Backache

23 December 2023

One in ten people in the world suffer from back pain. This condition leads to reduced working capacity and significantly limits the normal lifestyle. In some cases, back pain can be a symptom of a serious disease, the treatment of which is more effective with early diagnosis. Therefore, if unpleasant symptoms appear in the back area, especially in the lower parts, it is recommended to consult a doctor. The specialist will establish an objective diagnosis and develop a targeted therapeutic and rehabilitation plan.

The modern clinic employs highly qualified doctors, and care is provided in accordance with international standards. You can make an appointment by phone or online. The reception of specialists is organized at times convenient for the patient.

About the disease

Back pain, especially in the lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists and orthopedists. Job losses due to the pathology of the musculoskeletal system occupy one of the main places, since, as a rule, the most active group of the population is affected, aged 20-60 years and, most often, 25-45 years.

The spinal column withstands a colossal mechanical load, but at the same time it is a complex anatomical formation in which the circulatory, supporting and spinal structures that innervate the entire human body are closely intertwined. That is why changes in the spine, leading to compression or irritation of the spinal elements, can manifest themselves as pathology of any internal organ (headache, vascular dystonia, hypertension, arrhythmia, sexual dysfunction, etc. ).

Types of back pain

Pain is an unpleasant sensory and emotional experience caused by existing or potential tissue damage. The duration of back pain can vary, so there are 3 types:

acute – lasts up to 6 weeks;
subacute – present for more than 6 weeks;
chronic – bothers a person for more than 3 months.

Taking into account the causes of pain in the back area, it can be specific or non-specific. The most common pain encountered in clinical practice is nonspecific pain, which can occur at any age. This condition is characterized by the absence of a clear cause-effect relationship between the existing symptoms and the objective data of the examination (physical and instrumental). Timely treatment can stop the pain impulse.

Doctors speak of specific back pain if during a thorough diagnostic research one or more pathological processes are discovered. In this case, the mechanisms leading to the development of pain syndrome may be:

compression of nervous structures;
inflammatory damage to the joints of the spine;
instability of different segments of the spine (the lumbar region most often suffers);
muscle and fascia damage.

Depending on the underlying cause, specific back pain is classified as follows:

discogenic – the cause lies in damage to the intervertebral disc;
radicular – caused by compression of the nerve roots emerging from the spinal cord through the intervertebral foramina;
myofascial: pain occurs due to damage to the muscles surrounding the spine and/or the connective tissue membranes covering them;
joint – the pain is caused by arthrosis of the facet joints.

Spontaneous back pain, which occurs for no apparent reason, is a category of its own.

Back pain symptoms

The disease can begin with sharp pain in any part of the back, which intensifies with active movements and bending. But more often it all starts with a feeling of "tolerable" discomfort in the interscapular, lumbar and shoulder girdle areas. The discomfort intensifies in the evening, with weakness of the paravertebral muscles, or in the morning, due to poor sleeping conditions.

Depending on the mechanism of pain development, it may be accompanied by other symptoms:

numbness in an arm or leg;
decreased muscle tone;
pathological sensitivity: crawling sensation, burning sensation, etc. ;
pelvic organ dysfunction: incontinence of urine, gas or feces, intimate disorders in men, etc.

Most common causes of back pain

According to observations and retrospective studies, the most common causes of back pain in patients visiting a medical center are the following conditions:

herniated disc, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative damage to the intervertebral joints (spondyloarthrosis), increased mobility of the spinal segments (spinal instability) and slipping of the vertebrae (degenerative spondylolisthesis);
uncomplicated traumatic injuries of the spine;
pathological fractures of the vertebrae occurring against the background of osteoporosis (a minor external impact is enough to disrupt the integrity of the bone);
aggressive hemangioma: a tumor originating from blood vessels that can compress nearby tissues;
Primary and metastatic tumors affecting the spine.

Back pain diagnosis

To identify possible causes of pain, doctors of the medical center carry out a comprehensive examination of the patient. The diagnostic program is compiled individually for each patient.

In addition to a physical neurological examination, the following diagnostic procedures may be prescribed:

Computed tomography of the spine. In the clinic, the examination is carried out using a high-precision device that creates 128 sections of the anatomical area. This allows you to detect various anomalies in the structure of the spine, incl. in the early stage of development. CT is informative in identifying developmental anomalies and degenerative-dystrophic lesions in the vertebrae, foci of inflammation, bone tumors, fractures and displacements of the vertebrae, narrowing of the spinal canal, hemorrhages in the spinal cord, which are associated with rupture of the arterio- venous malformation.
Computerized densitometry of the spine. The study allows objective measurement of bone mineral density, which is important for the early diagnosis of latent osteoporosis. The sooner this condition is detected, the sooner your doctor can prescribe treatment to strengthen your bones.
Magnetic resonance imaging of the spine. Most professional centers have a modern tomograph that generates a magnetic field of 1. 5 Tesla, which allows you to obtain extremely precise detailed images. MRI can detect not only bone pathologies, but also soft tissue lesions. The method is informative for detecting various forms of osteochondrosis (intervertebral hernias and protrusions, arthrosis of the joints), lesions and deformities of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of various densities, etc.
X-ray of the spine. A robotic 3D X-ray complex allows you to examine various parts of the spine in a single procedure, while computer software performs digital "stitching" of the images. This significantly increases the diagnostic value of the method. The clinic is equipped with computers and MRI scanners with extensive functionality, which allow it to examine even heavy patients (up to 200 kg).

