Symptoms, Causes, & Risk Factors

There’s a lot riding on your spinal column. It’s your body’s main structural support. It needs to keep you stable enough to stand upright but flexible enough for movement. So it’s no surprise that many people have back problems from time to time.

The hurt can stem from sore muscles, ligaments, and tendons, or from herniated disks, fractures, and other problems in your upper, middle, and lower back. Sometimes you feel the effects right away. But in many cases, back problems develop over time.

Causes

We often bring on our back problems through bad habits, such as:

• Poor posture, like sitting incorrectly at a desk or behind the steering wheel
• Repeating the same motion or overdoing it
• Pushing, pulling, and lifting things carelessly

The spine is actually a stack of 24 bones called vertebrae. A healthy spine is S-shaped when viewed from the side. It curves back at your shoulders and inward at your neck and small of your back. It houses and protects your spinal cord, the network of nerves that transmit feeling and control movement throughout your entire body.

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One of the more common types of back pain comes from straining the bands of muscles surrounding the spine. It happens most often in the curve of the low back and the base of the neck. These areas support more weight than your upper and mid back, which are less prone to trouble.

Injuries from contact sports, accidents, and falls can cause problems ranging from minor muscle strains, to herniated disks, to fractures that damage to the spinal column or cord.

Stabbing low back pain could be from muscle spasms, when your muscles seize up and don’t relax, like a cramp.

Osteoarthritis can affect your vertebrae, when the cartilage between them wears down. Bone spurs or a herniated disk can push on nerves.

Pregnancy often brings on back pain, too. Hormonal changes and weight gain put new kinds of stresses on a pregnant woman’s spine and legs.

Sometimes your back might be sore for no clear reason. That’s called nonspecific backache. It could come from weak muscles that can’t handle everyday walking, bending, and stretching.

Other Symptoms

Back pain — whether a dull ache or shooting — is just one sign that something’s going on with your back. You may also have feelings in your legs or arms:

• Radiating pain
• Numbness
• Tingling
• Weakness

Uncontrolled peeing or pooping could mean a serious problem like spinal cord compression. Call your doctor right away.

Diagnosis

You should see a doctor:

• After you get hurt, like in a fall or accident
• When the pain gets in the way of your daily activities
• If it lasts longer than 6 weeks, or spreads

During your exam, your doctor will test your range of motion — unless you can’t move — and check how well your nerves are working. That may be enough to decide what to do next.

You might need imaging tests, like X-rays, an MRI, or a CT scan. But they’re not always useful, and there’s not always a direct link between the results of these tests and how much it hurts.

Treatment

Your specific treatment will depend on what’s causing your pain and where in your back it is.

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Despite what you may think or have been told before, staying in bed isn’t usually the answer; gentle exercise is. It will help work out the kinks, build support for your spine, and improve your flexibility. A physical therapist can work with you to design a set of exercises, give you relief from the pain, and get you moving again.

Over-the-counter pain relievers, ice, and heat will work to take the edge off most back pain. Your doctor can prescribe stronger medicines, but some can make you drowsy or dependent on them if you’re not careful.

Complementary therapies, such as chiropractic spinal manipulation, acupuncture, and massage, can help ease pain, too.

If a bone is damaged, or you have a herniated disk or pinched nerve, you may need surgery. But for ongoing back pain, doctors will try other treatments first.

Counseling could help you learn to live with chronic pain better as well as deal with symptoms of depression because of it.

Prevention

Exercise! Strengthening the muscles around your spine and in your core will help keep you stable and balanced. Walking is great for your low back, and it’s simple to do.

Practice good posture. As a rule of thumb, aim to keep your ears, shoulders, and hips aligned when you sit, stand, and walk. Lift heavy things correctly, using your hips and knees for power while keeping your back straight.

Try sleeping on your side, with a medium-firm mattress.

Don’t smoke. It restricts blood flow, so your muscles and tissues don’t get a good supply of nutrients and oxygen. That can lead to weakness and aches. Repeated coughing could strain your back.

Middle back pain: Causes, treatment, and exercises

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Middle back pain refers to pain or discomfort in the thoracic spine — the region of the back between the rib cage and the base of the neck.

In this region, there are 12 spinal disks, several vertebrae, and many muscles and ligaments. Any of these structures can become irritated or damaged, leading to middle back pain.

Read on to learn more about the causes of middle back pain and discover techniques to find relief.

There are many possible causes of middle back pain, ranging from injury to poor posture.

Potential causes include:

1. Aging

Pain in any part of the back becomes more likely as a person ages. Back pain is typical in people aged 30 to 60, but it can affect people of any age.

Natural causes of back pain in older adults include:

• less fluid between spinal joints
• reduced muscle mass
• thinning bones

2. Arthritis

There are a number of different forms of arthritis, some of which can affect the back.

Osteoarthritis (OA) is a common degenerative joint disease that affects 30 million adults in the United States. OA causes the ends of bones to rub together, leading to pain, swelling, and stiffness.

Ankylosing spondylitis is a type of arthritis that affects the spine. Symptoms include pain and stiffness in the back. Over time, it causes the vertebrae to fuse together, which can impact posture and mobility.

3. Fractured vertebrae

A fracture or broken bone can occur in any of the vertebrae in the middle back as a result of a sports injury, automobile crash, or fall.

Extreme deterioration of the spine over time, such as from osteoarthritis, can also cause a fractured vertebra.

Symptoms include intense pain that gets worse with movement. If the injury affects the spinal cord, it can lead to tingling, numbness, and incontinence. Fractures require immediate medical treatment.

4. Herniated disks

Disks are located between the vertebrae, where they act as shock-absorbing cushions. They also help a person move.

The disks are filled with liquid and can rupture or bulge outward. This is known as a herniated disk, slipped disk, or ruptured disk, and it puts pressure on the surrounding nerves.

A herniated disk in the middle back does not always cause symptoms, but it may result in pain, tingling, or numbness.

5. Kidney problems

Kidney problems can cause pain in the middle back, just underneath the ribcage on either side of the spine.

The most common causes of kidney pain are infections and kidney stones. Additional symptoms include:

• fever
• difficulty urinating
• pain while urinating
• chills
• nausea and vomiting

6. Lifestyle factors

A lack of exercise leads to weak muscles, which can contribute to pain. People who exercise using improper lifting techniques can also experience pain in the back.

Research suggests that people who smoke tobacco also have an increased risk of developing chronic back pain. Smoking is also thought to reduce the nutrient supply to the spinal disks, which increases the risk of pain, degeneration, and injury.

7. Muscle strain or sprain

Repeatedly lifting heavy objects or carrying items improperly can cause the muscles and ligaments in the back to stretch or tear.

8. Obesity

Being overweight or obese puts additional strain on the muscles, bones, and other structures in the back.

In a meta-analysis of almost 100 studies, obesity was found to increase the risk of back pain.

9. Osteoporosis

Osteoporosis is a type of bone disease that results in brittle bones. It occurs when the body does not make enough new bone to replace natural bone loss.

Approximately 54 million people in the U.S. have osteoporosis or are at risk of developing it.

People with osteoporosis in the back can experience middle back pain due to strains or compression fractures.

10. Poor posture

Incorrect posture while sitting or standing is a leading cause of back pain. Slouching increases pressure on the spine and leads to strained muscles as they try to maintain balance.

11. Mental health conditions

People who experience depression or anxiety tend to be at increased risk of developing back pain.

Research suggests that people with depression are 60 percent more likely to develop back pain than people who do not have depression.

12. Scoliosis

Scoliosis causes the spine to curve sideways. It leads to an uneven distribution of weight throughout the back and may cause middle back pain.

13. Tumor

If a tumor grows in the middle back, it can affect spinal alignment and put pressure on the nearby nerves, muscles, and ligaments.

The treatment for middle back pain will depend on the underlying cause. Doctors usually suggest home remedies first but may recommend medical and surgical interventions if needed.

Home remedies

At-home methods to treat middle back pain include:

Contrast therapy

Alternating hot and cold compresses, or ice and heat, can provide relief from many types of middle back pain. Heating pads and cold compresses are available for purchase online.

Over-the-counter pain relief

Ibuprofen (Advil) or naproxen (Aleve) may relieve pain and swelling. These medications are also available for purchase online.

Improvements to posture

Poor posture should be corrected to alleviate back pain. Practice correct posture by:

• standing tall with the shoulders back
• not slouching
• taking regular breaks from sitting or using a computer

Workstations should be ergonomically optimized for back health. People should adjust the height and positioning of the chair, desk, computer screen, keyboard, and mouse for their needs.

Exercises

Several exercises may help to stretch and strengthen the muscles in the middle back to treat and prevent pain.

Beneficial stretches include:

• Cat-Cow Pose: Position yourself on your hands and knees. Then, arch your back as far as comfortable (like a cat) before sinking your back toward the ground in a U-shape (like a cow).
• Cobra Pose: Lying flat on the ground, use your arms to prop up the upper body, stretching the back.
• Seated twist: Sitting cross-legged, twist your upper body to the right, placing your left hand on the right knee for support. Repeat on the other side.

Beneficial exercises include:

• Low-impact activities. Good options include yoga, swimming, and walking.
• Core-strengthening exercises. Working the abdominal and back muscles using bridges and planks helps to support the back.

People should speak with a doctor or physical therapist before beginning any new exercise regimen.

Medical treatments

A person should see a doctor for back pain that persists for several days or does not respond to home remedies.

Possible medical treatments for middle back pain include:

• prescription medications, including painkillers, muscle relaxants, or steroid injections
• physical therapy, such as exercises and massage

Surgery

If medication or physical therapy do not alleviate middle back pain, surgery may be necessary. Types of surgery for the middle back include:

• Discectomy. People with a herniated disk may need a discectomy to remove the injured part of the disk and prevent further damage.
• Fusion. A fusion procedure involves joining two vertebrae and using a spacer to replace damaged disks.
• Laminectomy. Used to decompress the spinal cord, a laminectomy removes the back wall of a vertebra (the lamina).
• Laminotomy. In this surgery, a portion of the lamina is removed to treat a pinched nerve.

Not all cases of middle back pain are preventable, but the following steps may reduce the risk of injury:

• Maintain a healthful weight. Being overweight or obese puts extra stress on the back muscles.
• Sleep on one side or on the back. People who sleep on their stomach may experience spinal misalignment. It is best to sleep on the back, or one side with a pillow between the knees.
• Practice proper posture. Stand tall with the shoulders back and keep the pelvis in a neutral position.
• Ergonomically optimize all workspaces. Make sure computers are at eye level, look for a seat with armrests and lower back supports, and wear supportive shoes.
• Lift with caution. Where possible, avoid heavy lifting or find someone to help. When lifting, keep the back straight and bend at the knees.
• Try physical therapy. Ask the therapist for a personalized program to improve posture, core strength, and mobility.

Share on PinterestMiddle back pain may cause numbness, stiff muscles, or burning sensations.

Middle back pain symptoms vary depending on the underlying cause of the pain.

Some common symptoms include:

• burning sensations
• dull or aching pain
• sharp or stabbing pain
• tight or stiff muscles

More severe symptoms include:

• a tingling sensation in the arms, chest, or legs
• chest pain
• incontinence
• numbness
• weakness

A person should see a doctor if they experience any of the symptoms for more than 3 days, especially if they do not respond to home remedies.

