Back pain

There are primary and secondary pain sensations, each of which can be caused by different conditions and diseases. In this article, we will try to consider only the most basic ones.

Non-specific (initial). This type of pain is directly related to problems in the spine and surrounding tissues.

Causes of back pain related to the spine:

• Scoliosis. Postural disorders that cause gradual curvature of the spine, displacement of the vertebrae and muscle tension.
• Osteochondrosis. The reason for the development of the disease is a decrease in the cushioning ability of the spine: damage to the intervertebral discs, rupture of the fibrous ring and, as a result, disruption of the disc core. Pain sensations are localized in the region of that part of the spine where there are pathological changes. Thus, with thoracic lumbar osteochondrosis, back pain is localized in the thoracic region (the shoulder blade hurts between the shoulder blades and under the ribs), a person with lumbar osteochondrosis experiences pain in the lumbar region.
• Intervertebral hernia. Due to damage to the intervertebral disc, the soft structures of the vertebra protrude with the possibility of disruption (normal and strangulated hernia). The pain is localized at the site of the hernia.
• Ankylosing spondylitis. It is characterized by back pain and limited mobility in the spine, which leads to a forced "forward bend" in the patient.
• Osteomyelitis. The cause of the disease is an infectious process that has developed in the spine. The patient feels that the pain covers not only the spine, but also the back muscles.
• Spinal injury. In this case, the cause of back pain is the injury and its accompanying complications. The intensity of pain sensations and their localization are directly related to the type of injury and the affected part of the spine.

In 40-50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3-5% of severe back pain is due to damage to the roots of the spinal cord (radicular pain).

Back pain associated with pathological changes in muscles:

• Fibromyalgia. The inflammatory process develops in the muscles surrounding the spine, is characterized by symmetry and can be chronic. In this case, the back muscles ache along the entire spine. The important point is that the peak pain occurs when you press on certain places.
• Polymyositis. Hypothermia can cause illness. As a result of the development of the disease, the patient feels muscle weakness and pain, which increases when trying to turn.
• Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that lower immunity can act as a trigger. It is manifested by pain that increases with the development of the disease and can cover all parts of the back. Severe back pain impairs mobility to such an extent that the patient cannot move independently. A clear asymmetry is visible in the back.
• Charcot disease. Symptoms are caused by inflammation of the peripheral nerves along the spinal column. As a result of the pathological process, along with quite strong pain, a change in the person's gait occurs.

In 50-60% of cases of non-specific back pain, their localization is in the muscles.

Specific (secondary pain). This type of pain, despite the localization in the back, is often not directly related to diseases of the spine or the surrounding muscular skeleton. The causes of specific pain are extremely diverse, but the most dangerous are oncological diseases. Thus, pain radiating to the back can be caused by a malignant neoplasm in the mammary glands, lungs or prostate region, which causes metastasis to the spine.

Diseases that cause specific pain include:

• Compressed nerve roots in the chest. Often this leads to the development of intercostal neuralgia. In this case, the pain is localized at the pinch site. Thus, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinching occurs). The pain has a different degree - from sharp pain to fever. Often, the pain syndrome occurs when moving or pressing on the affected area. This fact is the main difference between intercostal neuralgia and heart and lung diseases, which can be manifested by pain under the left (or right) shoulder blade from behind.
• Diseases of the gastrointestinal tract. More often they cause pain on the right side, in some cases it can also move to the left side of the body. Most of the pain is localized in the lumbar and sacro-lumbar regions. Sufficiently strong pain sensations are manifestations of pancreatic diseases, colon diverticulum, intestinal obstruction, retrocecal appendicitis, etc.
• Ulcerative foci. Ulcerative lesions of the organs of the upper abdominal cavity (gastric ulcer of the duodenum and stomach) can manifest as pain in the thoracic and lower back region. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is localized in the lumbar region. The intensity of the pain can be different, but the peak is often reached at night.
• Appendicitis. In cases of acute appendicitis, the appendix (appendix) is located behind the intestine, pain in the lower back. Pains are variable in nature and can range from painful, mild to severe.
• Kidney diseases. Often they are manifested by pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies directly related to the spine is based on the analysis of other clinical manifestations and research results.
• Urolithiasis disease. Back pain in the lower back with renal colic. The pain is pronounced, severe, occurs suddenly and does not depend on the position of the body. Pain in the back, lower back and staghorn nephrolithiasis. Manifestations of pain syndrome are of low intensity, the pain is quite painful in nature.
• Diseases of the female reproductive system and menstrual pain. In these cases, the pain is more often localized in the lumbar region.
• Neoplasms in the pulmonary system. In this case, pain appears when peripheral tumor elements (metastases) germinate in the pleural region of the lungs and the chest wall. The nature of the pain is strong, debilitating.
• Cardiovascular diseases. The most common causes of localized pain in the thoracic back are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
• Inflammatory processes in the joints. Infectious arthritis can cause pain to spread from the affected joint to nearby areas, including back pain.

In most cases, the causes of the manifestation of pain in the back are the same for both sexes, but it is necessary to highlight a number of diseases that differ in gender.

back pain in men

Although the causes of back pain are mostly the same in both sexes, there are a number of diseases that men are more susceptible to due to their lifestyle.

