What are the main symptoms of mono. How long does mono typically last. What are effective home remedies for mono. How can you treat mono-related back pain. When should you seek medical attention for mono symptoms.

Understanding Mononucleosis: Causes and Transmission

Mononucleosis, commonly known as mono or the “kissing disease,” is a viral infection that primarily affects teenagers and young adults. While anyone can contract mono, it’s most prevalent among individuals in their late teens to early twenties. The virus responsible for mono is typically transmitted through saliva, which explains its colloquial name.

Transmission of mono can occur through various means:

• Kissing
• Sharing drinking glasses or eating utensils
• Sneezing and coughing
• Contact with blood or other bodily fluids (in some cases)

The primary culprit behind mono infections is the Epstein-Barr virus (EBV), accounting for up to 50% of all cases. However, other viruses can also cause mono-like symptoms. It’s worth noting that mono is generally less contagious than the common cold, but its symptoms can persist for a longer duration.

Recognizing Mono Symptoms: From Fever to Back Pain

Mono presents with a variety of symptoms that can range from mild to severe. The incubation period for mono can be quite long, with symptoms typically appearing 4-6 weeks after infection. Once symptoms manifest, they can last anywhere from a few days to several weeks.

Common symptoms of mono include:

• Fever (usually lasting about two weeks)
• Sore throat (persisting for approximately two weeks)
• Swollen lymph nodes in the neck, underarm, and groin areas
• Fatigue and weakness (lasting 2-4 weeks)
• Muscle aches (2-4 weeks duration)
• White patches on the throat
• Skin rash
• Headache
• Poor appetite

One of the less commonly discussed but significant symptoms of mono is back pain. This discomfort is often related to an enlarged spleen, a condition that affects nearly half of all mono patients.

Back Pain and Enlarged Spleen in Mono

An enlarged spleen, medically known as splenomegaly, can cause various symptoms, including:

• Pain in the left side of the abdomen
• Back pain
• Feeling of fullness
• Fatigue
• Shortness of breath

Is back pain always a sign of an enlarged spleen in mono patients? Not necessarily. While back pain can be associated with splenomegaly, it may also result from general muscle aches and fatigue characteristic of the infection. However, if you experience sudden, sharp pain in your left upper side, it could indicate a ruptured spleen – a rare but serious complication of mono that requires immediate medical attention.

Treatment Approaches for Mono: Why Antibiotics Aren’t the Answer

Given that mono is caused by viruses, antibiotics are ineffective in treating the underlying infection. In fact, certain antibiotics like amoxicillin and penicillin can even trigger a rash in mono patients. Research has shown that common antiviral drugs also have limited efficacy against the Epstein-Barr virus.

So how is mono treated? The approach typically focuses on managing symptoms and supporting the body’s natural healing process. This may include:

1. Rest and relaxation to allow the body to recover
2. Over-the-counter pain relievers to manage fever, headaches, and muscle aches
3. Staying hydrated to help reduce fever and soothe a sore throat
4. Treating secondary bacterial infections if they occur

Can mono be cured quickly? Unfortunately, there’s no quick fix for mono. Recovery typically takes several weeks, and in some cases, fatigue may persist for months. The key is to be patient and focus on supportive care.

Home Remedies and Lifestyle Changes to Manage Mono Symptoms

While medical treatments for mono are limited, there are numerous home remedies and lifestyle changes that can help alleviate symptoms and support recovery:

Hydration and Nutrition

Staying well-hydrated is crucial when battling mono. Consume plenty of:

• Water
• Fruit juices
• Herbal teas
• Soups and broths

A nutrient-rich diet can also boost your immune system. Focus on consuming:

• Green, leafy vegetables
• Bell peppers
• Apples
• Tomatoes
• Olive oil
• Coconut oil
• Whole-grain pasta
• Brown rice
• Barley
• Salmon
• Green tea

Avoid sugary snacks, refined white bread, white rice, white pasta, crackers, fried foods, and alcohol, as these can potentially hinder your recovery.

Over-the-Counter Medications

OTC pain relievers can help manage fever, headaches, and muscle aches. Options include:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil)
• Aspirin (not recommended for children and teens)

Cold and flu medications containing pain relievers, such as Benadryl, Dimetapp, Nyquil, Sudafed, Theraflu, and Vicks, may also provide relief. However, it’s crucial to follow dosage instructions carefully to avoid potential harm.

Throat Gargles

To soothe a sore throat, try gargling several times a day with:

• Salt and warm water
• Apple cider vinegar and warm water

Fever Management

To cool down a fever, consider:

• Wet towel compresses
• Cool baths
• Cold foot baths
• Consuming cold treats like ice cream or popsicles

Rest and Relaxation

Rest is paramount when recovering from mono. This means:

• Staying home from work or school
• Canceling non-essential appointments
• Avoiding strenuous activities

How long should you rest when you have mono? It’s advisable to rest until you’ve fully recovered, which can take several weeks. This not only aids your recovery but also prevents complications like a ruptured spleen.