Symptoms of severe back pain that require prompt medical treatment include:

• a tingling sensation in the arms, chest, or legs
• chest pain
• incontinence
• numbness
• weakness

People should seek immediate medical treatment for back symptoms following a fall, collision, or another injury.

Causes, treatment, and home remedies

Many people have back pain at some point in their lives. Middle right back pain involves the area of the back between the base of the neck and the rib cage. Pain can sometimes affect one side more than the other.

This article examines some potential causes of middle right back pain.

The middle back is also called the thoracic spine.

The area includes 12 spinal vertebrae — T1 to T12 — along with muscles and ligaments.

Damage or irritation to any of these areas can lead to middle back pain. The pain may sometimes affect one side more than the other, leading to pain on the right side.

Learn more about the anatomy of the back here.

There are many possible causes of middle and middle right back pain, including injury and poor posture.

Aging

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), people 45 years and older are more likely to develop back pain.

Learn more about middle back pain here.

Lifestyle factors

Various lifestyle factors may increase a person’s risk of developing back pain. These include:

• Obesity: Excess body weight puts more strain on the back, which can cause pain.
• Exercise: Back pain is common in people who have not exercised for a while or ramp up their workouts too fast after an extended break.
• Occupational hazards: Some jobs that require a lot of lifting, pushing, twisting, and pulling can increase a person’s risk of developing back pain. People who sit and slouch all day are more likely to have bad posture, which can also contribute to back pain. This type of pain can occur on either side of the back.

Learn how exercise and diet can help treat back pain.

Arthritis

Most back pain is temporary. However, arthritis-related back pain is a chronic condition. According to the Arthritis Foundation, people often experience arthritis of the lower back, but it can occur in the middle back area.

There are many forms of arthritis, so the treatment depends on the type of arthritis a person has.

An example of a type of arthritis that can affect the spine is ankylosing spondylitis (AS). The pain usually starts in the lower back, but a person with AS may also have middle back pain.

AS causes a dull and diffuse pain instead of sharp, localized pain. It can occur on only one side of the body, sometimes alternating.

Learn about different types of arthritis here.

Injury

While it is possible to injure the thoracic spine, the American Association of Neurological Surgeons (AANS) indicate that it is an unlikely spot for an acute injury because it is much more rigid than other spinal areas.

Herniated disk

However, injuries do happen. For instance, a herniated disk in the middle of the back can press on a nerve, causing pain in the middle back, along with weakness and numbness.

Other symptoms of a herniated disk in the thoracic spine include:

• chest pain
• pain upon taking a deep breath
• pain around the rib cage

Learn about what causes a herniated disk and how to treat it here.

Sprains and strains

Most mild injuries, such as sprains and strains, will heal on their own. Rest, physical therapy, and over-the-counter (OTC) nonsteroidal anti-inflammatories (NSAIDs) can help speed recovery.

Learn the differences between a sprain and strain here.

Spinal injuries

Serious spinal injuries, such as those resulting from a car accident, may require surgery. Severe spinal injuries may even leave individuals paralyzed.

Learn more about different types of paralysis here.

Muscles and soft tissue

Muscular or soft tissue issues of the middle back may cause the following sensations:

• sharp pain
• aching
• throbbing
• weakness
• muscle fatigue
• spasms

If the problem is nerve-related, a person may feel the following:

• burning
• shooting pain
• weakness because of nerve impingement
• tingling or numbness

Learn how a pinched nerve can cause back pain here.

Kidney pain

People sometimes mistake pain in the kidneys as back pain. The kidneys are under the rib cage on both sides of the spine.

Pain due to a kidney infection or kidney stones can sometimes feel like back pain in the middle back. The pain may occur on one side or both.

Other symptoms of a kidney infection include:

People with kidney stones may experience the following in addition to back pain:

• strong urge to urinate
• frequent urination
• painful urination
• blood in urine
• nausea and vomiting

People who suspect they have a kidney infection should seek immediate medical care.

While some kidney stones may pass easily, larger stones can be unbearably painful and may require surgical intervention.

Learn the differences between back and kidney pain here.

Scoliosis

People with scoliosis have abnormal spinal curvature. According to the AANS, about 2–3% of people in the United States live with this condition.

Not everyone with scoliosis develops back pain. The site of the pain depends on the degree of severity of the curvature.

Other symptoms of scoliosis include:

• uneven shoulder height
• protruding shoulder blades
• head off-center
• unusually high hips
• asymmetrical rig cage height
• abnormal skin texture along the spine
• leaning to one side

Treatment for scoliosis may involve a wait-and-see approach in children and teens. Other treatment options include bracing and surgery.

Learn about exercises and stretching for scoliosis here.

Pancreatic cancer

According to the American Cancer Society, abdominal pain that turns into or radiates to the middle back pain is a possible symptom of pancreatic cancer. Depending on the location of the tumor, pain may have various possible locations.

Other symptoms of pancreatic cancer include:

• jaundice
• dark urine
• itching
• pale-colored stools
• poor appetite
• unexplained weight loss
• diabetes

Often doctors do not diagnose pancreatic cancer in its early stages, and according to the American Cancer Society, it has a low 5-year survival rate. Possible treatments include surgery, ablation, radiation therapy, chemotherapy, and immunotherapy.

However, the cause of these symptoms is usually something other than pancreatic cancer.

Learn more about back pain and cancer here.

A doctor may prescribe medications or, in more severe cases, recommend surgery.

A person can also use several home remedies for middle right back pain, including:

• using hot or cold therapy
• taking OTC NSAIDs
• stopping or limiting activities or exercises that worsen the pain
• maintaining proper form and posture throughout the day
• switching positions frequently
• avoiding sitting too long
• using supportive seating when working
• changing sleeping position and avoiding sleeping on the stomach
• avoiding lifting heavy objects or carrying heavy loads

Learn more about home remedies for back pain here.

The following videos show how to do some stretches and exercises to help strengthen and stretch the back muscles and prevent and treat pain.

Knee-to-chest

This stretch involves lying down on the back with feet positioned flat on the floor. The person can also sit in a chair.

Pull one knee into the chest and hold the position for about 5 seconds, then change sides. Keep the spine pressed to the floor.

Cat-Cow Pose

Start on all fours in the tabletop position. Then, arch the back upward like a cat and then lower it, bringing the belly toward the floor.

Repeat with each leg several times.

Child’s Pose

This easy yoga pose helps elongate and stretch the spine.

Kneel with the buttocks resting on the lower legs and feet. Place the knees apart in a comfortable position.

To perform the stretch, fold forward and lower the chest down to the knees.
If possible, bring the forehead to the floor, but this is not a requirement.

Stretch the arms long in front of the body with the hands on the floor. Hold the pose for 20–30 seconds before returning to a sitting position.

Bridge Pose

To perform the Bridge, lie on the back on the floor with the knees bent and feet flat. Gently raise the buttocks off the floor while squeezing the bottom and abdominal muscles.

Hold the position for several seconds, then release and slowly lower the buttocks down to the floor.

If performing specific movements causes a person’s pain to worsen, they should stop immediately. A medical professional can help an individual determine which exercises are safe and appropriate.

If performing specific movements causes a person’s pain to worsen, they should stop immediately. A medical professional can help an individual determine which exercises are safe and appropriate.

Learn how to do six yoga poses that help with back pain here.

Doing regular exercises to strengthen the muscles in the back and abdomen can help prevent back pain. A healthful diet is vital to help maintain a healthy weight and a strong spine.

People can also work on their posture and try to avoid slouching when sitting or standing.

Another way to avoid back pain is to use proper form when exercising and when lifting heavy objects. Always use the legs and abdominal muscles rather than the back when lifting to prevent injury.

Learn about exercises to improve posture here.

A doctor will ask about family and medical history to determine whether an acute injury or medical condition is causing a person’s back pain.

A doctor may also ask about the specific location of the pain. A physical exam will help a doctor reach a diagnosis.

They may also order blood tests, X-rays, and other imaging tests to confirm a diagnosis.

People should see a doctor if their back pain does not improve after several weeks.

A person should also visit a doctor if they experience the following symptoms with back pain:

• tingling and numbness
• pain that does not improve after they take medication or change position
• pain that occurs after an acute injury or fall
• difficulty urinating
• numbness, weakness, or pain in the lower extremities
• fever
• unintentional weight loss
• severe stiffness in the spine

Back pain is an incredibly common ailment. Middle right back pain can happen for various reasons, including injury or issues affecting internal organs.

Being specific about the location and type of pain can help a doctor diagnose the issue.

People can often find relief from back pain with home remedies, such as OTC pain relievers and rest.

If the middle right back pain does not go away or worsens, a person should see a doctor.

Do you have stabbing pain in your upper back?

How many times have you had a stabbing pain in your upper back that increased with breathing or rolling in bed? Or even felt like s sharp pain into your heart when you take a deep breath? Or maybe felt a tension in a specific point in near your spine after sitting all day behind the desk? All what I mentioned are some of the signs and symptoms related to interscapular pain, imagine a muscle as small as the rhomboids can cause all of this!

Before digging into more details let’s go back to the anatomy of this muscles:
Location:

The rhomboid muscle group (composed of the rhomboid major and rhomboid minor muscles) is found lying deep to the Trapezius muscle, between the spine and the scapula in the mid- back region.

Function:

The rhomboid muscles function is to position the scapula during various movements of the shoulder and arm.

Muscle Actions:

Scapular adduction (pulling the shoulder blade towards the spine) as well as scapular elevation and rotation to smoothen the shoulder movement.

Antagonist:

Pectoralis major & serratus anterior. Excess muscle tension in the pectoralis muscles and inhibition of serratus anterior are common and will often overload the rhomboid muscles. This relationship allows trigger point activity to spread easily between these muscle groups.

Synergistic Muscle Groups:

Levator scapule, upper trapezius, middle trapezius fibers, latissimus dorsi. Those muscles help the rhomboids in their movement and share similar biomechanical functions with them, and may become overloaded if they are unable to perform their workload due to trigger point activity or injury. Which will eventually overload the rhomboids and cause trigger points.

Treatment:

The treatment is usually based on the medical practitioner perspective, some of them would prefer myofascial release, others would needle the rhomboids, and some will adjust the ribs or the thoracic spine. Well from my point of view all of them works! All of these techniques do have an effect of the muscle tension and trigger points, but are they enough? This is the main reason behind this article, why does it happen again and again no matter how many times the patient receive treatment? And why is it very common nowadays?

If we think of the body as a mechanical system integrated together and understood how it functions in motion, only then we can realize that localized treatment will not be enough for the mechanical injuries as we will be treating the symptoms not the causing factors.

Since this injury is common and non-traumatic, then what is the reason behind it? If we noticed the antagonist muscles work on the shoulder movement and some of the synergist works on the neck movements.

Due to our daily living posture requirements we end up by developing wrong postural habits in the way we are sitting behind the desk, scrolling in our mobiles, driving cars, watching TV any many more tasks that we do on daily basis. All the wrong habits will lead up to a rounded shoulders and text neck position, which eventually will end up with weak and inhibited rhomboids causing interscapular pain! What I am trying to deliver here is local rhomboids treatments are not enough for such condition especially for people who suffer from recurrence interscapular pain.

From my own point of view, Releasing and stretching the chest muscles which are main cause of the rounded shoulder position, and activating the deep neck flexors which are inhibited by the text neck position, as well as facilitating the Serratus anterior for more efficient scapular motion while the shoulder is in motion are absolutely crucial to be included in the treatment plan, however postural tips and instructions are as important as any other therapeutic exercise.