These predisposing factors include:

• work related to lifting and transporting heavy loads;
• strength sports (including various martial arts, powerlifting, etc. );
• bad habits.

As a result, diseases of musculoskeletal and cardiovascular systems may occur more often in men than in women.

Specific "male" diseases that can cause back pain are various pathologies of the prostate.

Prostatitis is an inflammatory disease of the prostate gland. At the beginning of the disease, the pain syndrome is localized in the groin, testicles and lower abdomen, but in the second stage and when the disease becomes chronic, the pain spreads to the back.

In this case, the localization of pain can either be concentrated in the lumbosacral region or spread to the entire back. This is due to the fact that the inflammatory process affects the nerve endings that surround this organ in large numbers.

The intensity of the pain directly depends on the stage of the disease. Thus, the pain in the acute stage is characterized as acute and short-term. In the chronic form, the pain syndrome is not very pronounced and is often permanent.

In this case, diagnosis and treatment is carried out by a urologist.

back pain in women

In some cases, back pain in women can be of a special nature related to the characteristics of the body and the processes occurring there. First of all, we are talking about the reproductive area.

As a rule, pain associated with gynecological diseases is localized in the thoracic and lumbosacral regions. The most common reasons include:

1. Menstrual cycle. During menstruation, the hormonal background of a woman changes, which leads to the appearance of a number of negative manifestations. This is primarily due to a decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold makes even minor pain sensations more pronounced. Also, hormonal changes cause irritation of the intestinal walls and fluid retention, which causes an increase in the volume of some organs and, as a result, compression of the nerve endings in the lower back. The combination of these factors causes back pain.
2. Pregnancy. In this case, back pain can be divided into two groups: First trimester pain. If painful sensations are accompanied by additional symptoms (bleeding, fever, etc. ), we can talk about the risks of miscarriage. Pain in the second half of pregnancy. Often, such pains are associated with physiological changes, namely: the active growth of the fetus, which causes a change in the body's center of gravity, and the preparation of the pelvic bone for the upcoming labor.
3. Diseases of the reproductive system. Most of the pain is concentrated in the lumbar region, which is explained by the topography of the female reproductive organs. The most common causes of this manifestation of pain syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
4. Menopause. Strong changes and fluctuations in hormonal levels occur during menopause. This kind of restructuring of the body leaves a mark on many systems of the female body. First of all, the skeletal system suffers, which is more fragile and prone to various types of diseases under the influence of hormonal changes.
5. Big chest. The large size of the bust, together with poorly supported underwear, creates an additional load on the spine, resulting in a woman's shoulder blades and back pain in the lower back.
6. High heel. Wearing high-heeled shoes causes pathological changes in the musculoskeletal system and the development of a number of diseases related to back pain.

Back pain with coronavirus

The coronavirus infection affects many organs, but the lungs are the first to suffer. Therefore, often pain between the shoulder blades or under them is a manifestation of advanced inflammation in the lung tissue. Depending on which lung is more affected, the patient will feel pain under the left or right shoulder blade.

In addition to lung tissue damage, there is general intoxication of the body and an increase in temperature, which can cause pain (pain) in the back and limbs.

Back pain after the coronavirus is explained by the fact that the disease can not only damage the nervous system, but chronic diseases, including internal organs and the musculoskeletal system, are exacerbated against the background of a general decrease in immunity.

Back pain after sleep

The reasons for your back pain after sleep can be:

• work related to physical activity and weight lifting;
• low back muscle tone;
• history of intervertebral hernia and osteochondrosis;
• long-term hypothermia of the back;
• curvature of the spine, which causes muscle tension and uneven contraction;
• excess body weight, resulting in increased back load;
• stressful situations;
• restless bed.

Unpleasant sensations can be of different intensity and appear under the ribs, in the lower back, between the shoulder blades and under them.

To eliminate pain after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.

Back pain - which doctor should I see?

The initial diagnosis of back pain is made by a general practitioner. If necessary, a number of additional examinations and advice of highly qualified specialists can be prescribed:

• neurologist;
• gastroenterologist;
• gynecologist;
• urologist;
• pulmonologist.

To make an accurate diagnosis, it is necessary to conduct a detailed analysis of the patient's condition. For these purposes, the doctor may prescribe a number of additional studies:

• Laboratory tests. Often, this list includes general and biochemical blood tests, urinalysis, stool and, in some cases, hormone level analysis. These studies help identify possible inflammatory processes and infections. If you suspect some diseases or an oncological component, the doctor can prescribe a number of special studies (biopsy, tumor markers, etc. ).
• Hardware research. They help to get a more visual understanding of the course of the disease, which cannot be achieved by visual examination and palpation. The most prescribed X-ray, MRI, ultrasound.

Back pain treatment

Internal consultation of specialists is necessary for the purpose of specialized treatment. Therapy is selected strictly based on the diagnosis and taking into account the general condition of the patient. Self-treatment of back pain can cause the disease to progress or become chronic.

Prevention of back pain

The main preventive measures depend, first of all, on what caused the appearance of back pain. Common recommendations include:

• healthy lifestyle;
• complete and healthy nutrition;
• acceptable dose of physical activity;
• timely treatment of identified diseases;
• regular preventive examinations, including by narrow-profile specialists.