Backache

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

Nonspecific (primary). This type of pain is directly related to problems in the spine and surrounding tissues.

Causes of back pain related to the spine:

• Scoliosis. Violation of posture, leading to a gradual curvature of the spine, displacement of vertebrae and muscle strain.
• Osteochondrosis. The reason for the development of the disease is the decrease in the cushioning 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. Pain sensations are localized in the region of that part of the spine, in which there are pathological changes. So, with osteochondrosis of the thoracic spine, back pain is localized in the thoracic 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 damage to the intervertebral disc, the soft structures of the vertebrae protrude with the possibility of damage (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 bending" position 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 muscles of the back.
• Spinal cord injury. In this case, the cause of back pain is an 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 associated with damage to the roots of the spinal cord (radicular pain).

Back pain associated with 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 back muscles hurt along the entire spine. The important point is that the maximum 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 weakness and muscle pain, which increases when he tries to make a turn.
• Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that lower immunity can serve as a trigger. It appears with pain that increases with the development of the disease, able to cover all parts of the back. Severe back pain impairs mobility to the extent that the patient is unable to move independently. A clear asymmetry is visualized in the back.
• Charcot's disease. Symptoms are caused by inflammation in the peripheral nerves along the spine. As a result of the pathological process, in addition to severe pain, a change in the person's gait is observed.

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

Specific (secondary pain). This type of pain, regardless of 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. So, pain that radiates to the back can be caused by a malignant neoplasm in the area of the mammary glands, lungs or prostate, which provokes metastases in the spine.

Diseases that cause specific pain include:

• Pressed nerve roots in the chest. Most often this leads to the development of intercostal neuralgia. The pain in this case is localized at the pinching site. So, intercostal neuralgia can appear: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinching occurred). Pain has a different degree - from pain to sharp, shooting. Most often, the pain syndrome occurs when you move or press on the affected area. This fact is the main difference between intercostal neuralgia and diseases of the heart and lungs, which can also be manifested by pain under the left (or right) shoulder blade from the back.
• Diseases of the gastrointestinal tract. Most often they provoke pain on the right side, in some cases it can also pass to the left side of the body. Most of the pain is localized in the lumbar and sacro-lumbar regions. Quite strong pain sensations are characteristic of pathologies related to the manifestations of diseases of the pancreas, diverticulitis of the large intestine, intestinal obstruction, retrocecal appendix, etc.
• 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 part of the lumbar spine. 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 be different, but the peak often reaches at night.
• Appendicitis. In acute appendicitis, in cases where the appendix (appendix) is located behind the intestine, the back hurts in the middle part. Pains are variable in nature and can vary from mild to sharp, intense pain.
• Kidney diseases. Very often they are manifested by pain in the middle region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies that have a direct connection with the spine occurs on the basis of an 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, appears suddenly and does not depend on the position of the body. Back pain in the lower back and staghorn nephrolithiasis. Manifestations of the 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 located in the lower back.
• Neoplasms in the pulmonary system. In this case, the pain appears at the stage when the lungs undergo the germination of peripheral tumoral elements (metastases) in the pleural region and the chest wall. The nature of the pain is intense, debilitating.
• Cardiovascular diseases. The most common causes of localized chest pain 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.

For the most part, the causes of back pain are identical for both sexes, but it is necessary to highlight a number of diseases that differ in sexual predisposition.

back pain in men

Although the causes of back pain are largely the same for both sexes, there are a number of ailments that men are more susceptible to due to their lifestyle.

These predisposing factors include:

• work that involves lifting and carrying heavy loads;
• power sports (including various martial arts, powerlifting, etc. );
• bad habits.

As a result, diseases of the musculoskeletal and cardiovascular system in men may appear more often 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, scrotum and bottom of the abdomen, but in the second stage and in cases where the disease has become chronic, the pain spreads to the back.

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

The intensity of the pain is directly related to 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 permanent.

Diagnosis and treatment in this case is done by a urologist.

back pain in women

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

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, a woman's hormonal background changes, which leads to the appearance of a number of negative manifestations. This is mainly due to the decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold leads to the fact that even small pain sensations become more pronounced. Also, hormonal changes lead to irritation of the intestinal walls and fluid retention, which provokes 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 provokes the appearance of back pain.
2. Pregnancy. Back pain in this case 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 abortion. Pain in the second half of pregnancy. Most often, such pains are associated with physiological changes, namely: the active growth of the fetus, which provokes 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 reproductive organs. The most frequent causes of this pain syndrome manifestation are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
4. Menopause. During menopause, strong changes and fluctuations in hormonal levels occur. Such restructuring of the body leaves an imprint on many systems of the female body. First of all, the skeletal system suffers, which, under the influence of hormonal changes, becomes more fragile and prone to various types of diseases.
5. Big chest. The large size of the bust, combined with underwear with poor support, creates an additional load on the spine and, as a result, the woman has back pain in the area of the shoulder blades and in the lower back.
6. High heel. Wearing high-heeled shoes leads to the development of a number of diseases related to 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 to suffer. Therefore, often the pain between the shoulder blades or under them is a manifestation of inflammation that has developed in the lung tissue. Depending on which lung is most affected, the patient will feel pain under the left or right shoulder.

In addition to damage to the lung tissue, there is a general intoxication of the body and an increase in temperature, which can also 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 against the background of a general decrease in immunity, chronic diseases, including internal organs and the musculoskeletal system, are aggravated.

Back pain after sleep

The reasons why your back hurts after sleeping can be:

• 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 strain and uneven contraction;
• excess body weight, resulting in an increase in the load on the back;
• stressful situations;
• uncomfortable bed.

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

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 contact?

The main diagnosis of pain in the back area is carried out by a general practitioner. If necessary, a series of additional examinations and consultations with highly specialized specialists may be prescribed:

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

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

• Laboratory tests. Most often, this list includes general and biochemical blood tests, urine analysis, feces and, in some cases, an analysis of hormone levels. These studies help identify possible inflammatory processes and infections. If you suspect some diseases or an oncological component, the doctor can prescribe a series of specific studies (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 prescribed X-ray, MRI, ultrasound.

Back pain treatment

For the purposes of qualified treatment, internal specialist consultation is necessary. Therapy is chosen 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 to the transition to a chronic phase.

Back pain prevention

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

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