What Causes Sharp Lower Back Pain?

Severe pain in your lower back typically occurs due to a problem in your spine or hip but may also originate from your internal organs. This blog provides a guide to the accompanying symptoms and potential causes of acute, severe lower back pain.

Lower Back Strain Video

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Lower back strain is a common cause of sharp lower back pain. Watch: Lower Back Strain Video

Range of symptoms that may accompany sharp pain the lower back

Acute pain in your lower back may be limited to one or both sides. You may also feel that the pain originates from a particular spot on the left or right side of your lower back. Sharp lower back pain typically includes one or more of the following symptoms and characteristics:

• Decrease in motion. Severe lower back pain is typically associated with increased tension and spasm in the surrounding muscles, causing stiffness and a decreased range of motion.
• Radiate through nerves. If your lower back problem originates from your spinal nerve roots, a shooting pain may radiate into your leg through the affected nerve.
• Cause neurologic deficits. Lower back pain that is caused by irritation or compression of nerves may be associated with neurologic symptoms, such as numbness, tingling, a pins-and-needles sensation, and a general feeling of weakness in the leg(s).

These symptoms may be aggravated or relieved by specific postures or activities, such as sitting, standing, walking, and lying down. While spinal pain typically resolves in a few days to weeks, the symptoms can become debilitating, significantly affecting your daily activities.

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Common musculoskeletal causes of severe lower back pain

The most common causes of acute lower back pain include a sudden or repetitive injury to one or more structures that support your back, such as muscles, ligaments, joints, and intervertebral discs.

Muscle strain

A pulled muscle (muscle strain injury) can send intense flareups of pain, spasm, and stiffness across your lower back. This injury may also be localized and cause sharp pain in the left or right side of your lower back. Common symptoms of a muscle strain injury in your lower back include:

• Acute, shooting pain that intensifies with movement
• Difficulty in standing or walking
• Sharp pain while going from a sitting-to-standing or standing-to-sitting position

The pain is typically relieved when you recline with support and elevate your legs or lie down and elevate your knees. Following the PRICE protocol may also help relieve pain and heal the injured muscle.

See Pulled Back Muscle Treatment

Lumbar herniated disc

Your spinal discs serve as shock absorbers between your vertebrae, support your upper body, and allow a wide range of lower back movements. If your lower spinal disc(s) herniates, it may leak its inner contents, irritating or compressing a nearby spinal nerve root.¹ The resulting cascade of inflammatory events causes a variety of symptoms, such as:

• Acute lower back pain and stiffness
• Increased pain during certain activities, such as lifting heavy objects or strenuous exercise
• Burning feeling in the buttock, thigh, and/or calf
• Sharp pain or a dull ache along the outer side or under the foot
• Weakness, numbness, and tingling in the leg

When these symptoms originate from your sciatic nerve roots (L4 to S3), it’s called sciatica.²

Herniated disc symptoms may be relieved by taking anti-inflammatory medications and performing specific types of lumbar extension exercises, which may also help heal the disc. More intense medical treatment(s) may be required when significant neural compression occurs with severe symptoms.

Read more: Lumbar Herniated Disc: What You Should Know

Piriformis syndrome

This pain syndrome affects the piriformis muscle, located deep in your buttock. If you have piriformis syndrome, your buttock and hip become painful, and this pain may be referred to your lower back.³ Common symptoms include:

• Sharp, searing pain in the buttock that increases while sitting for a long time
• Acute lower back pain and stiffness
• Warm sensation or a burning feeling along the back of your thigh

Piriformis syndrome pain may be relieved by taking pain-relieving medication. In severe cases, muscle relaxants (obtained through a prescription) may help relieve muscle stiffness and pain. Long term management usually includes piriformis muscle stretch and physical therapy.

Read more about Piriformis Syndrome Treatment

Sacroiliac joint dysfunction

Sacroiliitis, a condition that causes inflammation and dysfunction of your sacroiliac (SI) joint, which connects the bottom of your spine to your pelvis on each side may cause⁴:

• Sharp, stabbing, or shooting pain felt directly over your affected joint – on the right or left side of your lower back and buttock
• Burning sensation along the back of your thigh
• Positional flare-ups that may occur when you move from standing to sitting, climb stairs, or lie on the affected side

Pain-relieving medications in combination with postural correction and sacroiliac joint exercises may help reduce the acute symptoms. Medical treatments, such as radiofrequency ablation may be required if the joints are severely inflamed and irritate nearby nerve tissues.

See Treatment Options for Sacroiliac Joint Dysfunction

While these are relatively common patterns, the actual presentation of these conditions can vary significantly, making it difficult to self-diagnose the root cause of pain. It is also possible for severe lower back pain to occur with no identifiable cause. This condition is called nonspecific lower back pain.⁵

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Acute back pain due to inflammation of internal organs

Pain in your lower back may occur due to the inflammation or irritation of an internal organ or may be a sign of infection. Organs of the mid-back, abdominal, or pelvic regions can cause pain specifically in the right or left side of your lower back or be generalized throughout the area.

Common examples of lower back pain stemming from internal organs include:

• Kidney stones. Acute lower back pain may be felt when a kidney stone moves inside the kidney or the ureter, a thin tube connecting the kidney to the bladder. The pain is typically localized to the left or right side depending on the kidney that’s affected.
• Kidney infection. Kidney infections usually start as urinary tract infections (UTI), causing inflammation and pain on the left or right lower back area, depending on the kidney affected.
• Ulcerative colitis. Persistent inflammation of the large intestine (colon) can cause abdominal cramping and sharp back pain on one or both sides of the lower back and abdomen.
• Pancreatitis. A lower left back pain may be due to inflammation of the pancreas, which also causes upper abdominal pain at the same time.
• Appendicitis. An inflamed appendix can cause a sharp pain in the lower right abdomen and back.

Women may develop lower back pain from specific conditions, such as uterine fibroids and endometriosis, and pregnancy.

View Slideshow: 7 Ways Internal Organs Can Cause Lower Back Pain

Caring for your lower back pain can help reduce the symptoms and improve function in your back and legs. While lower back pain typically subsides in a few weeks, some underlying problems may cause your pain to become chronic, lasting for months.

See Back Care for Lower Back Pain

Consult your doctor for an accurate diagnosis of your lower back problem to help understand if your pain originates from your lower spine and/or hip or form an internal organ. A doctor can conduct relevant medical tests to diagnose your pain and formulate an effective treatment plan.

Learn more:

Causes of Lower Back Pain

Non-Surgical Treatments for Lower Back Pain

References

A Guide to Lower Left Back Pain

Low back pain is sometimes felt only on one side of the body, either as a constant pain or as an ache that flares up for a time then subsides. Lower left back pain may be severe, sharp, and stabbing, or it may be a dull but constant ache. Some lower left back pain is alleviated or worse with movement and sensitive to pressure.

Lower Back Strain Video

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Lower back pain is most often caused by damage to the soft tissues in the lumbar spine.
See Lower Back Strain Video

Common Sources of Lower Left Back Pain

Lower left back pain is typically caused by either of the following sources:

1. Damage to the soft tissues supporting the spine and/or certain spinal structures, such as muscles, ligaments, and joints

   See Lumbar Spine Anatomy and Pain

2. A problem or disease involving an internal organ in the mid back, abdominal or pelvic region, such as the kidneys, reproductive organs, and intestines

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Most cases of lower back pain stem from minor injuries, such as a strained lower back muscle or ligament. While a muscle strain is minor and will heal within a few days or weeks, the pain may be severe and incapacitating.

See Pulled Back Muscle and Lower Back Strain

Other instances of lower back pain may signal a problem with an abdominal organ, or even present as a symptom of a larger problem, such as fibromyalgia or ankylosing spondylitis.

See Causes of Lower Back Pain

Understanding possible causes of lower back pain, along with typical characteristics and symptoms, can help patients in consulting with their doctors for an accurate diagnosis and treatments.

In This Article:

When to See a Doctor

If lower left back pain can be effectively managed using over-the-counter pain relievers, activity modification, and/or hot or cold packs, medical attention may not be needed. As a general guideline, seeing a doctor for lower left back pain is recommended if the pain follows an accident or injury, if it does not get better on its own, worsens, or interferes with daily functions such as standing, walking, or sleeping, or if it is accompanied by other troublesome or progressing symptoms.

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Some lower left back may indicate a medical emergency. For example, the following symptoms alongside lower left back pain may indicate a serious problem:

• Intense and sudden back pain that does not subside with rest
• Severe, unrelenting low back and/or abdominal pain

  See Abdominal Aortic Aneurysm

• Dizziness, confusion, or shortness of breath
• Persistent or sporadic fever and chills
• Nausea or vomiting
• Painful urination or blood in the urine
• Bowel and/or bladder incontinence

  See Cauda Equina Syndrome

• Significant weakness, numbness, or tingling in the lower body
• Unexplained, significant weight loss

Any of these symptoms may signal a serious underlying condition and warrants prompt medical attention.

Common Causes of Middle Back Pain

Underlying conditions and circumstances can result in middle back pain.

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Medically reviewed by Chris Iliades, MD

Like the upper back, the mid-back region is very stable, and this stability gives it some protection from injury. But the same underlying conditions and circumstances that can result in upper back pain also can result in middle back pain. These include:

1. Poor posture

This is a major risk factor for middle back pain, particularly if you have a desk job and are in the habit of hunching over a keyboard for long periods of time. You can stop middle back pain (and upper back pain) before it starts by getting into the habit of sitting up straight and doing frequent shoulder rolls and lifts in order to loosen the muscles of your upper back.

2. Muscle strain

Use the correct lifting technique to help you avoid middle back pain due to muscle strain—bend at the knees, and carry heavy objects close to your body.

3. Vertebral fractures

These are especially common in older adults, due to the bone-thinning disease osteoporosis. If you have osteoporosis, follow your doctor’s advice when it comes to taking osteoporosis medications, eating a calcium-rich diet, and supplementing with vitamin D if you don’t get sufficient sun to top up your vitamin D levels. (See also our post 10 Vitamin D Deficiency Symptoms You Can Identify Yourself.)

4. Herniated spinal disk

A herniated disk bulges out from between the vertebrae and may press on the spinal nerves, causing middle back pain. In some cases, surgery may be needed to remove a herniated disk.

5. Myofascial pain

Myofascial pain affects the fascia (the connective tissue in and between muscles), and is characterized by knotty “trigger points” that hurt if pressed. If your middle back pain is a burning, tingling sensation, it may be myofascial in nature, especially if you play sports that require heavy use of the large shoulder muscles. A physical therapist can show you exercises to stretch and strengthen your muscles, and your middle back pain also may respond to massage, trigger-point therapy (pressure applied to areas of knotted muscle), and trigger point injections (lidocaine shots directly into the trigger points).

Serious Causes of Middle-Back Pain

Rarely, middle back pain can herald a serious underlying condition, so always mention the pain to your doctor, particularly if it comes on suddenly or has no obvious cause, or is preceded or accompanied by other symptoms.

Look out for these back pain red flags:

6. Heart Attack

Women in particular may develop referred middle back pain from a heart attack. Call your doctor immediately if your middle back pain is accompanied by a feeling of tightness or pressure in your chest that radiates to your shoulders and arms, shortness of breath, dizziness, nausea, and/or vomiting.

