period.

It is important, after relieving acute pain and restoring tissue, to pay due attention to strengthening the back muscle corset. This will stabilize the spine and reduce pressure 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 vary. In some cases, nerve root compression occurs, in others, muscles and fascia are damaged, in others, intervertebral joints suffer. Sometimes the cause of pain is related to functional conditions.

What to do when your back hurts?

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

Will surgery help me return to my normal lifestyle?

Before surgery, the patient is examined in detail to choose the optimal surgical technique that will help break the "vicious circle". In most cases, surgical treatment can relieve pain and restore spinal mobility.