Supplements and Natural Remedies for Mono Recovery

While scientific evidence is limited, some people find relief from mono symptoms through various supplements and natural remedies. These may include:

• Omega-3 fatty acids
• Probiotic supplements
• Echinacea
• Cranberry
• Astragalus

Do natural remedies cure mono? While these supplements may support overall health and potentially ease symptoms, they don’t cure the underlying viral infection. Always consult with a healthcare provider before starting any new supplement regimen, especially when dealing with an infection like mono.

Managing Back Pain Associated with Mono

Back pain in mono patients can be particularly troublesome. Here are some strategies to manage this symptom:

• Apply heat or cold packs to the affected area
• Practice gentle stretching exercises, as approved by your doctor
• Use OTC pain relievers as directed
• Maintain good posture to reduce strain on your back
• Consider using a supportive mattress and pillow

Is it safe to exercise with mono-related back pain? While gentle movement can be beneficial, it’s crucial to avoid strenuous activities, especially those that might impact the abdominal area. Always consult your healthcare provider before starting any exercise regimen while recovering from mono.

When to Seek Medical Attention for Mono Symptoms

While mono typically resolves on its own with supportive care, there are instances where medical attention is necessary. Seek immediate medical care if you experience:

• Severe abdominal pain, especially on the left side
• Difficulty breathing
• Severe headache
• Stiff neck
• High fever that doesn’t respond to OTC medications
• Extreme weakness or dizziness
• Yellowing of the skin or eyes (jaundice)

How do you know if mono is serious? While most cases of mono are not severe, complications can occur. Pay attention to your symptoms and don’t hesitate to contact your healthcare provider if you’re concerned about your condition or if your symptoms worsen or persist beyond the expected duration.

Long-Term Outlook and Prevention of Mono

Most people recover fully from mono within a few weeks to a couple of months. However, fatigue may persist for several months in some cases. After recovery, the virus remains dormant in your body but rarely causes symptoms again.

To prevent the spread of mono:

• Avoid kissing or sharing personal items with someone who has mono
• Practice good hygiene, including regular handwashing
• Boost your immune system through a healthy diet, regular exercise, and adequate sleep

Can you get mono more than once? While it’s possible to experience a reactivation of the virus, it’s rare for individuals to have multiple episodes of acute mono. However, maintaining a healthy lifestyle can help prevent potential reactivation and support overall immune function.

Understanding mono, its symptoms, and management strategies can help you navigate this challenging infection more effectively. Remember, while mono can be uncomfortable and prolonged, with proper care and patience, most people make a full recovery. If you’re concerned about your symptoms or recovery progress, don’t hesitate to consult with your healthcare provider for personalized advice and care.

Treatments, Home Remedies, and More

Mono (mononucleosis) is also called infectious mononucleosis. This disease is sometimes referred to as the “kissing disease” because you can get it through saliva.

You can also contract mono by sharing drinking glasses, eating utensils, and through sneezes and coughs. Some kinds of mono are also transmitted through blood and other bodily fluids.

Mono usually affects teenagers and young adults, but anyone can get it.

Like the common cold, a virus causes mono. Similarly, there’s no specific treatment for mono.

This infection is usually less contagious than a cold. However, mono symptoms can last longer. You may have symptoms for four to six weeks or more.

It may take a few months before you completely recover from mono.

Viruses cause mono infections. This means antibiotics can’t effectively treat the condition. Some antibiotics, like amoxicillin and penicillin, can even cause a rash if you have mono.

Different kinds of viruses can cause mono. A research study that tested common antiviral drugs against the Epstein–Barr virus (EBV) found they didn’t work well at all in clinical cases.

EBV is a virus that can cause mono. It’s responsible for up to 50 percent of all mono infections.

Treating symptoms

Treatment usually involves treating symptoms like fever or a sore throat. Mono can cause a person to be prone to secondary bacterial infections. In this case, antibiotics can treat a bacterial:

• sinus infection
• strep infection
• tonsil infection

Mono usually causes swollen lymph nodes in the neck, underarm, and groin areas. You may also have other common symptoms, like:

• fever
• sore throat
• white patches on the throat
• muscles aches
• weakness
• fatigue
• skin rash
• headache
• poor appetite

Spleen symptoms

Along with other symptoms, mono can cause the spleen to get bigger. The spleen is an organ in your abdomen that stores and filters blood. Almost half of people with a mono infection have an enlarged spleen.

Enlarged spleen symptoms include:

• left side abdomen pain
• back pain
• feeling full
• fatigue
• shortness of breath

It’s important to rest if you have mono. An enlarged spleen can become more delicate, but you may not show any symptoms.