7. Aortic aneurysm

Middle back pain can also be a symptom of aortic aneurysm. The aorta is your largest artery, and carries oxygenated blood and vital nutrients to all parts of your body, including the heart. A healthy aorta has elastic walls that expand and contract with the ebb and flow of blood, but if any part of the aorta is rendered fragile by disease, the abnormal tissue can bulge or balloon out to form an aneurysm. Aortic aneurysms are a serious health risk because the pressure exerted on the aneurysm by normal blood flow may cause it to dissect or rupture. This causes severe chest pain, and rapid blood loss that can be life threatening.

8. Pleurisy

Pleurisy (inflammation of the lining surrounding the lungs) is another chest condition that can cause sharp, stabbing chest pain that radiates to cause pleurisy back pain. Pleurisy is not serious, but it can signal serious conditions like pneumonia and lung cancer.

Abdominal Pain vs. Middle Back Pain

What if the pain in your midsection isn’t related to bone- or muscle-related causes, or to the other conditions described above? It could, for example, involve kidney pain, which can seem as if it emanates from the mid-back region. Kidney pain could indicate a brewing infection that could severely damage your kidneys, particularly if you’ve recently had a urinary tract infection.

Also, pancreas pain caused by pancreatitis can radiate to the mid-back region from the abdomen, so tell your doctor immediately if you experience this type of radiating discomfort. It also may indicate pancreatic cancer. In one study, 17 percent of pancreatic cancer patients reported pain in the middle of their back as a symptom.

Originally published in 2016, this post is regularly updated.

90,000 Low back pain

Low back pain is often manifested as a consequence of diseases of the musculoskeletal system, for example, osteochondrosis, radiculitis. In women, it can also be due to gynecological diseases. Back pain in the lumbar region is characterized as “cutting”, “dull”, “stabbing”, “pulling” and others. The nature of the painful sensations depends entirely on the reasons that caused them.

Depending on the underlying causes of the condition, other clinical signs of the disease may join the pain.For example, patients often complain of numbness in the arms or legs, difficulty in movement, muscle weakness, and decreased performance. Other accompanying symptoms include headaches, discomfort in the lower back, and dysfunction of internal organs.

Causes of back pain

• Age-related degenerative-dystrophic changes in the structures of the spinal column and adjacent tissues;
• damage to nerve fibers and nerve nodules near the spinal column;
• inflammatory processes in cartilage and bone structures;
• adiculitis in the lumbar spine, lumbago, sciatica, intervertebral hernia and many other diseases of the musculoskeletal system;
• appendicitis, cholecystitis and other inflammatory lesions of internal organs;
• obesity of the fourth degree, provoking a high load on the lumbar spine;
• benign and malignant tumors;
• infectious diseases, most often – infectious lesions of bone tissue;
• in women – adnexitis, torsion of the ovarian cyst, pregnancy or menopause;
• in men, prostatitis or epididymitis.

Treatment of back pain

To diagnose the nature of back pain, the neurologist simply asks about the complaints. And in order to find out the cause of the pain syndrome, he conducts a comprehensive diagnosis. Collecting anamnesis, asking additional questions, examining the patient, performing simple physical tests. Referral for additional studies – for example, a complete blood and urine test, X-ray or computed tomography of the lumbar spine.

Treatment for low back pain is usually comprehensive. First of all, the cause of the pain is identified and specialized treatment is prescribed by the appropriate specialists, for example, a rheumatologist, gynecologist.

In the period of remission, he recommends physiotherapy exercises, physiotherapy procedures, manual therapy and other methods of exposure.

What to do in case of an attack of back pain

If you have a sharp attack of lower back pain, then you need to measure your body temperature.If it is increased, then there is a high probability that the pain syndrome is caused by an infectious or inflammatory process. You must immediately call a doctor or go to a hospital.

If the pain is caused by a muscle strain or injury, take a pain reliever or anti-inflammatory medication and get into a comfortable position. And be sure to see a doctor.

In the case when lower back pain accompanies a chronic disease, such as osteochondrosis, take the measures prescribed by your doctor.

Prevention of back pain

• Lead an active lifestyle to prevent the weakening of the muscle corset: do exercises in the morning, walk or work out in the gym;

• do not lift weights or engage in professional sports without proper training;
• Maintain correct posture, especially when sedentary work, and take breaks every hour;
• come for preventive examinations at least once a year in order to identify the asymptomatic course of the disease in time.

Determine the true cause of pain

Relieve pain, inflammation and swelling

Prevent the development of complications

Let’s return the previous mobility

90,000 Pain in the shoulder blades: what can be the causes?

Pain in the shoulder blades can indicate a variety of diseases: from taut muscles to spinal injury and heart attack.Even if the pain is weak and does not spread to the chest, it will not be superfluous to visit a specialist.

How can the shoulder blades hurt?

The focus of pain can be located both in the scapula itself and in the area around it, in the middle between the shoulder blades and under them. It is by the location that the first conclusions can be drawn, what exactly turned out to be the cause of the discomfort. Even internal organs can give off pain in the upper back due to closely spaced nerves.

Pain in the shoulder blades can be of varying severity, intensity and duration.Mild pain with numbness usually indicates physical muscle fatigue. Pulling – about the pathology of the spine. Acute and severe pain, especially under the shoulder blades, is a sign of pathology of internal organs that require immediate intervention.

Causes of pain in the shoulder blades

Among the reasons, three main groups can be distinguished: these are diseases of the spine, pathologies of organs, as well as pain that is not associated with internal problems of the body.

Spinal diseases

Pain from vertebral pathology – pulling and long.Due to the fact that it is rather weak, the patient often ignores it for a long time, not seeing serious problems in such a symptom. Among the diseases of the spine, the pain from which spreads to the area of ​​the shoulder blades, one can distinguish:

• Osteochondrosis of the cervical spine is accompanied by numbness of the fingers, stiffness of movements in the shoulders, frequent headaches. Aching pain will be concentrated in the area of ​​the shoulder blades and the base of the neck;
• herniated disc – protrusion of the intervertebral disc into the surrounding space.At the initial stage of the disease, the pain is tolerable, although it causes discomfort and hinders movement. A neglected hernia causes unbearable pain and requires surgical intervention due to the threat of loss of mobility;
• Due to kyphosis and scoliosis, curved parts of the spine, including between the shoulder blades, can hurt. The pain will increase with movement and spread to the back;
• Protrusion (displacement) of the intervertebral disc in the cervical or thoracic region. It causes constant pulling pain and numbness due to pinched nerves.In the absence of treatment, a hernia will begin to form in its place.

A neurologist and an orthopedist are involved in spinal problems. After taking the history, they can suggest different types of examinations:

• X-ray of the thoracic spine: the simplest images that show the condition of the bone tissue. If pathologies are not visible on them, then, most likely, the problem lies in the neighboring organs;
• Thoracic MRI will show the clearest pictures. It is with the help of magnetic resonance imaging that it is best to examine the ligaments, intervertebral discs and surrounding soft tissues in order to find hernias, protrusions and pinching of nerve endings;
• A CT scan of the thoracic region will be helpful to identify bone lesions or injuries

Until the cause and location of the pathology is established, blood or intra-articular synovial fluid tests can show little. However, you may be referred for general tests to determine the state of the body.

Diseases of internal organs

Pain from the entire chest can be given to the back: heart, lungs, stomach, gallbladder. These sensations are difficult to confuse with pain from, for example, osteochondrosis: all acute conditions of the internal systems respond with sharp pain – under the shoulder blades, between the ribs, in the side.The general mood will change: you will feel weak, dizzy and short of breath.

Can cause painful sensations in the shoulder blades:

• vascular and heart diseases: mild angina attacks are easily relieved by drugs. But if the pain in the chest and back does not subside, the pressure drops, the skin turns pale, the likelihood of a heart attack is high, so you cannot postpone calling an ambulance;
• Problems in the digestive system: exacerbation of stomach ulcers, pancreatitis and cholecystitis.Acute attacks of diseases – ulcer perforation, blockage of the bile duct – will be accompanied by burning unbearable pain in the abdomen, at the shoulder blades, on the side;
• abnormalities in kidney function: pyelonephritis, renal colic. The pain is concentrated in the lower part of the shoulder blades and lower back, accompanied by nausea, soreness during urination and mild fever;
• Diseases of the respiratory system: pleurisy and pneumonia. Pain in the shoulder blades accompanies each breath, the body temperature rises, and a cough may begin.It is fever and cough that are the main signs by which you can determine the pathology of the lungs. Usually, these diseases develop after a severe flu or ARVI.

In case of acute conditions – heart attack, ulcer perforation, cholecystitis attack – it is necessary to urgently call an ambulance. If you are worried about tolerable pain, and you know for sure that everything is in order with your back, you should check the organs of the chest. It is worth contacting a therapist who will more accurately determine the problem and refer you to the right specialist.It is difficult to independently determine the location of the pathology.

But if you know about your diseases that can cause such discomfort, then, of course, you should immediately contact a highly specialized doctor: a gastroenterologist, cardiologist or pulmonologist. You can find out from them what examinations may be useful to you:

• Electrocardiogram and ultrasound of the heart: for suspected cardiovascular diseases;
• Ultrasound of the abdominal organs: the examination will show information about the kidneys, liver, pancreas, gall bladder;
• fluorogram or CT scan of the lungs: to determine the state of the respiratory system;
• gastroscopy: for suspected gastric ulcer.

It will not be superfluous to do general and biochemical blood and urine tests, and if you suspect pneumonia, take a throat swab.

Causes of pain when excluding pathologies

And what if the spine is completely healthy, no abnormalities were found in the abdominal organs, but you continue to feel pain in the shoulder blades? Its causes can be many, from trauma to stress:

• scapula injury: dislocation or fracture;
• Stretching the muscles of the back due to high physical exertion;
• Incorrect posture, excess weight, prolonged uncomfortable posture: all this leads to muscle tension, often asymmetrical, due to static muscle strain;
• An uncomfortable sleeping place will also lead to a tight posture and muscle tension;
• Stress: It affects your well-being not directly, but indirectly.In nervous tension, we often slouch and take uncomfortable postures. It also leads to overexertion and back fatigue.

In the event of a scapula injury or muscle strain, contact a traumatologist. All other reasons are much easier to eliminate: you should pay attention to the organization of the sleeping place, monitor the position of the body and add at least simple gymnastics to your daily routine to relax your back muscles. If all these actions did not help, do not self-medicate and go to the doctor rather.

90,000 CAUSES OF BACK PAIN | orto.lv

Herniated disc. The vertebral disc is a soft pad located between all 33 vertebrae of the spine (with the exception of the sacrum, which has fused together). When an intervertebral disc ruptures, part of the disc extends beyond its physiological location and can affect the nerves that branch out from the spinal cord.

Nerve root irritation may cause sharp, sharp pain, itching, numbness, or stabbing pain.

A herniated disc can occur suddenly, for example, as a result of a fall, or gradually, constantly incorrectly loading the spine.

Degenerative disc disease Spondylosis or osteochondrosis is a condition that is often associated with age-related changes in both bone and soft tissues. The disc tissue loses its elasticity and the disc shrinks in size.

This is a widespread problem that can affect any part of the spine. People with this diagnosis experience persistent back pain with occasional episodes of severe pain.

