spinal pain

Spinal pain (back pain) is a common body language sign of physical illness. There are almost as many reasons as there are terms to describe the symptoms.Spinal discomfort is the leading reason people seek medical help. Almost 80% of adults face this problem. Back pain can cause significant disability and can be a problem that continues from childhood into adulthood.Back pain affects nearly every aspect of life. Sleep is disrupted and it becomes difficult to bend, reach, or turn. Difficulty driving a car, walking, lifting weights, and performing physical activity. If you have pain in your spine, seek medical attention immediately. The specialist will study the medical history, collect medical history and perform an examination. If any irregularities are found, conservative or surgical treatment is performed.

Why does my spine hurt?

Back pain is caused by muscle tension and spasms. Strain can be caused by hard physical work, awkward postures, or even poor posture.Studying the anatomy of the spine can help provide a deeper understanding of this issue. Main parts of the spine:

• The cervical spine is a mobile part prone to degenerative changes. As we age, pain often occurs in the so-called "transition zone" between the flexible cervical spine and the stiffer thoracic spine.
• Thoracic cage - connects the chest and connects the ribs. In particular, older adults may develop compression fractures in this area due to bone loss.
• Lumbar spine – lower back. Younger patients are more likely to experience discogenic low back pain, whereas older patients are more likely to experience joint structural disease.
• Sacrum – The lowest part of the spine. It consists of the flat, triangular sacrum that connects the hips and tailbone. Degeneration of this area often occurs in older patients or after a fall.

Between the upper back and coccyx are 17 vertebrae, many joints, the sacrum and coccyx, as well as fibrous and muscular support structures, intervertebral discs, spinal cord and nerve roots, and blood vessels. The spine is more than the sum of its parts, but here's what you need to know about them.The spine is typically made up of 33 vertebrae, each separated by intervertebral discs. Vertebrae are a series of small bones with attached muscles. Each vertebra is composed of two parts: the anterior body, which protects the spinal cord and nerve roots, and the posterior arch, which houses the spinal canal and protects the spinal cord.Back muscles are divided into three groups:

• Middle – Responsible for the movement of the ribs;
• Internal - Stabilizes the spine and controls the movement and position of the spine;
• Superficial – Provides movement of the neck and upper limbs.

The muscles that support the spine are structured in layers. They act as major stabilizers of bone and ligamentous structures. Patients of different ages may experience tightness in these muscles.Other parts of the spine should also be considered when determining back pain. These include ligaments and tendons, discs, and joints that provide stability and mobility.Inflammatory diseases, malignancy, pregnancy, trauma, osteoporosis, nerve root compression, radiculopathy, plexopathy, osteochondrosis, disc herniation, spinal stenosis, sacroiliac joint dysfunction, facet joint injuries and infectionsetc. are all part of the differential diagnosis. Differentiating the signs and symptoms of nociceptive (mechanical) pain and radiculopathy (neuropathic back pain) is an important first step in diagnosis.

degenerative disease

Degeneration includes endplate-related changes (sclerosis, defects, modal changes, and osteophytes) as well as disc changes (fibrosis, annular tears, desiccation, height loss, and myxoid annular degeneration).Degenerative changes in the intervertebral disc have been observed in one-third of healthy individuals aged 21 to 40 years. The high incidence of asymptomatic degenerative lesions should be taken into consideration when evaluating spinal symptoms.As we age, the fiber content of the intervertebral disc increases and its elasticity weakens. Degenerative changes progress when the structural integrity of the posterior annulus fibrosus is compromised by overload. This will eventually lead to the formation of cracks in the annulus fibrosus. Herniation is defined as the displacement of disc material (cartilage, nucleus pulposus, fragmented annulus, and apophyseal bone) out of the disc space.

Stachybotrys

The natural curve of the spine is important to ensure its strength, flexibility, and ability to evenly distribute load. Natural curves have a normal range. Abnormal curvatures include lordosis, kyphosis, and scoliosis.

abnormal lordosis

Lordosis is a spinal disorder defined as a severe inward curvature of the spine. Although this disease most commonly affects the lumbar spine, it can also occur in the cervical spine.The normal range of lordosis is considered to be between 40 and 60 degrees. Changes in posture can lead to an unstable gait and changes in body shape - the hips become more pronounced. Causes of Abnormal Lordosis: Spondylolisthesis, Osteoporosis, and Obesity.

abnormal kyphosis

Kyphosis is a spinal disorder defined as an excessive outward curvature of the spine that may cause a forward tilt. Most commonly, it affects the chest or thoracolumbar area, but it can also occur in the neck area. The normal range of kyphosis is considered to be between 20 and 45 degrees. However, when structural abnormalities cause the kyphosis curve to fall outside the normal range, the curvature can become abnormal and cause problems. It manifests as rounded shoulders and forward tilt of the head.

