The pain in the back — what to do?

Each day, one or two of a patient is mandatory. Regardless of age and sex, the activity and the physical. What is the pain? It is a protective reaction of the body, is very useful, because if there's no pain we can not know, that in the body, there are violations, that your health is faced with a threat.

The mechanism of development of pain in the body is similar to all the reflexes of the pain receptors of the momentum goes first in the spinal cord, and then is processed and transmitted to the brain. In this way, involving all the departments 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 happens that there is damage, and the pain is not. Most often, this occurs when the tumor process or when there is a violation of the pain receptors. When, because of the irritation of receptors and nerve fibres, the fibres and the centres in the brain are irritated, you are having chronic pain. The process much more difficult, because he is amazed to see not only the organs and tissues, where are the receivers, but they transmit the pain of the cells of the nervous system — the neurons.

Back pain can be caused by many different factors. Here, we share their location (i.e. the location) of the pain in the various departments of the back and discuss, which can hurt at different levels, and that affects the entire spinal column. We do not touch of rare diseases: to describe the most common causes of pain in the back, occur in practice.

1. The pain in the departments of the back

• First of all, you need to eliminate the most dangerous state of heart disease. Therefore, if pain in the departments of the back, in the area of the blades, especially the left, to prescribe the ECG (using electrocardiography), in order to exclude an acute coronary syndrome, myocardial infarction, if a person in old age. Myocarditis, and other inflammatory diseases from heart disease, so young age.
• If cardiogram without pathology, thinking of dorsalgia, in this part of the back correctly called torakalgiya (from the latin word thorax – chest), that is to say, the violation of the most of the spine or the muscles associated with the spine. Torakalgiya may be caused by osteochondrosis of the spine during a damage in the chest. It is the most common reason. The intensification of the pain occurs when driving, in particular during the rotation. If you look at this the back, we see, as tense muscles around the patient space. Linked to these pain with a certain event – raised the severity, cool, nervous, was a great load on the back. Often accompanied by pain in the region of the sternum, pain, growth of the night in the supine position. If the pain costs are appointed by the bites of analgesic, b-complex vitamins, muscle relaxants, everything is done for 3 days, rarely a week. If there is an injury of the spine the herniated disc, damage to the nerve roots are leaving the spinal column – a long-term treatment. Here it is necessary to do x-rays, and these patients lead to the neurologists. Because that formed the chronic pain with which the most difficult to manage. At this point, connect more stronger medication.
• We cannot exclude the pathology of the shoulder joint – arthritis or injury. It happens that the pain make it in the back.
• Of internal organs at the level of the top of the back are light. Back pain starts when the inflammation moves on the pleura envelops the lungs, rich painful receptors. The pain is strong, are enhanced in the breathing, in order to reduce the pain, the people lie down on the patient side. If there is temperature and pain in the chest, the physician should suspect irregularities in the lungs. Do x-rays, on which, most often, well, everything is visible. The treatment is still in the hospital. Inflammation of the pleura – pleurisy — is with different causes. Call can bacteria, viruses, such as mycobacteria and other infections.
• Pneumothorax spontaneous — air in the pleura. Often in stanichnyj young people with a hereditary defect of the connective tissue (dysplasia of the connective tissue, or JSP). He comes with a strong cough during the SARS, the inspiration, the deep trauma.

2. The pain in the average of the departments of the back, lumbar region and more

• Osteochondrosis of the vertebral column at the lumbar level is manifested as lumbalgia – it is a pain without irradiation in the leg, and lumbalgia – when the pain spreads to the external surface of the thigh. This is the case of interference to the roots of the nerves are. This is why the doctor checks the so-called "radicular symptoms or symptoms of tension. The patient lies on her back and raises a second step. When the interference to the nerve because of the pain in the leg can be raised only under a small angle.