To denote the process of degeneration of the vertebral discs, terms are used that characterize the place of disc degeneration in the spine: lumbago (in the lower back), cervical disc degeneration (in the cervical spine) or thoracic disc degeneration in the thoracic spine. Conservative therapy is usually used to treat this condition. Only in some cases is surgical intervention required.

Stenosis of the spinal canal It is caused by narrowing of the spinal canal, which puts pressure on the spinal cord and nerve roots.Stenosis usually presents as pain, numbness, itching, and weakness in the arms or legs. In the most severe cases of stenosis, it can be difficult to control bowel and bladder function. In this case, an urgent need to consult a doctor.

Spinal canal stenosis most commonly affects the lower back and cervical spine. In the case of lumbar stenosis (in the lower back), pain usually radiates to the legs in the buttocks. With stenosis in the cervical spine, the pain often radiates to the shoulder and arm.Most of these problems appear in people over 50. For the treatment of this condition, conservative therapy is mainly used, which temporarily reduces pain. However, in some cases, surgical intervention is required.

Scoliosis A common deformity of the spine. Scoliosis is the bending of the spine to one side or the other, as well as mutual rotation or twisting of the vertebrae. The most common form of scoliosis in 80% of all scoliosis cases is idiopathic scoliosis.Its causes have not yet been fully understood. The second most common group of scoliosis is congenital scoliosis, which occurs when the spine does not develop properly during a child’s growth. Scoliosis can develop actively in childhood and adolescence, but after the completion of growth, the deformity caused by scoliosis does not progress further. However, the resulting bends persist for life.

Untreated scoliosis over time can cause persistent back pain, as well as respiratory and cardiac problems.Scoliosis can be treated conservatively by strengthening the back muscles, trying to limit further spinal bending, or surgically. Sometimes surgery is the only way to stop and correct severe progressive scoliosis.

Fracture of the spine. It is usually caused by a fall or traffic accident. Spinal fractures are more common in people with osteoporosis or in highly dynamic sports. Undiagnosed fractures can cause long-term and devastating health problems.Spinal fractures cause spinal instability, severe pain, and a greater likelihood of spinal cord injury, which can lead to paralysis. If there is a suspicion of a spinal fracture, you should immediately consult a doctor.

Inflammation of the nerve root causes compression of the sciatic nerve in the lumbar spine. It causes pain that radiates in one or both legs, as well as numbness, weakness, or numbness. Inflammation of the sciatic nerve is not a diagnosis but a consequence of a herniated disc, degenerative disc disease, or spinal stenosis.In the case of this problem with the spine, the sciatic nerve can be pinched, resulting in inflammation of the nerve. Basically, sciatica is treated with pain relievers and anti-inflammatory drugs and physical therapy. In some cases, surgical treatment is the solution.

Pain radiating to the arm is caused by compression or inflammation of the nerve roots of the cervical spine. The pain can be felt in the neck, in the head, but most often people complain of pain or numbness in their hands.Mostly recoiling pain caused by inflammation of the nerves in the cervical spine is treated with pain relievers, anti-inflammatory drugs and physical therapy. In some cases, surgical treatment is the solution.

Acute back pain in the practice of a neurologist | Ekusheva E.V., Voitenkov V.B.

The article is devoted to the problem of acute back pain in the practice of a neurologist

Acute back pain is one of the leading reasons for seeking medical attention.In the International Classification of Diseases of the 10th revision, this pathological condition is designated as “dorsopathy”, however, in the modern scientific literature in recent years, the term “nonspecific back pain” is more often used.
The relevance of therapy for this condition is determined by its widespread prevalence, pronounced maladjustment and a decrease in the quality of life in people of working age, which leads to significant socio-economic damage in most developed countries of the world.In particular, pain in the lower back is noted up to 80% in the population, impairing the quality of life in patients under 45 years of age [1]. In the United States, back pain is the 5th most common cause of hospitalization and the 3rd most common indication for surgical treatment [1, 2].
In 80–90% of patients with adequate and timely therapy, acute back pain regresses within 2–3 months. [3, 4]. Chronization of dorsopathy is observed in 10–20% of patients of working age; it is this group of patients that is characterized by an unfavorable prognosis for recovery [4].It should be noted that up to 80% of all health care costs are spent on the treatment of chronic back pain, which is 3 times higher than the cost of therapy for cancer patients [5].
The epidemiology of pain in the lumbosacral region has been studied much better, which is partly due to the lower prevalence of BS in the cervical and thoracic spine. It has been shown that isolated pain in the upper back is observed only in 15% of patients [6]. At the same time, the most common in clinical practice (up to 85% of patients with back pain) are musculoskeletal BSs caused by irritation of the annulus fibrosus receptors, musculo-articular structures of the spine and not associated with root damage [6].However, they can also be observed in the case of reflex BS with root damage.
The issues of pharmacological effects in back pain are among the most studied in modern evidence-based medicine. Nevertheless, the ever-growing arsenal of funds and the increase in the number of patients (going in parallel with the growing aging of the population of developed countries) dictate the need to analyze the available data on this topic. Thus, according to a recent meta-analysis of the literature, acetaminophen is ineffective in the treatment of lower back pain, the effectiveness of NSAIDs in the treatment of this condition was lower in modern conditions than previously described, and the use of benzodiazepines in acute radiculopathy did not give an adequate clinical result [7].

Basic principles of management of patients with acute back pain

The tactics of managing patients with acute dorsopathy is as follows: exclusion of potentially dangerous diseases and / or conditions for the occurrence of BS; timely and effective relief of BS, contributing to the restoration of the patient’s activity, adequate expansion of the motor regimen and prevention of chronicity of the disease.
An important stage in the treatment of a patient with acute back pain is the exclusion of the specific or secondary nature of the pathological process, which may be based on serious, sometimes life-threatening diseases (Table 1).one).

When analyzing the existing BS, it is necessary to remember that back pain can be completely psychogenic in nature, leading to a significant violation of social adaptation, difficulty in professional activity. Among the possible criteria indicating the absence of an organic cause of back pain and / or its psychogenic nature, the following are considered: pain at the apex of the tailbone; pain and numbness “in the whole leg”, a feeling that “legs are giving way”, as well as a decrease in the severity of the Lasegue symptom when the patient’s attention is distracted [8].
It should be noted that there is no strict parallelism between the presence of back pain and the results of a paraclinical examination of the spine. There is no doubt about the diagnostic significance of the results of radiography and neuroimaging methods for back pain, but these methods allow mainly assessing anatomical rather than pathophysiological changes [9]. In particular, imaging methods with a high frequency reveal degenerative-dystrophic changes in the spine even in patients without back pain and the presence of any neurological symptoms, for example, according to MRI of the lumbar spine, asymptomatic hernias of intervertebral discs are detected in persons under 40 years of age. 30-40% of cases, and in people over 60 years old – in 100% [9].On the other hand, the presence of signs of degenerative-dystrophic lesions of the spinal tissues in patients with nonspecific back pain does not correlate either with the nature of the pain or with its intensity, therefore, despite the temptation to attribute the radiologically detected signs of osteochondrosis of the spine to the cause of pain, until now there was no convincing evidence of such a link [6]. In this regard, in modern domestic and foreign guidelines for the diagnosis of back pain, X-ray examination is not a necessary link in the primary examination [6, 7, 10].Thus, by themselves, without taking into account the clinical picture, neuroimaging data rarely allow a correct diagnosis, and the patient’s story about his disease is often no less important than the results of neuroimaging studies [11].
Methods of neurophysiological diagnostics often prescribed by neurologists during the initial examination of patients with back pain, primarily electroneuromyography, are of great value in detecting organic disorders of the peripheral nervous system, while their effectiveness in detecting functional disorders is limited [12].With the help of diagnostic transcranial magnetic stimulation, it is possible to study the transit time of the signal along the root or the indicator of “radicular delay”, the change of which makes it possible to reveal radiculopathy or damage to the spinal roots [13].
Imaging methods and other instrumental and paraclinical examinations, as well as consultations of relevant specialists, are recommended to be prescribed to patients with back pain in unclear cases, when there are suspicions of a specific nature of pain, which may be a consequence of tumor, inflammatory or traumatic lesions of the spine, infectious processes, metabolic disorders, diseases of internal organs, muscle damage, damage to the nervous system, etc.d.
A thorough clinical assessment of the patient’s status, including the state of his musculoskeletal system, is of leading importance for the correct diagnosis and selection of therapy for nonspecific back pain. In particular, during a neurological examination, it is advisable not to be limited to examining only the back, you should ask the patient to undress, paying attention to the presence and severity of scoliosis; on the position of the pelvis and the length of the legs; for the presence of smoothness of physiological lordosis at the lumbar level [14].The last symptom indicates spasm of the paravertebral muscles at this level, which is confirmed by palpation. Also, when examining a patient, it is important to pay attention to possible rashes on the skin; change in posture, posture, gait, range of motion in the spine, hip joints; on the degree of tension and muscle soreness, the localization of myofascial trigger points. At the same time, mild orthopedic symptoms in severe pain can be a sign of serious concomitant pathology [6].Neurological examination suggests damage to the roots and structures of the spinal cord.
In addition, anamnestic information (including information about the patient’s working conditions and the presence of constant stress), the results of physical and paraclinical examinations, and an assessment of the psychological state play an essential role in establishing the correct diagnosis.