Scoliosis

Defined as abnormal lateral curvature of the spine. Scoliosis is a progressive structural disease. Lordosis and kyphosis are characterized by a backward or forward curvature of the spine. Scoliosis involves an abnormal sideways curvature of the spine.The most common form of scoliosis is adolescent scoliosis, diagnosed between the ages of 10 and 18 years. The remaining 20% are due to neuromuscular, congenital, degenerative and traumatic causes.

developmental abnormalities

The symptoms often occur in conjunction with developmental defects and may be associated with neurological manifestations.Dorsal disease is associated with the following developmental abnormalities:

• Split - with small bone loss and moderate discomfort in the lumbosacral region. After some time, radiculopathy syndrome develops.
• Lumbar and sacral changes - pressure on the roots, accompanied by stinging or burning pain. May increase symptoms of sensitivity disorder or paralysis.
• Wedge-shaped vertebrae – Discomfort caused by prolonged pressure and static positioning. Accompanied by chest deformation and poor posture.

osteoporosis

It usually affects the thoracic and thoracolumbar spine and can cause debilitating pain. This disease is caused by a decrease in bone mineral density, resulting in brittle bones.Osteoporosis can cause compression fractures of the vertebrae, loss of height, hunching or even a hunchback. To prevent osteoporosis, you must ensure a balanced diet and quit smoking and drinking. An active lifestyle is also recommended.

Injuried

The severity of back pain corresponds to the severity of the injury. Often, it is combined with signs of damage to nervous tissue.Traumatic causes of spinal pain:

• Bruises are caused by a direct blow to the back or a fall. Back pain is localized and moderate. Gradually disappears within 1-2 weeks.
• Dislocation – Occurs due to high energy impact. Severe pain associated with sensitivity and impairment of motor activity. General conditions are also affected.
• Spondylolisthesis is a traumatic injury to the lumbar spine. Dorsal lesions radiated to the legs with positive symptoms of axial load.
• Compression fracture – Occurs when the hip falls or jumps from a height. The pain is sharp at first, then becomes severe and worsens with movement.

Pathological fractures occurring in the context of osteoporosis or tumors present with mild discomfort, persistent aches and pains. They remain unchanged over a long period of time.

Inflammation and infectious diseases

Ankylosing spondylitis is associated with stiffness and dull pain in the lower back. There is a typical circadian rhythm - symptoms appear at night and worsen in the morning. Intensity decreases after physical activity and water drinking routines. Back pain increases during rest and decreases during exercise. Over time, the mobility of the spine will be restricted, resulting in thoracic kyphosis.Additionally, TB can cause spinal pain. Localized deep discomfort is characteristic of vertebral body destruction. Back pain that worsens with exercise and is accompanied by excessive skin sensitivity. Shooting and radiating pain refers to nerve root compression. This condition is also accompanied by stiffness of movement.When you have osteomyelitis, you can experience severe back pain. The disease is diagnosed in children and adolescent patients. Its characteristic is blood-borne. The discomfort increases with exercise, so the patient must rest in bed. Osteomyelitis is associated with fever, weakness, and localized swelling.Arachnoiditis presents as pain radiating to areas innervated by nerve roots. Symptoms become persistent and resemble sciatica. It is also accompanied by movement disorders, sensitivity disorders, and loss of the ability to control the pelvic organs.

tumor

Benign tumors have an insidious or slow progression and mild symptoms. The most common are hemangioma, occurring in only 10-15% of cases. Discomfort is localized pain. Progresses at night and after physical activity. Spinal cord tumors are associated with radicular pain and impaired nerve conduction.Spinal sarcoma presents with moderate intermittent pain in the primary stages of progression that worsens at night. Accompanied by limited motor activity and radicular syndrome. Discomfort is localized to internal organs, legs, or arms (at the level taking into account the location of the tumor).

other illnesses

Spinal discomfort can also be observed in the following ways:

• Spinal epidural hemorrhage - signs similar to radiculitis, with spinal cord conduction disturbances.
• Calvey's disease - Radiates to the legs, occurs periodically, symptoms are mild. It decreases when lying down and increases during physical activity.
• Forestier's disease - is limited to the chest area and spreads to the lower back or neck. Symptoms are usually short-lived. There may be pain in the elbow or shoulder joint. Spinal stiffness cannot be ruled out.

