Back pain is not a distinct disease but is a symptom of many different ailments, and in most cases the exact cause is unknown. These are some of the most common complaints, which occur at any point on the back – the neck, the chest or the lumbosacral part, but in the majority of cases, they can feel in the waist.
According to research, 90% of people at least once suffered from back pain. In 50% of people, pains are periodically recurrent. Whether back pain is a disease state can be determined by the type and strength of the pain and the frequency with which it occurs.
These can be a symptom of many diseases, and in many cases, the exact cause of their occurrence is not specified. They can occur in any part of the back, but most often are localized in the waist.
By their length, back pain is divided into sharp, sub-chronic, chronic and recurrent. Acute pain is a symptom of tissue damage and lasts for 4 to 6 weeks.
Subacute pains last more than 6 weeks but not more than 3 months. Chronic pains last for more than three months, and recurrent are acute and occur in people who have had a similar localization pain followed by a period without symptoms.
According to the causes, the pain in the back is divided into local, reflected, radicular and muscle spasm pain, which protects damaged parts from movement. It is possible that the four types of pain manifest at the same time and create severe discomfort. Local pain is due to a pathological process that damages structures containing sensory endings. Radicular pain is sharp and strong, moving from the spine to the limb.
The causes of back pain have a multifactual nature since many diseases can cause them. Pain syndrome may be due to diseases of bone structures, apophyseal joints, muscles, or intervertebral discs. Mechanical causes of pain include spinal canal stenosis, degenerative diseases, congenital abnormalities, traumas and fractures, achondroplasia and many others.
Reasons for the degeneration of the spinal structure are age and genetic predisposition, minor trauma, and overweight. Degenerative changes in the structures of the spine develop along with the aging of the body, which begins after 30 years of age.
The clinical picture of back pain
The back pain begins with a sharp and suboptimal start. The course of pain depends on the cause of its occurrence and in most cases is an acute idiopathic pain in which there are no neurological symptoms and bone abnormalities in the spine. Disc herniation is the cause of acute, chronic and exacerbated back pain in 8% of cases. Chronic idiopathic pain is due to inadequate treatment, improper posture, weak muscles, and overloads.
Types of back pain
According to their duration, the pains are divided into sharp, subacute, recurrent and chronic. Acute pains are provoked by tissue damage and can last up to 6 weeks. The underlying back pain lasts for more than 6 weeks, but no longer than 3 months. Chronic pain lasts for more than 3 months, and recurrent pain occurs in a person who previously had episodes of similar localization pain followed by an asymptomatic period.
According to the cause, four types of pain are well-known: radicular, local, reflected, and pain from muscle spasm that protects affected areas from movement. It is not excluded that the four types of pain occur at the same time. Local pain is caused by a pathological process that damages structures containing nerve endings. Radicular or root pain is severe and acute. It moves from the spine to the corresponding limb.
Causes of Back Pain
The reasons for this condition are many. Many diseases can cause back pain and among the most prominent are diseases of bone structures, muscles, intervertebral discs that occur with or without consequent affections of the peripheral nerves and spinal cord brain. The mechanical causes that can cause back pain are spinal stenosis, degenerative diseases, traumas and fractures, congenital malformations, spondylolisthesis, achondroplasia and some others.
Degenerative processes evolve in parallel with the aging process starting after the age of 30. One of the most common degenerative diseases is spondylarthrosis. It affects different parts of the spine – joints, ligaments, bones, vertebrae and intervertebral discs, muscles. Chronic pains are most often due to inappropriate treatment of acute idiopathic pain.
Symptoms of back pain
Pain manifestations may have a sharp and subacute start. The clinical manifestations are different depending on the cause of the occurrence. Pain may appear suddenly and very pronounced, and in other cases, they are reinforced in specific movements and activities.
Sometimes they fade away all alone, but in severe cases, they are difficult to pass even after receiving painkillers. The pain can stiffen limbs, cause unpleasant sensation throughout the body.
Diagnosing back pain
Diagnosis is based on the history of complaints and the use of neurological examination. Some of the best neuro-imaging methods are X-ray, CT, Myelography and Magnetic Resonance Tomography, but they should not be used routinely in the presence of back pain. They apply only in cases where it is necessary to distinguish primary disease that provokes pain seriously. In rare cases, blood and urine tests are employed. These are needed for patients over 50 years of age who are suspected of having another more severe illness.
Diagnosis of back pain is based on a history of the disease and neurological examination. Electromyography is recommended for detecting a neurological problem as it enables the localization of the problem and the determination of its burden.
Treatment of back pain
Treatment on a case-by-case basis is different and, above all, aims to eliminate the pain, no matter what the cause is. Eliminating the pain is the first step in the treatment of back pain. Acute pain resolves gradually for several weeks and is treated with a combination of analgesics and non-steroidal anti-inflammatory drugs. In chronic pain, however, things are different.
There can be no expectation of its disappearance after the healing of the affected tissues. Treatment includes good physical activity, regional analgesia and various medications that are appointed by a specialist. If nerve root injury causes pain, antidepressants and anticonvulsants should be used.
According to a large number of specialists, massage is an excellent addition to the treatment of back pain. The benefits of massage are improving our blood circulation, relaxing the muscles and increasing the range of possible movements and level of endorphins, which are the body’s antibody systems.
Prevention of back pain
The safest way to prevent back pain is to maintain its strength through proper exercise.
Other appropriate measures that can be taken are:
- Heavy objects should not be carried with only one hand as the load must be evenly distributed. When a person carries heavy objects and has to turn away, he should not only bend his waist but the whole body.
- Before training, warming up is a crucial step in preventing injury. When a person spends more time sitting, the back should be upright. Back cramps can also be prevented by moving and getting up from the chair as often as possible.
- Wearing uncomfortable shoes and high heels can also cause back pain. In these cases, it is recommended to wear special orthopedic insoles. Sleeping on a hard mattress in many cases relieves the pain syndrome. The side position is best suited for sleeping, with the legs being slightly bent.
Image Credits: Flickr