Back pain

23 December 2023

One in ten people in the world suffers from back pain. This condition leads to a reduced ability to work and severely restricts 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 if diagnosed early. If you experience unpleasant symptoms in the back area, especially in the lower parts, it is advisable to consult a doctor. The specialist makes an objective diagnosis and creates a targeted treatment and rehabilitation plan.

The modern clinic employs highly qualified doctors. The care is provided according to international standards. You can make an appointment by phone or online. Reception of specialists is organized at a time 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. Loss of work due to pathologies of the musculoskeletal system occupies one of the leading places, since it usually affects the most active population group aged 20 to 60 and most often aged 25 to 45.

The spine carries an enormous mechanical load, but at the same time it is a complex anatomical structure in which circulatory, support and spinal structures that supply the entire human body are closely intertwined. For this reason, changes in the spine, leading to compression or irritation of the spinal elements, can manifest themselves as pathology of all internal organs (headaches, vascular dystonia, hypertension, cardiac arrhythmias, 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, they can be specific or non-specific. The most common pain encountered in clinical practice is nonspecific pain that can occur at any age. This condition is characterized by the lack of a clear cause-and-effect relationship between the existing symptoms and objective examination data (physical and instrumental). Timely treatment can interrupt the pain impulse.

Doctors speak of specific back pain when one or more pathological processes have been discovered during a thorough diagnosis. In this case, the mechanisms leading to the development of pain syndrome may be:

compression of nerve structures;
inflammatory damage to the joints of the spine;
Instability of various spinal segments (the lumbar spine suffers most often);
Damage to muscles and fascia.

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

discogenic – the cause is damage to the intervertebral disc;
radicular – caused by compression of the nerve roots exiting 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;
Articular – Pain is caused by facet-articular osteoarthritis.

Spontaneous back pain that occurs for no apparent reason forms a separate category.

Symptoms of back pain

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

Depending on the mechanism by which the pain occurs, it may be accompanied by other symptoms:

numbness in an arm or leg;
decreased muscle tone;
pathological sensitivity: feeling of crawling, burning, etc. ;
Dysfunction of the pelvic organs: incontinence of urine, flatulence 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 diseases:

Herniated disc, stenosis (narrowing) of the spinal canal, various forms of osteochondrosis - degenerative damage to the intervertebral joints (spondyloarthrosis), increased mobility of spinal segments (spinal instability) and slipping of the vertebrae (degenerative spondylolisthesis);
traumatic uncomplicated spinal injuries;
pathological vertebral fractures that occur against the background of osteoporosis (a small external influence is enough to disrupt the integrity of the bone);
aggressive hemangioma – a tumor that arises from blood vessels and can compress adjacent tissue;
primary and metastatic tumors of the spine.

Diagnosis of back pain

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 carried out using a high-precision device that makes 128 cuts of the anatomical area. This makes it possible to detect various anomalies in the structure of the spine, including at the initial stage of development. CT is informative in identifying developmental anomalies and degenerative-dystrophic lesions of 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 accompanied by rupture of the arteriovenous vessels and malformation.
Computer densitometry of the spine. The study allows you to objectively measure bone mineral density, which is important for the early detection 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 creates a magnetic field of 1. 5 Tesla, which allows you to get highly precise detailed images. Magnetic resonance imaging 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), injuries and deformations of the spine, vascular anomalies, inflammatory diseases of the spinal cord, tumors of varying density, etc.
X-ray of the spine. A robot-assisted 3D X-ray complex allows you to examine different parts of the spine in one operation, while computer software digitally "stitches" the images together. This significantly increases the diagnostic value of the method. The clinic is equipped with computer and magnetic resonance imaging scanners with comprehensive functionality, which enable the examination of patients even with great weight (up to 200 kg).

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

Expert opinion

Back pain is widespread in people over 60 years of age and many people attribute it to "old age" by consciously depriving themselves of the joy of active exercise. The problem can now occur at any age. Late diagnosis and improper treatment prolong the conditionIllness often lasts for many months, which leads to the need to transfer patients to a disabled group, and untimely surgical treatment often leads to permanent disability of patients. The number of people with disabilities due to the so-called spinal osteochondrosis has reached alarming proportions.

Which doctor should I contact if I have back pain?

General practitioners deal with general back pain. 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 a comprehensive treatment, physical exercise, massage, physiotherapy, reflexology, etc. are useful.

The further nature of conservative treatment depends on the cause of the pain syndrome. So, for arthrosis, anti-inflammatory drugs are used, for osteoporosis, drugs that block the activity of cells that destroy bone tissue, etc. Some pathologies initially require surgical intervention, because. . . Conservative measures prove to be ineffective a priori.

surgery

The surgical treatment of patients with back pain in the clinic can be carried out using different methods. In some cases, a minimally invasive procedure is performed, while in other cases, traditional surgery is required.

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

The main types of surgical care are the following:

Nucleoplasty. In the case of bulges or intervertebral hernias, a puncture is made in the projection of the affected intervertebral disc. Using an electrode (cold plasma or radiofrequency method), the deformed part of the nucleus is "evaporated", thereby reducing the pressure on the nerve root. This causes the pain to disappear. Rehabilitation is short - about 2 weeks.
Microdiscectomy. This microsurgical procedure is performed on larger intervertebral hernias. After removal of the prolapsed part of the nucleus pulposus, the pain syndrome is eliminated.
Radiofrequency denervation of the facet joints. The operation is indicated for myofascial back pain and severe spondyloarthrosis. Under the influence of high-frequency current, thermocoagulation of the nerve endings occurs, the irritation of which causes pain. It is a minimally invasive one-day operation with a short rehabilitation period (1-2 days).
Stabilization of the spine. A stabilizing structure is attached to the problem area, which firmly fixes the position of the vertebrae. Transpedicular screw fixation systems, interbody cages, systems with laminar hooks and ventral plates can be used as stabilizers.
Decompression of the spinal canal. The surgeon removes compressing fragments and structures. If individual spinal segments have increased mobility, additional stabilizing surgery can be performed.
Vertebroplasty. Sterile medical bone cement is injected into the diseased vertebra using a special needle. This restores stability and functionality to the spine.

Prevention of back pain

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

Regularly perform exercises to strengthen your back muscles.
avoid physical inactivity;
keep body weight under control;
Avoid lifting weights or do them properly without putting strain on the spine.
Treat and correct postural disorders, bone and joint diseases immediately;
Get regular checkups and follow all doctor's recommendations.

rehabilitation

The duration and nature of the rehabilitation period depend on the type of surgical intervention. After minimally invasive procedures, the patient is recommended to start walking on the first day; after major procedures, 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 treating doctor will inform you about the special features of the rehabilitation phase.

After relieving acute pain and restoring tissues, it is important to pay due attention to strengthening the muscular corset of the back. This stabilizes the spine and reduces the strain 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 varied. In some cases there is compression of the nerve roots, in other cases muscles and fascia are damaged, in other cases the intervertebral joints suffer. Sometimes the cause of pain is related to functional disorders.

What to do if your back hurts?

First, go to the doctor. As a 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 the operation, 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.