Back pain sometimes occurs with mental disorders. In this case, the clinical picture is unusual—it is not consistent with symptoms of a possible disease.

Causes of different parts of back pain

Chronic upper back pain affects 15% to 19% of the world's population. Postmenopausal women are at greater risk, possibly due to osteoporosis and vertebral compression fractures.Professional activities can also cause back pain. People who have to maintain static body positions for long periods of time, such as dentists or salespeople, are more likely to experience this problem than others. Office workers experience upper back discomfort due to poor workplace ergonomics.Back pain can occur in different parts of the spine. Locating areas indicate the cause of discomfort, greatly facilitating diagnosis.

pain on right side

The causes are excess weight, herniated disc or myositis. Discomfort can also occur on the right side of the back due to kyphosis.Physical diseases include salpingitis, ovarian inflammation, nephritis, and cholecystitis. Appendicitis and the presence of stones in the urinary system organs should also be emphasized.

pain on left side

Pain in the left side of the back due to splenitis (inflammation of the spleen), urolithiasis, oophoritis, duodenitis, root pressure. Lower back discomfort indicates lung serosal inflammation, bronchial damage, ischemia, and intercostal neuralgia.

lower back pain

The lumbar region is more prone to spinal pathological processes than other regions. This is because it carries a huge load. When nerve roots are damaged, an inflammatory process occurs. Hernias and osteochondrosis are also possible.Less common causes are a combination of prostatitis and urethritis, invasion of bone tissue structures, loss of density, lumbar sciatica, arthritis, spinal tuberculosis. In most cases, lower back discomfort is chronic.

right lower back pain

Back pain occurs when:

• Myositis;
• tuberculosis;
• Scoliosis;
• osteomyelitis;
• Spondylitis.

May indicate the presence of a tumor. Talk about radiculitis. Indicates liver dysfunction.

Left side waist pain

Discomfort occurs mainly after physical activity. The condition returned to normal after rest. If the discomfort does not subside with rest, then we are talking about scoliosis, osteochondrosis, spinal infections and circulatory diseases.

pinch nerve

In the vast majority of cases, the sciatic nerve is pinched (sciatica). At the same time, its myelin sheath was not damaged. Most often it occurs against the background of osteochondrosis. With acute, severe symptoms radiating to the lower back, sacrum, and lower extremities.During compressive radiculopathy, spinal nerve roots also become compressed. The cause is a herniated disc or a decrease in the distance between the vertebrae. People experience "superficial" discomfort that is acutely exacerbated by movement, sneezing, and coughing.

intervertebral hernia

It is characterized by herniation (herniation) of the nucleus pulposus into the intervertebral canal. In most cases, it occurs against the background of osteochondrosis. The central part of the squeeze core compresses the spinal cord. Even mild loads can lead to the progression of pathological processes. Back pain is sharp and severe, radiating to the legs or arms.

shoulder blade pain

Depending on the nature of the back pain, a presumptive diagnosis can be determined:

• Dullness, growth - gastric ulcer;
• Acute, worsening with movement—intercostal neuralgia;
• Numbness in hands, pressure changes, dizziness - osteochondrosis;
• Subclavian radiation - worsening of angina.

spine and back pain

Occurs due to compression of nerve endings against the background of spinal curvature. If symptoms are unclear, we can talk about prominence. Increased symptoms suggest osteochondrosis, myositis, or fracture.Severe discomfort in the spine indicates worn or thinned discs. May indicate spondyloarthritis. The pain is constant and severe.

pain below waist

Most commonly, they occur with spondyloarthropathy and osteochondrosis. It is less common in female genital diseases (oophoritis, cervicitis, endometritis, etc. ). They may appear during pregnancy, menstruation, appendicitis, ulcerative colitis, etc. In men, it indicates bladder or prostate disease.

diagnosis

First, a physical exam is performed to identify signs that indicate the need for further testing. The physical examination includes the following procedures:

• Examine the back and posture to identify anatomic abnormalities.
• Spinal Palpation/Percussion – Assess the condition of the spine and painful area.
• Neurologic examination - assesses reflexes, spinal sensitivity, and gait characteristics. In patients with suspected radiculopathy, the neurological examination should focus on the L5 and S1 nerve roots.

