Back pain — what can I do?

Every day, one to two patients necessarily. Regardless of age and gender, type of activity and physique. What is the pain? This is a protective reaction of the body, it is very necessary, because, if there is no pain, we can learn that there is a disturbance in the body that your health is threatened.

The Mechanisms of the development of the pain in the body similar to how all the reflexes from pain receptors pulse goes first in the spinal cord, then processed and redirected to the brain. In this path, all the divisions of the nervous system and the brain many pain centers at various levels. This suggests that the perception of pain is very important for the body.

But there is that damage, and no pain. Most often this happens in cancer processes, or if a violation of the pain receptors. If due to the constant irritation of the receptors and nerve fibers, even these fibers and centers in the brain are irritated, the result is chronic pain. It is not much more difficult to treat, because here only the organs and tissues of astonishment, where the receptors, but also the transmission of the pain are the cells of the nervous system — neurons.

Pain in the back area can be due to various causes. Here we share for the localization (i.e., local) pain in various parts of the back and analyze what hurt could be on different levels, and what affects the whole of the spine We touch rare diseases: we describe the most common causes of pain in the back, in practice, occurring.

1. Pain in the upper back area

• First of all, to eliminate the most dangerous state of disease of the heart. Therefore, in the case of pain in the upper back area, in the area of the shoulder blades, especially on the left side, dedicated to the ECG (electrocardiography), in order to exclude acute coronary syndrome, myocardial infarction, if a person in old age. Inflammation of the heart muscle and other inflammatory diseases of the heart, if the age of the young.
• If electrocardiogram without pathology, think of dorsalgia, in this part of the back right is torakalgiya (from the Latin word Thorax – the chest), that is, injury of the spine or the muscles of the spine associated. Torakalgiya may be due to osteochondrosis of the spine with damage to the thoracic. It is the most common cause. Amplification of pain occurs during the movement, especially when turning. If you have been awarded on such shows as the tense muscles to the sick of the place. Associated this pain with a particular event – lifted the heavy, chilling, nervous, was a great strain on the back. Often accompanied by pain in the area of the sternum, pain, rising in the night in the prone position. When the pain is fresh, the injections, pain relievers, vitamins, muscle relaxants, everything goes within 3 days, rarely weeks. If there is damage to the spine – herniated discs, damage to nerve roots that branch out from the spine – long-term treatment. Here it must be x-rayed and such patients, neurologists continued. Because chronic pain to cope with difficult formed. In this Phase, stronger drugs will be.
• We can not exclude pathology of the shoulder joint Arthritis or injuries. There is a pain radiating to the back.
• From the internal organs at the level of the upper back are the lungs. Back pain starts when the inflammation on the pleural cover of the lung, the scattered rich in pain receptors. Severe pain, worse when breathing to reduce the pain that people are on the sick side. If it is temperature and pain in the chest – the doctor has to suspect the injury in the lung. X-ray image, on the mostly, all are visible. Treatment in the hospital. Inflammation of the Pleura – pleural effusion — happens for various reasons. Can cause bacteria, virus, tuberculosis bacilli, and other infections.
• Spontaneous pneumothorax — entry of air into the Pleura. Often stanichnyj young people with a hereditary cause of the connective tissue (dysplasia of the connective tissue, or JSP). Happens in the case of a strong cough during the SARS, a sudden deep breath, injuries.

2. Pain in the middle back area, in the cross area and higher

• Osteochondrosis of the spine at the level of the lumbar spine is low back pain is a pain without irradiation in the leg, and lumbalgia – if the pain extends to the outer side of the thigh. This happens in the case of tension in the nerve roots. So the doctor checked, the so-called "radicular symptoms" or symptoms of tension. The Patient on the back and raises a second leg. In the case of tension of nerves because of the pain in the leg can lift, the only under a small angle.



