What are the main symptoms of shingles back pain. How is shingles diagnosed and what are the risk factors. What are the most effective treatments for managing shingles pain in the upper back. When should you seek medical attention for shingles symptoms.

Understanding Shingles: A Reactivation of the Varicella-Zoster Virus

Shingles is a condition caused by the reactivation of the varicella-zoster virus, the same virus responsible for chickenpox. After a person has chickenpox, the virus remains dormant in nerve cells, particularly those branching from the spine. This explains why shingles and back pain are often closely associated.

Anyone who has had chickenpox in the past is at risk of developing shingles later in life. In fact, approximately 99% of Americans born before 1980 have had chickenpox, making them potential candidates for shingles. The virus reactivates in about one in three people during adulthood, traveling along nerve pathways to infect the skin.

Recognizing the Phases and Symptoms of Shingles

Shingles typically progresses through three distinct phases, each with its own set of symptoms:

1. Pre-eruptive Phase

This early stage of shingles is characterized by:

• Nerve tingling or pain sensations
• Itching or numbness on one side of the body
• Burning or tingling skin sensations

These symptoms usually begin about 48 hours before the appearance of any visible skin changes.

2. Acute Eruptive Phase

The active stage of shingles includes:

• Intensified pain
• Flat, reddish discolorations of the skin
• Fluid-filled blisters similar to chickenpox
• Formation of a band-like rash, often on one side of the body

This phase typically lasts 2-4 weeks, with blisters drying and crusting over after about 7-10 days.

3. Chronic Phase

About 10-18% of people with shingles develop long-term pain known as postherpetic neuralgia (PHN). This phase may include:

• Persistent pain lasting a year or more
• Burning or tingling of the nerves (paresthesia)
• Uncomfortable skin sensations like crawling or stinging (dysesthesia)

Diagnosing Shingles: Methods and Tests

How do healthcare professionals diagnose shingles? The process typically involves:

1. Physical examination to assess the skin rash
2. Discussion of symptoms with the patient
3. Antibody tests to confirm past chickenpox infection
4. Blister tests to identify the presence of the varicella-zoster virus

Antibody Test for Chickenpox

For individuals unsure if they’ve had chickenpox, a blood test can detect the presence of IgM antibodies, indicating past infection and thus the potential for shingles.

Blister Tests for Shingles

Several methods are used to test blister fluid for the varicella-zoster virus:

• Polymerase Chain Reaction (PCR) Test: Considered the gold standard, this test checks for DNA specific to the virus.
• Direct Fluorescent Antibody (DFA) Test: Less sensitive than PCR but useful for quick diagnosis, especially for eye-related shingles.
• Tzanck Smear: An older, less accurate method sometimes used for rapid, inexpensive diagnosis.

Common Symptoms of Shingles Back Pain

What are the telltale signs of shingles affecting the back? Key symptoms include:

• Tingling or burning sensations in the skin, often preceding the outbreak
• Headaches and nausea
• Fever and chills
• A flat, reddish rash on one side of the body, potentially forming a band
• Development of fluid-filled blisters similar to chickenpox
• Intensifying pain during the outbreak phase
• Itching and stinging sensations on the skin

In some cases, shingles can lead to more severe complications:

• Ophthalmic shingles: Infection spreading to the eye, potentially causing blindness if left untreated
• Ear infections: May result in hearing loss
• Neurological complications: Including encephalitis or facial paralysis

Risk Factors for Developing Shingles

What factors increase the likelihood of experiencing shingles? Several conditions and circumstances can elevate your risk:

• Age: The risk increases significantly after 50, with about half of all cases occurring in individuals 60 or older
• Weakened immune system: Conditions like HIV/AIDS, cancer, or long-term use of immunosuppressive drugs can increase vulnerability
• Stress: High levels of stress can compromise the immune system, potentially triggering shingles
• Recent illness or surgery: These events can temporarily weaken the immune system
• Trauma or injury to the skin: Physical trauma may activate the dormant virus in nearby nerves

Effective Treatments for Managing Shingles Back Pain

How can you alleviate the severe back pain associated with shingles? Several treatment options are available:

Antiviral Medications

Prescription antiviral drugs such as acyclovir, valacyclovir, or famciclovir can help shorten the duration of the outbreak and reduce symptom severity. These medications are most effective when started within 72 hours of rash onset.

