Backache

What should you do if suddenly severe back pain appears, how to relieve the pain and can you do it yourself? Of course, it is good to know how to help yourself in case of sudden severe pain, but you should not limit yourself to this: after the first emergency self-aid, you should immediately consult a doctor. At the Paramita clinic in Moscow they will always help you: they will determine the cause of the pain and get rid of it.

What to do for acute back pain

Back pain occurs periodically in 60-80% of the population. This is the second most common cause of temporary disability after acute respiratory viral infections. Acute back pain can start suddenly and end just as suddenly, but it can subside a little and become chronic. This should not be tolerated; it is better to seek medical help immediately.

Just don't panic

The appearance of severe back pain does not mean that a person cannot be helped; in most cases, all this can be treated successfully, which means that there is no need to panic. But it is important to know how to help yourself and reduce the pain, and then immediately consult a doctor. Contacting a specialist is necessary, as back pain is caused by many diseases and they require different approaches to treatment.

How to ease your condition yourself

Sometimes the pain syndrome is so strong that the person remains in the position in which the attack caught him. In this case you need:

• Lie on your back on a hard surface, or on the floor, with a blanket over it; if you cannot straighten your back, then you should take a position that causes minimal pain.
• Ask your loved ones to give you a tablet of any pain reliever; all of them can be bought in pharmacies without a prescription:
• Apply any soothing medicine for external use to the skin over the painful area: rubbing solution, ointment, gel, emulgel and other over-the-counter drugs:
• Call an ambulance; the doctor will give you an anesthetic injection (usually injectable solutions of NSAIDs) and advise you on the best course of action: call a doctor at home or go directly to a specialized clinic.

When you should go to the doctor urgently for back pain

You should contact the clinic immediately if you have severe back pain:

• appeared after an injury;
• accompanied by high body temperature and maltreatment;
• as a result, problems with urination and defecation appeared;
• accompanied by impaired motor function of the limbs and their numbness;
• it has a banded nature, covering not only the back, but also the abdomen (suspicion of acute pancreatitis);
• radiates to the left hand (suspected myocardial infarction);
• it grows, it is not removed with tablets and ointments.

It is impossible to help yourself in such a state. To avoid serious complications, you should consult a doctor.

What to do for back pain of different types

Back pain can be different: acute, radiating to different parts of the body, deep, aching, very strong, constant or wavy. It can also be placed on different parts of the back: neck, chest, lower back, sacrum and coccyx. Even after a complete examination, it is not always possible to find out the cause of the back pain, and then they say that it is non-specific.

Such pain is called nociceptive, accompanied by irritation of pain receptors in tissues (muscles, ligaments, bones). Exciters can be mechanical (injurious), physical, chemical and inflammatory in nature. Moreover, the degree of changes in the spine does not always correspond to the intensity of the pain. Nonspecific pain accounts for about 80% of all back pain syndromes.

Neuropathic pain syndrome is associated with damage to nerve roots and nerve trunks. These pains account for 7-8% of all pain syndromes; their feature is the high possibility of confirming the diagnosis during instrumental studies.

The third type of pain - specific pain syndromes (for example, with spinal tuberculosis) are relatively rare.

Severe back pain due to coronavirus and other acute respiratory viral infections

With any acute respiratory viral infection, accompanied by a sudden onset and fever, muscle pain in the back, pain throughout the body and severe weakness may occur. These painful sensations are accompanied by general intoxication of the body. During a coronavirus infection with high fever, back pain can be one of the first manifestations.

When coronavirus pneumonia occurs, back pain increases due to damage to the pleura, which has many nerve endings, as well as due to the constant tension of the spinal muscles during obsessive coughing. A large amount of lactic acid accumulates in the back muscles, causing irritation and pain.

What will help: you can take Paracetamol orally - it is an analgesic and antipyretic. Taking any NSAIDs by mouth and applying them to the skin in the form of ointments and gels will also help.

Severe pain in the upper back (cervical back)

Acute pain syndrome can be of a mixed nonspecific and neuropathic nature. Non-specific pains are often associated with a forced wrong position at the table during work, tension in the muscles of the back and neck. A short-term painful attack may appear with angina and radiate to the left arm.