The diagnostic program for patients with back pain also includes laboratory tests. They allow you to adopt a global approach to evaluate the clinical situation and select the most optimal solution to the problem.

Expert opinion

Back pain is common in people over the age of 60, and many people attribute it to "age", deliberately depriving themselves of the joy of active movement. Meanwhile, the problem can arise at any age. Late diagnosis, as well as inadequate treatment, often prolong the disease for many months, forcing patients to be referred to establish a disability group, and premature surgical treatment often permanently disables patients. The number of people with disabilities due to the so-called spinal osteochondrosis has reached alarming proportions.

Which doctor should I contact for back pain?

General practitioners deal with general back pain problems. If highly specialized treatment is needed, the patient is referred to a neurologist, and if there are indications for surgical treatment, to a neurosurgeon.

Treatment of back pain

Conservative treatment

Nonsteroidal anti-inflammatory drugs, corticosteroid therapy, and local anesthetic blocks may be used to relieve pain. As part of a complete treatment, physical exercise, massage, physiotherapy, foot reflexology, etc. are useful.

The subsequent nature of conservative treatment is determined by the cause of the pain syndrome. Therefore, for osteoarthritis, anti-inflammatory drugs are used, for osteoporosis, drugs that block the activity of cells that destroy bone tissue are used, etc. Some pathologies initially require surgery, because. . . a priori conservative measures prove ineffective.

Surgery

Surgical treatment of patients with back pain in the clinic can be carried out using several methods. In some cases a minimally invasive procedure is performed, in others traditional surgery is necessary.

Depending on the cause of back pain, doctors use various surgical options.

The main types of surgical care are as follows:

Nucleoplasty. In case of intervertebral protrusion or hernia, a puncture is performed in the projection of the affected disc. Using an electrode (cold plasma or radio frequency method), the deformed part of the nucleus is "evaporated", thereby reducing the pressure on the nerve root. As a result, the pain disappears. Rehabilitation is short: about 2 weeks.
Microdiscectomy. This microsurgical operation is performed for intervertebral hernia of a fairly large size. After removing the prolapsed part of the nucleus pulposus, the painful syndrome is eliminated.
Radiofrequency denervation of the facet joints. The operation is indicated for back pain of myofascial origin and severe spondyloarthrosis. Under the influence of high-frequency current, thermocoagulation of nerve endings occurs, the irritation of which causes pain. This is a minimally invasive surgery lasting one day with a short rehabilitation period (1-2 days).
Spinal stabilization. A stabilizing structure is installed on the problem area, which firmly fixes the position of the vertebrae. Transpedicular fixation systems with screws, interbody cages, systems with laminar hooks and ventral plates can be used as stabilizers.
Spinal canal decompression. The surgeon removes the fragments and compressive structures. If there is increased mobility of individual segments of the spine, further stabilization surgery may be performed.
Vertebroplasty. Sterile medical bone cement is injected into the diseased vertebra through a special needle. As a result, stability and functionality are restored to the spine.

Prevention of back pain

Preventive measures are relevant both for those people who have never experienced pain, and for those who have already experienced unpleasant symptoms. Neurologists and orthopedists recommend:

regularly perform exercises aimed at strengthening the back muscles;
avoid physical inactivity;
keep body weight under control;
avoid lifting weights or do it correctly, without stressing the spine;
promptly treat and correct postural disorders, bone and joint pathologies;
undergo regular check-ups and follow all your doctor's recommendations.

Rehabilitation

The duration and characteristics of the rehabilitation period depend on the type of surgery. After minimally invasive interventions, the patient is advised to start walking within the first day; after more extensive operations, the patient becomes more active within a few days. Restriction of physical activity can also range from 1-2 days to 1. 5 months. Your doctor will inform you about the specifics of the rehabilitation period.

It is important, after relieving acute pain and restoring tissues, to pay due attention to strengthening the muscular corset of the back. This will stabilize the spine and reduce stress on the vertebrae. A set of physical exercises should be developed by a specialist, taking into account the initial state of the musculoskeletal system.

Questions and answers

Why does my back hurt?

The causes of pain can be various. In some cases there is compression of the nerve roots, in others the muscles and fascia are damaged, in others the intervertebral joints suffer. Sometimes the cause of pain is linked to functional conditions.

What to do when your back hurts?

First of all, go to the doctor. As first aid, you can apply creams or gels based on non-steroidal anti-inflammatory drugs to the sore spot.

Will surgery help me return to my normal lifestyle?

Before surgery, the patient is examined in detail to select the optimal surgical technique that will help break the "vicious circle". In most cases, surgical treatment reliably relieves pain and restores mobility of the spine.