Relief of acute non-specific back pain

Timely and effective relief of an acute episode of back pain is an extremely important stage in the management of this category of patients, since it allows increasing the volume of rehabilitation measures, adequately expanding the motor regimen and reducing the period of disability.
It has been shown that restrictive behavior (both intuitively chosen by the patient himself and recommended by the doctor), as well as adherence to prolonged bed rest (more than 7 days), is associated with a high risk of an increase in the duration of exacerbation, transformation of acute pain into chronic pain and a high probability of the formation of depressive disorders [15 ]. On the other hand, there is an obvious relationship between the effectiveness of pain therapy and the duration of recovery of an adequate motor regimen [16].In this regard, it is necessary to orient the patient to the earliest possible inclusion in the program of rehabilitation and rehabilitation measures, to recommend the patient active behavior as part of the course of rehabilitation treatment, to form positive motivation that provides the mood for achieving convalescence and compensation for the existing neurological and orthopedic defect [16, 17].
For the purpose of relief of BS, drugs from the NSAID group are most widely used. NSAIDs are a pathogenetic agent for the treatment of pain associated with pathological conditions caused by local and generalized inflammatory reactions, which determines the main indications for the appointment of this group of drugs in various fields of medicine – inflammatory processes of various origins, pain and fever [13].
The emergence and introduction of drugs used today from the NSAID group has its own history. More than 5 thousand years ago, willow bark was used as an anesthetic for diseases of the musculoskeletal system [18], from which salicillin was isolated in 1828 [19]. Paracetamol was synthesized by H. Morse in 1877, 10 years later it was applied in practice by D. Mehring, but it became widespread only in the middle of the 20th century. due to the erroneous concept of its toxicity [20].The prototype of modern NSAIDs was acetylsalicylic acid, synthesized by F. Hoffman at the end of the 19th century. The toxicity of high doses of the drug was a powerful incentive for the development of new, “nonsalicylate” NSAIDs, in particular diclofenac sodium, in the research laboratory of the Geigi company (1966) [20]. Over the next 10 years, the indomethacin, ibuprofen and naproxen used today were developed and used [19].
Currently, NSAIDs are a very numerous and heterogeneous group of drugs, the basis of the anti-inflammatory and analgesic action of which is the suppression of the activity of the enzyme cyclooxygenase (COX) and the biosynthesis of prostaglandins.The clinical efficacy of NSAIDs, as well as the nature of the side effects accompanying their use, are largely determined by the main points of application – the ability to inhibit the activity of COX type 1 or 2 [16]. The peculiarities of the chemical structure of drugs, their metabolic pathways in the body, and the ability to interact with other chemical compounds entering the body are also of some importance.
Two isoforms of COX differ in their expression characteristics depending on the state of the human body.Under normal conditions, COX-1 is produced in most tissues and takes part in a wide variety of adaptive reactions [16]. The anti-inflammatory effect of NSAIDs is due to the ability to inhibit the processes of COX-2 synthesis, since the increased expression of this particular isoform is observed during the development of the inflammatory process. The development of drugs with selective selectivity for COX-2 is due to the development of side reactions due to the suppression of the physiological enzyme, COX-1, while non-selective NSAIDs inhibit both COX isoforms.
Although at the population level all drugs from the NSAID group in equivalent doses have similar efficacy and toxicity, clinical experience indicates significant differences in the response to drugs in this group in individual patients [21]. For some of them, one drug is significantly more effective in suppressing pain and inflammation, or, conversely, more often causes toxic reactions than the other. The reasons for this phenomenon are not completely clear. The importance of individual characteristics of absorption, distribution and metabolism of drugs, the relative prevalence of mechanisms of action dependent and not dependent on COX blockade are discussed [21].
One of the selective COX-2 inhibitors is nimesulide (Nise®), which is a sulfonamide derivative. Nimesulide is a highly effective and well-studied drug in the course of numerous experimental and clinical studies with a wide range of various effects. In particular, it was shown that under the action of nimesulide, the production of short-lived prostaglandin H2 decreases, followed by a significant decrease in the blood concentration of its metabolic product, prostaglandin E2, which is one of the key inflammatory mediators [16].This effect leads to a decrease in the activation of EP-type prostanoid receptors, which results in the onset of analgesic and anti-inflammatory effects, since prostaglandins, using various mechanisms, increase the sensitivity of primary sensory neurons to pain. Nimesulide, like a number of other selective COX-2 inhibitors, has an effect on various body systems involved in the initiation and / or maintenance of inflammation processes, primarily the prevention of fibroblast activation.
It should be noted that nimesulide (Nise®) has a number of pharmacological effects independent of the class-specific effect on COX-2. In particular, it suppresses the overproduction of the main proinflammatory cytokines (interleukin 6, tumor necrosis factor alpha), reduces the activity of metalloproteinases, which are responsible for the destruction of the glycoprotein complex of cartilage tissue in osteoarthritis, and has an antihistamine effect [21]. The absence of a damaging effect of nimesulide on proteoglycans and collagen in cartilage tissue favorably distinguishes this drug from a significant number of NSAIDs and, probably, explains the preservation of cartilage tissue even with prolonged use of nimesulide [16].
Among the non-COX-2-associated effects of nimesulide, the ability to suppress the enzyme phosphodiesterase 4 and thereby reduce the activity of macrophages and neutrophils, which play an important role in the pathogenesis of an acute inflammatory reaction, should be especially noted [21]. It has been shown that nimesulide has the ability not only to inhibit the production of inflammatory mediators directly in the lesion focus, but also to reversibly inhibit the formation of prostaglandin E2 in the ascending pathways that conduct pain signals, in particular in the spinal cord.Due to its pharmacological effects, nimesulide inhibits the formation and conduction of pain impulses at different levels of the nociceptive system, thereby not only stopping acute pain, but also preventing the formation of chronic BS [21], which is important for patients with nonspecific back pain.
It has been shown that non-selective representatives of NSAIDs have greater gastro- and hepatotoxicity, and highly selective COX-2 inhibitors (primarily coxibs) more often promote thrombus formation, which can lead to cardiovascular diseases, such as strokes and heart attacks [22].Over the past years, considerable experience has been accumulated not only in the effective use of nimesulide (Nise®) for the treatment of various BSs, but also in its high safety and good patient tolerance even with prolonged use.
Thus, A.E. Karateev in 2009, a study devoted to a retrospective analysis of the development of side effects and complications from the gastrointestinal tract, the cardiovascular system and liver function with prolonged use of nimesulide (at least 1 year) in 322 patients with rheumatic diseases, did not show a clinically expressed pathology of the studied systems according to data additional laboratory and instrumental examinations [23].Nimesulide (Nise®) can be used in a fairly wide range of patients, differing from many other NSAIDs in the low risk of complications from the gastrointestinal tract and the cardiovascular system [17, 22, 23]. The obvious and significant advantages of nimesulide (Nise®) include a combination of a quick analgesic effect (15–20 minutes after oral administration of the drug), anti-inflammatory action, safety of use, good tolerance and affordable price [17].

Non-drug treatments for acute nonspecific back pain

Non-drug methods of treatment of acute back pain include manual therapy, physiotherapy exercises, acupuncture, physiotherapy, methods of social support [3], special devices for the musculoskeletal system or musculoskeletal system [11] – orthoses; you should remember about the need for comfortable furniture, the correct posture for seated work, etc.d.
Orthoses or corsets are external devices designed to affect the structural and functional characteristics of the musculoskeletal and musculoskeletal system: unloading, fixing, activating and correcting the functions of the damaged joint or limb. Since the frequent causes for the development of dorsopathy are muscular-tonic BS of the lumbosacral localization, the analgesic effect from the use of lumbosacral orthoses (LBO) is quite expected. SALW are one of the most widely used types of medical corsets and are used in the complex treatment of pain in the lower back or for orthopedic purposes – for posture correction [24].Therapy using orthoses is not only effective, but also more cost-effective than standard methods of exposure [25]. In particular, a large meta-analysis of 2008 demonstrated a greater effect of the treatment of nonspecific back pain with the help of SALW than the purely drug treatment [26]. When contacting medical institutions in other countries for pain mainly in the lumbar spine, wearing SALW is recommended in most cases (73%), and this appointment is carried out by primary care physicians [27].At the same time, the use of a brace helps to reduce the severity of pain, but does not affect the likelihood of recurrence of such an episode in the future [11].
Despite the obvious clinical effect of using braces in the form of a decrease in the severity of BS, there is a well-established idea of ​​the danger of developing muscle weakness and atrophy during long-term use [28, 29]. The direct mechanical effect of the orthosis on the adjacent muscles is considered as possible reasons [30].However, a large meta-analysis (36 literature sources), where this issue was studied, did not find such a relationship [31], as well as another meta-analysis that studied the possibility of a negative effect of prolonged wearing of SALW (up to six months) on the extensor muscles of the back using instrumental examination methods ( Ultrasound and MRI) [30].
In recent years, in the event of an acute episode of back pain, the method of kinesio taping has been widely used, which makes it possible to eliminate local pain and muscle tension to varying degrees [4, 7].Also, for acute nonspecific back pain, therapeutic transcranial magnetic stimulation is increasingly used; in this case, high-frequency protocols are mainly used [13].
Despite the complete and timely relief of acute BS, the further prognosis of the course of nonspecific back pain is not always unambiguous, since even with complete regression of pain in more than 50% of cases, patients have recurrences [9]. That is why adherence to behavioral guidelines and necessary lifestyle changes in patients with back pain is of particular importance in preventing recurrent pain episodes.At the same time, in the event of repeated relapses of nonspecific back pain, the timely use of an effective, safe and well-tolerated anesthetic and anti-inflammatory drug nimesulide (Nise®) to relieve acute pain and prevent further chronicity of the pathological process is pathogenetically justified.

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90,000 reasons, treatment methods, the use of painkillers and injections

To avoid complications after a spinal injury, it is imperative to undergo rehabilitation procedures.How is rehabilitation going? How much does rehabilitation cost and how to speed up recovery from a sports injury? Find out … It is possible to undergo injury rehabilitation on credit. View conditions … Back pain is quite common among people involved in sports. How can you get rid of pain A herniated disc of the spine is one of the most common causes of back pain. Find out the cost of treatment …

Sports injuries are one of the most common causes of back and lower back pain.By virtue of their activities, professional athletes have a higher risk of spinal injuries and the development of chronic pain syndrome. According to statistics, up to 10% of sports injuries occur in the back area.

Weightlifters, including bodybuilders and powerlifters, football players, basketball players, ice hockey players, figure skaters, skiers, tennis players, gymnasts and wrestlers are at high risk. The cause of injuries and injuries to the back is excessive stress on the spine, as well as inattention to pain.Athletes, like ordinary people, often ignore the need to see a professional doctor, as a result of which complications and repeated injuries occur, leading to chronic back diseases.

Statistics

• Regular back pain affects 80% of the world’s population. 98% of back pain has a mechanical cause.
• About 2 million people visit a doctor every year for back problems.
• Back pain is the most expensive medical condition to treat after heart disease and cancer.
• In Russia, pain in the neck, lower back and back affects from 42 to 80% of adults.
• Back problems are most common in people between the ages of 30 and 50.
• Half of the entire working-age population of Russia takes sick leave every year due to back pain.

Causes of back pain

One of the most common causes is traumatic spinal injuries resulting from excessive exertion during sports and stereotyped physical activity.Such injuries can have many consequences: vertebral fracture, rupture or deformation of intervertebral discs (hernia), stretching and inflammation of the joint capsule, rupture of the ligaments of the spinal column. Microtrauma can only be obtained as a result of an unsuccessful sudden movement, not to mention constant physical exertion during sports.

The following causes of back pain can also be distinguished: curvature of the spine, osteochondrosis, neuralgia, arthritis and inflammatory diseases, compression of nerve endings, oncological spinal tumors, postoperative and phantom pain, muscle spasm, fascia lesions (fibrositis).In addition to injury, chronic pain can be caused by diseases of various organs (for example, kidneys), burns, neuropathy, cancer, and a sedentary lifestyle. Among the possible reasons, one should not exclude such a common phenomenon as stress. Also, taking certain medications can cause back pain.

You should know this!
Specific causes of lower back pain include sciatica, bowel problems, diseases of the genitourinary system, scoliosis and lordosis of the thoracic region.In general, the causes of pain in the lower back can be divided into primary (associated with changes in muscles and skeleton) and secondary (associated with various diseases of the skeleton and internal organs). This means that treatment can only be started after a differential diagnosis has been made!

Types of back pain

Let’s start with the fact that chronic back pain is a physical and emotional experience that did not stop as a result of the necessary treatment and elimination of all pathologies and injuries that caused the pain.Chronic pain can be called pain that lasts more than 6 months. Some doctors consider chronic pain syndrome to be a separate disease that requires special treatment.

Sharp back pain occurs less often than aching and pulling. Not very intense pain may indicate pathological changes in the muscles of the back. Myotonic syndrome is characterized by a persistent increase in muscle tone, and myofascial syndrome is characterized by the formation of painful seals in the muscles – myogellosis.

Sharp and acute pain in the lower back and back may indicate a microtrauma: damage to the vertebra or disc, rupture of ligaments or stretching of joints, pinching of nerve endings. Sharp stitching and shooting pains can appear as a result of doing hard work, lifting heavy weights.

