What are the 5 signs of back pain that might indicate an emergency. How can you differentiate between normal and dangerous back pain. When should you seek immediate medical attention for back pain. What conditions can cause severe back pain in older adults.

Understanding Back Pain: Normal vs. Potentially Dangerous

Back pain is an extremely common condition, affecting approximately 80% of adults at some point in their lives. While most cases are benign and resolve on their own, it’s crucial to recognize when back pain might indicate a more serious underlying condition.

In our 20s and 30s, typical causes of back pain often include:

• Prolonged sitting
• Lifting children
• Overexertion during exercise

As we enter our 40s and beyond, the origins of back pain tend to shift towards:

• Work-related injuries
• Early stages of arthritis
• Degenerative conditions

How can you determine if your back pain is cause for concern? Here are some guidelines:

• If the pain is associated with a specific activity and subsides within 72 hours with rest and ice application, it’s usually not serious.
• Pain that develops gradually, appears suddenly, or persists may indicate a more significant issue.

5 Red Flag Symptoms: When Back Pain May Signal an Emergency

While most back pain is not life-threatening, certain symptoms warrant immediate medical attention. Here are five key signs that your back pain might be more than just a minor inconvenience:

1. Sharp Pain vs. Dull Ache

Is your back pain sharp rather than a dull ache? This could indicate:

• A torn muscle or ligament
• A problem with an internal organ in the back or side

2. Radiating Pain

Does your pain “move” or shoot to your buttocks or legs? This could be a sign of nerve compression, potentially caused by conditions such as:

• Sciatica
• Herniated disc
• Spinal stenosis

3. Sudden Leg Weakness

Have you experienced a sudden loss of strength in your legs? This symptom can have several causes:

• Compressed nerves in the spine
• Sciatica
• Spinal stenosis
• In rare cases, it could indicate a stroke

4. Incontinence

Are you experiencing back pain along with difficulty controlling your bowels or bladder? This combination could suggest:

• Serious nerve compression
• Spine infection (e.g., discitis or meningitis)

5. Numbness or Pins and Needles in the Groin or Buttocks

This sensation, known as saddle anesthesia, can indicate a serious nerve or spine condition. If you experience this symptom along with leg weakness and incontinence, you may have cauda equina syndrome – a medical emergency requiring immediate surgical intervention to prevent permanent nerve damage.

Cauda Equina Syndrome: A Spinal Emergency

Cauda equina syndrome is a rare but serious condition that requires immediate medical attention. But what exactly is it?

Cauda equina syndrome occurs when the bundle of nerves at the base of the spinal cord (cauda equina) becomes compressed. This compression can lead to:

• Loss of sensation in the legs, buttocks, and groin area
• Loss of bladder and bowel control
• Severe lower back pain
• Sexual dysfunction

Why is cauda equina syndrome considered a medical emergency? If left untreated, it can lead to permanent paralysis and loss of bladder/bowel function. Prompt surgical decompression is often necessary to relieve pressure on the nerves and minimize long-term damage.

Common Causes of Back Pain in Older Adults

As we age, the likelihood of experiencing back pain increases. While some conditions may require surgical intervention, many can be managed through conservative treatments. Here are some common causes of back pain in seniors:

Degenerative Disc Disease

What is degenerative disc disease? This condition occurs when the intervertebral discs that cushion the spine begin to break down due to age-related wear and tear. Symptoms may include:

• Chronic low back pain
• Pain that worsens with certain movements
• Numbness or tingling in the extremities

Lumbar Arthritis

Lumbar arthritis refers to inflammation of the joints in the lower back. How does it affect older adults?

• Causes stiffness and pain in the lower back
• May lead to reduced mobility
• Can worsen with prolonged periods of inactivity

Spinal Stenosis

Spinal stenosis involves the narrowing of the spinal canal, which can put pressure on the nerves. What are the typical symptoms?

• Back pain that radiates to the legs
• Numbness or weakness in the legs
• Difficulty walking for extended periods

Treatment Options for Chronic Back Pain

For many older adults experiencing chronic back pain, non-surgical treatments can provide significant relief. What are some common approaches?