Pain Management

• Over-the-counter pain relievers: Acetaminophen or ibuprofen can help manage mild to moderate pain
• Prescription pain medications: For severe pain, doctors may prescribe stronger analgesics
• Topical treatments: Lidocaine patches or creams can provide localized pain relief
• Capsaicin cream: Derived from chili peppers, this can help reduce pain signals in nerve endings

Alternative Therapies

Some individuals find relief through complementary approaches:

• Cool compresses: Applying cool, wet compresses to affected areas can soothe irritated skin
• Calamine lotion: This can help relieve itching and promote healing of blisters
• Colloidal oatmeal baths: These can provide relief from itching and discomfort
• Stress reduction techniques: Practices like meditation or yoga may help manage stress-related pain

Preventing Shingles: Vaccination and Lifestyle Measures

Is it possible to prevent shingles? While not foolproof, there are steps you can take to reduce your risk:

Vaccination

The Centers for Disease Control and Prevention (CDC) recommends the shingles vaccine for adults 50 and older. Two vaccines are currently available:

• Shingrix: A newer, more effective vaccine recommended for adults 50 and older, even if they’ve previously received Zostavax or had shingles
• Zostavax: An older vaccine no longer available for use in the United States as of November 18, 2020

Lifestyle Measures

While not guaranteed to prevent shingles, these practices can support overall health and potentially reduce risk:

• Maintain a healthy diet rich in immune-boosting nutrients
• Exercise regularly to support overall health and reduce stress
• Get adequate sleep to support immune function
• Practice stress-reduction techniques like meditation or deep breathing exercises
• Avoid close contact with individuals who have active shingles or chickenpox if you’ve never had chickenpox or been vaccinated

When to Seek Medical Attention for Shingles Symptoms

At what point should you consult a healthcare professional about potential shingles symptoms? It’s crucial to seek medical attention if you experience:

• A painful, blistering rash, especially if it’s on one side of your body or face
• Symptoms affecting your eyes, including redness, pain, or vision changes
• A rash or pain near your ears, which could potentially affect hearing
• Signs of infection in the rash area, such as increased redness, warmth, or pus
• Severe pain that doesn’t respond to over-the-counter pain relievers
• A weakened immune system due to conditions like HIV/AIDS or cancer treatments

Early treatment can significantly reduce the severity and duration of a shingles outbreak, as well as lower the risk of complications like postherpetic neuralgia.

Long-Term Management of Shingles-Related Back Pain

For individuals experiencing prolonged pain after a shingles outbreak, what strategies can help manage chronic symptoms?

Postherpetic Neuralgia Treatment

Postherpetic neuralgia (PHN) can be challenging to treat, but several approaches may provide relief:

• Anticonvulsant medications: Drugs like gabapentin or pregabalin can help manage nerve pain
• Tricyclic antidepressants: These medications can help alleviate nerve pain even in non-depressed individuals
• Topical treatments: Lidocaine patches or capsaicin cream may provide localized relief
• Transcutaneous electrical nerve stimulation (TENS): This therapy uses low-voltage electrical current to relieve pain
• Spinal cord stimulation: In severe cases, this implanted device can help manage chronic pain

Lifestyle Adjustments

Certain lifestyle changes can complement medical treatments for chronic shingles-related back pain:

• Regular, gentle exercise to maintain flexibility and reduce stiffness
• Stress-reduction techniques like mindfulness meditation or progressive muscle relaxation
• Proper sleep hygiene to ensure adequate rest and pain management
• Dietary adjustments to support overall health and potentially reduce inflammation

By combining medical treatments with lifestyle modifications, many individuals can effectively manage long-term shingles-related back pain and improve their quality of life.

