Up to 76% of the population suffers from back pain during the year;in 7% of cases, patients complain of acute back pain.The hospital's rheumatologists determine the cause of back pain using the latest instrumental and laboratory research methods.To relieve pain and better 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 spasm.The most common forms of back pain are grouped together.Lumboischialgia is characterized by 3 forms of pain: musculo-tonic in the form of piriformis, gastrocnemius and gluteal muscle syndromes, neurovascular and neurodystrophic.
There are primary and secondary back pains.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 musculo-ligamentous system of the back;
- Intervertebral disc herniation.
Psychogenic back pain in its pure form is rare.It is difficult to diagnose because the patient suffering from a mental disorder often presents with musculoskeletal disorders and other comorbid neurological disorders that can cause pain.In patients under twenty and over fifty years old, secondary pain syndrome predominates.
Doctors consider pain lasting less than six weeks to be acute, pain lasting six to twelve weeks to be subacute, and pain lasting more than twelve weeks to be chronic.Muscle pain in the back occurs with myositis, osteochondrosis and after injuries.Patients with acute, subacute, and chronic back pain differ in their prognosis for recovery and return to work.Rheumatologists use different approaches to diagnose the cause of various pains and treat them.
Causes of back pain
One of the most common causes of back pain is traumatic spinal injuries, which occur as a result of excessive stress during stereotypical physical and sports activities.Such injuries have the following consequences:
- Spinal fracture;
- Deformation or rupture of the intervertebral discs;
- Inflammation and stretching of the joint capsule;
- Rupture of spinal ligaments.
Microtrauma can occur as a result of an unsuccessful sharp movement during constant physical activity.
The following causes of back pain are also identified:
- Curvature of the spine;
- Neuralgia;
- Osteochondrosis;
- Compression of nerve endings;
- Arthritis and inflammatory diseases;
- Oncological tumors of the spine;
- Fascia damage;
- Muscle spasm.
The causes of chronic back pain can be diseases of internal organs (heart, lungs, kidneys), burns, cancer pathology, sedentary lifestyle and emotional overload.Severe back pain can be caused by uncontrolled use of certain medications.If the back pain radiates towards the leg, consider sacral radiculitis.Back pain in the lumbar region is characteristic of diseases of the intestines, kidneys, prostate in men and diseases of the reproductive system in women.Pain in the spine in the middle of the back can be a manifestation of myocardial infarction.Pain under the ribs of the back occurs with intercostal neuralgia.
Recently, in clinical guidelines dealing with the problem of back pain, the term "non-specific back pain" is often used.It refers to pain associated with musculoskeletal disorders without signs of lesions of the cervical, thoracic, lumbar and sacral roots, or specific lesions of the spine.
Determining the cause of back pain
The hospital has unique diagnostic capabilities that allow you to quickly determine the cause of back pain.Doctors link clinical manifestations of the disease with data from additional research methods.The examination program for a patient with back pain includes the following diagnostic measures:
- Radiological examination of the spine;
- CT scan;
- Magnetic resonance imaging.
X-ray examination has important diagnostic value for back pain.Standard diagnostic methods include radiography in anteroposterior and lateral projections, functional spondylograms in the position of maximum flexion and extension.Computed tomography and magnetic resonance imaging help to clarify the localization of the pathological process.
Patients suffering from back pain are prescribed the following types of instrumental studies:
- Electrocardiography (in case of cardiac dysfunction);
- Magnetic resonance or computed tomography with contrast;
- Optical skeletal topography and stabilization diagnostics;
- Ultrasound examination of joints and spine;
- Densitometry (determination of bone tissue density);
- Electroneuromyography;
- Spiroarteriocardiorythmography.
Patients undergo a complete blood count, urinalysis, C-reactive protein and rheumatoid factor tests.The differential diagnosis of acute back pain is carried out between the following diseases:
- Potentially dangerous diseases of spinal and non-spinal origin (compression of the cauda equina, traumatic, tumor, inflammatory and infectious lesions of the spine, osteoporosis and diseases of internal organs);
- Compression radiculopathy;
- Benign musculoskeletal back pain.