• Physical therapy: Helps improve strength, flexibility, and posture
• Medications: May include over-the-counter pain relievers or prescription drugs
• Injectable anesthetics: Can provide targeted pain relief
• Combination therapies: Often yield the best results

In some cases, a combination of these treatments can effectively manage symptoms without the need for surgery. However, it’s crucial to work closely with a healthcare provider to develop an individualized treatment plan.

When to Seek Immediate Medical Attention

Given the potential severity of certain back pain symptoms, when should you seek immediate medical care? Consider the following scenarios:

• You experience sudden, severe back pain accompanied by fever
• Your back pain follows a fall or other traumatic injury
• You have a history of cancer and develop new back pain
• You experience any of the five red flag symptoms mentioned earlier

In these cases, it’s crucial to err on the side of caution and seek prompt medical evaluation. Early intervention can often prevent more serious complications and improve outcomes.

Preventive Measures for Back Health

While not all back pain can be prevented, there are steps you can take to reduce your risk and maintain a healthy spine. What are some effective strategies?

• Regular exercise: Focus on strengthening core muscles and improving flexibility
• Proper posture: Be mindful of your posture during daily activities, especially if you have a desk job
• Ergonomic workspace: Ensure your work environment is set up to support good posture
• Healthy weight: Maintain a healthy body weight to reduce stress on your spine
• Proper lifting techniques: Always lift with your legs, not your back
• Stress management: Chronic stress can contribute to muscle tension and back pain

By incorporating these practices into your daily routine, you can help protect your back and reduce the likelihood of developing chronic pain.

The Importance of Professional Evaluation

While this article provides general guidelines, it’s important to remember that back pain can be complex and multifaceted. Why is professional evaluation crucial?

• Accurate diagnosis: A healthcare provider can determine the underlying cause of your pain
• Personalized treatment: Your doctor can develop a treatment plan tailored to your specific condition and needs
• Early intervention: Prompt treatment can prevent minor issues from becoming major problems
• Peace of mind: Professional evaluation can alleviate anxiety about potentially serious conditions

If you’re experiencing persistent or concerning back pain, don’t hesitate to consult with a healthcare professional. They can provide the expertise and guidance needed to address your symptoms effectively and improve your overall quality of life.

Remember, while back pain is common, it should never be ignored when accompanied by alarming symptoms. By staying informed and attentive to your body’s signals, you can ensure prompt treatment when necessary and maintain optimal spinal health throughout your life.

5 signs your back pain might be an emergency | Back and Spine | Orthopaedics and Rehab

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

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

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

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

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

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

5 sensations that might indicate a medical emergency

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

Radiating pain could be a sign of nerve damage.

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

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

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

Other conditions that cause back pain in older adults

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

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

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

Rare, non-spine conditions that cause back pain

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

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

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

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

Related reading: Prostate Cancer Awareness Guide

Existing patients may also schedule an appointment using MyChart.

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Why back pain requires a team approach to care

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

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

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

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

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

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

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Get help for back, neck, and leg pain caused by spinal stenosis | Orthopaedics and Rehab

Too many people live with unnecessary pain related to spinal conditions. One of the most common ones I treat is spinal stenosis, in which the spinal canal narrows and puts pressure on the spinal cord and nerves.

Normal wear and tear as we age causes our spines to change. The American Academy of Orthopedic Surgeons says up to 95 percent of people 50 or older experience degenerative changes of the spine, and spinal stenosis can affect 8 to 11 percent of them.

Spinal stenosis symptoms can be managed and treated. This doesn’t always mean surgery, but if you do need surgery, know there are minimally invasive options that can make recovery a little easier than in the past. Let’s talk about what causes spinal stenosis, its symptoms, and how we can treat it.

What is spinal stenosis?

The spinal canal is the space though which the spinal cord passes. When this space narrows, it can put pressure on the spinal cord and nerves and cause pain.

