Back pain — what to do?

Every day one or two patients is necessary. Regardless of age and sex, activity and body. What is pain? This is a protective reaction of the body is very necessary, because if there is no pain we can not learn, that there is a body of violations that the health is threatened.

The development of pain in the body Mechanism, like all reflexes, pain receptors, the impulse to the spinal cord is the first, and then sent to the treated brain. In this way, with all the parts of the nervous system and the brain many pain centers at different levels. This suggests that the perception of pain is very important for the body.

But it does not happen, what damage is and is not pain. Most often this paid tumor processes during or when there is a violation of the pain receptors. Because Kun and the constant stimulation of receptors in nerve fibers, the fibers and these are the centers of the brain irritated, not chronic pain. To deal with the more difficult they are many, because it affects the pointless fb organs and tissues, with receptors, but the pain sends so, the nervous system — nerve cells.

Back pain can be caused by many different reasons. Here I divide them according to localization (i.e. the location) of pain across the back and to investigate, which could cause damage to different levels and it affects the whole spine. We on rare diseases: to describe the most common causes of back pain encountered in practice.

1. Pain in the upper part of the back

• First, man must remove the dangerous condition – heart disease. So when the pain in the upper part of the back, the blades, especially the left, perform an electrocardiogram (ECG) to exclude an acute coronary syndrome, myocardial infarction, if the person is in old age. The heart muscle inflammation of diseases and other inflammatory heart, if the young age.
• If the ECG location of the pathology, think of dorsalgia in this part of the back is properly called torakalgiya (from the Latin word for chest – chest), i.e., violation of the spine or the muscles associated with the spine. Thoracalgia can be due to osteochondrosis of the spine damage to the chest. This is the most common cause. Increased pain to pay, when movement, especially when turning. If you look back, you can see how tense the muscles around the sore spot. These pains associated with any particular event – picked up a weight, lost, nervous, back there was a big strain. Often accompanied by pain in the sternum, aching, worse at night when lying down. If the pain is fresh — appointed injections of painkillers, vitamins, muscle relaxants, pay inside all 3 days, sometimes a week. If there is damage to the spine – herniated discs, damaged nerve roots that branch off the spine of a long-term treatment. Here it is necessary to make and x-rays of such patients are neurologists. Because it has become chronic pain more difficult to cope with. At this stage, to attach to the stronger drugs.
• It is impossible to close the poi pathology of the shoulder joint arthritis or injuries. Sometimes give pain in the back.
• The visceral level of the upper back are light. Break begins when inflammation persists to the pleura and the lungs, that is rich in pain receptors. The pain is severe, worse when breathing to reduce pain, the people lying on the affected side. If you have a fever and chest pain – the doctor is suspect of violations in the lungs. We will take x-rays, that stuff's mostly good to see. Treatment is always in the hospital. Inflammation of the pleura – pleurisy may be for different reasons. It can be bacteria, viruses, Mycobacterium tuberculosis and other infections.
• Spontaneous pneumothorax — entry of air in the pleural. Use the camera of y stanichnyj the young, which is a hereditary defect of the connective tissue (connective tissue dysplasia or JSP). Pay for It when there is a strong cough during the SARS sharp deep breathing, injury.

2. Pain near found in parts of back, lumbar region and above

• Osteochondrosis of the spine in the lumbar level occurs lumbalgia is pain without irradiation in the leg and lumbalgia – when pain extends to the outer thigh. It is a pinched nerve roots. Therefore, the doctor checks the so-called "radicular symptoms" or symptoms of tension. The patient lie down and lift back one leg member. When foot pinched nerve pain can be raised in vain at a slight angle.



• Around this level are located in the kidneys. Then the doctor check symptom pasternatskogo so gently to win him back to the area referred to, the kidneys, and if there is pain, it means that the kidneys are sick. It is often a symptom of acute kidney infection or kidney stones. Therefore, the algorithm of examination of pain in the lumbar area of the back has to be urine. When the kidney infection, acute pyelonephritis or exacerbation of chronic, sometimes high fever, pain in the lower back can be at the slightest touch. In general, the analysis of urine increased the number of white blood cells – inflammatory changes.
• The stones are not only kidneys, but also the gall bladder. Very often confused with pain in the spine disease and pain, inflammation of the gallbladder. The gallbladder right rib is located, and give pain on the right side of the back. But this is so the body insidious, the pain that in that case, cholecystitis may be given a right shoulder, lower back, legs, and even. The stone can sit not only in the gall bladder, but also in the Swamp. The stone can be, and the inflammation of the gallbladder and ducts, caused by, for example, lamblia, opisthorchis and other parasites. Usually, inflammation of the gallbladder detected by palpation of the abdomen, and particularly the definition of the reflex symptoms of inflammation of the gallbladder. If signs of cholecystitis, is sent to the patient and do an ultrasound of the abdomen gastroenterologist. If the gallstones in the acute stage – this is the surgical treatment. Insidious this disease, which can be at a temperature of bitterness in the mouth, loose stool, but no pain. This pay, long kun, when it has become chronic pain.
• Pancreatitis – inflammation of the pancreas. Pain in the back often radiates, to no avail left. It is paid when the infection covers the tail of the pancreas. If the inflammation on top of the head, then give pain in the lower back near. Here is all the clearer, acute pancreatitis can progress without dyspeptic phenomena. Here, in addition to severe pain, most often it is the "stabbing" abdominal pain can be nausea, vomiting. Pain And of course it is always associated with the violation of the diet, intake of alcohol with greasy food. Acute processes – work surgeons. The pancreas As it can begin to digest, this is called necrotizing pancreatitis and require urgent intervention. If a chronic process is the observation gastroenetrology. And diet apart from fat.
• Herpes Zoster – shingles. A paid back area, often the waist. First pain, then cold sores in the form of small bubbles. Called one of the types of herpes infection. Hardens the therapist, and usually a neurologist. The pain can be very strong, burning. This virus spreads along the nerve. Sometimes at the beginning of the pain until the rash a week and the diagnosis is difficult to determine.