• Almost at this level are the kidneys. Here, the doctor checks the symptom Pasternatskogo, that is to say, slightly beat the back to the normalization of the kidneys, and if the pain appears, it means that the kidneys are sick. Most often it is the sign of an acute inflammation of the kidney or renal calculi. Therefore, in the algorithm of the investigation of pain in the lumbar region of the back, always a urine analysis. When inflammation of the kidneys, acute pyelonephritis or worsening of the chronic, it happens at a high temperature, pain in the lower back can be, at the slightest touch. In general, the analysis of urine promoted the number of leukocytes is inflammatory.
• The stones are not only in the kidneys, but in the gallbladder. Very often confused with the pain of the pathology of the spine, and the pain of the inflammation of the gallbladder. The gallbladder is located right under the rib, and the pain traveling in the right half of the back. But this body is treacherous as well as pain during the cholecystitis can give the right shoulder, lower back and even into the foot. The stone can "sit", not only in the gallbladder, but in the common bile duct. Can stone not to be, and to be an inflammation of the gall bladder and vas deferens, resulting, for example, Giardia, opisthorchis and other parasites. Usually, the inflammation of the gallbladder is revealed during palpation of the abdomen and of the definition of special symptoms of the inflammation of the gallbladder. If revealed signs of cholecystitis, the patient is send to do an ULTRASOUND of the abdomen and to a gastroenterologist. If cholelithiasis in the acute phase is already a surgical treatment. Cunning this disease, which may not be the temperature, the bitterness in the mouth, watery stool, as well as the pain. This occurs after a long period of time, when he formed the chronic pain.
• Inflammation of the pancreas – pancreatitis. The pain is often giving away in the back, just to the left. This happens when the inflammation covers the tail of the pancreas. If the inflammation in the area of the head, pain traveling in the lower back and right in the middle. Here, everything is more clear, acute pancreatitis simply cannot occur without dyspeptic phenomena. Here, with the exception of a severe pain, most often it is the "dagger" pain in stomach, perhaps nausea, vomiting. And, of course, the pain is always related to a violation of the plan, it is the reception of the alcohol combined with fat food. Sharp work processes for surgeons. Because the pancreas may start to digest itself, it is called pankreonekroz and requires an emergency response. If the process is a chronic observation gastroenetrology. And the plan with the exception of fat.
• The herpes Zoster shingles. Occurs in the region of the back, usually to the waist. First of all, the pain, the sweat, herpes in the form of small bubbles. Caused by one of types of the herpes simplex infection. Usually processes the therapist and the neurologist. The pain can be very strong, burning. This virus spreads along the nerve. Sometimes, the onset of pain the rash a week and the diagnosis is difficult to determine.

3. Pain lumbosacral

• The most common reason — the manifestations of the degenerative disc disease of the spine. The violation or degenerative changes in the vertebrae at the level of lumbosacral articulation, aching in the tailbone to the top or spine to a pole.
• The causes that can give pain in the back (it all depends on the anatomical position), inflammatory diseases of the organs female.
• Urolithiasis, if the stone is in the ureter, most commonly in the lower parts of the abdomen, but can be and in the back.
• The pathology of the hip joint (as in our case, that is first of the article), arthritis, osteoarthritis, or even a fracture of the hip can produce pain in the lower back.
• The diseases of the rectum – hemorrhoids, the institute of benign or malignant (if the tumor is malignant, they give pain, not only in themselves, but perhaps the pain and metastases in the spine, liver, lungs).
• Finally, the disease of the prostate may be benign dysplasia of prostate cancer, may be cancer of the prostate. These diseases develop in adulthood, therefore, often takes place during a long period of time, even without visible symptoms, but with the weakening of the body can give metastases in the lumbar spine, in the lungs, local lymph nodes.

