Backache

23 December 2023

Every tenth person in the world experiences back pain. This condition leads to decreased 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 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 establish an objective diagnosis and draw up a targeted treatment and rehabilitation plan.

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

The spinal column bears a colossal mechanical load, but at the same time it is a complex anatomical formation in which circulatory, supporting, and spinal structures innervating the entire human body are closely intertwined. That is why changes in the spine, which lead to compression or irritation of the spinal elements, can manifest 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 that is 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 longer than 6 weeks;
chronic – bothers a person for more than 3 months.

Taking into account the causes of pain in the back area, it can be specific or nonspecific. 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 the 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 were discovered during a thorough diagnostic search. 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 spinal column;
instability of different segments of the spine (the lumbar region most often suffers);
damage to muscles and fascia.

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

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

Spontaneous back pain, which occurs for no apparent reason, is a separate category.

Symptoms of back pain

The disease can begin with acute 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. Discomfort intensifies in the evening, with weakness of the paravertebral muscles, or in the morning, as a result of poor sleep conditions.

Depending on the mechanism of development of pain, 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 who visit 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 slipping of the vertebrae (degenerative spondylolisthesis);
traumatic uncomplicated injuries of the spinal column;
pathological fractures of the vertebrae that occur against the background of osteoporosis (a minor external impact is sufficient 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 conduct 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 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, incl. at 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 displacements of the vertebrae, narrowing of the spinal canal, hemorrhages in the spinal cord, which are associated with rupture of the arteriovenous malformation.
Computer 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 obtain highly 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 deformities of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of varying density, etc.
X-ray of the spinal column. A robotic 3D X-ray complex allows you to examine various parts of the spine in one procedure, while computer software performs digital "stitching" of images. This greatly increases the diagnostic value of the method. The clinic is equipped with computer and magnetic resonance imaging scanners with wide functionality, which allow examining 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 selecting the most optimal solution to the problem.

Expert opinion

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. Meanwhile, the problem can arise at any age. Late diagnosis, as well as improper treatment, often prolongs 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 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.

Treatment of back pain

Conservative treatment

Nonsteroidal anti-inflammatory drugs, corticosteroid therapy, and local anesthetic blockades can be used to relieve pain. As part of a comprehensive treatment, physical exercise, 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. . . conservative measures a priori turn out 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 various 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. Using an electrode (cold plasma or radio frequency method), the deformed part of the nucleus is "evaporated", 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 fairly large size. After removing the prolapsed 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 nerve endings occurs, irritation of which provokes pain. This is a minimally invasive one-day operation with a short rehabilitation period (1-2 days).
Spinal stabilization. A stabilizing structure is installed on 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.
Decompression of the spinal canal. The surgeon removes compressive fragments and 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.

Prevention of back pain

Preventive measures are relevant 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 putting stress on the spine;
promptly treat and correct postural disorders, diseases of bones and joints;
undergo regular examinations 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, the patient is recommended to start walking within the first day; after more extensive operations, the patient becomes more active within a few days. Restriction 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 relieving acute pain and restoring tissue, 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.

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, 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 sore spot.

Does surgery help me return to my normal lifestyle?

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