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Why back pain: causes and treatment

Back pain is a popular disease of modern civilization: almost everyone suffers from back pain at least once in their life. Fortunately, in about 90% of cases, the causes do not threaten health. Therefore, patients themselves can do a lot to combat back pain - from heat compresses to exercises to develop back muscles. Learn more about the causes and treatment of back pain in this article.

back, back pain

brief information

  • Back, back pain: is one of the most common types of pain and mainly affects women. Often, back pain is nonspecific.
  • Classification:duration (acute, subacute and chronic low back pain), position (upper, middle or lower) and form (specific and non-specific low back pain).
  • Reasons:there is no reason for non-specific back pain. In contrast, there is a detectable symptom of specific low back pain.
  • Inquiries:depending on the patient's physical condition: blood and urine tests, neurological examination, gynecological examination, electroneurography, etc.
  • Treatment:Heat treatment, herbs, proper bending and stretching, sports to strengthen the back, workouts for the spine in the workplace, relaxation techniques, acupuncture, maybe medications

Back pain: description and classification

Low back pain, lumbago, back stiffness, or just low back pain are the names of a symptom. Sometimes he squeezes the cross, sometimes he pulls his neck. Sometimes back pain spreads to the sides, arms or legs. Symptoms may be permanent or only temporary. Sometimes they are so strong that the victims are unable to move.

No matter how different the nature and scale of the complaints: back pain can haunt people of almost any age. It is one of the most common problems of modern man. Women in each age group report more back pain than men. This phenomenon manifests itself in other types of pain.

Doctors classify back pain according to different criteria:

Classification according to the localization of back pain

  • Top shovel:Pain in the upper part of the spine (neck) can be acute or chronic. It is often felt on the shoulders, arms and / or back of the head. Neck pain can be caused, for example, by poor posture at work, a herniated disc, or a mental disorder.
  • In the middle of the back:Chest back pain is rarely caused by an injury. It is often caused by irritation of large muscle groups in this area or dysfunction of the costal vertebral joints.
  • On the lower back:low back pain is most common in the lower back. Because the spine is more prone to injury and damage than the spine and cervical spine. Low back pain is called "back pain". Possible causes are, for example, herniated discs or muscle tension.

Classification by duration of back pain

Depending on the duration of symptoms, doctors distinguish between acute, subacute and chronic back pain:

  • Acute back pain:is low back pain that occurs painlessly for the first time or after at least six months and lasts for a maximum of six weeks. The prognosis is generally good: acute back pain disappears within a few weeks in most victims.
  • Subacute back pain:If back pain lasts from six weeks to a maximum of three months, they are considered subacute.
  • Chronic back painor chronic recurrent low back pain: lasting more than three months. The intensity of the pain can vary during this time - back pain is sometimes mild, sometimes more severe. Chronic back pain is more common with age.

Classification of causes of back pain

Depending on whether it is possible to determine the exact cause of the disease, doctors distinguish between specific and non-specific back pain. Read more in the next section.

The main reasons

Low back pain can be roughly divided into two main causes: non-specific and specific low back pain.

Non-specific low back pain

For non-specific low back pain, the doctor cannot find the exact cause of the symptoms. The vast majority of all back pain cases fall into this category.

Special back pain

An overview of the main causes of specific low back pain:

  • Muscle tension:Often, back pain is caused by muscle tension. Poor posture, one-sided load, or lack of physical activity make the muscles uneven - some muscles are overworked, while others are underused. As a result, the muscles shorten or stiffen, which can cause tension and pain. Compressed nerves can also cause muscle tension and back pain.
  • Herniated disc. . . The discs are located between individual vertebral bodies in the form of pillow-shaped shock absorbers. It consists of a soft gelatinous core surrounded by a fibrocartigue ring. If the jelly core slides through the fiber sheath and breaks, a herniated disc is formed. When a mass of gelatin from a slippery disc presses on nearby nerves, it causes severe back pain.
  • Erosion of the spine(arthrosis of the spinal joints, phase syndrome): the vertebral joints wear out in the body with age.
  • Rachiocampsis. . . When scoliosis is called, the spine bends laterally. This causes premature wear, which can lead to muscle tension and back pain. In addition, the so-called Scheuermann's disease is characterized by curvature of the spine. The results are back pain, low back pain and limited mobility.
  • Spondylolisthesis(Spondylisthesis): In this condition, the vertebrae are unstable, so they can move easily. This is especially true in the lower back. Many patients have very few complaints. However, exercise and certain movements can cause back pain. When the displaced vertebrae press on the nerve root, neurological disorders such as emotional disorders or paralysis are also possible.
  • Osteoporosis(bone loss). With osteoporosis, the bones become increasingly fragile. You can break them with even the smallest load (for example, falling, stumbling). This often leads to vertebral fractures associated with back pain. Even a precursor of osteoporosis - osteopenia can already be associated with back pain.
  • Pregnancy:Many pregnant women have back pain. There are several reasons for this. For example, hormonal changes in pregnant women cause relaxation of tendons and ligaments in the pelvic floor. As a result, they become unstable, which can cause pain in the pelvis and lower back. In addition, a woman's center of gravity changes as the fetus grows. It can also cause back pain. In addition, stroke and premature birth may be associated with back pain.
  • Pyelonephritis:Pelvic nephritis is usually caused by bacteria, especially in women. It can cause back pain for a long time, especially if it is a chronic condition.
  • Kidney stones:Unlike pelvic nephritis, kidney stones are more common in men. Sometimes it is so small (semolina) that it is simply excreted in the urine. Large kidney stones can be located in the ureter. The result is renal colic, which can cause burning and back pain, depending on the location of the kidney stone.
  • I have pneumonia(pneumonia): In addition to cough with fever and back pain, sometimes pneumonia is also included. Inflammation is mainly caused by bacteria.
  • Inflammation of the pancreas(pancreatitis): Both acute and chronic pancreatitis cause pain in the upper abdomen. It often spreads to the back and is perceived as back pain.
  • Swelling of the spine and swelling of the ribs:Low back pain can also be caused by a tumor in the lower back or chest. Sometimes these tumors are benign, sometimes malignant. In the latter case, these are almost always secondary tumors of cancerous tumors in other parts of the body, such as breast cancer or lung cancer.

Low back pain risk factors

There are several factors that increase the risk of back pain. This is primarily:

  • Job-related factors:Carrying and lifting heavy loads, vibrations (for example, when working with a hammer) and working in uncomfortable positions puts stress on the spine, joints and muscles. This can cause back pain for a long time. Therefore, some back diseases are known as occupational diseases.
  • Work-related psycho-social conditions:People who are dissatisfied with their workplace or have to work monotonously from morning to evening (for example, on an assembly line) are more prone to back pain. In addition, social conflicts in the workplace and high labor intensity (in the form of money, recognition, promotion opportunities) without adequate rewards can cause back pain.
  • Social situation.Back pain is more common in people with low social status in terms of education, occupation and income than in people with high social status.

The course of existing back pain can be affected by adverse conditions such as psychological factors. These include, for example, back pain, depression, as well as fears of passive or overactive behavior, ie restraint or excessive activity.

Treatment of low back pain

With specific back pain, the doctor will eliminate the cause of the disease, if possible. For example, conservative (non-surgical) therapy, such as thermal therapy, physiotherapy, relaxation techniques, and painkillers or muscle relaxants, is usually sufficient for a herniated disc. Surgery is rarely needed. If your back pain is caused by pyelonephritis, your doctor will usually prescribe antibiotics. Many bacteria are the cause of inflammation.

It is always best to consult your doctor before trying a technique.

  • Training and sports:Physical therapy and back exercises are especially recommended for subacute and chronic non-specific back pain, but not for acute back pain.
  • Recreation procedures:Purposeful rest helps counteract stress and tension (both of which play an important role in back pain). If the pain is already chronic, VUR can also be helpful. By the way, there are other relaxation techniques such as autogenic training and meditation. Many patients with low back pain have had positive experiences in this area.
  • Unified methods and practices:yoga, qigong and tai chi chuan also have a relaxing effect. These complex training techniques are suitable for the prevention of lumbago and herniated discs.
  • Thermal therapy:Applying heat (for example, pillows, thermoses, mud baths, fango bags) relaxes the muscles and can relieve non-specific back pain.
  • Medicinal plants:ash and aspen mixture preparations can relieve back pain. A capsaicin cream or patch can help for painful muscle tension.
  • Aromatherapy:If you experience lumbago (back pain), you can rub candle, sandalwood or ginger oil on the affected area. It can help relieve symptoms.
  • Backpack friendly nutrition:bones, joints, muscles and discs need a lot of nutrients to function. Make sure you have enough essential fatty acids, calcium, fluoride, vitamins C, D and E, as well as B vitamins, magnesium, boron, selenium and zinc. Not only does it help the back well, but it also helps overall health.
  • Drink a lot:The food supply to the intervertebral discs works only with large amounts of fluid.

