Back pain — what to do?

Every day one–two of the patient necessarily. Regardless of age and gender, the type of activity and physique. What is this pain? This is a defensive reaction of the body, is very useful, because if you don't have pain, we won't be able to find that in the body there are irregularities that do not exceed your health is in danger.

The mechanism of the development of pain in the body is similar for all reflexes from the receptors of the impulse goes first to the spinal cord, then is processed and sent to the brain. In the way involved all departments of the nervous system and in the brain many pain centers at different levels. This suggests that the perception of pain is very important for the body.

But it happens so that the damage is there, and there is no pain. Most often this happens in cancer processes, or when there is a violation of the receptors. When due to continuous irritation of the receptors and the nerve fibers themselves these fibers and the center in the brain is irritated, appearing to chronic pain. Cure is much more difficult, because here you will be amazed, not only organs and tissues, where they are located receptors, but also transmit the pain of the cells of the nervous system are neurons.

Back pain can be caused by a variety of causes. Here we divide them according to their localization (i.e. the location) painful sensations in different parts of the back and understand that it can hurt at different levels, and that affects the entire spine. We we touch rare diseases: we describe the most common causes of back pain we encounter in practice.

1. Pain in the upper back

• Firstly, it is necessary to exclude the most dangerous condition – heart disease. Therefore, when pain in the upper back, in the area of the blades, especially on the left side, prescribe the ECG (electrocardiography) to exclude acute coronary syndrome, myocardial infarction, if there is a person in advanced age. Myocarditis and other inflammatory diseases of the heart, if the young age.
• If cardiogram without pathology, we think of dorsalgia, in this part of the back is properly called torakalgiya (from the Latin word thorax – the chest), i.e. violating the very the spinal column helena muscles associated with the spine. Torakalgiya may be caused by osteochondrosis of the spine when damage to the thoracic department. This is the most common reason. Increased pain occurs upon movement, especially when turning. If you look at such back, is to see how tense the muscles around a sick place. Associated these pains with a certain development – have highlighted the severity of, lost, nervous, it was a big burden on your back. It is often accompanied by pain in the sternum, pain, increasing at night in lying down position. If the pain fresh — are injected pain medication, b vitamins, muscle relaxants, everything takes place over 3 days, rarely a week. If there is damage to the very spine – herniation of the intervertebral disc, damage to the roots of the nerves, which diverge from the spine – the treatment longer. Here it is necessary to x-rays, and these patients leading neurologists. Because it is formed by chronic pain, with which it is more difficult to handle. At this stage connect more than strong drugs.
• You cannot rule out pathology in the area of shoulder joint – arthritis helena injury. It happens that the pain they give in the back.
• Of internal organs at the level of the upper part of the back are light. Ill start to spin, when inflammation goes on the pleura – the shell of the lung, rich in pain receptors. The pains are strong, they are more intense when breathing, to reduce pain, people walk on the injured side. If it is temperature and pain in the chest – the doctor necessarily suspected disorder in the lungs. An x-ray, which most often was good to see. Treatment is always in the hospital. Pleurisy – inflammation of pleura — it happens for various reasons. Cause it can harbor bacteria, viruses, TB Mycobacterium and other infections.
• Spontaneous pneumothorax — entry of air in the pleura. Often occurs in stanichnyj young people with genetic damage to connective tissue (dysplasia of the connective tissue helena JSP). Happens with a strong cough during SARS, a sharp deep inhalation, injury.

2. Pain in the middle part of the back, in the lumbar and higher

• Osteochondrosis of the spine is the lumbar manifested as lumbalgie – it's a pain without irradiation step, and lumbalgia – when the pain spreads over the outer side of the thigh. This is the case when the interference of the roots of the nerves. So the doctor checks, the so-called "radicular symptoms" helena symptoms of tension. The patient lays on his back and picks up the one and the other leg. When interference to the nerve due to the leg pain can be lifted only under a small angle.