Working out, lifting something heavy, or other strenuous activity can cause the spleen to burst. Wait until you’ve fully recovered from mono before getting back to your normal activities.

Call 911 or go to an emergency room if you feel a sudden, sharp pain in your left, upper side. It may a sign of a ruptured spleen. This complication of mono is rare, but it can happen.

There’s no specific treatment for mono, but you can help ease your symptoms. Taking care of yourself with rest and at-home remedies can help make you more comfortable.

Stay hydrated

Drink plenty of water, fruit juice, herbal tea, soup, and broth. Fluids help bring down a fever and soothe a sore throat. Drink as much as you can to raise your energy levels and prevent dehydration.

Over-the-counter (OTC) medications

Use OTC pain relievers to help bring down a fever and ease headaches and muscle aches. These medications won’t get rid of the virus, but they can help make you more comfortable:

• aspirin (but don’t give it to children and teens)
• acetaminophen (Tylenol)
• ibuprofen (Advil)

Take these medications only as directed. Taking too much can be harmful. You can also take OTC cold and flu medications that contain pain relievers, such as:

• Benadryl
• Dimetapp
• Nyquil
• Sudafed
• Theraflu
• Vicks

Throat gargles

Throat gargles can help soothe a sore throat. Gargle with these home remedies several times a day:

• salt and warm water
• apple cider vinegar and warm water

Cool down a fever

Cool a fever with wet towel compresses, a cool bath, or a cold foot bath. Also try eating something cold, like ice cream or a popsicle.

Rest

It’s very important to rest and relax if you have mono. Stay home from work or school. Cancel your appointments. Resting helps your body recover and prevent any complications. Not going out also helps prevent transmitting the virus to others.

Boost your immune system

Eat healthy whole foods to help your immune system fight the mono virus.

Eat more antioxidant-rich and anti-inflammatory foods, like:

• green, leafy vegetables
• bell peppers
• apples
• tomatoes
• olive oil
• coconut oil
• whole-grain pasta
• brown rice
• barley
• salmon
• green tea

Avoid consuming things like:

• sugary snacks
• refined white bread
• white rice
• white pasta
• crackers
• fried foods
• alcohol

Supplements

Add these supplements to your daily diet for your immune and gut health:

• omega-3 fatty acids
• probiotic supplements
• echinacea
• cranberry
• astragalus

If you contract the mono virus, you may not have any symptoms at all for four to six weeks. Symptoms may last for only a few days to two to six weeks. Here are some common symptoms and their usual duration:

• A fever and sore throat may last for about two weeks.
• Muscle aches and fatigue may last for two to four weeks.
• An enlarged spleen may take up to eight weeks to go back to normal.

Mono may make you feel unwell for up to two months. However, it’s considered rare for symptoms to last longer than six weeks.

Rare complications of mono, like an injured or ruptured spleen, can take up to three months to heal. You may need other treatment for a ruptured spleen.

You can’t always prevent getting mono. Someone who has the virus and doesn’t yet have symptoms might not know they have it. Lower your risk for contracting mono and other viral illnesses with these tips:

• Avoid sharing cups and other drink bottles.
• Avoid sharing eating utensils.
• Avoid kissing someone who has symptoms of a respiratory infection.
• Wash your hands several times a day.
• Avoid touching your face and eyes.
• Boost your immune system with a healthy diet.
• Get plenty of sleep every night.

You can get mono in more ways than just kissing someone. You may not be able to prevent getting this viral illness. Mono is contagious even if you don’t have symptoms. You may not know you have it.

Once you have symptoms, help your recovery and avoid transmitting mono to others by staying home. Rest and avoid strenuous activity to prevent spleen injuries and combat fatigue. Ask your doctor when it’s safe to get back to your normal activities.

Enjoy low-key activities, like reading and watching movies, as you recover. Eat plenty of whole foods and stay hydrated. Treat symptoms with OTC cold and flu medications and pain-relieving drugs.

Mononucleosis Information | Mount Sinai

Mono; Kissing disease; Glandular fever

Mononucleosis, or mono, is a viral infection that causes fever, sore throat, and swollen lymph glands, most often in the neck.

This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.

This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.

Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.

Acrodermatitis enteropathica is a skin condition peculiar to children that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B infection or other viral infections. The lesions appear as small coppery-red, flat-topped firm papules that appear in crops and sometime in long linear strings, often symmetric.

Splenomegaly is an enlargement of the spleen.

Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.

This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.

Gianotti-Crosti disease is also called acrodermatitis of childhood. These red, elevated lesions do not contain pus and can occur on the limbs, buttocks, face, and neck.

Infectious mononucleosis causes a sore throat, enlarged lymph nodes, and fatigue. The throat may appear red and the tonsils covered with a whitish material. Mononucleosis and severe streptococcal tonsillitis appear quite similar. Unless there are other findings to suggest mononucleosis, a throat culture and blood studies may be necessary to make an accurate diagnosis.

Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.

Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

Causes

Mono is often spread by saliva and close contact. It is known as “the kissing disease.” Mono occurs most often in people ages 15 to 17, but the infection may develop at any age.

Mono is caused by the Epstein-Barr virus (EBV). Rarely, it is caused by other viruses, such as cytomegalovirus (CMV).

Symptoms

Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.

A pink, measles-like rash can occur, and is more likely if you take the medicine ampicillin or amoxicillin for a throat infection. (Antibiotics are typically not given without a test that shows you have a strep infection.)

Common symptoms of mono include:

• Drowsiness
• Fever
• General discomfort, uneasiness, or ill feeling
• Loss of appetite
• Muscle aches or stiffness
• Rash
• Sore throat
• Swollen lymph nodes, most often in the neck and armpit

Less common symptoms are:

• Chest pain
• Cough
• Fatigue
• Headache
• Hives
• Jaundice (yellow color to the skin and whites of the eyes)
• Neck stiffness
• Nosebleed
• Rapid heart rate
• Sensitivity to light
• Shortness of breath

Exams and Tests

Your health care provider will examine you. They may find:

• Swollen lymph nodes in the front and back of your neck
• Swollen tonsils with a whitish-yellow covering
• Swollen liver or spleen
• Skin rash

Blood tests will be done, including:

• White blood cell (WBC) count — will be higher than normal if you have mono
• Monospot test — will be positive for infectious mononucleosis
• Antibody titer — tells the difference between a current and past infection

Treatment

The goal of treatment is to relieve symptoms. Steroid medicine (prednisone) may be given if your symptoms are severe.

Antiviral drugs, such as acyclovir, have little or no benefit.

To relieve typical symptoms:

• Drink plenty of fluids.
• Gargle with warm salt water to ease a sore throat.
• Get plenty of rest.
• Take acetaminophen or ibuprofen for pain and fever.

Also avoid contact sports if your spleen is swollen (to prevent it from rupturing).

Outlook (Prognosis)

The fever usually drops in 10 days, and swollen lymph glands and spleen heal in 4 weeks. Tiredness usually goes away within a few weeks, but it may linger for 2 to 3 months. Nearly everyone recovers completely.

Possible Complications

Complications of mononucleosis may include:

• Anemia, which occurs when red blood cells in the blood die sooner than normal
• Hepatitis with jaundice (more common in people older than 35)
• Swollen or inflamed testicles
• Nervous system problems (rare), such as Guillain-Barré syndrome, meningitis, seizures, damage to the nerve that controls movement of the muscles in the face (Bell palsy), and uncoordinated movements
• Spleen rupture (rare, avoid pressure on the spleen)
• Skin rash (uncommon)

Death is possible in people who have a weakened immune system.

When to Contact a Medical Professional

The early symptoms of mono feel very much like any other illness caused by a virus. You do not need to contact a provider unless your symptoms last longer than 10 days or you develop:

• Abdominal pain
• Breathing difficulty
• Persistent high fevers (more than 101.5°F or 38.6°C)
• Severe headache
• Severe sore throat or swollen tonsils
• Weakness in your arms or legs
• Yellow color in your eyes or skin

Call 911 or the local emergency number or go to an emergency room if you develop:

• Sharp, sudden, severe abdominal pain
• Stiff neck or severe weakness
• Trouble swallowing or breathing

Prevention

People with mono may be contagious while they have symptoms and for up to a few months afterwards. How long someone with the disease is contagious varies. The virus can live for several hours outside the body. Avoid kissing or sharing utensils if you or someone close to you has mono.

Ebell MH, Call M, Shinholser J, Gardner J. Does this patient have infectious mononucleosis?: the rational clinical examination systematic review. JAMA. 2016;315(14):1502-1509. PMID: 27115266 pubmed.ncbi.nlm.nih.gov/27115266/.

Johannsen EC, Kaye KM. Epstein-Barr virus (infectious mononucleosis, Epstein-Barr virus-associated malignant diseases, and other diseases). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 138.

Weinberg JB. Epstein-Barr virus. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 281.

Winter JN. Approach to the patient with lymphadenopathy and splenomegaly. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 159.

Last reviewed on: 3/10/2022

Reviewed by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Lumboischialgia – causes, treatment | MOTRIN®

Author, editor and medical expert – Anna Yurievna Budovskaya.

Editor and medical expert – Harutyunyan Mariam Harutyunovna

Number of views: 35 841

Last update date: 12/29/2022 9 0003

Average reading time: 6 minutes

Content:

Causes of sciatica
Symptoms of sciatica
Diagnosis of lumboischialgia
Treatment of lumboischialgia
Prevention of lumboischialgia

Pain in the lower back during life occurs in more than 70% of people, most often in young people aged 35 to 55 years. Lumbosacral pain is one of the most common causes of temporary disability ^1.2 .