According to statistics, with acute back pain, 10% of patients have discogenic pain and pain associated with dysfunction of the facet joints. In 4% of cases, compression radiculopathy of the lumbosacral roots is detected, in 3% – neurological complications of lumbar stenosis, in 4% – compression fractures of the vertebral bodies associated with osteoporosis, and in 2% of cases – spondylolisthesis.

Reference
Spondylolisthesis is a disease that is most common among athletes involved in hockey, gymnastics, football, and weightlifting. The cause of this disease is the frequent flexion and extension movements of the lower back, as well as large dynamic loads on the lumbar spine.

Diagnostics

Diagnostics and treatment can include visits to a number of specialists: neurologist, traumatologist, orthopedist, physiotherapist, chiropractor, reflexologist, therapist, cardiologist.Men over 50 years old will also have to visit a urologist, and people suffering from chronic pain syndrome – a psychotherapist. The following types of instrumental examinations can be prescribed: ECG (for disturbances in the work of the heart), MRI, CT with contrast, radiography of the joints and spine, optical topography of the skeleton and stabilodiagnostics, ultrasound of the joints and spine, densitometry (determination of bone density), electroneuromyography, spiroarteriocardiorhythmography … You will also need tests: a clinical blood test, a general urinalysis, tests for C-reactive protein and rheumatoid factor.

Methods for the treatment of back pain

Pain Management is one of the most effective modern methods of treating chronic pain syndrome. The method is a point effect on the affected areas: injections of pain relievers are injected into areas precisely defined using an X-ray. The blockade of pain impulses in combination with a complex of individual treatment procedures can relieve the patient from pain for a sufficiently long period of time: from several months to several years.

Reference
Pain Management is a comprehensive approach to pain management that includes an individually tailored set of treatments that combine different techniques.

If we talk about individual methods of treatment, there are quite a few of them. Drug therapy is an insufficiently effective method in itself, which must be combined with other types of treatment, such as exercise therapy, massage, acupuncture, kinesiotherapy, aquatherapy, wearing muscle corsets, etc.e. Individually selected exercises of physiotherapy exercises can create a real miracle, starting the process of tissue regeneration, and completely restore the motor functions of the spine. Therapeutic massage and myostimulation using the latest equipment can solve most of the problems. These methods are necessary for the complete recovery of the patient.

One of the popular non-drug methods for relieving localized pain is transcutaneous electroneurostimulation. This is a blockade of pain syndrome using electrical impulses at the site of its localization.Another effective method is biofeedback, or biofeedback, created at the intersection of psychology and physiology. A special device reads the information coming from the patient’s body, after which its computer model is formed on the screen, on which all processes occurring in the body, including pain sensations, are clearly visible. Finally, in some cases, 100% treatment of back diseases is possible only with the help of surgical intervention – as a rule, these are especially severe, chronic processes or severe injuries.To avoid such a radical intervention, you should always pay attention to preventive measures and consult a doctor on time.

Preventive measures

You can start preventing back pain right now – pay attention to your posture and correct it, make your workplace more comfortable, and in between work, do a small set of stretching exercises that will improve blood circulation not only in the area back, but also in all organs.Avoid overexertion, stress, overuse, and sudden movements. Sometimes it makes sense to wear a corset to maintain posture, a routine checkup with a chiropractor and regular massage treatments are important. If you experience pain, be sure to contact a specialist in order to identify the problem at an early stage and save time and money in the future. Remember: professional help is needed not only during the direct treatment of the disease, but also during rehabilitation, which is an obligatory and, perhaps, the most important component in the process of combating diseases of the spine.

Modern methods of treating diseases of the spine in specialized medical centers have a fairly high rate of effectiveness: after 12 sessions of exercise therapy in combination with other methods, the pain syndrome completely disappears in 71% of patients, minor residual effects persist in 25% of cases.

Where can you get treatment for spinal diseases?

The most important criterion when choosing a medical institution is not its size or even “age”. Choose a center that uses the largest number of modern techniques combined with an individual approach to each patient.One of these institutions is the Three Sisters Rehabilitation Center, which specializes in spinal problems, as well as rehabilitation after injuries. Highly professional specialists with extensive experience will select for each patient an individual program for recovery after spinal injuries, spinal cord disorders, osteochondrosis, surgical treatment of vertebral hernias and other diseases. Comprehensive treatment in the Three Sisters rehabilitation center includes classic, newest, and also author’s methods, developed by their own scientists-doctors on the basis of many years of practice.

License of the Ministry of Health of the Moscow Region No. LO-50-01-011140, issued by the Three Sisters RC LLC on August 02, 2019.

Backache: causes and treatment

Back pain can occur for a wide variety of reasons and absolutely at any age. A lot of people at different stages of life notice pulling, cutting, stabbing, aching, shooting, sharp, dull pain in themselves. The back often hurts in the lumbar region, between the shoulder blades, on one side or the other.Pain is not always harmless, so at the first discomfort you should pay attention to it.

Causes of back pain

Factors provoking unpleasant sensations in the back, an almost endless number.

• Temporary – usually they pass on their own. These include:
  – a long stay of the body in an uncomfortable position. Predominantly pulling pains in the back of the back are observed, caused by prolonged muscle tension and improper deflection of the spine;
  – pregnancy.Most often, during preparation for childbirth, women suffer from lower back pain, which is associated with the production of a special hormone by the body, designed to soften and stretch the ligaments, thereby allowing the child to pass through the birth canal.
• Degenerative – More serious and requiring treatment. These include:
  – osteochondrosis. The intervertebral discs are destroyed. A person has a backache, often headaches, dizziness, hearing problems are added to the symptom, lameness may occur;
  – intervertebral hernia.It appears as a result of a change in the position of the intervertebral disc. The back hurts with a uniform, aching pain, aggravated by moments of physical exertion or coughing. Lack of timely competent treatment can lead to paralysis;
  – displacement of the vertebra. The back hurts in the lower back, it can give to the legs. Occurs due to a congenital anomaly or unnatural changes in the spine;
  – disc loss. One of the further stages after the formation of a hernia. The patient experiences severe acute back pain;
  – sciatica.The roots of the spinal cord are pinched, after which the back hurts between the shoulder blades and below. If you do not respond for a long time, there is a decrease in the general sensitivity of the back, as well as severe shooting pain;
  – osteoporosis. There are two reasons for this phenomenon: natural age-related and hormonal changes. Bone tissue loses its former structure, becoming more fragile. As a result, the back hurts on a sharp change in weather or during a long stay in one position;
  – ankylosing spondylitis.The joints are weakened, and the back hurts in the spine. In particular, sensations are pronounced at night.
• Infectious – caused by infectious diseases:
  – tuberculosis – often directly affects the spinal column, is accompanied by severe pain, long-term treatment and often leads to the patient’s disability;
  – osteomyelitis – a disease of bone tissue and bone marrow with the appearance of pus and fistulas on the surface of the body. As with tuberculosis, it is characterized by severe pain in the back, head, increased body temperature, nausea, and diarrhea.
• Irradiating – provoked by pathologies of internal organs:
  – kidneys. Due to inflammation of the kidneys or the appearance of stones in them, the back in the lower back hurts: the pain is encircling, supplemented by strongly yellowed urine and frequent trips to the toilet, the body temperature may rise;
  – Gastrointestinal tract. The back hurts in the area of ​​the shoulder blades and slightly below due to gastritis or stomach ulcers. The sensations are exacerbated if the person is hungry or has just eaten, may be accompanied by bloating, belching, diarrhea, or constipation;
  – female genital organs.There is discomfort in the lumbar zone, it can be supplemented by malfunctions of the menstrual cycle and abundant discharge with an uncharacteristic color and smell;
  – lungs. The back hurts under the shoulder blades and in the chest with increased inspiration, accompanied by rapid breathing, palpitations, shortness of breath even at rest, dizziness, increased fatigue;
  – a heart. The back hurts, the shoulder blades, the thoracic region, mainly on the left, can be given to the left hand. Often the symptom is accompanied by a rapid heartbeat, dizziness, shortness of breath.

Treatment of back pain

There is no single scheme that would help to cope with discomfort in the back area, as well as one specific specialist who would solve all possible problems in this area. It all depends on the reason that provoked the appearance of the pain syndrome.

Therefore, when the first symptoms appear, do not wait until they get worse, contact the Pain Treatment Center. If you do not know why your back hurts, and what kind of specialist you need, you should visit a therapist.In addition to him, an orthopedist is involved in back problems, surgeons and other narrow-profile specialists.

You can get a detailed consultation with any of the listed and many other specialists by making an appointment at Medicina JSC (Academician Roitberg’s clinic). The multifunctional medical center has gathered highly qualified specialists within its walls. Thanks to modern equipment of the highest class, any analyzes and diagnostics will be carried out quickly, comfortably and demonstrate the most accurate results.

The clinic is located in the central district of Moscow at 10 2nd Tverskoy-Yamskaya lane, near the Mayakovskaya metro station. Recording is carried out by calling +7 (495) 775-73-60. You will be assigned to a specialist who will be able to provide a full consultation as quickly as possible.

90,000 Spine hurts – causes, symptoms and treatment

Spine hurts – main signs

Discomfort in the spine can be both minor and significant.Unpleasant sensations depend on the severity of the patient’s condition, the diagnosis, the stage of the pathology and individual factors, including the tolerance of pain.

What types of pain occur most often, why pain in the spine occurs:

1. Nonspecific discomfort in diseases of the spine – includes a number of factors, including temporary muscle damage associated with unfavorable, mildly irritating factors. Examples are prolonged sitting in an antalgic (uncomfortable) posture, muscle strain associated with excessive physical exertion.Also, non-specific discomfort includes adverse factors, including hypothermia and muscle inflammation (myositis).
2. Radiating or reflected pain – less common, but also periodically occurring in medical practice. Examples are pain in other organs close to the back. It is not uncommon for some women to experience pulling back pain in the period before menstruation. This is due to the contractile activity of the uterus. Sometimes the muscles of the back in the thoracic region hurt with discomfort in the stomach.Some types of heart attacks cause numbness, lumbago, and pain in the limbs.
3. Mechanical damage. Are directly related to injury. This list includes bruises, sprains and fractures. In this case, the pain will be acute, without irradiation. The discomfort is usually caused by severe inflammation due to injury. Another option for mechanical discomfort is radiculitis, osteochondrosis, hernia or protrusion. These factors are associated with degenerative changes in the spine.

If you make a general classification, it looks like this. Depending on the occurrence of a specific disease, the symptoms of a disease of the spine acquire specific signs that are distinguishable from other ailments.

What are the symptoms

Pain has various manifestations and depends on the severity of the manifestation, the frequency of attacks and other important factors, including such symptoms of pain in the spine :

1. By the nature of sensations – sharp, dull, burning, aching, stabbing, cutting or pulling pain in the back, front, left or right.
2. The degree of manifestation in terms of strength – weak, moderate, strong, unbearable. It is also important to take into account the diagnosis and the individual values ​​of the pain threshold for each person. In the chronic course of the disease, the discomfort will be less pronounced than during the exacerbation.
3. Presence of localized or spreading pain. When a patient has a pain in his entire back, and he cannot determine a specific pain point, then this is a rare complication. With degenerative complications from the musculoskeletal system, the patient is usually able to point to a painful point.
4. If pain occurs in one part of the back and radiates to another, then such discomfort is called wandering. It has nothing to do with irradiation, since pain in neighboring organs is not felt.
5. If the back pain is severe and periodically worsens the patient’s quality of life, interfering with daily activities, then the prognosis in the treatment of this type of pain syndrome may be positive. Usually, paroxysmal pain does not last constantly, but sometimes occurs during exacerbations. It is easier to treat and stop such discomfort in advance by changing your lifestyle so as not to lead to exacerbations.Dull pains with low intensity are harder to treat, they are mild, but they are felt all the time, so more effort must be made to relieve such discomfort.

