Up to 76% of the population experience back pain during the course of a year; in 7% of cases, patients complain of acute back pain.The hospital's rheumatologists use the latest instruments and laboratory research methods to determine the cause of back pain.To relieve pain and further treat patients, doctors prescribe modern medications that are highly effective and have minimal side effects.Rehabilitation experts use innovative restorative treatments to speed up the recovery process for back pain patients.
What types of back pain are there?There are 4 types of back pain: localized (localized), projection, radicular (nerve root), and pain that occurs due to muscle spasm.The most common form of back pain is mixed.Lumbar pain is characterized by 3 forms of pain: muscle tension pain, neurovascular pain, and neurodystrophic pain in the form of piriformis, gastrocnemius, and gluteal syndrome.
Back pain can be classified into primary and secondary forms.Primary pain syndromes most commonly occur between the ages of 20 and 50 years.It is based on the following mechanical factors:
- Spondylosis and intervertebral osteochondrosis;
- Dysfunction of the musculoligamentous apparatus in the back;
- Herniated disc.
Purely psychogenic back pain is rare.Diagnosis is difficult because patients with psychiatric disorders often have musculoskeletal disorders and other neurological conditions that may cause pain.Secondary pain syndromes predominate in patients younger than twenty and older than fifty.
Doctors consider pain that lasts less than six weeks to be acute pain, pain that lasts between six to 12 weeks to be subacute pain, and pain that lasts more than 12 weeks to be chronic pain.Back muscle pain occurs after myositis, osteochondrosis, and injury.Prognosis for recovery and return to work differs among patients with acute, subacute, and chronic back pain.Rheumatologists use different methods to diagnose and treat various causes of pain.
causes of back pain
One of the most common causes of back pain is traumatic lesions of the spine, which occur due to excessive stress during traditional physical activities and sports.Such injuries can have the following consequences:
- Vertebral fractures;
- Deformed or ruptured intervertebral discs;
- joint capsule inflammation and stretching;
- Spinal ligament rupture.
Sudden unsuccessful movement during sustained physical activity may result in microtrauma.
The following causes of back pain have also been identified:
- curvature of the spine;
- neuralgia;
- osteochondrosis;
- Compression of nerve endings;
- Arthritis and inflammatory diseases;
- neoplastic spinal tumors;
- Fascial damage;
- Muscle spasms.
The causes of chronic back pain can be diseases of the 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 back pain radiates into the legs, sacral radiculitis should be considered.Lower back pain is characteristic of intestinal, renal, and prostate disorders in men and disorders of the female reproductive system.Pain in the midline of the back may be a sign of myocardial infarction.Pain in the back below the ribs with intercostal neuralgia.
Recently, the term “nonspecific back pain” appears frequently in clinical guidelines for addressing back pain.It represents pain associated with musculoskeletal disorders but without evidence of damage to the cervical, thoracic, lumbar, and sacral roots, or in the absence of specific damage to the spine.
Determine the cause of back pain
The hospital has unique diagnostic capabilities that allow you to quickly determine the cause of your back pain.Physicians make connections between clinical manifestations of disease and data from other research methods.The examination plan for patients with back pain includes the following diagnostic measures:
- Spine X-ray;
- computed tomography;
- Magnetic resonance imaging.
X-ray examination has important diagnostic value for back pain.Standard diagnostic methods include radiography in anteroposterior and lateral projections, and functional spinal imaging in maximum flexion and extension positions.Computed tomography and magnetic resonance imaging can elucidate the localization of the pathological process.
People with back pain need the following types of instrumental studies:
- Electrocardiogram (cardiac insufficiency);
- Magnetic resonance or contrast-enhanced computed tomography scan;
- Bone optical morphology and stability diagnosis;
- Ultrasound examination of joints and spine;
- Densitometry (measurement of bone tissue density);
- neuroelectromyography;
- Spiral arterial cardiogram.
Patients underwent complete blood count, urinalysis, C-reactive protein, and rheumatoid factor testing.The differential diagnosis of acute back pain requires identification of the following diseases:
- Potentially dangerous diseases of vertebral and non-vertebral origin (cauda equina compression, trauma, tumors, inflammatory and infectious lesions of the spine, osteoporosis and diseases of internal organs);
- Compressive radiculopathy;
- Benign musculoskeletal back pain.