There are several types of spinal stenosis, and they relate to where along the spine the narrowing occurs:

• Cervical spinal stenosis, which occurs in the neck
• Thoracic stenosis, which occurs in the mid-back
• Lumbar stenosis, which occurs in the lower back

Spinal stenosis can develop at any age, but it’s most common among people 50 and older. Some of the most common causes of spinal stenosis include:

• Aging: As noted earlier, the spine changes as we age. The ligaments become thicker or the bones and joints get bigger, resulting in a narrower spinal canal.
• Arthritis: Vertebrae, or the bones that form the spine, can begin to compress and wear against the joints that allow it to flex after years of repetitive motion. This can cause the joints to deteriorate, resulting in inflammation or the development of bone spurs, which are bony projections that form on the surface of bones.
• Congenital defect: Some people are born with a small spinal canal. This is the most common type of spinal stenosis found in young people. It might present in teens who play contact sports and experience recurring numbness or weakness in their hands, or what we call “stingers,” which are pinched nerve injuries.
• Spinal deformities: Spinal conditions such as scoliosis, in which there is a curvature of the spine, or spondylolisthesis, in which a vertebrae moves out of position onto the vertebra below it, can cause the spinal canal to narrow.

Symptoms of spinal stenosis

Spinal stenosis is a degenerative disease, which means it gets worse over time. It starts slowly, and by the time you notice pain, it’s probably been brewing for some time.

Nerves relay sensation to specific parts of the body. Pressure on these nerves can cause pain, tingling, or numbness in those body parts. Common symptoms include:

• Pain in the neck or back
• Pain that radiates down into the legs
• Tingling, numbness, or weakness in the arms, legs, or buttocks
• Muscle atrophy or motor loss in extreme cases

If you are experiencing any of these symptoms, request an appointment to talk to a doctor about whether you may have spinal stenosis or another spinal condition.

Diagnosis of spinal stenosis starts with discussing your medical history and symptoms. If we suspect spinal stenosis, we’ll likely get high-resolution imaging such as a magnetic resonance imaging (MRI) or computerized tomography (CT) scan. Once we confirm it’s spinal stenosis, we can discuss treatment options.

How we treat spinal stenosis

There isn’t one “right” treatment for spinal stenosis. What works for one person may not work for another.

We always try to start with the most conservative methods, such as:

• Anti-inflammatories or muscle relaxants
• Cortisone injections
• Physical therapy

These treatments work for the vast majority of spinal stenosis patients, with only a small percentage needing surgery. Remember, spinal stenosis is a degenerative disease, and these methods are most effective at the early stage, underscoring the importance of early diagnosis and treatment.

If these methods don’t bring pain relief, you may need surgery to make more room for the spinal cord and nerves in the spinal canal. I know many people are scared by the thought of back surgery, but these aren’t the surgeries of years past. We offer a number of minimally invasive options, which require smaller incisions and a shorter recovery period, allowing you to more quickly get back to daily activities.

You and your doctor will examine the best options for your situation. If you don’t feel comfortable, get a second opinion. You shouldn’t have to live with back pain or tingling, numbness, or weakness in your arms and legs. Talk with your doctor to find the cause of your pain and to begin a treatment plan.

Lumboischialgia – causes, treatment | MOTRIN®

Author, editor and medical expert – Anna Yurievna Budovskaya.

Editor and medical expert – Harutyunyan Mariam Harutyunovna

Number of views: 35 841

Last update date: 12/29/2022 9 0003

Average reading time: 6 minutes

Content:

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

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

Pain in the lower back is called variously ³ :

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

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

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Causes of lumboischialgia

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

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

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

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

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Symptoms of sciatica

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

There are 2 forms of lumboischialgia:

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

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

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

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

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

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Diagnosis of lumboischialgia

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

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

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Treatment of lumboischialgia

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

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

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

Non-drug methods of pain relief include ^3.8 :

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

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

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Prevention of lumboischialgia

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

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

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

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References

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

Spinal pain in the middle of the back | “Hello!”

Features and causes of pain syndrome

Doctors distinguish between acute and chronic manifestations of ailments. A pathological condition is considered acute if the pain manifests itself for the first time. If a person experiences discomfort constantly, with a periodic increase and decrease in the intensity of unpleasant symptoms, the pain is chronic.

Pain may be:

• pulsating;
• sharp, sharp;
• stabbing or cutting;
• pulling.

Sometimes the pain is accompanied by swelling or numbness of the back, arms, legs, face.