Neuropathic pain has an acute, burning nature, radiates to the arm and shoulder blade on the affected side and is associated with pinched nerve roots of the cervical spine.

How can I help:

• for pain due to diseases of the spine - NSAIDs;
• heart attack - nitroglycerin tablet under the tongue; if the pain does not go away within a minute, take another tablet and call an ambulance.

Severe chest and shoulder pain

The back in the chest region and between the shoulder blades most often hurts due to a sedentary lifestyle and the body in an uncomfortable position for a long time. Very often, this condition appears in those who sit in front of the computer for several hours a day. Weakened muscles cannot withstand the load and get injured.

A child's development can be impaired due to incorrect posture - a lateral curvature of the thoracic spine occurs - scoliosis. If measures are not taken in time, the vertebrae are displaced and a compression fracture can occur.

Severe pain between the shoulder blades can occur when the spinal nerve roots of the thoracic spine are pinched. It may radiate to the intercostal spaces or the left arm and resemble an attack of angina, but is not relieved by nitroglycerin.

Acute pain in the shoulder area can appear due to various diseases of internal organs: heart, stomach, pancreas, lungs (with damage to the pleura), kidneys, gall bladder.

How can I help:

• in case of damage to the musculoskeletal system - NSAIDs (see the section "How to relieve your condition yourself");
• for spasm of the arteries that supply the heart muscle (angina attack) - a nitroglycerin tablet under the tongue;
• for diseases of internal organs - only a doctor can decide; in some cases, taking painkillers can lead to serious complications, for example, with appendicitis or cholecystitis, pain that indicates the need for surgery can be removed.

If you do not understand what hurts you, it is better to call an ambulance.

My lower back hurts a lot

Acute low back pain syndrome is most often associated with the condition of the spine, is non-specific in nature and accounts for about 80% of all pain in this area.

Neuropathic pain syndrome accounts for about 7-8%. Thus, sudden acute pain in the lower back (lumbago) is usually associated with compression of the spinal roots in the lumbar spine. Sudden acute pain in the buttocks, radiating to the back of the thigh (sciatica) is a pinched or inflamed sciatic nerve.

The lower back can also hurt with diseases of the kidneys, urinary tract and genitals.

How can I help:

• for myositis - NSAIDs;
• for neuropathy - NSAIDs do not always relieve pain, you should consult a doctor to prescribe a full course;
• for diseases of internal organs - it depends on the diagnosis, which can only be established by a doctor.

Severe back and stomach pain

Such pains are dangerous, most often they are associated with diseases of internal organs. When they appear, they first think of acute pancreatitis. The acute pain syndrome is of a surrounding nature, accompanied by nausea, vomiting and requires urgent hospitalization of the patient. If this is not done, necrosis of the pancreatic tissue may occur and the patient will die.

Less commonly, back pain occurs with kidney disease. This condition also requires medical attention. With cholecystitis and an attack of cholelithiasis, the pain can appear on the right side, radiating up to the collarbone.

Acute lumbar pain can occur with intercostal neuralgia caused by compression of the spinal roots of the lower parts of the thoracic spine. The pain is so strong that it deprives the patient of sleep.

How can I help:

• for intercostal neuralgia - NSAIDs;
• for diseases of internal organs - immediately call an ambulance; Before the doctor comes, you can take 2 No-shpa tablets.

Severe back pain that radiates to the legs

Radiating acute pain in the buttocks and on the back surface of the right or left leg up to the knee indicates damage to the nerve roots of the lumbar region with the involvement of the sciatic nerve in the process. The pain syndrome is particularly strong, has the character of an electric discharge and is accompanied by painful convulsive tremors.

How to help: call an ambulance as soon as possible, and before that take NSAIDs and apply anesthetic ointment, but this is not very effective.

My back hurts when I inhale too much

Painful breathing occurs more often:

• with intercostal neuralgia - the pain is intensified by any movement, including inhalation and coughing;
• for acute diseases of the lungs and bronchi involving the pleura - pleuropneumonia, lung cancer.

How to help: call a doctor at home and understand the problem; It is impossible to do this yourself.