Sometimes the strength of pain and character may differ depending on the location in the back. An example – in the cervical spine, pulling and unpleasant sensations are more often felt, when acute discomfort can occur in the lower back. Below are some common back illnesses and their symptoms.

Osteochondrosis

With osteochondrosis back pain occurs in any part of the spine – cervical, thoracic or lumbar.Among all the lesions of the musculoskeletal system, osteochondrosis develops most often in the ridge. The degenerative process is the destruction of the cartilage tissue of the joint, which affects the vertebrae. Due to the thinning of the cartilaginous plate, the distance between them is reduced. In the future, without therapy, this is fraught with the appearance of a hernia of the spinal column.

With osteochondrosis, the patient may feel at the initial stages mild, periodically nagging pain. Over time, they intensify and become permanent, stronger, even during the day.The patient suffers even at rest, and movements and minimal physical activity bring severe torment. The degenerative process cannot be stopped, but it can be slowed down using an integrated approach to treatment. If pain occurs above the lower back, then this indicates a lesion of the thoracic region.

Used from medicines – muscle relaxants, NSAIDs, chondroprotectors, vitamin supplements. It is useful to attend massage courses, carry out daily exercise therapy and do light gymnastics to improve blood flow in the body.

Myositis

This disease is characterized by the presence of an inflammatory process in muscle tissue. The back is most often affected. The clinical picture during the diagnosis and collection of anamnesis – myositis is accompanied by sharp, aching pain and is accompanied by lumbago. Usually, discomfort is localized in one area. Less commonly, there is a migration of discomfort to adjacent muscle groups or irradiation. A patient with myositis needs a sparing mode of life. You can’t catch a cold, you need to dress warmly.Also, NSAIDs, warming ointments, help with muscle inflammation.

Hernia or protrusion

When protrusion or intervertebral herniation occurs, specific distinguishing symptoms occur, by which these problems can be suspected. At first, there is aching pain in that part of the spine where there is a protrusion of the disc or rupture of the annulus fibrosus. The pain is dull in nature, increases over time. Stiffness in the back is felt in the morning, and warming ointments often temporarily improve mobility.A protrusion or hernia most often occurs in the lumbar spine.

When there is a pinching of the nerve roots of the spinal cord, a person feels shooting pains that radiate to the arm, leg, buttock, neck or shoulder blade. Often, paresthesias (twitching) in the fingers can be observed, which indicates a violation of innervation due to compression of the spinal canal of the lower back. Protrusions and hernias occur with age due to improper posture, with excessive physical exertion, due to lifting weights.

Physical inactivity is an aggravating factor. Due to a sedentary lifestyle, the back muscles lose their tone, which increases the load on the spine. As a result, the intervertebral discs cannot withstand, and their inner contents bulge out. This is a hernia. Protrusion is the previous state.

Treat such diseases in a complex way, prescribing medications – NSAIDs, analgesics, antispasmodics, B vitamins, muscle relaxants. During the rehabilitation period, exercise therapy and physiotherapy are indicated. If the hernia has complications, then surgery is indicated.

Spondyloarthritis or ankylosing spondylitis

This condition is characterized by the occurrence of degenerative changes in the cartilage and bone tissue of the spine. At first, the cartilage of the joint is destroyed, and at the initial stages, a person does not feel negative changes in the musculoskeletal system. When the cartilage tissue becomes very thin, degenerative processes occur in the bone tissue. This situation provokes an inflammatory process and severe, excruciating pain, regardless of body position.As the pathology progresses, bone tissue is replaced by growths near the bones – osteophytes. These growths cause a feeling of stiffness and impaired mobility of the back, sharp pain when moving. Most often, the area of ​​the iliac joints, large articular elements are affected.

In this case, surgery is indicated. At the initial stages of the disease, warming ointments, anesthetic, vitamin preparations are prescribed. Conservative therapy is aimed at relieving pain and normalizing the body’s motor activity.Warming agents improve blood flow in the affected area, which temporarily makes the patient feel better. The disease is incurable, there is a gradual destruction of bone tissue. The reasons for the appearance are trauma, congenital pathologies of the spine, heredity.

Injuries of bone and connective tissue

When injured, different muscles and ligaments can suffer. Fractures and cracks are also this type of injury, causing back pain. If the patient has received a slight bruise or sprain, then in most cases, therapy is not required.Minor injuries and minor muscle strains disappear within 2-3 weeks, with complete rest and without the use of medications. Minor pain may occur at the site of injury, but trauma does not appear externally.

Damage of moderate degree is characterized by the appearance of certain signs – swelling, inflammation occurs at the site of injury, possibly bruising. Examples of injuries are muscle or ligament tears. In such a situation, full recovery is possible within a few months.The acute period is accompanied by severe pain and whining at first, even at rest. Subject to bed rest and the use of medication, the condition returns to normal quickly.

During the recovery period, it is necessary to strengthen the damaged area with the help of exercise therapy, physiotherapy and massage. Recommended drugs for the acute period are cooling ointment, NSAIDs, analgesics. The drugs used during the rehabilitation period are muscle relaxants, warming ointments, vitamins of group B. If the injury was received during physical exertion, they should be started carefully and gradually, with the permission of the attending physician.

In case of severe injury, long-term immobilization of the damaged area is required. An example is fractures, cracks, ligament ruptures. The recovery period after receiving severe injuries takes about six months. If the joint is severely damaged, surgery may be required. Use the same medications as for moderate injuries. After removal of the plaster or the fusion of torn ligaments, the patient should consult a rehabilitation therapist. The specialist conducts, together with the patient, special exercises aimed at restoring the correct movement pattern.

Scoliosis and kyphosis

These conditions are associated with curvature of the spine during prolonged stay in incorrect, antalgic postures. With a curvature of the spine, it hurts where the deformation has occurred, including the lumbar region and above. The prerequisites for the appearance of these diseases appear since childhood, when the child does not want to properly sit at the table at school. In scoliosis, the curvature is of the C and S type. In the first case, the spine is bent to the right or left to one side, near the lumbar or thoracic spine.In the second case, soreness and distortion is observed on both sides.

Kyphosis is characterized by the disappearance of the natural bend of the ridge in the lumbar region. The thoracic region is also curved, which is manifested by severe pain in a neglected situation. It is recommended to consult a doctor so that exercise therapy is prescribed for the treatment of the pathological process, muscle tension is relieved and the correct sitting is taught. The main rule of treatment is to adhere to the correct posture. You will also need drug therapy.

Causes of back pain not related to spinal problems

If a patient has irradiation, then this indicates gastrointestinal diseases, pathologies of the cardiovascular system, disturbances in the work of the hepatobiliary system, oncology, kidney problems, nervous disorders.

Why back pain occurs for other reasons:

1. Diseases of the gastrointestinal tract and hepatobiliary system. In case of a violation in the work of internal organs, pathological changes occur, leading to painful sensations.Abdominal pain will be different from joint pain. Irradiation to the thoracic back and higher is possible, which will be felt by muscle heaviness. In parallel, there are unpleasant sensations at the level of the solar plexus. What causes abdominal pain – ulcers, gastritis, food poisoning. With diseases of the gallbladder and liver, the pain arises sharply and suddenly, radiates to the lower back. The reason is cramps and colic.
2. Kidney pain is manifested by irradiation near the coccyx and lower back. Unpleasant sensations are observed from two sides – to the right and left behind.The nature of the discomfort is sharp, pulling. You cannot endure unpleasant sensations for a long time. Such pains can lead to pathological serious changes that impair the functioning of a vital organ.
3. Cancer diseases. A tumor is a dangerous condition that may not show signs of the disease for a long time. It can start to hurt if the size of the malignant neoplasm is large and squeezes the nerve endings. During the development of the tumor, radiating pain occurs, affecting the region of the shoulder blades, neck and lower back.If the brain is affected, the neck will hurt. With ovarian cancer, the lower back hurts. In breast cancer – thoracic region, armpit.
4. Cardiac disorders. These pathologies are often associated with back pain, especially in the thoracic region. Some disorders can be detected precisely during the diagnosis – arrhythmias, heart murmurs. With heart pain, a burning sensation of discomfort is observed, radiating to the abdomen, behind the spine, near the shoulder blades. If taking nitroglycerin relieves pain, then the discomfort really indicates impaired health on the part of the cardiovascular system.Otherwise, it may indicate a neurological disorder.
5. Intercostal neuralgia is a neurological disorder that is often confused with an attack of angina pectoris. Usually there is no clear localization of the painful sensation. It seems to the patient that at first pain in the right back , then there are lumbago in the region of the heart. Sometimes there is acute pain in the spine , which quickly passes. If hurts on the left in the back , then the symptoms may be confused with osteochondrosis.If, during the next visits to the doctor, no problems with the heart or back are found, then muscle relaxants, sedatives, B vitamins are prescribed.
6. Diseases of the respiratory system sometimes manifest as discomfort in the thoracic spine. These causes of back pain are associated with irradiation and an infectious and inflammatory process. With a disease of the upper respiratory tract, there is a sore throat, runny nose. If the lower respiratory tract is affected, then the patient suffers from shortness of breath, cough.Spitting up blood indicates a severe injury that requires urgent medical attention.

Why back pain occurs – diagnosis

If you have pain in the spine, you need to contact your local doctor. The therapist will take anamnesis and conduct an initial examination. Then he will refer you to diagnostic procedures.

What tests need to be passed:

1. General and biochemical blood analysis, urinalysis. These appointments are a standard protocol and are necessary in order to assess how vital organs are functioning.Analyzes show the state of the kidneys, liver, gallbladder, pancreas, hemostasis system. You can also determine the presence of a latent inflammatory process.
2. X-ray of a specific section of the spine. Using the X-ray method, it is possible to detect osteochondrosis, signs of a hernia and gross changes in the bone structure. It is a fast and inexpensive diagnostic method.
3. MRI. One of the most accurate methods for assessing the work of internal organs. An MRI is sent to see a hernia, neoplasm, or protrusion.Disadvantages of MRI are the high cost of the procedure.

If during the diagnosis no problems with the spine are found, then they are sent for diagnosis to specialists of a narrow profile – a cardiologist, rheumatologist, gastroenterologist, pulmonologist, neurologist.

Backache – treatment

Therapy is determined by the diagnosis. Treatment of back pain is aimed at symptomatic relief of discomfort in the acute period. During the treatment of back pain, use medications, physiotherapy, exercise therapy.

What methods of treatment are usually used:

1. Non-steroidal anti-inflammatory drugs. These drugs have a powerful analgesic effect, which is important for injuries, bruises, myositis, hernias and osteochondrosis of the spine. Exacerbation is easily stopped by injection. It is better to use such medicines in a short course, because they have a wide range of side effects. Over time, with pain in the spine, they switch to external anesthetic or warming ointments, depending on the specific diagnosis and the stage of recovery.