4. Some diseases affect the spine or its services

• Osteochondrosis – the most often it of the degenerative changes of the spine, which affected all departments of the spine. There are polysegmental osteochondrosis. Its manifestations produce signs and symptoms in all departments of the spine, therefore, for the diagnosis can be particular difficulties, very often, this occurs due to osteoporosis.
• Osteoporosis – a decrease in the calcium content in the bones, occur with age. Men and women is different reasons, but in the same way. In women after the menopause is associated with low levels of estrogen, which in of reproductive age) regulate the metabolism of calcium in men is most often due to a lesion of the gastrointestinal tract and disorders of the absorption of calcium. In osteoporosis the bones are brittle, purposes. This relates to the spine. Experience of micro-diseases at the slightest injury at advanced stage.
• The myeloma disease – refers to a group of leukemias or blood institute, when the tumor grows to the level of the bone marrow. Increases the number of cells of the hematopoietic system, which turns in the leukocytes, the pressure of this mass causes bone pain. When this disease affects the flat bones, most commonly the sternum, but can be a pain in the spine. Now, an increase in the number of cases of leukemia. Diagnosed by the presence in urine of proteins Ben Jones, modified proteins, which produce tumor cells.
• Ankylosing spondylitis and other autoimmune diseases — when the inflammation of the vertebrae inauspicious auto-immune in nature, that is to say, when the body produces antibodies against its own cells. Now, there is an increase in autoimmune diseases.
• Infectious diseases of the spine – tuberculosis (may be combined with HIV), syphilis, osteomyelitis is very rare, but the physician must take into account and know. Tuberculous osteomyelitis is difficult to diagnose, most often, the diagnosis is ultimately not identified, but the treatment must be carried out seriously. Tuberculosis is an insidious disease, and any weakening of the immunity, it can enter the body and manifest symptoms of unexpected. Last year I saw two of these patients.

5. A persistent back pain can indicate a serious illness

When the symptoms of a doctor suspected the oncology and sends it to an in-depth review:

• the pain in the back of a bad pass in the treatment of pain,
• a reduction of the mass of the body,
• low-grade fever (37-37,5 degrees, which is a long time does not pass),
• anemia, decreased hemoglobin, outwardly, it resembles a pallor or yellowing of the skin, cyanosis of the hue of the lips, the "community" under the eyes,
• the increase of the sedimentation rate (vs) in general, the analysis of blood,
• a bleeding tendency.

The algorithm of the investigation of the pain in the back

1. First of all it is necessary to pass routine tests – blood analysis, urine analysis. This will give us an idea of the state of the body, the inflammatory processes in it, the state of the urinary tract. If we see a change in the analysis of the urine, then immediately suspect that the pain caused by namely of kidney disease.

2. Biokhimicheski a blood analysis, are taken into account liver function tests (ALT, AST, bilirubin, alkaline phosphatase), PSA (c-reactive protein), rheumatoid factor — indicators of the activity of the inflammation, the amount of protein, the ratio of different types of proteins in the blood, albumin and globulins, and other indicators, if the doctor suspects any disease.

3. Tumor markers – in case of suspicion of tumor process.

4. The tests on infectious diseases, the HIV, viral hepatitis, tubers, syphilis.

5. The x-ray of the spine – shows the change in the spinal of the pole, hernias vertebrae, metastasis of the institute, the inflammatory phenomena.

6. CT of the spine and internal organs – a very important survey, it is better than on the x-rays are visible changes in the tissues.

7. MRI – more expensive and informative of the method used to refine the results of the ct scan. You can pass combined the survey that capture the internal organs and even the spine. This survey allows us to identify the causes of damage to internal organs.

8. If the doctor thinks something of the rare disease he attributes of surveys special (on the autoimmune diseases rare of the infection, and research in greater depth to determine the state of the body).

The treatment of pain in the back, of course, is appointed according to the cause. But we always start with the pain relievers – nonsteroidal anti-inflammatory or antispasmodic.

Despite the diversity of causes of pain in the back, our medicine is developed enough, in order to establish an accurate diagnosis and proceed to treatment. The most important thing to not run the disease and consult a doctor if the pain does not pass in a period of three days, not to mention long intense pain.

Be in good health!