My back hurts a lot under my ribs

This localization is often associated with diseases of internal organs:

• sharp, severe pain that does not subside and does not relieve, radiating to the stomach and spreading to the opposite side of the back; accompanied by nausea and vomiting - in acute pancreatitis;
• acute paroxysmal pain, often radiating to the groin area - with urolithiasis during the passage of a stone through the urinary tract.

How to help: call an ambulance - this is an emergency situation that often requires hospitalization; A pain reliever can help ease the pain a bit.

Back pain

Acute pain in the sides of the back can also be associated with diseases of the musculoskeletal system and internal organs. Based on the location and nature of the pain, its origin can be assumed. If there is pain on the right side:

Location on the right side of the middle of the back:

1. acute pain radiating along the nerves between the ribs - it can be assumed that the nerve roots of the thoracic spine are pinched;
2. local pain – muscle inflammation;
3. deep, aggravated by deep inspiration and coughing - often associated with diseases of the pleura - pleurisy, lung cancer with germination in the pleura.

Location on the right side under the ribs:

1. intercostal neuralgia due to damage to the right nerve root;
2. diseases of the pancreas, liver and biliary tract.

Pain on the left side:

1. Severe burning pain along the ribs at any level is neurogenic pain associated with spinal pathology.
2. Acute, sudden, short-term pain in the upper and middle back, often radiating to the left arm - an angina attack.

How can I help:

• for diseases of the spine - NSAIDs;
• for angina pectoris - Nitroglycerin under the tongue;
• for attacks of pancreatitis, cholecystitis, urolithiasis - take 2 No-shpa tablets.

If the pain does not go away, you should call an ambulance.

Back muscles hurt a lot

Pain in the back muscles occurs with a cold, acute respiratory viral infection, or after a long workout. In people who lead a sedentary lifestyle, muscles can ache even with little physical activity.

Any spine disease (osteochondrosis, disc herniation, scoliosis, etc. ) is always accompanied by tension in the back muscles, as they protect the spine from any negative impact. At the same time, muscle tension increases back pain.

How to help: contact a neurologist, do an examination and find out the cause of the pain; You can relieve severe pain yourself by using an NSAID ointment or gel, but it will be difficult to completely get rid of the pain.

Severe back pain at night and in the morning

Back pain at night and in the morning is a serious symptom, one of the signs of the inflammatory process. As a rule, the pain is combined with other symptoms: age up to 40 years, gradual onset, stiffening of movements in the morning for up to half an hour or more, elimination of pain after starting physical activity.

This is a serious symptom that deprives patients of sleep and develops in diseases such as ankylosing spondylitis (ankylosing spondylitis), reactive arthritis, psoriatic arthritis, chronic juvenile arthritis, arthritis associated with chronic inflammatory bowel disease.

How to help: do not do anything yourself, you should contact a rheumatologist, do an examination and treat the identified pathology.

Severe back pain during pregnancy

Pain syndrome during pregnancy is mechanical in nature. A growing fetus increases the load on the muscles and ligaments of the back. In the muscles of the back, with constant tension, an increased amount of lactic acid is produced, which leads to the appearance of painful muscle pain.

The pain syndrome can also have an acute, paroxysmal nature, which indicates damage to the spinal roots against the background of a large load on the spine. A pregnant woman experiences severe pain, lacks sleep and is constantly in a state of stress.

How can I help:

• contact a neurologist or an antenatal clinic therapist, he will conduct an examination and prescribe the necessary treatment; You cannot take medicine yourself: many NSAIDs are contraindicated during pregnancy;
• Wearing a bandage to support the abdomen is indicated.

The most common diseases that cause back pain

Back pain syndrome in most cases develops against the background of any disease of the musculoskeletal system, neuroendocrine system or internal organs. The most common are osteochondrosis, intervertebral hernia, ankylosing spondylitis, oncological processes in the spine, etc.

Osteochondrosis and disc herniation

This is a degenerative-dystrophic process that leads to the gradual destruction of the intervertebral discs (shock-absorbing cartilaginous plates with an elastic core in the middle). Discs crack, lose their elasticity and may collapse completely. In this case, the core of the disc stretches and compresses the nerve roots or the spinal cord - a disc herniation develops.

When the roots are pressed, severe back pain appears, often radiating to large nerve trunks. Most often this happens in the middle region, which can withstand the highest load. It first hurts in the lumbar region, and then radiates to the back surface of the lower limbs (lumboischialgia). The sooner the treatment for this disease is started, the sooner the patient will get rid of the pain.

