There are primary and secondary pain sensations, each of these types can be caused by a wide range of conditions and diseases. In this article, we will try to consider only the most basic.
Nonspecific (primary). This type of pain is directly related to problems in the spine and surrounding tissues.
Causes of back pain associated with the spine:
- Scoliosis. Violation of posture, leading to a gradual curvature of the spine, displacement of the vertebrae and muscle tension.
- osteochondrosis. The reason for the development of the disease is a decrease in the depreciation ability of the spine - damage to the intervertebral discs, rupture of the fibrous ring and, as a result, infringement of the disc nucleus. Pain sensations are localized in the region of that part of the spine, in which there are pathological changes. So, with osteochondrosis of the thoracic spine, back pain is localized in the thoracic region (the back hurts between the shoulder blades and under the ribs), with osteochondrosis of the lumbar spine, a person experiences pain in the lumbar region .
- intervertebral hernia. Due to the damage of the intervertebral disc, the soft structures of the vertebrae protrude with the possibility of infringement (normal and strangulated hernia). The pain is localized to the hernia site.
- ankylosing spondyloarthritis. It is characterized by back pain and limited mobility in the spine, leading to a forced "forward bending" position in the patient.
- Osteomyelitis. The cause of the disease is an infectious process that has developed in the spine. The patient feels that the pain covers not only the spine, but also the back muscles.
- Spinal injury. In this case, the cause of back pain is an injury and its accompanying complications. The intensity of pain sensations and their localization are directly related to the type of injury and the affected part of the spine.
In 40-50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3-5% of severe back pain is associated with damage to the roots of the spinal cord (radicular pain).
Back pain associated with pathological changes in the muscles:
- Fibromyalgia. The inflammatory process develops in the muscles surrounding the spine, is characterized by symmetry and can be chronic. In this case, the back muscles hurt along the entire spine. The important point is that the maximum pain occurs when you press on certain places.
- Polymyositis. Hypothermia can cause the disease. As a result of the development of the disease, the patient feels muscle weakness and pain, which increases when trying to turn.
- Polymyalgia rheumatica. The etiology of the disease is not clear. Infectious diseases that lower immunity can serve as triggers. It is manifested by pains that increase with the development of the disease, capable of covering all parts of the back. Severe back pain affects mobility to such an extent that the patient cannot move independently. A clear asymmetry in the back is visualized.
- Charcot's disease. The symptoms are caused by inflammation of the peripheral nerves along the spine. As a result of the pathological process, in addition to quite intense pain, there is a change in the person's gait.
In 50-60% of cases of non-specific back pain, its location is in the muscles.
Specific (secondary pain). This type of pain, despite the location in the back, often has no direct relation to diseases of the spinal column or the surrounding muscular skeleton. The causes of specific pain are extremely diverse, but the most dangerous are oncological diseases. So, the pain radiating to the back can be caused by a malignant neoplasm in the area of the mammary glands, lungs or prostate, causing metastases in the spine.
Diseases that cause specific pain include:
- Pinched nerve roots in the chest. Most often, this leads to the development of intercostal neuralgia. The pain in this case is localized at the pinch site. So, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinch occurred). The pain has a different degree - from aching to sharp, stabbing. Most often, pain syndrome occurs when moving or pressing on the affected area. This fact is the main difference between intercostal neuralgia and diseases of the heart and lungs, which can also be manifested by pain under the left (or right) shoulder blade from the back.
- Diseases of the gastrointestinal tract. Most often they cause pain on the right side, in some cases it can also pass to the left side of the body. Most of the pain is located in the lumbar and sacral-lumbar regions. Sufficiently strong pain sensations are characteristic of pathologies associated with manifestations of diseases of the pancreas, colonic diverticulum, intestinal obstruction, retrocecal appendicitis, etc.
- ulcerative foci. Ulcerative lesions of the organs of the upper abdominal cavity (peptic ulcer of the duodenum and stomach) can manifest in the form of pain in the thoracic and lower lumbar back. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is localized in the lower back. The intensity of the pain can be different, but the peak is usually reached at night.
- Appendicitis. In acute appendicitis, in cases where the appendix (appendix) is located behind the cecum, the back hurts in the lumbar region. The pains are variable in nature and can range from aching, mild to sharp, intense.
- Kidney diseases. Most often they are manifested by pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation of pathologies that have a direct connection with the spine occurs on the basis of an analysis of other clinical manifestations and research results.
- Urolithiasis disease. With renal colic, the back hurts in the lumbar region. The pain is pronounced, intense, comes on suddenly and does not depend on the position of the body. The back hurts in the lumbar area and with staghorn nephrolithiasis. Manifestations of pain syndrome are of low intensity, the pain is quite painful in nature.
- Diseases of the female reproductive system and menstrual pain. In these cases, the pain is most often located in the lower back.
- Neoplasms in the pulmonary system. In this case, the pain appears at the stage when the lungs experience germination of peripheral tumor elements (metastasis) in the pleural region and chest wall. The nature of the pain is intense, debilitating.
- Cardiovascular diseases. The most common causes of localized thoracic back pain are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
- Inflammatory processes in the joints. Infectious arthritis can cause pain to radiate from the affected joint to nearby areas, including back pain.
For the most part, the causes of the manifestation of pain in the back are identical for both sexes, but it is necessary to highlight a number of diseases that differ in sexual predisposition.
back pain in men
Although the causes of back pain are mostly the same for both genders, there are a number of diseases that men are more susceptible to due to their lifestyle.
