Back pain

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

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

Causes of back pain related to the spine:

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

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

Back pain related to pathological changes in the muscles:

• Fibromyalgia. The inflammatory process develops in the muscles surrounding the spine, is characterized by symmetry, and can be chronic. In this case, the muscles of the back hurt along the entire spine. The bottom line is that peak pain occurs when you press on certain places.
• Polymyositis. Hypothermia can provoke the disease. As a result of the development of the disease, the patient feels muscle weakness and pain, which increases when he tries to turn.
• Polymyalgia rheumatica. The etiology of the disease is unclear. Infectious diseases that reduce immunity can serve as a trigger. It manifests itself in 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. There is a clear asymmetry on the back.
• Charcot disease. The symptoms are caused by inflammation of the peripheral nerves along the spinal column. As a result of the pathological process, in addition to quite intense pain, the way a person walks also changes.

In 50-60% of cases of non-specific back pain, they are localized in the muscles.

Specific (secondary pain). This type of pain, despite being localized in the back, is often not directly related to diseases of the spinal column or the surrounding musculoskeletal system. The causes of specific pain are extremely diverse, but the most dangerous are oncological diseases. So, pain radiating to the back can be caused by a malignant tumor in the mammary glands, lungs or prostate, which causes metastasis to the spine.

Diseases that cause specific pain are:

• Pinched nerve roots in the chest. Most often, this leads to the development of intercostal neuralgia. In this case, the pain is localized at the site of the bite. So, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the sting occurred). The pain is of different degrees - from aching to sharp, to shooting. Most often, the pain syndrome occurs when moving or pressing the affected area. This fact is the main difference between intercostal neuralgia and heart and lung diseases, which can also manifest as pain under the left (or right) shoulder blade from the back.
• Diseases of the gastrointestinal tract. They more often cause pain on the right side, in some cases they can also spread to the left side of the body. Most of the pain is localized in the lumbar and sacro-lumbar regions. Sufficiently strong pain is caused by diseases of the pancreas, colon diverticulum, intestinal obstruction, retrocecal appendicitis, etc. is typical of pathologies associated with its manifestations.
• Ulcerative foci. Ulcerative lesions of the organs of the upper abdominal cavity (peptic ulcer of the duodenum and stomach) can appear in the form of pain in the chest and lower lumbar back. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is localized in the lumbar region. The severity of the pain can vary, but the peak is often reached at night.
• Appendicitis. In acute appendicitis, in cases where the cecum (cecum) is located behind the cecum, the back hurts in the lumbar region. Pains are variable in nature and can range from aching, mild, to sharp, intense.
• Kidney diseases. Quite often, they manifest themselves as pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies directly related to the spinal column is based on the analysis of other clinical manifestations and research results.
• Urolithiasis disease. With renal colic, the back hurts in the lumbar region. The pain is pronounced, intense, occurs suddenly and does not depend on the position of the body. Back pain in the lower back and staghorn nephrolithiasis. The manifestations of the pain syndrome are of low intensity, the pain is more aching.
• Diseases of the female reproductive system and menstrual pain. In these cases, the pain is more often localized in the lower back.
• Neoplasms in the pulmonary system. In this case, the pain appears at the stage when peripheral tumor elements in the lungs (metastases) germinate into the pleural region and the chest wall. The nature of the pain is intense, debilitating.
• Cardiovascular diseases. The most common causes of localized pain in the back of the chest are heart attacks and strokes. Usually, these diseases are accompanied by pain between the shoulder blades.
• Inflammatory processes in the joints. Infectious arthritis can cause pain from the affected joint to nearby areas, including back pain.

The causes of back pain are mostly the same for both sexes, but several diseases that differ in sexual orientation should be highlighted.

back pain in men

Although the causes of back pain are mostly the same for both sexes, there are many diseases to which men are more susceptible due to their lifestyle.

These predisposing factors are:

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

As a result, musculoskeletal and cardiovascular diseases may occur more frequently 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. At the beginning of the disease, the pain syndrome is localized in the groin, scrotum and lower abdomen, but in the second stage and in cases where the disease has become chronic, the pain spreads to the back.

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

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

The diagnosis and treatment in this case is carried out by a urologist.

back pain in women

In some cases, back pain in women can be of a specific nature, which is related to the characteristics of the body and the processes taking place in it. First of all, we are talking about the reproductive sphere.

Pain associated with gynecological diseases is usually localized in the thoracic and lumbosacral regions. The most common reasons are:

1. Menstrual cycle. During menstruation, a woman's hormonal background changes, which leads to the appearance of many negative manifestations. The reason for this is primarily the decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold results in the fact that even minor pain sensations become more pronounced. In addition, hormonal changes lead to 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 of the lumbar spine. The combination of these factors causes back pain.
2. Pregnancy. In this case, lower back pain can be divided into two groups: First trimester pain. If the 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. Most often, such pains are associated with physiological changes, namely: the active growth of the fetus, which causes a change in the center of gravity in the position of the body, and the preparation of the pelvis for the upcoming labor activity.
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 genital organs. The most common causes of this manifestation of pain syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
4. Age of change. Strong changes and hormonal fluctuations occur during menopause. This restructuring of the body leaves its mark on many systems of the female body. First of all, the skeletal system suffers, which becomes more fragile due to hormonal changes and more prone to various diseases.
5. Big chest. The large size of the breast and ill-fitting underwear put an additional load on the spine, as a result of which the woman has back pain in the shoulder blades and lower back.
6. High heels. Wearing high-heeled shoes leads to the development of many diseases that are associated with pathological changes in the musculoskeletal system and back pain.

back pain with coronavirus

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

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

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

Back pain after sleep

Back pain after sleep can be caused by:

• work related to physical activity and weight lifting;
• low back muscle tone;
• intervertebral hernia and osteochondrosis in history;
• prolonged hypothermia of the back;
• curvature of the spine, which led to muscle tension and uneven contraction;
• excessive body weight, which results in an increase in the load on the back;
• stressful situations;
• uncomfortable bed.

Discomfort can vary in intensity and appear under the ribs, in the lower back, between and under the shoulder blades.

In order to eliminate the pain that occurs after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.

Back pain - which doctor should I see?

The primary diagnosis of back pain is made by a general practitioner. If necessary, a number of additional tests and consultations of highly qualified specialists may be prescribed:

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

In order to establish an accurate diagnosis, a detailed analysis of the patient's condition must be carried out. For this purpose, the doctor may prescribe a number of additional tests:

• Laboratory tests. Most often, this list includes general and biochemical blood tests, urinalysis, feces and in some cases analysis of hormone levels. These tests help to identify possible inflammatory processes and infections. If you suspect certain diseases or oncological components, the doctor may prescribe a number of special tests (biopsy, tumor markers, etc. ).
• Hardware research. They help to get a more visual picture of the course of the disease, which cannot be achieved by visual examination and palpation. The most commonly prescribed radiography, MRI, ultrasound.

Treatment of back pain

In order to receive qualified treatment, an internal specialist consultation is required. The therapy is selected strictly based on the diagnosis and taking into account the general condition of the patient. Self-treatment of back pain can lead to the progression of the disease or transition to a chronic stage.

Prevention of back pain

The main preventive measures depend primarily on what exactly triggered the appearance of back pain. General recommendations include:

• healthy lifestyle;
• complete and healthy diet;
• reasonable dosage of physical activity;
• timely treatment of identified diseases;
• carrying out regular preventive examinations, including narrow-profile specialists.