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Back and Spine;

Orthopaedics and Rehab

July 3, 2019

Back and Spine;

Orthopaedics and Rehab

Douglas Dickson, M. D.

Orthopaedic Surgery

Kavita Trivedi, D.O.

Physical Medicine and Rehabilitation

About 80% of adults will experience back pain in their lives, so it’s important to be able to identify the severity of your symptoms.

In our 20s and 30s, “normal” back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.  

In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.

Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.

Approximately 80% of adults will experience back pain in their lives, so it’s important to be able to identify the severity of your symptoms and track how long the pain lasts.

If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, it’s usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition. 

5 sensations that might indicate a medical emergency

1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.
2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.

Radiating pain could be a sign of nerve damage.

3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.
4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.
5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition. 

If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.

Related reading: Get help for back, neck, and leg pain caused by spinal stenosis

Other conditions that cause back pain in older adults

We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.

• Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
• Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
• Ankylosing spondylitis is an inflammatory arthritis that causes patients’ spines to become inflexible, resulting in a continual hunched forward position and spine pain.
• We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.

Take an inside look at The Spine Center at UT Southwestern, where the multidisciplinary team of physicians, nurses, and providers delivers cutting edge treatment for back pain and spine-related injuries.

Rare, non-spine conditions that cause back pain

Occasionally, our spine team finds that a patient’s back pain is caused by an underlying condition that is not spine related. 

Kidney and digestive issues, including pancreatitis and gallstones, can cause low-back discomfort that patients might assume is spine pain. In women, uterine fibroids and endometriosis are notorious for causing core pain that can radiate into the back.

Rarely, we discover that a patient with sudden, severe back pain has experienced a ruptured aneurysm, which is a weakening and tearing of part of a blood vessel. This is a medical emergency because it causes internal bleeding that can lead to a heart attack or stroke. Similarly, aortic dissection – the tearing of an inner layer of tissue in the aorta, the main vessel carrying blood from the heart to the rest of the body – sometimes causes back pain and can be fatal if not immediately treated.

Research suggests the spine is also prone to receiving cancer cells that spread from other parts of the body. Batson’s plexus, a network of veins that connect the venous system and spine, might (for unknown reasons) direct spreading cancer cells to the spine. For example, prostate cancer has been known to spread to the spine.

Related reading: Prostate Cancer Awareness Guide

Existing patients may also schedule an appointment using MyChart.

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Why back pain requires a team approach to care

Whether back pain requires surgery or is manageable with conservative treatment, it’s important to see a spine specialist for diagnosis and care. The doctors at our Spine Center work as a team with experts in nerve, muscle, and bone conditions, as well as nurses and physical therapists who work closely with patients to manage symptoms and reduce the risk of recurrence.  

Each week, our multidisciplinary team meets to discuss challenging cases and educate each other on the latest research and techniques. Together, we see a range of patients with complex medical needs. For example, if a patient with a spinal infection is taking a medication that suppresses the immune system, such as immunotherapy for cancer, we work together to find an effective treatment that is safe for their unique needs.

Some medications or medical conditions put patients at greater risk for low bone density, fractured vertebrae, or back pain. In these cases, we get referrals from and collaborate with oncologists, hematologists, rheumatologists, mineral metabolism doctors, and primary care doctors to reduce patients’ risks and manage their symptoms. 

If you are worried about back pain, come see us for reassurance. The earlier you are diagnosed, the better your outcomes can be. 

If you or a loved one might benefit from a back pain consultation, call 214-645-8300 or request an appointment online.  

Laurie Zapatka was injured in a car accident 20 years ago and her condition became progressively worse. By the time she came to UT Southwestern, her mobility was severely limited. A day after posterior spinal fusion surgery, she was up and moving with “zero pain.”

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Sharp Back Pain: Stabbing Pain in Back

Ouch! A sudden sharp pain in your back can stop you in your tracks. Unlike the dull ache of sitting too long at a computer or the gradual neck stiffness from too much driving, the cause of a sudden sharp pain in your back (also known as acute back pain) is not always obvious.

In fact, there are a number of common and less-common causes for acute back pain, and they are both mechanical and medical in nature.

Diagnosing Sharp Back Pain: Common Causes

Acute, sharp back pain caused by a mechanical problem within the back (meaning a problem with the bones, disks, ligaments, or muscles of the back) is one of the most common types of back pain. Some specific causes of acute, sharp back pain include:

• Muscle spasm. A muscle spasm is a prolonged contraction or stiffening of the back muscles, which can be triggered by trauma or repetitive strain. The back muscles spasm to protect the spine from further injury. A spasm can produce sharp back pain in either the upper or lower back.
• Herniated disk. A herniated disk — also called a bulging disk, slipped disk, ruptured disk, or pinched nerve — can also cause sudden, sharp back pain. It can result from the improper lifting of heavy objects or overly strenuous activity. Sharp back pain that shoots down through the buttocks into the legs, called sciatica, is a common symptom of a herniated disk.
• Compression fracture. This term refers to a fracture of the spine bones (vertebrae). It can be caused by trauma (a fall or car accident) or by weakened bones (osteoporosis), and the pain is often very sharp.
• Infection. Sometimes the vertebrae themselves can become infected in a rare condition known as osteomyelitis. With infection, back pain is usually accompanied by fever and other symptoms.

Other Causes of Sharp Back Pain

“Occasionally, sharp back pain that seems to be coming from the back is not really back pain at all,” says Cynthia Haines, MD, chief medical officer at HealthDay, a daily health news website based in Norwalk, Connecticut.

For example, rupture of the main artery in the abdomen (called a ruptured splenic artery aneurysm) can be a very serious cause of sharp back pain. Also, kidney infection (pyelonephritis) and an infection of the lining of the lungs and chest (pleurisy) can mimic back pain. In these cases, treatment of the underlying cause will usually resolve the back pain.

Keep in mind that it is always best to consult with your doctor.

“Anytime you experience a pain that comes on suddenly, with no apparent cause, you should call your doctor,” says Dr. Haines. She also advises a call to your doctor if the pain you are experiencing is anything other than very minor.

Other symptoms that require immediate medical attention include back pain with fever, numbness or tingling, shooting pains in the extremities or groin, progressive weakness, difficulty walking, or loss of bowel or bladder control.

Bottom line: There are many causes of sharp back pain, but most have simple treatment solutions. By talking with your doctor, you can determine the cause and get on the road to recovery — and back to your everyday activities as soon as possible.

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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) can 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 lumbodynia 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 of occurrence, in what 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 a 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:

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

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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, 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 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):

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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 negative emotions that accompany them. Unlike radicular or referred pain (when the localization of pain does not coincide with the focus of damage), psychogenic pain decreases or disappears after motor 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. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories can use different research methods and units of measurement to perform the same analyzes.

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