back pains

23 December 2023

Every tenth person in the world experiences back pain. This condition leads to reduced working capacity and significantly limits the usual way of life. In some cases, back pain can be a symptom of a serious illness, the 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 make an objective diagnosis and prepare a targeted treatment and rehabilitation plan.

Highly qualified doctors work in the modern clinic, 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, especially in its lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists and orthopedists. Losses of work due to the pathology of the musculoskeletal system occupy one of the leading places, since, as a rule, the most active group of the population aged from 20 to 60 years, and most often - 25-45 years, is affected.

The spine bears a colossal mechanical load, but at the same time it is a complex anatomical formation in which the blood-bearing, supporting and spinal structures innervating the entire human body are closely intertwined. That is why changes in the spine that lead to compression or irritation of the spinal elements can manifest as pathology of the internal organs (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.

Taking into account the causes of back pain, it can be specific and 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 lack of a clear causal relationship between the existing symptoms and the data of the objective examination (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 thorough diagnostic examination. 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 various segments of the spine (the lumbar region is most often affected);
muscle and fascia damage.

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

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

A separate category is spontaneous back pain that occurs for no apparent reason.

Back pain symptoms

The disease can begin with a sharp pain in any part of the back, which increases with active movements and bending. But more often everything starts with a "tolerable" feeling of discomfort in the interscapular, lumbar and shoulder girdle areas. Discomfort increases in the evening, with weakness of the paravertebral muscles, or in the morning, as a result of bad sleep.

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 (spinal instability) and slipping of the vertebrae (degenerative spondylolisthesis);
traumatic uncomplicated spinal injuries;
pathological fractures of the vertebrae occurring against the background of osteoporosis (a slight external impact is enough to break 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 conduct a comprehensive examination of the patient. The diagnostic program is drawn up 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 with a highly precise device that makes 128 incisions in the anatomical area. This makes it possible to detect various abnormalities in the structure of the spine, incl. in the initial stage of development. CT is informative in identifying developmental anomalies 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 rupture of the arteriovenous malformation.
Computed densitometry of the spine. The examination 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 detecting various forms of osteochondrosis (intervertebral hernias and protrusions, arthrosis of the joints), injuries and deformations of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of different densities, etc.
X-ray of the spine. The robotic 3D X-ray complex allows you to examine different parts of the spine in one procedure, while computer software performs digital "stitching" of images. This significantly increases the diagnostic value of the method. The clinic is equipped with computer and magnetic resonance scanners with wide functionality, which allow 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 the assessment of the clinical situation and choose 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 occur at any age. Late diagnosis, as well as incorrect treatment, often prolong the diseasewith many months, which forces patients to be referred to establish a disability group, and premature surgical treatment often leads to permanent disability of patients. The number of people with disabilities due to the so-called osteochondrosis of the spine reaches alarming proportions.

Which doctor should I see for back pain?

General practitioners deal with common back pain problems. If highly specialized treatment is needed, the patient is referred to a neurologist, and if surgical treatment is indicated, to a neurosurgeon.

Back pain treatment

Conservative treatment

Nonsteroidal anti-inflammatory drugs, corticosteroid therapy, and local anesthetic blocks can be used to relieve pain. Physical exercises, massage, physiotherapy, reflexology, etc. are useful as part of complex treatment.

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

surgery

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

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

The main types of surgical care are the following:

Nucleoplasty. In case of protrusion or intervertebral hernia, a puncture is performed in the projection of the affected disc. With the help of an electrode (cold plasma or radio frequency method), the deformed part of the nucleus is "vaporized", 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 an intervertebral hernia of a fairly large size. After removal of the prolabile part of the nucleus pulposus, the pain syndrome is eliminated.
Radiofrequency denervation of the facet joints. The operation is indicated for myofascial origin of back pain and severe spondyloarthrosis. Under the influence of high-frequency current, thermocoagulation of the nerve endings occurs, the irritation of which provokes pain. It is a minimally invasive one-day operation with a short rehabilitation period (1-2 days).
Stabilizing the spine. 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. If there is increased mobility of individual segments of the spine, additional stabilization surgery can be performed.
Vertebroplasty. Through a special needle, sterile medical bone cement is injected into the diseased vertebra. As a result, the stability and functionality of the spine is restored.

Prevention of back pain

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 activity;
keep body weight under control;
avoid lifting weights or do it correctly without straining the spine;
timely treatment and correction of posture disorders, bone and joint diseases;
undergo 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 operations, it is recommended that the patient start walking on the first day, after more extensive operations, the patient becomes more active within a few days. Limitation of physical activity can also vary from 1-2 days to 1. 5 months. Your attending physician will inform you about the specifics of the rehabilitation period.

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

What to do when your back hurts?

First of all, see a doctor. As a first aid, you can apply creams or gels based on non-steroidal anti-inflammatory drugs on the inflamed area.

Will the surgery help me get back to my normal lifestyle?

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