Back pain

There are primary and secondary sensations of pain, and each of these types can be caused by a wide variety of conditions and diseases. In this article we will try to consider only the most basic ones.

Non-specific (primary). This type of pain is directly related to problems in the spine and surrounding tissues.

Causes of back pain related to the spine:

• Scoliosis. Violation of posture, which leads to gradual curvature of the spine, displacement of the vertebrae and muscle strain.
• Osteochondrosis. The reason for the development of the disease is a decrease in the cushioning capacity of the spine: damage to the intervertebral discs, rupture of the fibrous ring and, as a result, injury to the core of the disc. Painful sensations are localized in the region of that part of the spine where there are pathological changes. Thus, with osteochondrosis of the thoracic spine, back pain is localized in the thoracic region (the back hurts between the shoulder blades and under the ribs), with osteochondrosis of the lumbar spine, a person feels pain in the lumbar region.
• Intervertebral hernia. Due to damage to the intervertebral disc, the soft structures of the vertebrae protrude with the possibility of injury (normal and strangulated hernia). The pain is localized at the site of the hernia.
• Ankylosing spondylitis. It is characterized by back pain and limited mobility of the spine, which leads to forced forward bending of the patient.
• Osteomyelitis. The cause of the disease is an infectious process that has developed in the spine. The patient feels that the pain covers not only the spine, but also the back muscles.
• Spinal injury. In this case, the cause of back pain is an injury and accompanying complications. The intensity of painful sensations and their localization are directly related to the type of injury and the affected part of the spinal column.

In 40-50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3-5% of severe back pain is associated with damage to the roots of the spinal cord (radicular pain).

Back pain associated with pathological changes in the muscles:

• Fibromyalgia. The inflammatory process develops in the muscles surrounding the spine, is characterized by symmetry and can be chronic. In this case, the back muscles along the entire spine hurt. The important thing is that the most pain occurs when you press on certain places.
• Polymyositis. Hypothermia can cause illness. As a result of the development of the disease, the patient feels muscle weakness and pain, which intensifies when trying to turn.
• Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that reduce immunity can serve as a trigger. It is manifested by pain that increases with the development of the disease, capable of covering all parts of the back. Severe back pain hinders mobility to the extent that the patient cannot move independently. A clear asymmetry is visible on the back.
• Charcot disease. The symptoms are caused by inflammation of the peripheral nerves along the spinal column. As a result of the pathological process, in addition to quite intense pain, there is a change in the person's gait.

In 50-60% of cases of non-specific back pain, their localization is in the muscles.

Specific (secondary pain). This type of pain, despite its localization in the back, is often not directly related to diseases of the spinal column or the surrounding muscular skeleton. The causes of specific pain are extremely diverse, but the most dangerous are oncological diseases. Therefore, pain radiating to the back can be caused by a malignant neoplasm in the region of the mammary glands, lungs or prostate, which causes metastases on the spine.

Diseases that cause specific pain include:

• Tight nerve roots in the chest. Most often, this leads to the development of intercostal neuralgia. In this case, the pain is localized at the point of pinching. Thus, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinching occurred). The pain has different degrees - from painful to sharp, shooting. Most often, the pain syndrome occurs when moving or pressing on the affected area. This fact is the main difference between intercostal neuralgia and heart and lung disease, which can also be manifested by pain under the left (or right) scapula from the back.
• Diseases of the gastrointestinal tract. More often they cause pain on the right side, in some cases it can also move to the left side of the body. Most of the pain is localized in the lumbar and sacro-lumbar region. Sufficiently strong feelings of pain are characteristic of pathologies associated with the manifestations of pancreatic disease, colon diverticulum, intestinal obstruction, retrocecal appendicitis, etc.
• Ulcerative foci. Ulcerative lesions of the organs of the upper part of the abdominal cavity (peptic ulcer of the duodenum and stomach) can manifest in the form of pain in the thoracic and lower part of the lumbar back. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is localized in the lumbar region. The intensity of the pain can be different, but it often reaches its peak at night.
• Appendicitis. In acute appendicitis, in cases where the appendix (caecum) is located behind the cecum, the back hurts in the lumbar region. Pains are variable in nature and can vary from painful, mild to sharp, intense.
• Kidney diseases. They are often manifested by pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies that have a direct connection with the spinal column occurs based on the analysis of other clinical manifestations and research results.
• Urolithiasis disease. With renal colic, the back hurts in the lumbar region. The pain is pronounced, intense, occurs suddenly and does not depend on the position of the body. Back pain in the lower back and nephrolithiasis. Manifestations of the pain syndrome are of low intensity, the pain is quite painful in nature.
• Diseases of the female reproductive system and menstrual pain. In these cases, the pain is more often localized in the lower back.
• Neoplasms in the pulmonary system. In this case, the pain occurs at the stage when peripheral tumor elements (metastases) germinate in the lungs in the pleural region and chest wall. The nature of the pain is intense, debilitating.
• Cardiovascular diseases. The most common causes of pain localized in the thoracic part of the back are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
• Inflammatory processes in the joints. Infectious arthritis can cause pain to spread from the affected joint to nearby areas, including back pain.

The causes of back pain are mostly identical for both sexes, but it is necessary to highlight a number of diseases that differ by gender predisposition.

back pain in men

Although the causes of back pain are mostly the same for both sexes, there are a number of diseases that men are more susceptible to due to their lifestyle.