Shingles Back Pain: Symptoms, Causes, And Treatment

Content

• Overview
• What are shingles, and how can they be diagnosed?
• Symptoms of shingles
• What are the risk factors?
• How to ease severe back pain from shingles
• Can you prevent shingles?
• When is the right time to visit a doctor?
• Four fast facts about shingles back pain
• The lowdown

As an adult, the infections that we had in childhood can sometimes rear our heads again as we grow older. Shingles are one such condition. As with many activities and health issues that affect the back as we age, shingles back pain is a common challenge among those who develop the condition.

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Shingle is a condition caused by the virus that causes chickenpox. This virus is called ‘varicella-zoster.

Once infected, the varicella-zoster virus never leaves your body but instead stays inactive in nerve cells, especially those that branch out from your spine. This is why shingles and back pain often go hand in hand. It’s also why anyone who has had chickenpox in the past, which is 99% of people in the US who were born before 1980, can contract shingles.¹

In adulthood, the virus is reactivated in about one in three people and travels along the nerves to infect the skin. It’s marked by a rash that often appears on the chest, abdomen, or lower back, although it may appear anywhere on the body, including the face.²

What does an early case of shingles look like?

You’ll first notice some nerve tingling or pain sensations when shingles is in its early stage. These symptoms can be accompanied by itching or numbness on one side of your body.

Phases of shingles

There are three phases of shingles:

• Pre-eruptive phase: This is the early stage of shingles, marked by burning or tingling skin sensations. It begins around 48 hours before you notice skin rashes or blisters.

• Acute eruptive phase: This is the active stage of shingles, during which your pain will intensify, and you’ll first notice flat, reddish discolorations of the skin that may change into fluid-filled blisters, similar to chickenpox. These marks may form a band, often on one side of the body. They will dry and crust over after about 7–10 days, and the phase typically lasts 2–4 weeks while the skin heals completely.

• Chronic phase: About 10–18% of people with shingles will develop long-term pain from the reactivation of the varicella-zoster virus. This is known as postherpetic neuralgia (PHN). It may last a year or more and be accompanied by burning or tingling of the nerves (known as paresthesia) and crawling, stinging, or other uncomfortable skin sensations (known as dysesthesia).³ ⁴ ⁵

How are shingles diagnosed?

Your doctor begins with a physical examination to check the appearance of your skin rash and discuss your symptoms with you.

Chickenpox test

If your doctor suspects that you have shingles, an antibody test can be done on people who aren’t sure if they’ve had chickenpox in the past. Your doctor will draw blood and test it for the IgM antibody. If this antibody is present, this means you’ve had chickenpox in the past, and therefore you may have shingles.

Blister tests

Several methods may be used to test the fluid within your skin blisters or eye fluid for outbreaks near your cornea to confirm if the outbreak is shingles. The three main types of blister tests are:

• Polymerase chain reaction (PCR) test: This is the gold standard shingles test that checks the fluid for DNA unique to the varicella-zoster virus.

• Direct fluorescent antibody (DFA) test: Though less sensitive than PCR tests, DFA tests are sometimes used to diagnose shingles that affect the eye or provide a quick diagnosis. A follow-up PCR test is often conducted to confirm the diagnosis.

• Tzanck smear: Though this test is older and less accurate than PCR and DFA tests, it is sometimes used for quick, inexpensive diagnosis of shingles, and just like with DFA tests, it’s then confirmed with a PCR test if it comes back positive.

The most common symptoms of shingles include:

• Tingling or burning sensations of the skin, especially before an outbreak occurs

• Headaches and nausea

• Fever and chills

• A flat, reddish rash on one side of the face, neck, chest, abdomen, or back, which may form a band around your torso, back, or other areas

• The development of fluid-filled blisters similar to chickenpox after the initial rash occurs

• Pain that intensifies during the outbreak phase

• Itching and stinging sensations on the skin

Other symptoms may include:

• Infection that spreads to the eye, known as ophthalmic shingles, which may cause blindness if left untreated

• Infections that spread to the ears may cause hearing loss

• Infections that spread to the face may cause temporary paralysis in that region

Can shingles cause back pain?

Yes, the virus often settles in nerve “roots” that extend out from the spine, and therefore you may experience back pain, even if the outbreak doesn’t occur on your back.