Pain in the lower back is called variously ³ :

• lumbalgia – if it is felt only in the lower back;
• lumboischialgia – when pain occurs not only in the lumbar region, but also spreads to the lower limb;
• lumbago – in cases where there is acute and intense pain in the lower back (lumbar backache).

In all these cases, back pain is a serious symptom that requires alertness and a mandatory visit to a doctor. In this article, we will talk in detail about lumboischialgia: why it occurs, how to alleviate unpleasant symptoms and prevent their recurrence.

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Causes of lumboischialgia

In more than 90% of cases, doctors do not find any serious disease (inflammation, infection, tumor, or fracture) that could cause lumboischialgia attacks ² . The most common causes of pain are complications of lumbar osteochondrosis, such as displacement of the vertebrae or a herniated disc ³ . In the elderly, lumboischialgia is usually due to degenerative processes (disc destruction) in the lumbar spine ^2.9 , and in young and middle-aged people it is often due to reflex irritation of the nerves, for example, when the intervertebral disc bulges ^9.12 .

Intervertebral discs are structures that serve as shock absorbers during the movement of the spine. Each disc has a nucleus pulposus and a fibrous (dense) annulus that prevents the nucleus from going beyond the disc ¹³ .

In a herniated disc, the intervertebral disc moves outward and irritates the pain receptors of the annulus fibrosus. This causes reflex muscle spasms, which provoke pain in the lower back and lower limbs ⁹ .

At risk of developing lumboischialgia are people whose work is associated with lifting weights or “twisting” loads that are inadequate for the spine. Such movements during work are usually performed by loaders, locksmiths, as well as athletes – gymnasts, tennis players, skiers ¹¹ . However, osteochondrosis and its complications in the form of lumboischialgia are also often found in people of “sedentary” professions, for example, office workers and drivers of vehicles who are forced to stay in one, sometimes very uncomfortable for the spine, position for a long time.0035 11 .

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Symptoms of sciatica

Lumbosciatica can occur due to sudden movement, bending over, lifting heavy objects or falling ⁹ . For many, the pain is aggravated by straining, coughing, sneezing, staying in one position for a long time, and even sitting in a deep chair ⁹ . At the moment of the attack, the person takes a forced position, usually leaning to the healthy side, or lies with his leg pressed to his stomach to relieve pain ⁹ .

There are 2 forms of lumboischialgia:

• In neuropathic the source of pain is the root of the spinal nerve, which turned out to be compressed by a displaced vertebra or herniated disc ³ . When squeezing the root (radiculopathy), the pain is sudden, shooting and intense ³ . Since the sciatic nerve is part of the root ¹⁴ , the pain “radiates” to one leg, but does not have clear boundaries and can “move” within the lower limb ³ .
• Reflex occurs due to irritation of the muscles, joints and ligaments in the lumbar region ¹¹ . At the same time, aching and more often bilateral pain is observed, which is most pronounced in the buttocks and thighs, rarely goes below the knee ³ . Sometimes discomfort is felt constantly ³ .

Consult your doctor if you experience any pain. Often low back pain is a manifestation of specific conditions that require emergency care ³ .

The following danger symptoms (“red flags”) are distinguished for lumboischialgia ² :

• under 18 and over 50 years of age;
• recent back injury;
• long-term treatment with hormonal drugs;
• dramatic weight loss;
• persistent progressive pain that does not improve with rest;
• soreness, which is felt not only in the back, but also in the perineum, vagina, rectum, sometimes associated with urination or defecation;
• increased body temperature;
• marked spinal deformity.

If on the background of lumboischialgia you have found at least one “red flag” – immediately seek help from a specialist ⁵ .

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Diagnosis of lumboischialgia

Pain in the lumbar region radiating to the gluteal region and the leg (or both legs) may be a manifestation of acute lumboischialgia (lasts up to 6 weeks) and chronic (troubles more than 12 weeks ) ³ . Often it goes away on its own ⁵ , but in order for the problem not to become chronic, you need to be examined by a doctor in time and exclude serious diseases.

If you have frequent symptoms of sciatica, you should contact your general practitioner. If necessary, he will refer you to a neurologist, traumatologist, rheumatologist and other specialists ² .

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Treatment of lumboischialgia

Pain relief is one of the important tasks of the syndrome therapy ¹¹ . For this purpose, non-drug, medical and surgical methods can be used ^{8. 11} .

For the symptomatic treatment of acute and chronic sciatica, non-steroidal anti-inflammatory drugs are used ^4,6,11 , which relieve pain and increase the functional activity of patients ¹¹ . Motrin® is a drug from the NSAID group, the active ingredient of which is naproxen. The drug is indicated for adults and adolescents from 15 years of age with lumboischialgia as an anesthetic ⁷ .

