Back pain

23 December 2023

Every tenth person in the world experiences back pain. This condition leads to reduced working capacity and greatly limits the usual way of life. In some cases, back pain can be a symptom of a serious illness, the treatment of which is most 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 make an objective diagnosis and create a targeted treatment 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. Specialist appointments are organized at a time convenient for the patient.

About the disease

Pain in the back, especially in the lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists and orthopedists. Loss of work due to the pathology of the musculoskeletal system occupies one of the leading places, because as a rule, the most active group of the population is affected between the ages of 20 and 60, and most often - 25-45 years.

The spinal column carries 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. Therefore, changes in the spine, which lead to compression or irritation of the spinal elements, can manifest as a 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 – torments a person for more than 3 months.

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

Doctors talk about specific back pain if one or more pathological processes are detected during a detailed diagnostic examination. In this case, the mechanisms that lead to the development of pain syndrome can be:

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

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

discogenic – the cause lies in the damage of the intervertebral disc;
radicular – caused by compression of the nerve roots exiting the spinal cord through the intervertebral openings;
myofascial – pain is caused by damage to the muscles surrounding the spine and/or the connective tissue membrane that covers them;
joint – the pain is caused by facet-joint osteoarthritis.

Spontaneous back pain, which occurs for no apparent reason, is a special category.

Back pain symptoms

The disease can begin with acute pain in any part of the back, which is aggravated by active movements and bending. But more often everything starts with a "tolerable" feeling of discomfort in the interscapular, lumbar and shoulder girdle. The discomfort intensifies in the evening, with weakness of the paravertebral muscles, or in the morning, as a result of 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, etc. ;
pelvic organ dysfunction: incontinence of urine, gas or feces, intimate disorders in men, etc.

The 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:

disc herniation, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative damage of intervertebral joints (spondyloarthrosis), increased mobility of spinal segments (spinal instability) and slipping of vertebrae (degenerative spondylolisthesis);
traumatic uncomplicated injuries of the spinal column;
pathological vertebral fractures that occur against the background of osteoporosis (a minor external impact is enough to damage 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.

Diagnosis of back pain

In order to identify possible causes of pain, doctors at the medical center conduct a comprehensive examination of the patient. The diagnostic program is compiled individually for each patient.

In addition to an objective neurological examination, the following diagnostic procedures may be prescribed:

Computed tomography of the spine. In the clinic, the examination is performed using a high-precision device that makes 128 sections of the anatomical area. This allows the detection of various abnormalities in the structure of the spine, incl. in the initial stage of development. CT is informative in the identification of developmental anomalies and degenerative-dystrophic lesions in the vertebrae, foci of inflammation, bone tumors, fractures and dislocations of the vertebrae, narrowing of the spinal canal, bleeding in the spinal cord, which are associated with arteriovenous rupture. malformation.
Computer densitometry of the spine. The study allows you to objectively measure 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 get very precise and detailed images. Magnetic resonance 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, joint arthrosis), injuries and deformations of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of different densities, etc.
X-ray of the spine. The robotic 3D X-ray complex allows you to examine different parts of the spine in one procedure, while the computer software performs digital "stitching" of the images. This greatly increases the diagnostic value of the method. The clinic is equipped with computer scanners and magnetic resonance scanners with wide functionality, which allow patients to be examined evenand with a large weight (up to 200 kg).

The diagnostic program for patients with back pain also includes laboratory tests. They provide you with a comprehensive approach to assessing the clinical situation and choosing the most optimal solution to the problem.

Expert opinion

Back pain is common in people over 60, and many attribute it to "old age", deliberately depriving themselves of the joy of active movement. Meanwhile, the problem can appear at any age. Late diagnosis, as well as improper treatment, often delay the disease for several months, which is why patients are referred to the disability group, and premature surgical treatment often permanently disables patients. The number of people with disabilities due to the so-called osteochondrosis of the spine has reached alarming proportions.

Which doctor should I see for back pain?

General practitioners deal with general back pain problems. If highly specialized treatment is required, 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 can be used to relieve pain. As part of the comprehensive treatment, physical exercises, massages, physiotherapy, reflexology, etc. are useful.

The cost of conservative treatment is determined by the cause of the pain syndrome. Thus, anti-inflammatory drugs are used for osteoarthritis, drugs that block the activity of cells that destroy bone tissue are used for osteoporosis, etc. Some pathologies initially require surgical intervention, because. . . conservative measures a priori turn out to be ineffective.

Operation

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

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

The main types of surgical care are as follows:

Nucleoplasty. In case of protrusion or intervertebral hernia, a puncture is performed in the projection of the affected disc. With the help of an electrode (cold plasma or radiofrequency method), the deformed part of the nucleus is "vaporized", which reduces 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 a rather large intervertebral hernia. After removing the prolapsed part of the nucleus pulposus, the pain syndrome is eliminated.
Radiofrequency denervation of facet joints. Surgery is indicated for myofascial origin of back pain 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 one-day operation with a short rehabilitation period (1-2 days).
Stabilization of the spine. A stabilizing structure is placed on the problem area, which firmly fixes the position of the vertebrae. Screw transpedicular fixation systems, interbody cages, systems with laminar hooks and ventral plates can be used as stabilizers.
Decompression of the spinal canal. The surgeon removes compressive fragments and structures. If there is increased mobility of certain segments of the spine, additional stabilization surgery can 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 encountered 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 putting a load on the spine;
treat and correct posture disorders, bone and joint diseases in a timely manner;
undergo regular check-ups and follow all doctor's recommendations.

Rehabilitation

The duration and characteristics of the rehabilitation period depend on the type of surgical intervention. After minimally invasive operations, the patient is recommended to walk on the first day, and after more extensive operations, the patient becomes more active within a few days. Limitation of physical activity can also be from 1-2 days to 1. 5 months. Your doctor will inform you about the specifics of the rehabilitation period.

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

Questions and answers

Why does my back hurt?

The causes of pain can be different. In some cases, nerve roots are compressed, in others, muscles and fascia are damaged, and in others, intervertebral joints suffer. Sometimes the cause of pain is related 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 painful area.

Will the surgery help me get back to my normal lifestyle?

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