Only after establishing the exact cause of the back pain, doctors draw up a treatment plan for the patient.
Back pain treatment
The pain syndrome is based on 2 main mechanisms which determine the management of a patient suffering from back pain: damage to the spine and a spasm or sprain of the muscles and ligaments.From the first day of treatment, patients are prescribed nonsteroidal 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 affect the production of prostaglandins associated with the mobilization of calcium in smooth muscles.For muscle pain in the back, patients are prescribed muscle relaxants.
If analgesics and nonsteroidal anti-inflammatory drugs have no effect or there are contraindications to 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 gradual and sustained release of the drug.
Antidepressants are prescribed to treat chronic back pain.They reduce the intensity of pain in patients suffering from chronic back pain.The analgesic effect of antidepressants does not depend on the presence or absence of concomitant depression.For short-term pain relief, pepper patch applications may be used.
Patients suffering from back pain are advised to avoid bed rest and continue with normal daily activities or resume them as soon as possible.With acute pain in the lumbar region, active physical exercise is ineffective during the first two weeks of the disease.
One of the most effective modern treatments for chronic back pain is “pain management.”The method is a targeted effect on the affected areas: painkillers are injected into precisely defined areas by x-ray.Blocking pain impulses in combination with a set of individual treatment procedures can relieve the patient of back pain for a long time.
Doctors of the hospital combine drug treatment of back pain with the following types of treatment:
- Physiotherapy;
- Massage;
- Acupuncture;
- Physiotherapy.
In case of acute back pain, the doctor may recommend that the patient wear muscle corsets.Their effectiveness in chronic pain syndrome has not been proven.Individually selected physiotherapy exercises start the process of tissue restoration and completely restore the motor functions of the spine.Therapeutic massage and myostimulation using the latest equipment that the rehabilitation clinic is equipped with can quickly relieve the patient of back pain.These methods are necessary for the complete recovery of the patient.
One of the most popular non-drug methods for relieving localized back pain is transcutaneous electrical nerve stimulation.This is a pain blockade using electrical impulses at the site of its 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 trained on the screen.It clearly shows all the processes occurring in the body, including pain.If the patient does not return to a normal level of daily activity four weeks after the onset of acute back pain, it is necessary to refer them to chiropractic therapy.
Which doctor treats back pain?The hospital takes a multidisciplinary approach to treating patients with chronic back pain.These are programs of drug treatment, patient education, therapeutic exercises and psychotherapeutic interventions, which are carried out regularly with the participation of several specialists (neurologist, vertebrologist, rheumatologist, psychotherapist, rehabilitator, therapist).
Cognitive-behavioral psychotherapy reduces the intensity of back pain and improves functional status.Programs combining behavioral psychotherapy and gradual increase in physical activity allow the patient to quickly return to normal work.
Physical rehabilitation for back pain
In the physical rehabilitation of patients suffering from back pain, therapeutic exercises play a major role.With the help of individually selected exercises, motor and neurological disorders are corrected, trophism and tissue restoration are improved.The hospital's rehabilitation specialists use ideomotor and passive exercises for back pain.
Passive exercises are performed with the maximum possible range of motion of the joint, in one direction, strictly in the same plane, at the same speed.The rehabilitator performs them starting with the large joints, then gradually moving to the small joints.Ideomotor exercises are used to restore damaged pathways of transmission of nerve impulses from the center to the periphery.They are widely used for persistent pain syndrome.
For patients with muscle weakness, rehabilitation therapists prescribe active isometric muscle exercises.Patients perform them without straining or holding their breath, while maintaining tension.These exercises improve blood circulation in spasmodic muscles, prevent muscle wasting and restore the transmission of nerve impulses.When increasing muscle strength, active dynamic exercises are used from light starting positions.When performing them, the attachment points of the antagonist muscles are brought together and the attachment points of the trained muscle are spaced apart 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 make an appointment with a neurologist or rheumatologist.After a complete examination and determination of the cause of back pain, the doctor will prescribe comprehensive treatment.After relieving acute spinal pain, patients undergo rehabilitation treatment in a rehabilitation clinic using the latest equipment and innovative techniques.