• Roughly at this level are the kidneys. Then the doctor checks the symptom of Pasternatskogo, i.e. slightly beat it back in the projected area of the kidneys, and if there is pain, it means that the kidneys are diseased. More often it is a sign of acute inflammation of the kidneys helena urinary diseases. Therefore, in the algorithm of examination of pain in the lumbar area of the back necessarily involves a general analysis of urine. In inflammation of the kidneys, acute pyelonephritis helena exacerbation of chronic, tends to be high fever, pain in the lower part of the back can be at the slightest touch. In the overall analysis of urine increased the number of leukocytes – inflammatory changes.
• Stones occur not only in the kidney, but also in the gallbladder. Very often confused pain pathology of the spine and the pain from the inflammation of the gallbladder. The gallbladder is located on the right side under the rib, but the pain they give into the right half of the back. But this authority is so insidious, that the pain in cholecystitis may put on his right shoulder, in the lower part of the back and even legs. The stone can "sit", is not only in the gallbladder but also in the Bayou. Can stone not to be, but be inflammation of the gallbladder and ducts, caused by, for example, Giardia, opisthorchis and other parasites. Usually inflammation of the gallbladder, recorded in the palpation of the abdomen and determining the special reflective symptoms of inflammation of the gallbladder. If the identified symptoms of cholecystitis, the patient they are sending to do the abdominal ULTRASOUND and gastroenterologist. If gallstone disease in the stage of aggravation – it is a surgical treatment. Insidious this disease that can be temperature, bitterness in the mouth, liquid faeces, but only pain. This happens when the long-term course, when already formed chronic pain.
• Inflammation of the pancreas – pancreatitis. Pain often gives to the back, only on the left side. It happens when there is inflammation of the covering of the tail of the pancreas. If there is inflammation in the area of the head, pain in the giving away of the lower part of the back to the right and in the middle. Here, everything is brighter, acute pancreatitis just can't flow without dyspeptic phenomena. Here, in addition to severe pain, most often it is the "dagger" pain in the abdomen, may be nausea, vomiting. And of course these pains are always connected with the violation of the diet is the intake of strong alcohol in combination with fatty foods. Sharp processes – work for the doctor. Because the pancreas can start to digest itself, it is called pancreatic necrosis and requires acute intervention. If it is a chronic process is observation, gastroenetrology. And diet with the exception of fat.
• Herpes Zoster – shingles. Arises in the area of the back, more often the lower part of the back. First appear pain, then herpes rash in the form of small bubbles. Called one of the species herpes infection. Cures is usually a therapist and a neurologist. The pain can be very strong, burning. This virus is spread along the course of the nerve. Ever since the beginning of the pain of the rash takes place a week and a diagnosis is difficult to establish.

3. Pain in the lower part of the back

• The most common reason — the manifestations of degenerative disc disease of the spine. Violation of helena degenerative changes in the vertebrae is the lumbar-sacral the completion of the joints, the pain gives to the coccyx, helena up on pozvonocna pole.
• Gynaecological causes can be a pain in the back (all depends from anatomical position) — inflammatory diseases of the female organs.
• Kidney stones disease, if the stone passes to the ureter, often occurs in the lower lateral parts of the abdomen, but can be side and back side.
• Pathology of the hip joint (as in our case, which is given at the beginning of the article), arthritis, arthrosis, helena even fracture of the femoral neck may give pain in the lower part of the back.
• Diseases of the rectum – hemorrhoids, tumors benign helena malignant (if it is the palatine malignant, giving pain not only to themselves, but can be a pain and metastases in the spine, liver, lungs).
• Finally, diseases of the prostate — this can be benign dysplasia of prostate cancer, can be prostate cancer. This disease develops in adulthood, and so often occur after a long period of time, even without visible symptoms, but when the weakening of the body can give metastases in the lumbar department of the spine, in the lungs, the local lymph nodes.