Shingles on the lower back

Since the torso and waist areas are the most common regions where shingles outbreaks occur, lower back pain is a common symptom of the condition.

A weakened immune system is one of the main triggers for a shingles outbreak. Older people are also at a higher risk for the condition, especially those aged 50 and older. In fact, people aged 60 and older account for almost half of all shingles cases in the US, and the risk for serious complications rises in this age group.

Likewise, older people are more at risk than younger people for developing postherpetic neuralgia (PHN), or chronic pain, after having a shingles outbreak.  

Managing your severe back pain from shingles is a multi-treatment strategy that includes antiviral medications, pain relievers, and at-home remedies.

Antiviral medications

The three most common antiviral medications for shingles all help reduce your risk of developing PHN, particularly if you begin taking them within the first few days of symptom appearance. They are:

• Acyclovir

• Valacyclovir

• Famciclovir

These medications are aimed at helping you clear up the outbreak faster. Although people taking antiviral medications don’t typically experience side effects, they may cause diarrhea, nausea, headaches, stomach aches, or vomiting in a minority of cases.  

Pain relief remedies

Drugs called gabapentinoids and tricyclic antidepressants are some of the most commonly prescribed pain relievers for people who experience pain both during and after their shingles infection has healed on the skin.

More recently, thanks to clinical trials, a delivery method of the drug gabapentin (the generic form of Neurontin) was approved by the FDA. It allows for timed release of this pain relief medicine. The treatment is called ‘gastroretentive gabapentin,’ and has been shown to provide “significant” pain relief for people with PHN. It also has been shown to help with sleep interruptions caused by PHN (such as shingles back pain at night), which is important because proper rest can help with pain management.

Topical lidocaine patches and creams are also prescribed to help numb back pain. In addition, a natural ingredient in chili peppers called ‘capsaicin’ has been shown to reduce pain when administered in high doses. In fact, capsaicin 8% patches have been shown to be effective in reducing PHN pain after just 60 minutes.⁶

These patches are available by prescription, and some can even be purchased over the counter.

At-home care

Some natural ways to help ease your severe back pain from shingles. These include:

• Getting extra rest

• Looking for over-the-counter topical creams that contain capsaicin in them to help decrease pain symptoms

• Practicing proper dietary habits for pain, including eating foods that reduce inflammation to help better control nerve pain

• Engaging in stress-relieving activities, such as nature walks and mindfulness meditation, which has been shown to help with PHN of the back

• Applying cold packs wrapped in a towel or cloth to your back

According to the National Institutes of Health (NIH), the vaccine known as ‘Shingrix,’ given in two doses, is 90% effective at preventing shingles. For people ages 50–69 with healthy immune systems, the Centers for Disease Control (CDC) states Shingrix is actually 97% effective. Even in adults with compromised (weak) immune systems, the vaccine is 68–91% effective in preventing the condition. It is also 89–91% effective at preventing PHN (post-infection pain) for adults ages 50 and older.⁷

The NIH recommends taking Shingrix if:

• You’re unsure if you’ve had chickenpox

• You had the older (less effective) Zostavax vaccine for shingles

• You have had chickenpox or the chickenpox vaccine

• You have already had shingles

Visit your doctor if you suspect you may have shingles. Taking the medication within three days of the first symptoms is the most effective way to treat this condition.

Anyone with ongoing pain after a shingles outbreak should also visit a doctor to discuss long-term treatment options.

Can shingles go up your spine?

Although rare, there are cases of shingles traveling up the spine and causing meningitis, stroke, and other serious health risks.

Can shingles make your back hurt?

Yes, because shingles clusters often occur in nerves that branch off from the spine, shingles back pain is common.

What helps with back pain from shingles?

Start on antiviral medications as soon as you notice symptoms of shingles to help reduce your risk of developing shingles back pain. Pain medications such as tricyclic antidepressants and ‘gastroretentive gabapentin’ are prescribed for pain caused by outbreaks and  PHN. Capsaicin 8% patches, cold compresses, stress-reducing activities, extra sleep, proper diet, and over-the-counter lidocaine numbing creams can also help you manage these symptoms.

