Up to 76% of the population experiences back pain during the year;in 7% of cases, patients complain of acute back pain.The hospital's rheumatologists use the latest instrumental and laboratory research methods to determine the cause of back pain.To relieve pain and further treat patients, doctors prescribe modern drugs that are highly effective and have minimal side effects.Rehabilitation specialists use innovative methods of restorative therapy to speed up the recovery process for patients with back pain.
What types of back pain are there?There are 4 types of back pain: local (local), projection, radicular (radicular) and pain due to muscle spasms.The most common forms of back pain are combined.Lumboischialgia is characterized by 3 forms of pain: muscle tonic in the form of syndromes of the piriformis, gastrocnemius and gluteal muscles, neurovascular and neurodystrophic.
There are primary and secondary back pain.Primary pain syndrome most often develops between the ages of 20 and 50.It is based on the following mechanical factors:
- Spondylosis and intervertebral osteochondrosis;
- Dysfunction of the muscle-ligament apparatus of the back;
- Intervertebral disc herniation.
Psychogenic back pain in its pure form is rare.It is difficult to diagnose because a patient with a mental disorder often has comorbid musculoskeletal and other neurological disorders that can cause pain.In patients younger than twenty and older than fifty, the secondary pain syndrome predominates.
Doctors consider pain that lasts less than six weeks to be acute, pain that lasts six to twelve weeks to be subacute, and pain that lasts longer than twelve weeks to be chronic.Back muscle pain occurs after myositis, osteochondrosis and injuries.Patients with acute, subacute and chronic back pain have different prognoses for recovery and return to work.Rheumatologists use different approaches to diagnose and treat the cause of different pain.
Causes of back pain
One of the most common causes of back pain is a traumatic change in the spine, which occurs as a result of excessive stress during stereotypical physical activity and sports.Such injuries have the following consequences:
- vertebral fracture;
- Deformation or rupture of the intervertebral discs;
- Inflammation and stretching of the joint capsule;
- Rupture of the ligaments of the spinal column.
Microtrauma can occur as a result of an unsuccessful sudden movement during constant physical activity.
The following causes of back pain are also identified:
- The curvature of the spine;
- Neuralgia;
- Osteochondrosis;
- Compression of nerve endings;
- Arthritis and inflammatory diseases;
- Oncological spine tumors;
- damage to the fascia;
- Muscle spasm.
Chronic back pain can be caused by diseases of the internal organs (heart, lungs, kidneys), burns, cancer, sedentary lifestyle and emotional overload.Severe back pain can be caused by uncontrolled use of certain medications.If the back pain radiates to the leg, then sacral radiculitis should be considered.Back pain in the lower back is typical for diseases of the intestines, kidneys, and prostate in men, and diseases of the reproductive system in women.Spinal pain in the middle of the back can be a manifestation of a heart attack.Pain under the ribs from the back occurs in case of intercostal neuralgia.
Recently, the term "non-specific back pain" is often found in clinical guidelines dealing with the problem of back pain.It refers to pain associated with musculoskeletal disorders without evidence of damage to the cervical, thoracic, lumbar, and sacral roots or specific spinal injuries.
Determining the cause of back pain
The hospital has unique diagnostic capabilities that allow you to quickly determine the cause of back pain.Doctors establish a connection between the clinical manifestations of the disease and the data of further research methods.The examination program for patients with back pain includes the following diagnostic measures:
- X-ray examination of the spine;
- Computed tomography;
- Magnetic resonance imaging.
X-ray examination has an important diagnostic value in the case of back pain.Standard diagnostic methods include radiography in anteroposterior and lateral views, functional spondylogram in maximal flexion and extension.Computed tomography and magnetic resonance imaging make it possible to clarify the localization of the pathological process.
The following types of instrumental tests are prescribed for patients with back pain:
- electrocardiography (in case of cardiac dysfunction);
- Magnetic resonance or computed tomography with contrast;
- Optical topography of the skeleton and stabilization diagnostics;
- Ultrasound examination of joints and spine;
- Densitometry (determination of the density of bone tissue);
- electroneuromyography;
- Spiroarteriocardiorhythmography.
Patients undergo a complete blood count, urinalysis, C-reactive protein and rheumatoid factor.The differential diagnosis of acute back pain is made between the following diseases:
- Potentially dangerous vertebral and non-vertebral diseases (compression of the cauda equina, traumatic, neoplastic, inflammatory and infectious spinal changes, osteoporosis and diseases of internal organs);
- Compression radiculopathy;
- Benign musculoskeletal back pain.
Only after determining the exact cause of the back pain, doctors prepare a treatment plan for the patient.