Patients with psychological disorders that cause back pain may experience accompanying physical symptoms, also known as Waddell signs. These include excessive patient responsiveness during physical examination, superficial tenderness, and unexplained neurologic deficits (eg, loss of sensation, sudden weakness, or tics during motor examination). The presence of multiple Waddell signs suggests a psychological component to back pain.

Treat spinal pain

If back pain occurs, it should be treated by a doctor. Specialists refer patients for examination and, based on the results obtained, develop an effective treatment plan.Other treatments should be used with caution and in consultation with a doctor. There are possible risks and side effects with any type of medication, so self-medication is not acceptable.

Pre-diagnosis help

Basic home remedies that are effective in combating mild to severe pain caused by muscle tension include:

• Rest periods are short. Many episodes of low back pain can be relieved by eliminating physical activity. Resting for more than 2-3 days is not recommended as prolonged inactivity can hinder healing.
• Activity changes. It is recommended to stay active but avoid activities and body positions that aggravate back pain. For example, if sitting in a car or at a desk for long periods of time increases discomfort, you should warm up every 20 minutes.
• Exposure to heat or cold. A heating pad or warm bath can relax tense muscles, improve blood flow, and reduce discomfort. If your lower back is painful due to inflammation, you can use ice or cold compresses to reduce swelling.

The most common over-the-counter medications for back pain are ibuprofen, naproxen, and acetaminophen. These medications can relieve inflammation and reduce discomfort in the lower back.

Conservative treatment

Oral drug therapy:

• Painkillers. Prescribe aniline drugs such as paracetamol. Provides long-lasting pain relief. They have a synergistic effect with NSAIDs and their combined use may enhance pain relief without increasing toxicity.
• NSAIDs. They have analgesic properties. At higher doses, they have anti-inflammatory effects.
• Muscle relaxants. They play a central role and influence the activity of muscle stretch reflexes. A combination of NSAIDs and muscle relaxants can significantly relieve back pain. The main side effects are drowsiness, headache, dizziness and dry mouth.
• Neuropathic analgesics. Tricyclic antidepressants relieve chronic pain. Low doses may be enough to control symptoms. They don't work immediately and it may take several weeks to see improvement in symptoms. Potential role occurs when discomfort is mediated by peripheral and central mechanisms.

Local or regional anesthesia via injection is part of the treatment plan for some people with back pain. The injection site may be an area of local injury or a myofascial trigger point (area of muscle pain).Epidural corticosteroid injections are used to treat radicular pain that is refractory to minimally invasive treatments. Used to relieve conditions such as intervertebral hernia, spinal stenosis, and radiculopathy. Reduce back pain and quickly restore sensory function.

Surgery

A small percentage of people with back pain require surgery to improve their condition. Indications for surgery vary based on patient characteristics and include:

• Severe radicular symptoms, especially if progressive neuromotor deficits are present;
• Radical symptoms not suitable for conservative treatment.

The choice of surgical intervention depends on the characteristics of the spinal injury. Surgery is most effective when the patient's clinical manifestations are dominated by nerve compression. The most common problem is insufficient nerve decompression. Related conditions include hip arthritis, osteoporosis and cardiovascular disease.For patients who experience radicular pain due to a herniated disc, surgery primarily involves decompression. Herniated, extruded, or isolated disc material is removed. Check and release the nerve roots.

prevention

Complications depend largely on the cause. They are divided into physical and social. The first includes neurological effects such as chronic pain, deformity, motor or sensory deficits, bowel or bladder damage. From a social perspective, complications are often measured through disability and performance decline.Patients of all ages should:

• Eliminate bad habits;
• maintain an active lifestyle;
• Enhance the body’s protective function;
• Lift heavy objects correctly;
• Get a preventive check-up from your doctor.

It is important not to slouch and keep your back straight. Places for sleeping and working must be arranged correctly. It is recommended to do light gymnastics every day after getting up. You should also balance your diet by enriching it with foods rich in vitamins and minerals. It is recommended to take a contrast shower in the morning.