Only after determining the exact cause of back pain will the doctor develop a treatment plan for the patient.
Back pain treatment
Pain syndromes are based on two main mechanisms that determine the treatment of patients with back pain: spinal injury and muscle and ligament spasm or sprain.From the first day of treatment, patients started taking 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 positively influence the production of prostaglandins associated with the mobilization of calcium in smooth muscle.For back muscle pain, patients take muscle relaxants.
Weak opioids (codeine, tramadol) may be used to relieve severe back pain if analgesics and NSAIDs are ineffective or if their use is contraindicated.Potent opioids are administered in the form of transdermal therapeutic systems in which the drug is gradually released over time.
Antidepressants are used to treat chronic back pain.They can reduce pain intensity in people with chronic back pain.The analgesic effect of antidepressants does not depend on the presence of concomitant depression.For short-term pain relief, pepper patches can be used.
People with back pain are advised to avoid bed rest and continue normal daily activities or resume as soon as possible.For acute pain in the waist, active physical exercise in the first two weeks of onset is ineffective.
One of the most effective modern treatments for chronic back pain is "pain management."This method produces a targeted effect on the affected area: painkillers are injected into precisely defined areas via radiography.Blocking pain impulses combined with a separate treatment program can provide long-term relief to patients' back pain.
Doctors at the hospital combine medication for back pain with the following types of treatments:
- physical therapy;
- massage;
- acupuncture;
- Exercise therapy.
When acute back pain occurs, your doctor may recommend that your patient wear a muscle corset.Their effectiveness for chronic pain syndromes has not been proven.Individually selected physical therapy exercises initiate the tissue repair process and fully restore motor function to the spine.Therapeutic massage and muscle stimulation using the latest equipment in a rehabilitation clinic can quickly relieve patients' back pain.These methods are necessary for the patient's complete recovery.
One of the popular non-drug methods for relieving localized back pain is transcutaneous electrical nerve stimulation.This uses electrical pulses to block pain at the painful site.Another effective pain relief method used in hospitals is biofeedback.It is created at the intersection of psychology and physiology.A special device reads information from the patient's body.A computer model of it then takes shape on the screen.It clearly shows all the processes happening in the body, including pain.If a patient has not returned to normal levels of daily activities four weeks after an episode of acute back pain, a referral to chiropractic care is warranted.
Which doctor treats low back pain?The hospital uses a multidisciplinary approach to treat patients with chronic back pain.It involves programs of pharmacotherapy, patient education, therapeutic exercises and psychotherapeutic interventions, which are carried out regularly with the participation of several specialists (neurologists, chiropractors, rheumatologists, psychotherapists, rehabilitation specialists, therapists).
Cognitive behavioral psychotherapy can reduce the intensity of back pain and improve functional status.A program that combines behavioral psychotherapy with a gradual increase in physical activity can allow patients to quickly return to normal work.
Physical rehabilitation for back pain
Therapeutic exercises play an important role in the physical rehabilitation of people with back pain.With the help of individually selected exercises, it is possible to correct motor and neurological diseases, improve nutrition and tissue recovery.Rehabilitation specialists at the hospital use ideokinesis and passive movement to treat back pain.
Passive exercises are performed within the maximum possible range of motion of the joint, in one direction, strictly in the same plane, and at the same speed.Rehabilitation practitioners start with the large joints and then gradually move to the smaller joints.Psychomotor exercises are used to restore damaged pathways of nerve impulses from the center to the periphery.They are widely used to treat persistent pain syndromes.
For patients with muscle weakness, rehabilitation therapists perform active isometric muscle exercises.The patient does not need to tense up and hold his breath while performing these maneuvers while maintaining tension.These exercises improve circulation to spastic muscles, prevent muscle atrophy, and restore the transmission of nerve impulses.When increasing muscle strength, perform active dynamic exercises from a lightweight starting position.When training is performed, the attachment points of the antagonist muscles are brought closer together, while the attachment points of the trained muscles are moved as far apart 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 thorough examination and determining the cause of your back pain, your doctor will prescribe a comprehensive treatment plan.After relieving acute pain in the spine, patients undergo rehabilitation at the rehabilitation clinic using the latest equipment and innovative techniques.