These predisposing factors include:
- jobs that involve lifting and carrying heavy loads;
- strength sports (including various martial arts, weightlifting, etc. );
- bad habits.
As a result, diseases of the musculoskeletal and cardiovascular systems in men may occur more often than in women.
Specific "male" diseases that can cause back pain are various pathologies of the prostate.
Prostatitis is an inflammatory disease of the prostate gland. At the beginning of the disease, the pain syndrome is localized in the groin, scrotum and lower abdomen, but in the second stage and in cases where the disease has become chronic, the pain spreads to the back .
The localization of pain in this case can be concentrated in the lumbosacral region or spread to the entire back. This is due to the fact that the inflammatory process affects the nerve endings, which envelop this organ in large numbers.
The intensity of the pain is directly related to the stage of the disease. So, in the acute phase, the pain is characterized as sharp and short-lived. In the chronic form, the pain syndrome is not very pronounced and is usually permanent.
Diagnosis and treatment in this case is performed by a urologist.
back pain in women
In some cases, back pain in women can have a specific character associated with the characteristics of the body and the processes that take place in it. First of all, we are talking about the reproductive sphere.
As a rule, the pain associated with gynecological diseases is localized in the thoracic and lumbosacral regions. The most common reasons include:
- Menstrual cycle. During the period of menstruation, the hormonal background of a woman changes, which leads to the appearance of a number of negative manifestations. This is mainly due to a decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold leads to the fact that even minor pain sensations become more pronounced. In addition, hormonal changes lead to irritation of the intestinal walls and fluid retention, which causes an increase in volume in some organs and, as a consequence, compression of the nerve endings of the lumbar spine. The combination of these factors causes the appearance of back pain.
- The pregnancy. Low back pain in this case can be divided into two groups: First trimester pain. If the painful sensations are accompanied by additional symptoms (bleeding, fever, etc. ), we can talk about the risks of miscarriage. Pain in the second half of pregnancy. In most cases, these pains are associated with physiological changes, namely: the active growth of the fetus, which causes a change in the center of gravity in the position of the body, and the preparation of the pelvis for the upcoming labor activity .
- Diseases of the reproductive system. Most of the pain is concentrated in the lumbar region, which is explained by the topography of the female reproductive organs. The most common causes of this manifestation of pain syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
- Menopause. During menopause, there are strong changes and fluctuations in hormone levels. Such restructuring of the body leaves an imprint on many systems of the female body. First of all, the bone system suffers, which, under the influence of hormonal changes, becomes more fragile and prone to various kinds of diseases.
- big chestThe large size of the bust, combined with poor underwear, creates an additional load on the spine, and as a result, the woman has back pain in the area of the shoulder blades and lower back.
- High heel. Wearing shoes with high heels leads to the development of a number of diseases associated with pathological changes in the musculoskeletal system and back pain.
coronavirus back pain
Coronavirus infection affects many organs, but the lungs are the first to suffer. Therefore, often pain between the shoulder blades or below them is a manifestation of inflammation that has developed in the lung tissue. Depending on which lung is more affected, the patient will feel pain under the left or right shoulder blade.
In addition to damage to the lung tissue, there is a general intoxication of the body and an increase in temperature, which can also cause pain in the back and limbs.
Back pain after coronavirus is explained by the fact that the disease can not only damage the nervous system, but, against the background of a general decrease in immunity, chronic diseases, including internal organs and the musculoskeletal system , they get worse.
back pain after sleeping
The reasons why your back hurts after sleeping can be:
- work associated with physical activity and weight lifting;
- lower back muscle tone;
- intervertebral hernia and osteochondrosis in history;
- prolonged hypothermia of the back;
- the curvature of the spine, which caused muscle tension and uneven contraction;
- excess body weight, resulting in an increased load on the back;
- stressful situations;
- uncomfortable bed.
Unpleasant sensations can have different intensity and appear under the ribs, in the lower back, between the shoulder blades and under them.
To eliminate the pain that occurs after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.
Back pain: which doctor should I contact?
The primary diagnosis of pain in the back area is made by a general practitioner. If necessary, a number of additional examinations and consultations with highly specialized specialists may be prescribed:
To make an accurate diagnosis, it is necessary to conduct a detailed analysis of the patient's condition. For these purposes, the doctor may prescribe a number of additional studies:
- Lab tests. Most often, this list includes general and biochemical blood tests, urine tests, feces, and in some cases, an analysis of hormone levels. These studies help identify possible inflammatory processes and infections. If any disease or oncological component is suspected, the doctor may prescribe a series of specific studies (biopsy, tumor markers, etc. ).
- Hardware research. They help to get a more visual picture of the course of the disease, which cannot be achieved by visual examination and palpation. The most commonly prescribed radiography, MRI, ultrasound.
back pain treatment
For qualified treatment purposes, internal consultation of specialists is necessary. Therapy is selected strictly on the basis of the diagnosis and taking into account the general condition of the patient. Self-treatment of back pain can lead to the progression of the disease or the transition to a chronic stage.
Back pain prevention
The main preventive measures depend mainly on what exactly caused the appearance of back pain. General recommendations include:
- healthy life style;
- complete and healthy nutrition;
- reasonable dose of physical activity;
- timely treatment of identified diseases;
- regular approval of preventive examinations, even by narrow-profile specialists.