Tablets should be taken whole (including with meals) and washed down with a sufficient amount of liquid ⁷ . To relieve the pain of sciatica, you can take as follows: starting dose – 2 tablets (500 mg), and then one tablet (250 mg) up to 4 times a day (every 8 hours). In this case, usually the daily dose used to relieve pain is 2-3 tablets (500-750 mg). It is allowed to use the drug as an anesthetic without consulting a doctor for up to 5 days. If unpleasant symptoms persist or worsen, be sure to consult a specialist ⁷ .

Non-drug methods of pain relief include ^3.8 :

• therapeutic exercises;
• manual therapy;
• acupuncture;
• massage.

If there is pain in the lower back that radiates to the leg, experts recommend maintaining physical activity and avoiding bed rest – this has a beneficial effect on the course of the pathology and helps to recover faster ^6,8,11 .

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Prevention of lumboischialgia

To prevent attacks of pain, it is important to follow the recommendations of doctors: 5 2 ;

Lumbosciatica is a problem that can affect both the elderly and young people ¹ . It indicates the resulting complications of osteochondrosis and requires careful attention ³ . With a properly organized work schedule, sufficient physical activity and timely access to a doctor, exacerbations and complications of chronic back pain can be avoided ¹¹ .

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

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References

1. WHO Priority diseases and reasons for inclusion 2013 6.24 Low back pain https : //www . who . int/medicines/areas/priority_medicines/Ch6_24LBP.pdf
2. Parfenov Vladimir Anatolyevich, Golovacheva Veronika Alexandrovna Diagnosis and treatment of acute nonspecific lumbosacral pain // Therapeutic archive. 2019. No. 8. URL: https : //cyberleninka . ru/article/n/diagnostika-i-lechenie-ostroy-nespetsificheskoy-o-krpoyasnichtsovoy-boli
3. Levin O. S., Chimagomedova A.Sh., Shugurova I.M., Nikitina A.N. Modern approaches to the diagnosis and treatment of chronic back pain // STPN. 2020. No. 3-4. URL: https : //cyberleninka . ru/article/n/sovremennye-podhody-k-diagnostike-i-lecheniyu-hronicheskoy-boli-v-spine
4. Shirokov Vasily Afonasevich, Potaturko A.V., Terekhov N.L. Non-steroidal anti-inflammatory drugs, muscle relaxants and vitamins of group B in the treatment of lumboischialgia // Neurology, neuropsychiatry, psychosomatics. 2020. №6. URL: https : //cyberleninka . ru/article/n/nesteroidnye-protivovospalitelnye-preparaty-miorelaksanty-i-vitaminy-gruppy-v-v-lechenii-lyumboishialgii
5. Shakhabov I.V., Polishchuk N.S. Evaluation of recommendations for the appointment of magnetic resonance imaging in the provision of outpatient care in a planned form for pain at the level of the lumbar spine // ORGZDRAV: News. Opinions. Education. Vestnik VSHOUZ. 2020. No. 3 (21). URL: https://cyberleninka. ru/article/n/otsenka-rekomendatsiy-po-naznacheniyu-…
6. Parfenov Vladimir Anatolievich, Isaikin A.I., Kuzminova T.I., Chernenko O.A., Milovanova O.V., Romanova A.V., Samkhaeva N.D., Shor Yu.M. Treatment of patients with acute and subacute lumbalgia and lumboischialgia // Neurology, neuropsychiatry, psychosomatics. 2019. No. 3. URL: https : //cyberleninka . en/article/n/lechenie-patsientov-s-ostroy-i-podostroy-lyumbalgiey-i-lyumboishialgiey
7. Instructions for use of the drug MOTRIN ® tablets //Reg.number P N002874/01// GRLS RF. – URL: https : //grls . rosminzdrav . en/Grls_View_v2.aspx?routingGuid=868bad0c-d10e-47a9-b9d8-2595d9a01ac7&t=
8. Parfenov V.A., Parfenova E.V. Questions of therapy of chronic nonspecific lumbalgia // MS. 2020. No. 8. URL: https://cyberleninka.ru/article/n/voprosy-terapii-hronicheskoy-nespetsif…
9. Shostak N.A., Pravdyuk N.G. Back pain and comorbidity – diagnosis, treatment tactics. Outpatient surgery. 2016;(3-4):44-50. https://www.a-surgeon.ru/jour/article/view/59
10. Vertkin A.L., Karateev A.E., Kukushkin M.L., Martynov A.I., Parfenov V.A., Yakhno N.N., Knorring G.Yu. National guidelines for the management of patients with back pain for internists and general practitioners of polyclinics. Therapy. 2018; 3 (21) https://therapy-journal.ru/ru/archive/article/36103
11. Russian Interregional Society for the Study of Pain. Clinical guidelines Diagnosis and treatment of musculoskeletal (non-specific) pain in the lower back, 2019https : //painrussia . en/educational-programs/2020/zoom/%D0%9A%D0%A0_%D0%91%D0%A1_%D0%A0%D0%9E%D0%98%D0%91_2020_%D1%84%D0% B8%D0%BD%D0%B0%D0%BB%20(1).pdf
12. Diagnosis of viscero-vertebral and vertebro-visceral pain syndrome in lumbar osteochondrosis. Drivotinov B.V., Gamanovich A.I., Medical Journal No. 4 2012 From 46-50.
13. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition. Spine.https : //xn--90aw5c . xn--c1avg/index . php/%D0%9F%D0%9E%D0%97%D0%92%D0%9E%D0%9D%D0%9E%D0%A7%D0%9D%D0%98%D0%9A (accessed : 05.10.2021)
14. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition. Sciatic nerve. https : //xn--90aw5c . xn--c1avg/index . php/%D0%A1%D0%95%D0%94%D0%90%D0%9B%D0%98%D0%A9%D0%9D%D0%AB%D0%99_%D0%9D%D0% 95%D0%A0%D0%92 (date of access: 05.10.2021)
15. Frick et al. Efficacy and safety of naproxen sodium and ibuprofen for pain relief after oral surgery. Current Therapeutic Research. 1993;54(6):619-27.