The causes of back pain in the thoracic spine may be associated with problems in different body systems. Most often they are caused by diseases of the musculoskeletal system. Reflected soreness is less common in pathologies of internal organs. In some cases, both factors take place: diseases of the spine, which is the “axis” of the whole organism, often lead to prolapse, displacement or compression of the internal organs.

Soreness with increased exertion

After intensive physical work, pulling pain often appears. It is most commonly caused by muscle tension and fatigue. Such sensations can occur after carrying weights, sitting for a long time (static load) or sports training. Women sometimes experience pulling pains during pregnancy.

Diseases of the spine

If pain is accompanied by tingling, cutting or heat in the spine, then it is most likely not due to muscle fatigue. Such symptoms usually signal diseases of the spine:

• arthrosis;
• retrolisthesis;
• osteochondrosis;
• deformations;
• protrusion or hernia.

These pathologies are characterized by chronic pain, which increases sharply after emotional stress, physical exertion or hypothermia.

The fact that it is the spine that hurts in the middle of the back is indicated by the following signs:

1. crunching or clicking when moving;
2. increasing stiffness;
3. increased pain when changing body position, turning the head and other movements;
4. coldness of hands and feet;
5. periodic numbness of hands, face, back, legs, neck;
6. sensation of “current” in the body;
7. frequent dizziness, migraine.

If the spine becomes numb in the middle of the back, this indicates compression or damage to the nerve roots. Left untreated, this problem can lead to spinal cord injury, loss of sensation, and loss of mobility.

If the spine hurts in the middle of the back when pressed, the pain is most likely caused by myositis or another inflammatory disease of the muscle tissue.

Soreness under stress

Diseases of the musculoskeletal system are not always the cause of pain. Often, pain in the collar region, thoracic region and lower back is caused by a stressful condition. Due to strong emotional stress, a person constantly strains his muscles, stoops, raises his shoulders – all this leads to uncomfortable sensations. To get rid of pain, you must first deal with stress. High efficiency is shown by spa treatment, manual therapy, massage and physiotherapy, including therapeutic baths.

Referred pains

If the ailment is caused by diseases of the internal organs, the following symptoms may accompany the pain:

• cough;
• shortness of breath;
• temperature increase;
• cardiac arrhythmias;
• constipation, diarrhea;
• vomiting;
• bloating;
• the appearance of a yellowish tinge to the eyes and skin;
• plaque on the tongue.

In tuberculosis, the back hurts in the back of the lungs. With inflammation of the gallbladder or liver disease, pain occurs in the back and on the right under the ribs, while nausea appears, and sometimes the temperature rises. With inflammation of the kidneys, pain is accompanied by difficult or frequent urination.

Features of diagnosis

The presumptive reason why the spine hurts in the middle of the back can be determined by the nature of the discomfort and additional symptoms, but only a doctor can make an accurate diagnosis. If you are only concerned about pain in the back, you should consult a neurologist or orthopedist. If discomfort appeared after a bruise or other injury, an examination by a traumatologist is needed. If you have a cough and fever, you may need to consult a phthisiatrician.

The exact causes of pain in the middle of the back in the spine can be determined using various diagnostic procedures:

• x-ray;
• MRI;
• CT;
• Ultrasound of internal organs;
• ECG;
• laboratory tests.

MRI or X-rays in several planes reveal curvature of the spine, changes in the width of the vessels, damage to the intervertebral discs, displacement of the vertebrae. ECG, ultrasound and tests help to detect diseases of the internal organs.

Treatment for pain in the spine in the middle of the back

Pathologies of the musculoskeletal system (musculoskeletal system) and the complications caused by them require surgical treatment only in the later stages. In other cases, conservative methods are sufficient.

Mandatory elements of the treatment plan are:

• medication;
• physiotherapy;
• physiotherapy exercises;
• normalization of the regime of rest and work;
• healthy diet.

These measures are necessary to strengthen the ligaments and muscles in order to reduce the load on the spinal column and develop mobility. They also allow you to restore the integrity of the intervertebral discs and get rid of protrusions and hernias, eliminate pain, prevent inflammation, accelerate tissue regeneration and normalize blood circulation.