Lumbago

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.

Non-specific (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 body posture, which leads to gradual curvature of the spine, displacement of the vertebrae and muscle strain.
• Osteochondrosis. The reason for the development of the disease is a decrease in the damping 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 located in the area of that part of the spine, in which there are pathological changes. Thus, 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 impingement (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, leading to a forced "forward bend" position for 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 back muscles.
• 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 location 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 related to 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 ache throughout the spine. The important point is that the maximum pain occurs when you press on certain points.
• Polymyositis. Hypothermia can cause the disease. As a result of the development of the disease, the patient feels muscle weakness and pain, which increases when he tries to make a turn.
• Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that reduce immunity can serve as a trigger. It is manifested by pains that increase with the development of the disease, capable of covering all parts of the back. Severe back pain reduces mobility to such an extent that the patient cannot move independently. A clear asymmetry can be seen on the back.
• Charcot disease. The symptoms are caused by inflammation in the peripheral nerves along the spine. As a result of the pathological process, in addition to quite intense pain, there is also a change in the person's gait.

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

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

Diseases that cause specific pain include:

• Pinched nerve roots in the chest. Most often this leads to the development of intercostal neuralgia. The pain in this case is localized at the site of the bite. Thus, 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 has a different degree - from pain to sharp, shooting. Most often, the pain syndrome occurs when moving or pressing 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 cause pain on the right side, in some cases it can also pass to the left side of the body. Most of the pain is located in the lumbar and sacro-lumbar region. Sufficiently intense pain sensations are characteristic of pathologies associated with manifestations of diseases of the pancreas, diverticular colon, intestinal obstruction, retrocecal appendicitis, etc.
• Ulcerative foci. Ulcerative lesions of the organs of the upper abdominal cavity (peptic ulcer of the duodenum and stomach) may manifest in the form of pain in the thoracic and lower 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 comes at night.
• Appendicitis. In acute appendicitis, in cases where the appendicitis (appendicitis) is behind the cecum, the back hurts in the lumbar region. The pains are of varied nature and can vary from aching, mild to sharp, severe.
• Kidney diseases. Quite often they manifest themselves with pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies directly related to the spine is based on analysis of other clinical manifestations and research results.
• Urolithiasis. With renal colic, the back hurts in the lumbar region. The pain is sharp, intense, appears suddenly and does not depend on the position of the body. Back pain in the lower back and with dropsy nephrolithiasis. The manifestations of the pain syndrome are of low intensity, the pain is rather painful.
• Diseases of the female reproductive system and period pain. In these cases, the pain is most often located in the lower back.
• Neoplasms in the pulmonary system. In this case, the pain occurs at the stage when the lungs undergo sprouting of peripheral tumor elements (metastases) in the region of the pleura and the chest wall. The nature of the pain is intense, debilitating.
• Cardiovascular diseases. The most common causes of pain located in the thoracic back 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 that radiates from the affected joint to nearby areas, including back pain.

For the most part, the causes of the manifestation of back pain are identical for both sexes, but it is necessary to point out some diseases that differ in terms of sexual predisposition.

back pain in men

Although the causes of back pain are mostly the same for both sexes, there are a number of diseases that men are more prone to because of their lifestyle.

These predisposing factors include:

• work that involves lifting and carrying heavy loads.
• strength sports (including various martial arts, powerlifting, etc. )
• Bad Habits.

As a result, diseases of the musculoskeletal and cardiovascular systems in men may occur more often than in women.

Specific "male" conditions 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 located 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.

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

The intensity of the pain is directly related to the stage of the disease. Thus, in the acute phase the pain is characterized as acute and short-term. In the chronic form, the pain syndrome is not very intense and is often permanent.

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 related to the characteristics of the body and the processes taking place in it. First of all, we are talking about the reproductive sphere.

As a rule, pain associated with gynecological diseases is located in the thoracic and lumbosacral regions. The most common reasons include:

1. Menstrual cycle. During the period of menstruation, the hormonal background of a woman changes, which leads to the appearance of certain 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 intense. Also, hormonal changes lead to irritation of the intestinal walls and fluid retention, which causes an increase in the volume of certain organs and, as a result, compression of the nerve endings of the lumbar spine. The combination of these factors causes back pain to occur.
2. Pregnancy. Lower back pain in this case 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 reproductive organs. The most common causes of this manifestation of the pain syndrome are ovarian cysts, adexitis, ectopic pregnancy, endometriosis, etc.
4. Menopause. During menopause, strong changes and fluctuations occur in hormone levels. Such a 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 breast. The large size of the bust, in combination with poorly supported underwear, 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 shoes with high heels leads to the development of a number of diseases 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 to suffer. Therefore, often 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 blade.

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 in the context of a general decrease in immunity, chronic diseases, including internal organs and the musculoskeletal system, worsen.

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 the 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 be of different intensity and appear under the ribs, in the lower back, between the shoulder blades and below them.

To eliminate the pain that occurs after sleep, it is necessary to exclude all the causative 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 consultation with highly qualified specialists may be prescribed:

• neurologist;
• Gastroenterologist;
• gynecologist;
• urologist;
• pulmonologist.

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

• Laboratory Tests. Most often, this list includes general and biochemical blood tests, urinalysis, stool and, in some cases, 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. ).
• Material 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 X-ray, MRI, ultrasound.

Back pain treatment

For the purposes of specialized treatment, internal specialist consultation is required. The treatment 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 the transition to a chronic stage.

Prevention of back pain

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

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