Lower back pain – causes, in which diseases it occurs, diagnosis and methods of treatment

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Lower back pain – the causes of occurrence, in which diseases it occurs, diagnosis and methods of treatment.

Low back pain occurs in almost everyone, especially after 40 years. One of the reasons is osteochondrosis – a degenerative-dystrophic change in the spine. However, in many cases it does not explain the nature, severity and duration of back pain.

Varieties of pain

Back pain can be a symptom of a serious illness, but the vast majority of back pain is benign. One of the main points to consider when diagnosing back pain, and in particular in the lower back, is their duration. In most cases, muscle pain can last up to two weeks and then disappear. Pain caused by organic changes in the spine (intervertebral hernia, arthrosis) lasts much longer and can radiate to the leg, perineum, accompanied by a feeling of numbness, burning, goosebumps.

Pain caused by cardiovascular diseases, diseases of the abdominal organs are more intense and longer.

Possible causes

Pain caused by disease or injury of the spine

In most cases, back pain is caused by dysfunction of the intervertebral joints.

A decrease in the distance between the vertebrae due to degenerative changes in the intervertebral discs leads to an increase in the friction of the articular surfaces. This can cause subluxation and blockage of the joint. The muscles surrounding the affected joint are in a state of overexertion for a long time, which increases joint pain.

Most often, pain in diseases of the spine is dull in nature, i.e., its intensity increases gradually, intensifying with movements and weakening at rest. .

In cases of severe osteochondrosis, pain can be caused by compression of the nerve endings (spinal roots) during the formation of a herniated disc. Acute shooting or piercing pain can become constant over time and occasionally radiate to the leg with sudden movements, coughing, sneezing. The pain syndrome is usually accompanied by numbness, tingling, burning. Similar symptoms are combined with loss of sensitivity in the area of ​​the affected nerve, loss of reflexes, muscle weakness.

Serious spinal injuries (fracture, fracture dislocation) are accompanied by severe pain and require emergency medical intervention.

If a fracture occurs as a result of compression of the vertebral body, then it is called a compression fracture.

In older people, such a fracture is possible due to osteoporosis, which is more common in women. A compression fracture, sometimes even with minimal external load, is caused by damage to the spine during metastasis of malignant tumors.

Diagnostics and examinations

When diagnosing, the doctor takes into account orthopedic defects, the presence of symptoms such as impaired urination or defecation; pain spreading down the leg; lack of relief after taking painkillers; weakness and numbness in the leg. To confirm the diagnosis, you must perform:

• CT scan

CT scan of the lumbosacral spine

Examination that allows diagnosing pathologies of the spine and surrounding tissues.

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MRI of the lumbosacral spine

Diagnostic examination to determine the pathology of the lumbosacral spine and surrounding tissues.

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Clinical blood test: general analysis, leukoformula, ESR (with microscopy of a blood smear in the presence of pathological changes)

Synonyms: Complete blood count, UAC. Full blood count, FBC, Complete blood count (CBC) with differential white blood cell count (CBC with diff), Hemogram.
Brief description of the study CBC: general a…

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What should be done when pain occurs?

In acute pain, it is necessary to ensure peace and limit the load on the spine.

In the presence of radicular syndrome, bed rest is observed for two weeks. After an acute period, you should gradually return to an active lifestyle.