Ankylosing spondylitis

The correct name of the disease is ankylosing spondylitis. This is a chronic inflammatory systemic disease of the connective tissue that is associated with autoimmune processes (allergy to the patient's own tissues) and severe heredity. They are mainly men under 40 years old.

Damage to the joints and ligaments of the spine appear, accompanied by severe back pain and the gradual formation of immobility of the spine (ankylosis). The process starts in the lower parts of the spine and gradually goes up. The characteristics of the pain syndrome are: back pain at night and in the morning, stiffness in the morning, which goes away no less than half an hour after waking up and starting active movements. It is very important to immediately pay attention to these symptoms and consult a doctor as soon as possible.

Lung cancer

The tumor develops slowly from the mucosa of large or small bronchi. At first, the disease is asymptomatic, then a cough appears and inflammatory processes develop periodically in the bronchi and lungs. When the tumor grows in the pleura (a thin layer that covers the chest with one layer and the lungs with the other), back pain appears, which intensifies with deep breathing, coughing or sneezing.

If you experience back pain that worsens with breathing and coughing, you should immediately consult a doctor!

Diagnosing

Accurate diagnosis of the disease is very important, as treatment is prescribed based on its results. It is determined on the basis of a survey and examination of the patient by a doctor and additional examination data, including:

• Laboratory tests - general and biochemical blood tests, urine tests; immunological blood tests, rheumatoid factor;
• Instrumental studies: X-ray of the spine; magnetic resonance or computed tomography (MRI or CT); radioisotopic scintigraphy – performed at the slightest suspicion of oncological pathology.

But even with a thorough examination, it is not always possible to identify or exclude one or another cause of pain.

How to treat back pain

The main goal of treatment is to relieve pain and suppress the transition of an acute pathological process to a chronic one. For this purpose, the treatment of the underlying disease is prescribed, as well as symptomatic therapy with drugs and non-drug treatment methods.

Algorithm for the treatment of acute pain syndrome:

• short-term bed rest (2 – 5 days) in combination with drug therapy and reflexology (RT); long-term adherence to bed rest contributes to the transition from an acute process to a chronic one; it is possible to prescribe a short course of wearing orthopedic devices: a cervical collar for pathology in the upper back and neck or lumbar girdle;
• half bed rest for the next 7 - 8 days; the course of drug therapy and RT continues, light physical exercises and physiotherapeutic procedures (electrophoresis with sedative medicinal solutions) are added;
• mode of physical activity with small restrictions (10-20 days); drug therapy is carried out according to indications; physiotherapy (laser and magnetic therapy), RT; add a course of manual therapy and massage;
• a mode of physical activity without restrictions (but without lifting weights) by performing specially selected exercise therapy exercises;
• pain prevention – regular exercise therapy and possible sports to raise the quality of life to a new level.

Drug therapy

Since the examination does not always reveal the causes of the pain, the treatment takes into account its nature (nociceptive, neuropathic):

1. For very strong, sharp pain, paravertebral blocks with novocaine are performed. If the pain syndrome is not relieved, epidural blocks are performed - pain relief by injecting anesthetics into the epidural cavity located between the dura mater and the periosteum of the spine.
2. Less severe pains are relieved by intramuscular administration of drugs from the NSAID group. The selection of drugs is carried out individually, taking into account the properties of the drug and the individual characteristics of the patient. The most effective drug can cause gastrointestinal complications, so if the patient has stomach disease, more modern NSAIDs will help relieve back pain.
3. To eliminate back muscle spasms, muscle relaxants are prescribed.
4. B vitamins (B1, B6, B12) have a beneficial effect on the peripheral nervous system and increase the analgesic effect of NSAIDs. These medications can be given as injections of individual vitamins or as a solution containing all 3 vitamins and the pain reliever lidocaine. After the condition improves, you can take tablets orally.
5. For neuropathic pain associated with the involvement of nerve fibers in the process, antidepressants and anticonvulsants are included in the complex treatment. These medications help relieve pain.

When treating severe back pain, the most important thing is to prevent acute pain from turning into chronic pain. Therefore, the patient should seek medical help as soon as possible.