Backache

23 December 2023

Every tenth person in the world experiences back pain. This condition leads to a decrease in work capacity and greatly limits the usual way of life. In some cases, back pain may be a symptom of a serious illness, 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 establish an objective diagnosis and draw up 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 over the phone or online. The reception of specialists is organized at a time convenient for the patient.

About the disease

Back pain, especially in the 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 prominent places, since, as a rule, the most active group of the population is affected, in the age group from 20 to 60 years, and most often - 25-45 years.

The spine bears a colossal mechanical load, but at the same time it is a complex anatomical formation in which the circulatory, supporting and spinal structures innervating the entire human body are closely interconnected. That is why changes in the spine, which lead to compression or irritation of spinal elements, can manifest themselves as pathology of any 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, which is why 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 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 stop the pain momentum.

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

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

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 that emerge from the spinal cord through the intervertebral foramina;
myofascial – pain occurs due to damage to the muscles that surround the spine and/or the connective tissue membranes that cover them;
articular – the 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 more often, it all starts with a "tolerable" feeling of discomfort in the interscapular, lumbar and shoulder girdle areas. The discomfort intensifies at night, with weakness 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.

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 damage to the intervertebral joints (spondyloarthrosis), increased mobility of spinal segments (spinal instability) and slippage of the vertebrae (degenerative spondylolisthesis);
uncomplicated traumatic spinal injuries;
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 – tumor originating from blood vessels that can compress nearby tissues;
primary and metastatic tumors affecting the spine.

Back pain diagnosis

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. At the clinic, the examination is carried out using a high-precision device that makes 128 cuts of the anatomical area. This makes it possible to detect various anomalies in the structure of the spine, incl. in the initial phase of development. CT is informative in identifying developmental anomalies and degenerative-dystrophic lesions in 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 malformation.
Computerized 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 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 obtain detailed, high-precision images. MRI can detect not only bone pathologies, but also soft tissue injuries. The method is informative for detecting various forms of osteochondrosis (intervertebral hernias and protrusions, arthrosis of the joints), injuries and deformities of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of varying density, etc.
X-ray of the spine. A 3D robotic X-ray complex allows you to examine multiple 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 highly functional computed tomography and magnetic resonance imaging machines, which allow you to examine patients even with great 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 selecting the optimal solution to the problem.

Opinion of an 'expert

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

Which doctor should I contact 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 surgical treatment is indicated, to a neurosurgeon.

Back pain treatment

Conservative treatment

Non-steroidal anti-inflammatory drugs, corticosteroid therapy and local anesthetic blocks can be used to relieve pain. As part of a comprehensive treatment, physical exercises, massages, physiotherapy, reflexology, etc. are useful.

The subsequent nature of conservative treatment is determined by the cause of the pain syndrome. So, 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. . . conservative measures a priori prove to be ineffective.

Surgery

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

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

The main types of surgical care are as follows:

Nucleoplasty. In case of intervertebral protrusion or 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 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 intervertebral hernias of rather large size. After removing the prolapsed part of the nucleus pulposus, the pain syndrome is eliminated.
Radiofrequency denervation of 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 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 frame is installed in the problem area, which firmly fixes the position of the vertebrae. Transpedicular fixation systems with screws, interbody cages, systems with laminar hooks and ventral plates can be used as stabilizers.
Spinal canal decompression. The surgeon removes fragments and compressive structures. If there is increased mobility of individual segments of the spine, additional stabilizing surgery may 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 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 straining your spine;
promptly treat and correct postural disorders, bone and joint diseases;
have 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, it is recommended that the patient starts walking on the first day; After more extensive operations, the patient becomes more active within a few days. Restriction 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, after relieving acute pain and restoring tissues, to pay due attention to strengthening the back muscle corset. 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 the 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 your back hurts?

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 painful area.

Will surgery help me return to my normal lifestyle?

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