Treatment of back pain
The pain syndrome is based on two main mechanisms that determine the treatment of a patient with back pain: damage to the spine and spasm or sprain of the muscles and ligaments.From the first day of treatment, patients are prescribed non-steroidal anti-inflammatory drugs (NSAIDs).Their anti-inflammatory effect is due to the inhibition of cyclooxygenase-2.NSAIDs not only inhibit the metabolism of this inflammatory mediator, but also actively influence the production of prostaglandins associated with the mobilization of calcium in smooth muscles.For back muscle pain, patients are prescribed muscle relaxants.
If painkillers and non-steroidal anti-inflammatory drugs are ineffective or there are contraindications for their use, weak opioids (codeine, tramadol) are used to reduce severe back pain.Strong opioids are used in the form of transdermal therapeutic systems with a gradual prolonged release of the drug.
Antidepressants are prescribed to treat chronic back pain.They reduce the intensity of pain in patients with chronic back pain.The analgesic effect of antidepressants does not depend on the presence or absence of concomitant depression.Paprika patches can be used for short-term pain relief.
Patients with back pain are advised to avoid bed rest and resume normal daily activities or resume them as soon as possible.In the case of acute pain in the lumbar region, active exercise is ineffective in the first two weeks of the disease.
One of the most effective modern treatments for chronic back pain is 'pain management'.The method has a targeted effect on the affected areas: the pain reliever is injected into precisely defined areas with the help of radiography.Blocking pain impulses combined with individual treatment procedures can alleviate the patient's back pain for a long time.
Hospital doctors combine drug treatment for back pain with the following types of treatment:
- Physiotherapy;
- Massage;
- Acupuncture;
- Kinesiotherapy.
In case of acute back pain, the doctor may recommend that the patient wear a muscle brace.Their effectiveness in chronic pain syndrome has not been proven.Individually selected physical therapy exercises start the process of tissue restoration and completely restore the motor functions of the spine.Therapeutic massage and myostimulation performed with the latest equipment of the rehabilitation clinic can quickly relieve the patient's back pain.These methods are necessary for the complete recovery of the patient.
One of the popular non-pharmacological methods of local back pain relief is transcutaneous electrical nerve stimulation.This is the blockade of pain with electrical impulses at the site of localization.Another effective pain relief method used in the hospital is the biofeedback method.It was created at the intersection of psychology and physiology.A special device reads information from the patient's body.After that, a computer model is formed on the screen.It clearly shows all processes occurring in the body, including pain.If the patient does not return to normal daily activity levels four weeks after the onset of acute back pain, chiropractic treatment should be referred.
Which doctor treats back pain?The hospital uses a multidisciplinary approach to treating patients with chronic back pain.It includes the programs of drug treatment, patient education, therapeutic exercises and psychotherapy interventions, which are regularly carried out with the participation of several specialists (neurologist, vertebrologist, rheumatologist, psychotherapist, rehabilitation specialist, therapist).
Cognitive behavioral psychotherapy reduces the intensity of back pain and improves functional status.Programs that combine behavioral psychotherapy with a gradual increase in physical activity allow the patient to quickly return to normal work.
Physical rehabilitation for back pain
Therapeutic exercises play an important role in the physical rehabilitation of patients with back pain.With the help of individually selected exercises, motor and neurological disorders are corrected, trophism and tissue recovery are improved.The hospital's rehabilitation specialists use ideomotor and passive exercises in case of back pain.
Passive exercises are performed in the greatest possible range of motion in the joint, in one direction, strictly in the same plane, at the same speed.The rehabilitator does these, starting with the large joints and gradually moving on to the small joints.Ideomotor exercises are used to restore the damaged pathways of transmission of nerve impulses from the center to the periphery.It is widely used for persistent pain syndrome.
For patients with muscle weakness, rehabilitation therapists prescribe active isometric muscle exercises.Patients perform these without straining or holding their breath while maintaining tension.These exercises improve blood circulation in spasmodic muscles, prevent muscle atrophy and restore the transmission of nerve impulses.When increasing muscle strength, active dynamic exercises are performed from an easy starting position.When they are performed, the connection points of the antagonistic muscles are brought closer to each other, and the attachment points of the trained muscle are separated from each other as much as possible.
In some cases, surgery is used to treat back pain.To avoid surgery, if you have back pain, call the contact center and request an appointment with a neurologist or rheumatologist.After a complete examination and determination of the cause of the back pain, the doctor prescribes a comprehensive treatment.After relieving acute spinal pain, patients undergo rehabilitation therapy in a rehabilitation clinic using the latest equipment and innovative techniques.