These predisposing factors include:

• work that involves lifting and carrying heavy loads;
• strength sports (including various martial arts, powerlifting, etc. );
• bad habits.

This is why diseases of the musculoskeletal and cardiovascular systems can occur more often in men than in women.

Specific "male" diseases that can cause back pain are various pathologies of the prostate.

Prostatitis is an inflammatory disease of the prostate. At the beginning of the disease, the pain syndrome is localized in the groin, scrotum and lower abdomen, but in the second stage and in cases when the disease has become chronic, the pain spreads to the back.

The localization of pain in this case can be concentrated in the lumbosacral region or spread to the entire back. This is due to the fact that the inflammatory process affects the nerve endings, which in large numbers surround this organ.

The intensity of the pain is directly related to the stage of the disease. So, in the acute phase, the pain is characterized as acute and short-lived. In the chronic form, the pain syndrome is not very pronounced and is often permanent.

Diagnosis and treatment in this case is carried out by a urologist.

back pain in women

In some cases, back pain in women can be of a specific nature associated with the characteristics of the body and the processes that take place in it. First of all, we are talking about the reproductive sphere.

As a rule, pain associated with gynecological diseases is localized in the thoracic and lumbosacral region. The most common reasons include:

1. Menstrual cycle. During the period of menstruation, the hormonal background of a woman changes, which leads to the appearance of a number of negative manifestations. This is primarily due to a decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold leads to the fact that even minor pain sensations become more pronounced. Also, hormonal changes lead to irritation of the intestinal walls and fluid retention, which causes an increase in the volume of some organs and, as a result, compression of the nerve endings of the lumbar spine. The combination of these factors causes back pain.
2. Pregnancy. Pain in the lower back in this case can be divided into two groups: Pain in the first trimester. If painful sensations are accompanied by additional symptoms (bleeding, fever, etc. ), we can talk about the danger of miscarriage. Pain in the second half of pregnancy. Most often, such pains are associated with physiological changes, namely: the active growth of the fetus, which causes a change in the center of gravity in the position of the body, and the preparation of the pelvis for the upcoming labor activity.
3. Diseases of the reproductive system. Most of the pain is concentrated in the lumbar region, which is explained by the topography of the female reproductive organs. The most common causes of this manifestation of the painful syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
4. Menopause. During menopause, there are strong changes and fluctuations in the hormonal level. Such restructuring of the body leaves its mark on many systems of the female body. First of all, the bone system suffers, which under the influence of hormonal changes becomes more fragile and susceptible to various types of diseases.
5. A large chest. The large size of the bust, in combination with the underwear that she wears poorly, creates an additional load on the spine, and as a result, the woman has back pain in the area of the shoulder blades and lower back.
6. High heel. Wearing shoes with high heels leads to the development of a number of diseases associated with pathological changes in the musculoskeletal system and back pain.

back pain with corona virus

Corona virus infection affects many organs, but the lungs are the first to suffer. Therefore, pain between the shoulder blades or under them is often a manifestation of inflammation that has developed in the lung tissue. Depending on which lung is more affected, the patient will feel pain under the left or right shoulder blade.

In addition to damage to the lung tissue, there is a general intoxication of the body and an increase in temperature, which can also cause pain (pain) in the back and limbs.

Back pain after the corona virus is explained by the fact that the disease can not only damage the nervous system, but against the background of a general decline in immunity, chronic diseases, including internal organs and the musculoskeletal system, worsen.

Back pain after sleeping

The reasons why your back hurts after sleeping can be:

• work related to physical activity and weight lifting;
• lower back muscle tone;
• history of intervertebral hernia and osteochondrosis;
• prolonged hypothermia of the back;
• curvature of the spine, which led to muscle strain and uneven contraction;
• excess body weight, which results in increased load on the back;
• stressful situations;
• uncomfortable bed.

Unpleasant sensations can have different intensity and appear under the ribs, in the lower back, between the shoulder blades and under them.

To eliminate the pain that occurs after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.

Back pain - which doctor should I contact?

The primary diagnosis of back pain is made by a general practitioner. If necessary, numerous additional examinations and consultations by highly specialized specialists can be prescribed:

• neurologist;
• gastroenterologist;
• gynecologist;
• urologist;
• pulmonologist.

In order to make an accurate diagnosis, it is necessary to carry out a detailed analysis of the patient's condition. For these purposes, the doctor can prescribe a number of additional studies:

• Laboratory tests. Most often, this list includes general and biochemical blood tests, urine tests, feces and, in some cases, hormone level analysis. These studies help to identify possible inflammatory processes and infections. If you suspect a disease or an oncological component, the doctor can prescribe a series of specific studies (biopsy, tumor markers, etc. ).
• Hardware research. They help to get a more visual picture of the course of the disease, which cannot be achieved by visual inspection and palpation. Radiography, MRI, ultrasound are most often prescribed.

Treatment of back pain

For the purpose of qualified treatment, an internal specialist consultation is necessary. Therapy is selected strictly based on the diagnosis and taking into account the general condition of the patient. Self-treatment of back pain can lead to the progression of the disease or to the transition to a chronic phase.

Prevention of back pain

The main preventive measures depend primarily on what exactly caused the appearance of back pain. General recommendations include:

• healthy lifestyle;
• complete and healthy diet;
• reasonable dosage of physical activity;
• timely treatment of identified diseases;
• regular preventive examinations, including narrow-profile specialists.