How long does back pain last with shingles?

For 82–90% of people who don’t experience the chronic phase of shingles, back pain can last 2–4 weeks. Those who do develop PHN could have back pain that lasts 12 months or longer.

Anyone infected with the varicella-zoster virus that causes chickenpox can develop shingles. Since the virus often spreads out from spinal nerve “roots,” you may also experience back pain even if your outbreak occurred in a different area of the body. 

Shingle symptoms usually heal within 2–4 weeks with proper treatment, although 10–18% of those infected develop a chronic condition called postherpetic neuralgia (also known as long-term nerve pain or PHN) that can last a year or longer.

Shingles are most likely to occur in people older than 50 and have lowered immunity. Direct contact with someone who has an outbreak is also a risk factor if you have lowered immunity and already have had chickenpox. 

The vaccine Shingrix is proven to be 90% effective in reducing the risk of developing shingles and PHN, especially in people over 50. It’s also 89–91% effective at preventing PHN for adults aged 50 and older.

Early antiviral medication can lower your risk of getting PHN and the back pain it may cause when an outbreak of shingles does occur. But even without getting PHN, shingles pain often worsens during the acute eruptive phase. Because of this, tricyclic antidepressants and gabapentinoids, two classes of pain medications, are frequently recommended.

Numbing medications like lidocaine and capsaicin 8%  patches may also be prescribed or obtained over the counter. Shingles back pain can be treated at home with cold compresses, stress-relieving activities, a healthy diet, more sleep, and over-the-counter pain creams. If PHN arises, these treatments are also an option. Most shingles cases resolve in a month with proper treatment.

How to identify and other causes

A person can develop shingles when the varicella-zoster virus reactivates after a chickenpox infection. Shingles causes a painful, blistering rash on one side of the body. The rash can appear in one of several places on a person’s back.

The Centers for Disease Control and Prevention (CDC) explain that after a person recovers from chickenpox, the virus remains in the body. It usually stays dormant or inactive. If the virus reactivates, it causes shingles.

In the United States, 1 in 3 people will develop shingles.

People with shingles typically develop a blistering rash on one side of the body. As the rash clears, the blisters burst and crust over. The rash usually clears within 2–4 weeks.

This article explains whether a shingles rash can appear on the back. It also describes how the rash spreads across the body, how to tell if it is shingles, and outlines other possible causes of a rash on the back.

A shingles rash can appear anywhere on the body, including the back. It usually only affects one side.

The rash can appear:

• in a band around one side of the waistline, which can extend from the front of the torso all the way to the spine
• in a band that extends from the front of the ribcage around to the shoulder blades
• on the front and back of the shoulder and up to the neck

The rash typically begins on one side of the body or face in a small area.

Although it most commonly develops as a single stripe around one side of a person’s waistline, it can begin anywhere on the body. It can also affect one side of the face.

In those with weakened immune systems, the rash may be more widespread across the body. However, this is rare.

If the rash develops on the face, people should contact a doctor urgently. This is because it can affect the eye and result in vision loss.

How does the rash spread across the body?

The National Institute on Aging explains that after a chickenpox infection, the varicella-zoster virus moves from the skin to nerve cells in the spine.

There are 31 spinal nerve cells on each side of the body that branch out to send and receive sensations from the skin. Each nerve cell is associated with a particular area of skin called a dermatome. While each dermatome is associated with a single spinal nerve, there is some overlap between the zones.

The varicella-zoster virus travels along these nerve pathways, and the shingles rash usually appears in one or two adjacent dermatomes.

A shingles rash tends to center in one dermatome, but there may be odd blisters in an adjacent area if the branches of the spinal nerve cross into a different zone.

In the 1–2 days before the rash appears, people will experience burning, tingling, or pain on the area of the skin where the rash develops. This is because the virus stimulates the nerve as it travels along its pathway.

Once the virus reaches the skin, it forms a rash.

A shingles rash usually begins as groups of tiny pimples that spread to form a band or stripe. These pimples then fill with pus and form blisters.