• Approximately at this level are the kidneys. As the doctor checked Symptom Pasternatskogo, i.e., lightly hit the back in the designated area of the kidneys, and if there is pain, then the kidneys are sick. Often it is a sign of an acute inflammation of the kidney or kidney stones. Therefore, the algorithm in the investigation of pain in the lumbar region of the back of urine analysis is essential. In the case of inflammation of the kidneys, acute Pyelonephritis or exacerbation of chronic, often high fever, pain in the lower back can at the slightest touch. In the General analysis of urine, the number of leukocytes – inflammatory changes increased.
• Stones are not only in the kidney, but also in the gallbladder. Very often, the pain of the pathology of the spine and pain from the inflammation of the gall to be confused bubble. The gallbladder is located right under the rib, and a pain radiating into the right half of the back. But this body is so smart, that pain can give in the case of cholecystitis is in the right shoulder, in the back, and even in the foot. The stone can "sit" not only in the gallbladder but also in speed. Can't be a stone, but perhaps an inflammation of the gall bladder and the bile ducts by, e.g., Giardia, opisthorchis, and other parasites. In General, an inflammation of the gall bladder shows the Palpation of the abdomen and the determination of the specific reflex symptoms of inflammation of the gallbladder. If signs of a cholecystitis, the patient for each of the Abdominal-to do ultrasound and gastroenterologu. If Cholelithiasis in the acute stage, surgical treatment is already. Insidious this disease is the fact that may not be the temperature, the bitterness in the mouth, liquid stool, but only pain. This happens at a long current of, if you already have chronic pain formed.
• Inflammation of the pancreas – pancreatitis. Pain often in the back there, only on the left side. This happens when the inflammation involves the tail of the pancreas. If the inflammation in the area of the head, then a radiation of pain in the lower back to the right and in the middle. Here, everything is clear, acute pancreatitis can not phenomena easy to lick without dispepticakih. Here, in addition to severe pain, usually occurring stabbing" pain is "in the abdomen, can vomiting be nausea,. And, of course, such pain is always associated with the violation of the diet, is the ingestion of spirits in connection with fatty foods. Acute processes – work for the surgeon. Because the pancreas can start to digest itself, it is called pancreatic necrosis and the emergency requires Intervention. If the process is chronic, this observation gastro-etrology. And diet with the exception of fat.
• Herpes Zoster – Shingles. Occurs in the area of the spine, usually the lumbar spine. First of all, there is pain, then herpetic skin rash in the Form of small bubbles. Is called a type of Herpes infection. Heals in General, the Internist and neurologist. Pain can be very strong, pungent. The Virus spreads along the nerve pathways. Sometimes from the beginning of the pain to skin rashes week and the diagnosis is difficult to establish.

3. Back pain

• The most common cause is the Manifestation of osteochondrosis of the spine. An injury or degenerative changes in the vertebrae at the level of the lumbosacral joint, coccyx pain, or up pozvonocna post.
• Gynaecological causes can pain in the back (it all depends on the anatomical Position) inflammatory diseases of the female organs.
• Urolithiasis, if the stone is in the ureter, often in the lower abdomen, but can also be from the back.
• Pathology of the hip joint (as in our case, is the beginning of the article), Arthritis, osteoarthritis, or even a fracture of a neck of a hip can cause pain in the lower back.
• Diseases of the rectum – hemorrhoids, tumour is benign or malignant (if the Tumor is malignant, you can give the pain, not only for themselves, but maybe the pain and metastases in the spine, liver, lung).
• Finally, diseases of the prostate is a benign dysplasia of the prostate, can prostate cancer. These diseases develop in adulthood, therefore, are often lengthy, even without visible symptoms, but with the weakening of the body metastases to the lumbar spine can give, in the lungs, the local lymph nodes.