4. Some diseases affect the entire spine helena his department

• Osteochondrosis – is the most common – it is the degenerative changes of the vertebrae of the pillar, which affected all departments of the spine. There polysegmental osteochondrosis. His speeches give the symptoms in all parts of the spine, therefore, is for the diagnosis may be specific problems, very often this occurs due to osteoporosis.
• Osteoporosis – a decrease in the content of calcium in the bones, manifests itself more with age. In men and women is due to various reasons, but underway as well. In women after the menopause is associated with low levels of estrogen that are in their reproductive age regulate calcium metabolism, in men, most commonly due to lesions of the gastrointestinal tract and disorders of the absorption of calcium. In osteoporosis bones are made of brittle, thin. This applies also to the spine. Arise micro-fractures at the slightest injury in the far advanced stages.
• Myeloma disease – belongs to the group of leukemia helena tumors of the blood, when the palatine develops at the level of the bone marrow. Increases the number of cells, of blood, of which grow leukocytes, the pressure of this amount causes pain in the bones. When this disease affects the flat bones, most commonly in the sternum, but can be a pain in the spine. Now with the increased number of cases of this leukemia. To diagnose the presence of protein in the urine of Ben Jones, the altered protein, which produce tumor cells.
• Bechterew and other autoimmune diseases — when inflammation of the vertebrae are autoimmune in nature, i.e. when the body produces antibodies against its own cells. Now celebrating the increase in autoimmune diseases.
• Infectious diseases of the spine – tuberculosis (may be combined with HIV infection), syphilis, osteomyelitis are very rare, but a doctor should take into account and know about them. Tuberculous osteomyelitis difficult to diagnose, most often the diagnosis is definitely so and is not placed, but the treatment should be implemented seriously. Tuberculosis – an insidious disease, with every weakening of immunity can penetrate into your body and manifested unexpected signs. For the last year I have seen two such patients.

5. Persistent back pain can signal serious disease

When the following symptoms of a doctor suspected of Oncology and governed by the in-depth examination:

• pain in the back, ill take place in the treatment of pain medication,
• the reduction of body weight,
• low-grade temperature (37-37,5 degrees, which for a long time does not pass),
• anemia, decrease in hemoglobin, outwardly, it looks like the pallor of helena yellowing of the skin, cyanotic hue of the lips, "circles" under the eyes,
• increase the speed of sedimentation of red blood cells (ESR) in the general analysis of blood,
• tendency to bleeding.

The algorithm for back pain

1. In the first place it is necessary to pass routine tests – general blood analysis, general urine analysis. This will give us an idea about the state of the organism and inflammatory processes in it, the state of the urinary system. If we see that changes in the analysis of urine, then immediately the suspicion, that the pains are caused by the right kidney disease.

2. Biokhimicheski blood tests are taken into account liver function tests (ALT, AST, bilirubin, Alkaline phosphatase), PSA (C-reactive protein), rheumatoid factor — activity indicators of inflammation, the amount of protein, the ratio of different types of protein in the blood – albumin and globulins and other indicators, if the doctor suspected some kind of disease.

3. Tumor markers – when suspicion on the tumor process.

4. Tests for infectious diseases: HIV, viral hepatitis, tubercules, syphilis.

5. Radiograph spine – shows the changes in the spinal beam, the presence of hernia of the spine, such as tumor metastasis, inflammatory phenomena.

6. CT of the spine and internal organs – a very important examination, better on him and more than on the x-ray visible changes in the tissues.

7. MRI is more expensive and informative method is used to narrow the results of computer tomography. Can be performed in a combination of surveys, which depict the internal organs and alone the spine. This examination allows you to accurately identify the causes of damage to internal organs.

8. In the event that the physician thinks about a rare disease, then prescribes a special examination (on autoimmune disease, rare infections, a more in-depth study to determine the state of the organism).

Treatment of back pain, of course, it is assigned depending on the cause. But we started always with pain medication – non-steroidal anti-inflammatory drugs helena antispasmodics.

Despite the diversity of causes of pain in the back, our medicine is developed enough to establish an accurate diagnosis and start treatment. What is most important – do not start the disease and seek medical help if the pain persist for three days, not to mention long intense pain.

Be healthy!