According to medical statistics, acute back pain is the second most common cause of disability. At least 80% of people have suffered from them at least once. They may occur sporadically or be observed during exacerbations of spinal diseases. But in any case, acute and chronic back pain requires competent treatment and targeted action on the causes of their occurrence.
Acute back pain: causes
Acute pain is one that lasts less than 6 weeks. For most it disappears within 2 weeks. Although at first it is impossible to predict how long it will last. Nevertheless, in almost half of the cases, similar or more severe attacks recur in the future and become chronic pain.
Acute pain can be of varying intensity, dull, burning, etc. Sometimes it radiates to the arms, legs, buttocks. The so-called back pain often occurs after hypothermia, excessive exercise and as a result of sprains. Several days may pass between the impact of the traumatic factor and the direct manifestation of the pain syndrome, and this will occur under the influence of light physical exertion, such as inclination.
They can also be the result of a back injury or the first manifestation of spinal diseases, including:
- osteochondrosis;
- intervertebral hernia;
- spondyloarthritis;
- spinal stenosis and others.
Increase the likelihood of back problems:
- frequent stress;
- regular increased physical activity;
- overweight;
- frequent and prolonged straightening.
In addition to severe back discomfort, there may be headaches, burning sensations in the legs, and dizziness. All these symptoms should be reported to the doctor at the appointment.
No matter which anatomical structure was damaged first, it leads to a whole chain of successive changes that increase discomfort. Initially, inflammatory factors develop in the lesion, which cause swelling and irritation of the nerve fibers. In response, muscle spasm often occurs, which further aggravates the situation and provokes circulatory disorders in the affected area. This leads to a reduction in the amount of nutrients and oxygen entering the focus of the lesion, as well as the retention of metabolic products in it.
Treatment of acute back pain
To relieve pain, lie on your back on a hard surface. This will allow your back muscles to relax and relieve stress on your spine. To enhance the effect, orthopedic pillows can be placed under the knees and under the head, but it is important to avoid sagging in the lower back. In case of severe pain, short-term use of drugs from the group of NSAIDs is allowed. In the future, you must contact a neurologist or spinal surgeon to determine the cause of the pain syndrome.
As soon as possible, you should see a doctor if there is no improvement within a week, recurrence of attack or irradiation of pain in the legs or knees, impaired urination and defecation. To diagnose existing disorders, patients are shown:
- NMR;
- CT;
- x-ray;
- biochemical blood test;
- UAC.
Based on the results of the study and the characteristics of the symptoms, the doctor diagnoses and develops treatment tactics. In the case of acute pain that deprives a person of the ability to work, he may be asked to perform a spinal blockade, which relieves the pain syndrome for a few minutes.
After the discomfort subsides, it is important not to linger in bed. Moderate physical activity, supplemented by special exercises in medical gymnastics, is the best prevention of recurrence of such attacks in the future.
When you go to the hospital, you will definitely get high quality treatment for the pain syndrome and its causes. Specialists will be able to develop the most effective treatment tactics and quickly relieve pain with a well-made, accessible blockade.
Chronic back pain: causes
People suffer from pulling chronic back pain just as often. They can worsen and become an attack of sharp pain, which completely excludes a person from the usual rhythm. Most often they are the result of:
- Sedentary lifestyle that leads to weakening of the muscular corset. This provokes an increase in the load on the spine and compression of the vertebrae. The result is osteochondrosis, protrusion of intervertebral discs and herniated intervertebral discs, spondyloarthritis.
- Posture disorders. Long-term preservation of any position of the body, in which the natural curves of the spine are disturbed, provokes its distortion and the development of scoliosis or kyphosis. This leads to degenerative changes in the intervertebral discs, redistribution of the load on the muscles and pinching of the nerve roots.
- Weakening of the abdominal muscles. Because they act as a support for the internal organs and partially relieve the spine when they are weak, the load on the lower back increases, which increases lordosis and provokes chronic pain. In addition to a sedentary lifestyle, weakening of the abdominal muscles can be a consequence of pregnancy or obesity.
- Adult changes. Over the years, the intervertebral discs gradually become dehydrated, causing a decrease in their elasticity, strength and size. The annular fibrosis surrounding the jelly-like nucleus pulposus dries out and becomes more fragile. The loads provoke the formation of cracks in it, which leads to the formation of protrusions and hernias. The resulting bulge can squeeze nearby blood vessels, nerve roots, spinal cord, which provokes the appearance of pain syndrome.