Treatment

First of all, therapy should be aimed at relieving pain. The doctor may prescribe a blockade of the focus of inflammation with injections. Pain relief is achieved for a period of six weeks to six months. Another option is the appointment of non-steroidal anti-inflammatory drugs in combination with muscle relaxants. Treatment can be supplemented with vitamin therapy (a complex of B vitamins), as well as the use of antidepressants and anticonvulsants strictly as directed. After the removal of acute pain, according to the decision of the doctor, thermal and magnetic physiotherapy, manual and acupuncture, massage can be added to the treatment.

If conservative treatment has proved ineffective for several months, neurosurgical operations are resorted to. At the age of 45 years, decompression of the spinal cord, removal of an intervertebral hernia, prosthetic intervertebral discs often give a good result. In other cases, it is better to use epidural blockade and radiofrequency denervation. This allows not only to quickly eliminate pain symptoms, but also to minimize the use of painkillers.

Muscle pain

Muscular, or myofascial, pain occurs most often with overstrain, spasm or microtrauma of the muscles.

In these cases, a painful and hard area of ​​\u200b\u200bthe muscle is probed under the skin, pressing on which is accompanied by a strong pain impulse, and sometimes recoil to other areas. As a rule, there is a relationship between the occurrence of pain with prolonged overexertion or an unnatural position (often associated with professional activities), compression and overstretching of muscles due to wearing heavy bags or backpacks, hypothermia, diseases of internal organs or joints. In the latter case, the pain impulse from the affected organ leads to a protective tension of the surrounding muscles.

Diagnostics and examinations

When making a diagnosis, the doctor conducts an external examination, finds out the history of the development of pain, its connection with overload or disease of the internal organs. To exclude damage to the spine (osteoporosis, metastases to the spine, tuberculous spondylitis):

• CT

CT scan of the lumbosacral spine

Examination that allows diagnosing pathologies of the spine and surrounding tissues.

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MRI of the lumbosacral spine

Diagnostic examination to determine the pathology of the lumbosacral spine and surrounding tissues.

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US examination of pelvic organs (uterus, adnexa)

Ultrasound scanning of the organs of the female reproductive system to assess the shape and size, as well as exclude pathology.

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The absence of serious diseases of the spine and internal organs gives grounds for the diagnosis of myalgia, or muscle pain.

What should be done when pain occurs?

If the pain syndrome is due to muscle spasm, the first step should be to ensure rest and, if possible, relaxation.

The optimal effect is achieved in the supine position, preferably on an orthopedic mattress.

Treatment

The main therapy is to relieve pain and relax spasmodic muscles. This is achieved by the use of muscle relaxants and non-steroidal anti-inflammatory drugs. The course of treatment, on the recommendation of a doctor, can be supplemented with anticonvulsant drugs that reduce the intensity of pain, and vascular drugs that improve blood circulation in the muscles. The most effective conservative method is local injection blockade. After the removal of acute pain, it is possible to prescribe vitamins and biostimulants. Significant benefits are provided by non-pharmacological means: manual therapy, massage, acupuncture, physiotherapy, physiotherapy exercises.

Psychogenic pains

Psychogenic pain, as a rule, occurs without lesions and does not have a clear localization. Psychogenic pain develops as a response of the body to stressful situations and the accompanying negative emotions. Unlike radicular or referred pain (when the localization of pain does not coincide with the focus of damage), psychogenic pain decreases or disappears after physical activity.

Psychogenic pain does not exclude a real organic lesion and even often accompanies its manifestations.

Diagnostics and examinations

It is quite difficult to identify the cause of psychogenic pain and determine its nature, especially in older patients. It is possible to suspect the psychological component of pain in the absence of its clear localization and nature, as well as in the presence of previous or current depressive states.

Treatment

The elimination of psychogenic pain is achieved by activating the lifestyle and using light tranquilizers and antidepressants as prescribed by the doctor.

Other possible causes of back pain

Other causes of pain syndromes can be infectious processes (tuberculous spondylitis, herpes), metastatic damage to the vertebrae, metabolic disorders (osteoporosis, hyperparathyroidism), vascular diseases (associated with vascular pathology), and lesions of internal organs. All of these conditions require urgent treatment.

Which doctors should I contact?

Patients with back pain (if the pain is not of infectious or tumor origin) are treated by both general practitioners and neurologists, algologists, psychotherapists and exercise therapy doctors.

Sources:

1. Clinical guidelines “Degenerative diseases of the spine”. Developed by: Russian Association of Spine Surgeons, Association of Neurosurgeons of Russia, Association of Traumatologists and Orthopedists of Russia. – 2021.
2. Clinical guidelines “Osteoporosis”. Developed by: Russian Association of Endocrinologists, Russian Association for Osteoporosis, Russian Association of Rheumatologists, Russian Association of Orthopedic Traumatologists, Russian Association of Gynecologists and Endocrinologists, Russian Association of Gerontologists and Geriatricians. – 2021.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment.