back pain

One in ten people in the world will experience back pain. This condition results in a reduced ability to work and greatly limits normal lifestyle. In some cases, back pain can be a symptom of a serious illness, and early diagnosis and treatment are most effective. Therefore, if you experience symptoms of discomfort in your back, especially the lower part, it is recommended to see a doctor. Experts will make an objective diagnosis and develop a targeted treatment and recovery plan.The modern clinic employs highly qualified doctors and provides care in accordance with international standards. You can make an appointment by phone or online. Receptions with specialists are arranged at a time convenient for the patient.

About disease

Back pain, especially in the lower third, is one of the most common reasons patients turn to neurologists, surgeons, therapists and orthopedic surgeons. One of the dominant causes of labor losses due to pathologies of the musculoskeletal system is that, as a rule, the most active groups of the population are affected, those between 20 and 60 years of age, most often 25-45 years.The spine is subject to huge mechanical loads, but at the same time it is a complex anatomical structure in which the circulatory structures, support structures and spinal structures that govern the entire human body are closely intertwined. That is why spinal changes that lead to compression or irritation of spinal elements can manifest as pathologies of any internal organ (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. Back pain varies in duration, so there are 3 types:

• Acute - lasts up to 6 weeks;
• Subacute – lasting more than 6 weeks;
• Chronic - bothering a person for more than 3 months.

When considering the cause of back pain, it can be specific or non-specific. The most common pain seen in clinical practice is nonspecific pain, which can occur at any age. This condition is characterized by the lack of a clear cause-and-effect relationship between existing symptoms and objective examination data (physical and instrumental). Prompt treatment can interrupt painful impulses.Doctors talk about specific back pain if one or more pathological processes are discovered during a thorough diagnostic search. In this case, the mechanisms leading to the development of the pain syndrome may be:

• Compression of neural structures;
• Inflammatory damage to the spinal joints;
• Instability of different segments of the spine (the lumbar region is most susceptible);
• Muscle and fascial injuries.

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

• Discogenic – Caused by damage to the intervertebral disc;
• Radicular – caused by compression of the nerve roots of the spinal cord that pass through the intervertebral foramen;
• Myofascial – Pain that occurs due to damage to the muscles surrounding the spine and/or the connective tissue membrane that covers them;
• Joints – Pain caused by osteoarthritis of the facet joints.

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

Back pain symptoms

The disease may begin with severe pain in any part of the back and worsen with active movement and bending. But more often than not, it all starts with "tolerable" discomfort in the interscapular, lumbar and shoulder girdle areas. Discomfort increases in the morning, due to weakness of the paravertebral muscles at night, or due to poor sleeping conditions.Depending on the mechanism of pain, other symptoms may occur:

• numbness in the arms or legs;
• decreased muscle tone;
• Pathological sensitivity: crawling sensation, burning sensation, etc. ;
• Pelvic organ dysfunction: urinary incontinence, gas incontinence, fecal incontinence, male intimate diseases, etc.

The most common causes of back pain

Based on observational and retrospective studies, the most common causes of back pain in patients presenting to medical centers are:

• Herniated discs, spinal stenosis (narrowing), various forms of osteochondrosis - degenerative damage to the intervertebral joints (spondyloarthropathy), increased mobility of spinal segments (spinal instability) and sliding of the vertebrae (degenerative spondylolisthesis));
• Simple spinal trauma;
• Pathological fractures of the vertebrae occurring in the context of osteoporosis (a slight external impact is enough to destroy the integrity of the bone);
• Invasive hemangioma - a tumor that originates from blood vessels and can compress nearby tissue;
• Primary and metastatic tumors affecting the spine.

Diagnosis of back pain

To determine the possible cause of the pain, doctors at the medical center conduct a thorough examination of the patient. Diagnostic procedures are written 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 high-precision equipment that takes 128 slices of the anatomical area. This makes it possible to detect various abnormalities of spinal structure, including. In the early stages of development. CT provides a wealth of information that can identify vertebral dysplasia and degenerative dystrophic lesions associated with arteriovenous rupture, inflammatory foci, bone tumors, vertebral fractures and displacements, spinal stenosis, and hemorrhagic spinal cord malformations.
• Computed Densitometry of the Spine. This study allows you to objectively measure bone mineral density, which is important for early diagnosis of potential osteoporosis. The sooner the condition is detected, the sooner doctors can prescribe bone-strengthening treatments.
• Magnetic resonance imaging of the spine. Most specialized centers have modern tomography scanners that generate a magnetic field of 1. 5 Tesla, allowing you to obtain highly accurate and detailed images. Magnetic resonance imaging can detect not only bone lesions but also soft tissue lesions. This method is informative for the detection of various forms of osteochondrosis (intervertebral hernias and herniations, arthropathy), spinal injuries and deformities, vascular abnormalities, inflammatory diseases of the spinal cord, tumors of varying density, etc.
• X-ray of the spine. A robotic 3D X-ray machine allows you to examine various parts of the spine in one surgery, while computer software digitally "stitches" the images together. This greatly increases the diagnostic value of this method. The clinic is equipped with extensive computer and magnetic resonance imaging scanners, allowing examinations even on heavier patients (up to 200 kg).

The diagnostic plan for patients with back pain also includes laboratory tests. They enable you to take a comprehensive approach to assessing clinical situations and selecting the best solution to the problem.

Expert Opinion

Back pain is common among people over 60 years old, and many people attribute it to "age" and deliberately deprive themselves of the pleasure of active exercise. Also, this problem can arise at any age. Late diagnosis and inappropriate treatment often prolong the disease for months, forcing patients to be referred to disability groups, while premature surgical treatment often leaves patients permanently disabled. The number of people disabled by so-called osteochondrosis of the spine has reached alarming proportions.

Which doctor should I contact for back pain treatment?

General practitioners deal with general back pain problems. Patients are referred to a neurologist if highly specialized treatment is required and to a neurosurgeon if surgical treatment is indicated.

Treat back pain

Conservative treatment

Nonsteroidal anti-inflammatory drugs, corticosteroid therapy, and local anesthetic blocks may be used to relieve pain. As part of a comprehensive treatment, physical exercise, massage, physiotherapy, reflexology, etc. are all useful.The nature of subsequent conservative treatment depends on the cause of the pain syndrome. Therefore, for osteoarthritis, anti-inflammatory drugs are used; for osteoporosis, drugs that block the activity of cells that destroy bone tissue are used, etc. Some conditions initially require surgical intervention because. . . a priori conservative measures have proven ineffective.

Surgery

Clinically, different methods can be used for surgical treatment of patients with back pain. In some cases, minimally invasive intervention is required, while in other cases, traditional surgery is required.Depending on the cause of your back pain, doctors will use different surgical options.The main types of surgical treatment are as follows:

• Nucleoplasty. If a herniation or hernia is present, a puncture is performed at the affected disc herniation. Using electrodes (cold plasma or radiofrequency methods), the deformed portion of the cell nucleus is "vaporized", thereby reducing pressure on the nerve roots. As a result, the pain disappeared. Recovery time is short—about two weeks.
• Microdiscectomy. This microsurgery is performed on sizable intervertebral hernias. After the prolapsed part of the nucleus pulposus is removed, the pain syndrome can be eliminated.
• Facet joint radiofrequency denervation. This procedure is indicated for back pain of myofascial origin and severe spondyloarthropathies. Under the influence of high-frequency current, the nerve endings undergo thermal coagulation, causing stimulation and pain. This is a minimally invasive one-day procedure with a short recovery period (1-2 days).
• The spine is stable. Install a stabilizing structure over the problem area to firmly hold the vertebrae in place. Screw transpedicular fixation systems, interbody cages, systems with laminar hooks, and webs can be used as stabilizers.
• Spinal canal decompression. The surgeon removes compressed fragments and structures. If there is increased mobility in various segments of the spine, additional stabilization surgery may be performed.
• Vertebroplasty. Sterile medical bone cement is injected into the diseased vertebrae through a special needle. As a result, the spine regains stability and function.

Prevent back pain

Preventative measures are important for those who have never experienced pain as well as for those who have already experienced unpleasant symptoms. Neurologists and orthopedists recommend:

• Perform regular exercises designed to strengthen your back muscles;
• avoid physical inactivity;
• Weight control;
• Avoid lifting weights or lifting weights correctly to avoid stress on the spine;
• Timely treatment and correction of postural abnormalities and bone and joint diseases;
• Get regular checkups and follow all your doctor's recommendations.

recovery

The duration and characteristics of the recovery period depend on the type of surgical intervention. After minimally invasive surgery, patients are advised to start walking within the first day; after more extensive surgery, patients become more active within a few days. Restrictions on physical activity can also vary from 1-2 days to 1. 5 months. Your primary care physician will inform you of the specifics of your recovery period.It is important that after acute pain relief and tissue recovery, proper attention is paid to strengthening the muscle bundles in the back. This will stabilize the spine and reduce pressure on the vertebrae. Taking into account the initial state of the musculoskeletal system, a set of physical exercises should be prescribed by a specialist.

Questions and Answers

Why does my back hurt?

The causes of pain can vary. In some cases, nerve roots are compressed, in others, muscles and fascia are damaged, and in other cases, intervertebral joints are damaged. Sometimes the cause of pain is related to functional status.

What to do when your back hurts?

First, see a doctor. As a first aid, you can apply a nonsteroidal anti-inflammatory drug-based cream or gel to the painful area.

Will surgery help me return to a normal lifestyle?

Before surgery, patients are examined in detail to select the best surgical technique that will help break the "vicious cycle. "In most cases, surgical treatment can reliably relieve pain and restore spinal mobility.

Which doctor should I contact for back pain treatment?

General practitioners deal with general back pain problems. Patients are referred to a neurologist if highly specialized treatment is required and to a neurosurgeon if surgical treatment is indicated.