The CDC notes these blisters usually scab over within 7–10 days, with the rash clearing completely within 2–4 weeks.

The most distinctive feature of a shingles rash is that it only appears on one side of the body. Other symptoms include:

• fever
• upset stomach or diarrhea
• headaches
• muscle aches
• nerve pain
• vomiting

Shingles is not the only cause of a rash on the back. Other possible causes include:

• Lichen planus: This is a skin condition that causes shiny, firm bumps. They often appear on the lower back and can also commonly affect the wrists and ankles. A person with lichen planus can develop blisters, but these are rare.
• Poison ivy: A person can develop a blistering rash on the area of skin that comes into contact with the plant. A poison ivy rash may take 2–3 weeks to appear after contact with the plant if the person has not previously had a reaction. Before the rash appears, the area of affected skin will itch intensely.
• Contact dermatitis: This occurs when the skin comes into contact with a substance that results in an allergic reaction or irritates the skin. People will develop scaly, inflamed skin.
• Bullous pemphigoid: This is a rare skin condition that affects older adults. The rash is itchy and raised, and blisters develop as the condition develops.
• Reaction to medication: Some people develop blisters around their eyes after taking medications. The rash can be painful and develop alongside a fever.

Anyone with a blistering rash should consult a doctor as soon as possible.

Doctors can prescribe antiviral medications for shingles. If a person takes these medications within 2–3 days after developing the rash, this can:

• ease the pain
• shorten the infection time
• reduce the risk of developing complications

Doctors treat shingles with antiviral medications. These include:

• acyclovir
• valacyclovir
• famciclovir

Over-the-counter pain medicines and calamine lotion may also help reduce the itchiness.

People with shingles on the back have an itchy, blistering rash that affects one side of the body.

The rash can develop anywhere but most commonly appears in a strip around the waistline. Shingles can also develop on the back.

If a person notices symptoms of shingles, they should contact a doctor urgently.

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
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Upper back pain

Upper back pain is an extremely common symptom. It occurs in a variety of diseases, and therefore the key to its successful treatment is accurate diagnosis. A thorough examination usually reveals the cause of the pain.

Causes of pain in the upper back

Pain in the upper back usually accompanies various diseases of the internal organs. Respiratory system diseases:

• pleurisy with a feeling of cutting pain in the left or right side of the chest associated with respiratory movements;

• spontaneous pneumothorax with sudden acute chest pain radiating to the scapula. Characterized by a decrease in the excursion of the chest on the side of the lesion, the absence of noise during auscultation;

• pneumonia with intense or moderate pain in the left or right side of the chest or shoulder blade. The pain is aggravated by deep breathing and coughing, fever, coughing, wheezing in the lungs during auscultation;

• cancer of the lung or bronchi. The nature and intensity of pains depend on its localization and prevalence; if the apex of the lung is affected, Pencost syndrome develops, in which pain is noted in the shoulder, shoulder blade, medial surface of the arm, when the pleura grows, there is pain in the chest on the side of the lesion, significantly aggravated by breathing, coughing , movements of the trunk, in case of involvement of the intercostal nerve, the pain is girdle.

Diseases of the digestive system sometimes also cause pain in the upper back. Pay special attention to the localization of pain on the right or left. Pain in the upper back on the right may indicate acute cholecystitis. Pain lasts from several hours to several days, usually localized in the right precostal space and epigastrium. Possible irradiation to the right half of the chest, right shoulder, scapula, shoulder girdle, as well as to the region of the heart, associated symptoms:

• nausea;

• vomiting;

• fever;

• jaundice of the skin;

• pain on palpation in the right hypochondrium;

• tension of the abdominal muscles.

Left upper back pain often indicates acute pancreatitis with sudden intense pain in the epigastric region of a girdle character with irradiation to the left lower chest, shoulder blade, shoulder girdle, heart area; pronounced spasm of the abdominal muscles;

Diseases of the urinary system may cause pain in the upper back. Also similar to symptoms are observed in:

Sudden low back pain of unknown origin in a patient receiving anticoagulant therapy .