Back pain medications

Medications reduce back pain to such an extent that physical activity is possible again. Over time, the dose of the drug should be reduced and reduced: during exercise, patients generally need less medication to move painlessly. The doctor gives each patient specific instructions on when, in what dose and for how long to use the drug. Patients should follow these guidelines to avoid side effects or dependence.

Even if you have specific back pain, medication may be helpful and useful. Generally, only for a short time.

In principle, there are different groups of active ingredients for the treatment of low back pain. Depending on the type and severity of the symptoms, it depends on which drug is most appropriate in each situation:

  • conventional painkillers (analgesics);
  • very strong analgesics from the opiate group;
  • muscle relaxant: not recommended for non-specific low back pain;
  • some antidepressants, such as for chronic non-specific low back pain, if the patient is also suffering from depression or sleep disorders

When to see a doctor?

Low back pain is not always a sign of a more or less serious illness that requires a doctor's visit. Often there are relatively harmless reasons behind this, such as lack of exercise or poor posture. However, you should consult a doctor for safety in the following cases:

  • atypical low back pain
  • persistent back pain
  • increased back pain

Significant research

These studies help to clarify the causes of complaints:

  • cardiac catheterization;
  • joint puncture;
  • electromyography;
  • radiography;
  • medical history;
  • CT examination;
  • scintigraphy;
  • ultrasound;
  • cystoscopy;
  • arthroscopy.

Back pain: examinations

To clarify your back pain, your doctor will first talk to you in detail to compile your medical history. Possible questions:

  • Where does back pain occur?
  • Does your back pain spread to other parts of your body (such as your sides or one leg)?
  • How long does the current pain attack last?
  • Have you had back pain before? How did the pain continue?
  • Are there factors that cause, aggravate, or relieve back pain (e. g. , fever, chills, movement)?
  • How was back pain treated (medicine, massage)? Were the events successful? Are there any side effects?
  • What is the (daily) time course of back pain?
  • How bad is your back pain? Do they interfere in daily activities?
  • Do you have any mental or physical illness?

Examined by a doctor

After a medical history, your doctor may perform various tests to investigate the causes of your back pain.

  • Blood tests:Measurement of various blood counts may be evidence of spinal cord erosion, inflammation (pleurisy, prostatitis, pyelitis) or heart attack, for example, as a trigger for low back pain.
  • Urine analysis:A urine sample test can rule out or reinforce the suspicion of kidney disease or acute prostatitis.
  • Electromyography (EMG):Measuring the electrical activity of a muscle also serves to identify a herniated disc as a possible cause of back pain.
  • Ultrasound procedure:If your back pain is caused by pyelonephritis or kidney stones, an ultrasound can help determine the cause.
  • X-ray:A simple x-ray can give information about various possible causes of back pain, such as pneumonia, pneumothorax, spinal obstruction, spinal inflammation (ankylosing spondylitis) or osteoporosis.
  • Computed tomography (CT):It is performed when there is a suspicion that low back pain is caused by a herniated disc, spinal cord abrasions, aortic aneurysm, pancreatitis or lung tumor.
  • Magnetic resonance imaging (MRI):This test can be used to identify suspicions of a herniated disc or spinal inflammation (ankylosing spondylitis).
  • Scintigraphy:This nuclear medical test determines the activity of various tissues, such as bone tissue (bone scintigraphy: suspected ankylosing spondylitis) or lung tissue (lung scintigraphy: suspected pulmonary embolism).

What research is needed

Physical examination and laboratory tests (blood, urine) are very common in the diagnosis of low back pain. In contrast, X-rays - that is, X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) - are only recommended when specific low back pain is suspected. At first glance, acute and single chronic back pain are deliberately ruled out: too many examinations can cause the patient to fear that there may be a serious cause behind the back pain. This can make acute back pain chronic (chronic).