4. Some diseases affect the entire spine or of its departments

• Back pain – the most common is degenerative changes of the spine, to all areas of the spine. There are polysegmental osteochondrosis. His symptoms symptoms in all areas of the spine, can be therefore, for the diagnosis of the specific difficulties, very often this happens due to osteoporosis.
• Osteoporosis – reduction in the amount of Calcium in the bone to use, it shows more with age. In the case of men and women happen for various reasons, but the same. Women after the menopause is associated with low levels of estrogen, which regulate of childbearing age, the exchange of calcium, and men the most because of the defeat of the gastro-intestinal tract and poor Absorption of Calcium. In osteoporosis, the bones are still brittle, thin. This is also true for the spine. Micro fractures occur with the slightest injury in far-advanced stages.
• Multiple myeloma belongs to the group of leukemias or tumors in the blood when a Tumor developed at the level of the bone marrow. Increases the number of cells in the formation of blood, from which grow white cells, the pressure of this mass caused pain in the bone use. In this disease homeopathically on the flat bone of the stomach, usually, but there is pain in the spine. Now, the number of cases of this leukaemia growth. It is determined by the presence of produce of Protein in the urine Ben Jones, modified Protein in the tumor cells.
• Ankylosing spondylitis and other autoimmune diseases — if the inflammation of the vertebrae wear an auto-immune character, ie, when the body produces antibodies against its own cells. Now, there was an increase in the number of auto-immune diseases.
• Infectious diseases of the spine – tuberculosis (can be combined with HIV infection), Syphilis, Osteomyelitis are very rare, but the doctor should consider and know about them. To diagnose tuberculous Osteomyelitis is difficult, often the diagnosis definitively is not issued, but the treatment you should seriously. Tuberculosis – an insidious disease, with every weakening of the immune system, it can penetrate into the body and unexpected symptoms occur. Last year I saw two such patients.

5. Persistent back information on serious diseases can pain

In the case of the following signs, a doctor is suspected, Oncology, and leads to a thorough investigation:

• Back pain is go bad in the treatment of pain resources
• The reduction of body weight,
• low-grade fever (37-37,5 degrees, which is not going to happen for a long time),
• Anemia, low hemoglobin, from the outside it looks like paleness, or yellowing of the skin, lips bluish, "dark circles" under the eyes,
• increased erythrocyte sedimentation rate (ESR) in General, the analysis of blood,
• the tendency to bleeding.

Algorithm for the investigation of back pain

1. Especially you need to the Routine Tests – the General analysis of blood General analysis of urine. This gives us an idea about the condition of the body, inflammatory processes, the condition of the urinary system. If we see a change in the analysis of urine, then immediately suspect that the pain of kidney diseases that causes.

2. Biokhimicheski analysis of the blood, the liver values (alt, AST, Bilirubin, ALP), PSA (C-reactive Protein), rheumatoid factor , indicators of inflammatory activity, the amount of protein, the ratio of the different types of Protein in the blood – Albumin and globulins, and other indicators, if the doctor suspects a disease.

3. Tumor-markers – in case of suspicion on the Tumor process.

4. Tests on infectious diseases: HIV, viral hepatitis, tubercules, and Syphilis.

5. The x-ray of the spine shows the changes in the spine, the presence of hernias of the spine, metastatic tumors, inflammatory phenomena.

6. CT of the spine and internal organs – a very important investigation, the better and more than on the x-ray image is visible are the changes in the tissues.

7. MRI is more expensive and informative method used, your results of computed tomography. You can carry out the game of the investigation, the detection of the internal organs and the spine itself. This makes it possible to investigate the exact cause of the damage to the internal organs.

8. If the physician thinks about a rare disease, he has special studies (on auto-immune disease, a rare infection, further in-depth studies for determining the condition of the body).

Treatment of back pain, of course, depending on the cause. But we always start with pain relievers – nonsteroidal anti-inflammatory drugs or muscle relaxants.

Despite the diversity of causes of back pain, what our medicine is advanced enough to begin an accurate diagnosis and treatment. The most important thing – not to lead to illness and a doctor visit if the pain does not disappear within three days, not to mention the long, intense pain.

Stay healthy!