3. Lower back pain

• The most common cause — manifestations of osteochondrosis. Breach of, or degenerative changes in the vertebrae at the level of the lumbosacral joint, the perceived pain in the coccyx, up the spine.
• Gynecological reason you can give back pain (all depends on anatomical position), inflammatory diseases of the female organs.
• Urinary stone disease, if the stone passes through the ureter, the use of the camera paid to the lateral lower abdomen, but it could be back.
• Pathology of the hip joint (as in our case, which is given at the beginning of the article), arthritis, osteoarthritis, or even a hip fracture can give back pain.
• Diseases of the rectum – hemorrhoids, tumors benign or malignant (if it is a malignant tumor, he gave pain, not vain, but can be a pain in the metastases in the spine, liver, lungs).
• Finally, diseases of the prostate — this can be benign dysplasia of the prostate can be prostate cancer. These diseases develop in adulthood, therefore, often occur in a long time, even without visible symptoms, but can the deterioration of the body metastasize to the lumbar spine, lungs, local lymph nodes.

4. Some diseases affect the entire spine, or its departments

• Low back pain – is the most common degenerative changes in the spine which affects the spine. There is a polysegmental lower back pain. Symptoms give Its symptoms in all parts of the spine, the diagnosis then there may be special difficulties, very often this pay because of osteoporosis.
• Osteoporosis – a decrease in the calcium content of the bones, more pronounced with age. Men and women can be different reasons for that, but the same. In women after the menopause is associated with low estrogen levels who are of childbearing age to regulate the metabolism of calcium, for men, most often due to damage to the gastrointestinal tract and malabsorption of calcium. Osteoporosis bones are brittle, thin. This also applies to the spine. There are hairline fractures at the slightest injury in the later stages.
• Multiple myeloma include leukemias group, or tumors in the blood when a tumor develops at the level of the bone marrow. More hematopoietic cells, which increases white blood cells, the pressure of the mass causes pain in the bones. When the disease affects the flat bones, most often the stomach, but can be a pain in the spine. Number Now increased cases of leukemia. It is diagnosed in English in the urine protein to Ben Jones, a modified protein, which produces the cancer cells.
• Ankylosing spondylitis and other autoimmune diseases — when inflammation of the vertebrae is autoimmune in nature, i.e. when the body produces against the agents against its own cells. There has been an increase of autoimmune diseases.
• Infectious diseases of the spine – tuberculosis (may be combined with HIV infection), syphilis, osteomyelitis is rare, but you should consider your doctor know and they. Tuberculous osteomyelitis is difficult to diagnose, often the diagnosis in the end never exhibited, but will be treated serious. Tuberculosis is an insidious disease that weakening of the immune system, it can become and the body manifest itself in unexpected symptoms. During the past year I have seen two such patients.

5. Persistent back pain can indicate a serious disease

The following symptoms, When the doctor suspects cancer and its aim is a thorough investigation:

• back pain bad are in the treatment of pain,
• a decrease in body mass
• low-grade fever (37-37,5°, which is long passed),
• anemia, decreased hemoglobin, externally it looks or as pale yellowing of the skin, bluish color of the lips, "circles" under the eyes,
• increase in erythrocyte sedimentation rate (ESR) in the General analysis of blood,
• the bleeding tendency.

The algorithm for the study of pain in the back

1. Firstly, man must pass routine tests – blood test, General, General urine analysis. This gives us an idea of the condition of the body, the inflammatory process of the status of the urinary tract. See If we want to errors with the urine, the suspect then immediately, that the pain is caused by kidney disease.

2. Biokhimicheskii blood, count liver function tests (alt, AST, bilirubin, alkaline phosphatase), CRP (C-reactive protein), rheumatoid factor, indicators of inflammatory activity, the amount of protein, the ratio is different type of proteins in the blood of the son – albumins globulins and indicators and the other, if the doctor suspects some kind of disease.

3. Tumor markers – if you suspect a neoplastic process.

4. Tests for infectious diseases: HIV, hepatitis, tubercular, syphilis.

5. X-ray of the spine shows changes of the spine, English hernias of vertebral metastasis of tumors, inflammation.

6. CT of the spine and internal organs – a very important research, it is more like an x-ray visible changes in the tissues.

7. MRI is more expensive and informative method, which is used to confirm the CT results. It is possible to do a combined survey, which captures the internal organs and the spine. This study allows us to identify the exact causes damage to internal organs.

8. Doctor If you think about a rare disease, it gives specific research (there is an auto-immune disease, rare infections, more in-depth studies to determine the state of the body).

For the treatment of back pain, of course, is prescribed depending on the cause. But always we start with the pain medications – non-steroidal anti-inflammatory drugs or antispasmodics.

Despite the different reasons for back pain, our medicine is advanced enough to establish an accurate diagnosis and start treatment. The main thing – do not start the disease and consult a doctor if the pain does not go kp: in three days, not to mention long intense pains.

Healthy!