Chronic back pain conditions include:
- osteochondrosis;
- spondyloarthritis;
- osteoporosis;
- intervertebral hernia;
- facet syndrome;
- ankylosing spondylitis;
- spondylolisthesis; rheumatoid arthritis;
- intercostal neuralgia;
- cancer and others.
A common cause of chronic pain is deterioration of the facet joints. The cartilage located in them is also prone to thinning with excessive strain on the spine. As a result, when moving, they cease to perform a cushioning function, which provokes friction of bone fragments and the development of inflammation.
Treatment of back pain
Treatment tactics are developed based on what abnormalities are found during diagnostic studies. When spinal diseases are detected, conservative therapy is initially prescribed, including:
- drug therapy;
- physiotherapy;
- massage;
- training therapy.
Conservative therapy
A holistic, individualized approach is important in the treatment of back pain. Depending on the cause, patients are prescribed a number of medicines, in particular:
- NSAIDs - drugs from this group have anti-inflammatory and analgesic effects, but with prolonged use adversely affect the condition of the digestive tract;
- corticosteroids - drugs with pronounced anti-inflammatory properties, prescribed in moderate to severe cases;
- muscle relaxants - help to eliminate increased muscle tone and spasms;
- antidepressants - help to eliminate the psychological discomfort that often reduces the effectiveness of conservative therapy;
- topical agents - ointments or gels containing anti-inflammatory, warming or cooling components can help reduce the severity of pain and practically do not cause side effects;
- chondroprotectors - preparations containing glucosamine and chondroitin, have a beneficial effect on the condition of cartilage tissue, increase its elasticity and help restore normal thickness.
In mild cases, oral treatment is sufficient. However, in more complex situations, patients may be prescribed intra-articular injections. In case of severe pain, it is recommended to do blockades once or as a complete course, which may include up to 10 procedures.
To improve the effectiveness of drug therapy, patients are prescribed massage and physiotherapy sessions. The right effect on the back muscles helps to activate blood and lymph flow, improve metabolic processes and eliminate muscle spasms. Manual therapy is very effective in spinal deformities, especially in scoliosis 1-2 degrees. Regular sessions help to restore the normal position of the spine and relieve pressure on the internal organs.
As part of patients' physiotherapy, sessions are scheduled:
- UHF;
- magnetic therapy;
- currents of Bernard;
- laser therapy;
- electrophoresis;
- UFO;
- balneotherapy.
If it is not possible to improve the condition within six months or there is a risk of complications, patients may be offered surgical treatment of existing diseases.
Surgical treatment
Modern methods of surgical intervention are characterized by a high level of efficiency and safety. They allow you to quickly eliminate the pathological cause of the development of pain syndrome and often do not require a hospital stay. But most minimally invasive and microsurgical methods can only be applied when patients are referred to spinal surgeons in the early stages of the disease.
The indications for surgical treatment are:
- progressive intervertebral disc herniation;
- spinal stenosis;
- sequestered hernia;
- spinal fractures;
- scoliosis 3-4 degree;
- severe forms of spondyloarthritis;
- compression of the spinal cord or its nerve roots;
- hemangiomas of the vertebral bodies;
- instability of individual segments of the spine;
- cauda equina syndrome.
The surgeon determines the type of surgery based on the severity of the patient's condition. With the same diagnosis, surgical treatment can be performed in different ways, varying in degree of invasiveness, effectiveness, duration of rehabilitation, and cost.
Recently, minimally invasive methods of surgical treatment have become very popular. With their help the treatment of intervertebral protrusions, intervertebral disc herniations, hemangiomas and a number of other diseases is performed. Minimally invasive surgery takes no more than an hour and after its completion the patient can almost immediately go and leave the clinic the same or the next day.
The great advantages of the method are a good cosmetic effect (in most cases all the necessary surgical instruments are introduced through soft tissue punctures), ease of rehabilitation and affordable price. In the case of intervertebral hernias, only cold plasma nucleoplasty or hydroplasty (hydrodiscectomy) can be considered a more promising method.
In situations where microsurgical techniques cannot be applied, surgeons perform open operations. During them it is possible to completely remove pathologically altered formations, to compensate for severe deformities of the spine, to replace non-recoverable structures with implants and to achieve normal functioning of the spine by installing metal titanium structures.
Modern spinal surgery can deal with almost any back problem. All the latest methods for surgical treatment of spinal diseases are offered in many institutions. A team of doctors of different profiles will help get rid of acute or excruciating chronic back pain as soon as possible.
Prevention of back pain
Once the seizure is over and the pain has subsided to avoid a new episode, it is recommended:
- do not lift objects that are too heavy;
- do not bend;
- walk more;
- give up hard physical labor;
- When you sit down, take regular breaks to warm up.