The pain in the back — what should I do?

Each day one or two of the patient is necessary. Regardless of age and sex, type of activity and of body. What is pain? Is a protective reaction of the organism, it is very necessary, because if there is pain, we cannot know that in the body there is a breach of your health that affects.

The mechanism of development of pain in the body is similar to that of all the reflections of the receptors painful impulse is first in the spinal cord, then is processed and sent to the brain. In this route involved all the departments of the nervous system and the brain a lot of pain centres in the different levels. This suggests that the perception of pain is very important for the body.

But what happens is that the damage is, and the pain does not. Often, this occurs when the tumor process or when there is a violation of the receptors painful. When due to the constant irritation of the receptors and the nerve fibers, the fibers and the centers of the brain annoying), you experience the chronic pain. Try to be much more difficult, because here in amazement of not only organs and tissues, where here there are receptors, but they themselves transmit the pain of the cells of the nervous system neurons.

The pain in the back area can be caused by many different causes. Here we can divide them according to the location (i.e., location) of the painful sensations in different departments back and we're going to see that you can be ill in different levels, and that affects the entire spine. Did not touch on rare diseases: to describe the common causes of pain in the back, that are found in practice.

1. The pain in the departments of the back

• First of all, it is necessary to exclude the most dangerous in the state – heart disease. Therefore, when the pain in the departments of the back, in the area of the blades, especially the left, is prescribed ecg (electrocardiography), in order to exclude acute coronary syndrome, myocardial infarction, if the person in the old age. Myocarditis, and other inflammatory diseases of the heart, if the age of the young.
• If the ecg without pathology is, we think of dorsalgia, in this part of the back is called correctly torakalgiya (from the Latin word thorax – the thoracic cage) that is to say, the violation of one's spine or the muscles associated with the spine. Torakalgiya may be due to osteochondrosis of the vertebral column when it is damaged maternal division. It is the most frequent cause. The amplification of the pain is caused by the movement, especially in the curves. To see this back, looks like you tighten the muscles around the diseased area. Relate these pains with some particular event – he raised the gravity, lost, nervous, it was a great load in the back. Often accompanied by pain in the area of the sternum, the pain, which is reinforced by the night at bedtime. If the pain fresh — are assigned to injections of analgesics, vitamins of group b, muscle relaxers, everything happens within 3 days, rarely a week. If there is a damage in the spine – hernia of the intervertebral discs, damage to nerve roots that leave the spinal column – the long-term treatment. Here it is necessary to do an x-ray, and these patients are neurologists. Because it is generated by the chronic pain with which it is more difficult to handle. In this stage are connected to stronger drugs.
• Can not exclude the condition is of the shoulder joint – arthritis or injury. Happens that give pain in the back.
• Of the internal organs at the level of the upper part of the back is found here in the lungs. To hurt the back and begins when the inflammation passes into the pleura – the covering of the lungs, which is rich in pain receptors. Strong pains, strengthen the breathing, to lessen the pain, people go to bed on your side. If say the temperature and the pain in the chest – physician should you suspect violation in the lungs. We do an x-ray, in which, often, well everything looks. The treatment provided in the hospital. Inflammation of the pleura – pleural effusion — is for different reasons. To call it can be bacteria, viruses, Mycobacterium tuberculosis, and other infections.
• The spontaneous pneumothorax — entry of air in pleura. Often stanichnyj of young people with a hereditary defect of the connective tissue (connective tissue dysplasia or JSP). It happens when there is cough during acute respiratory infections, abruptly, inspires a deep, injuries.

2. The pain in the colleges of the departments of the back, in the lumbar region and above

• The osteochondrosis of the vertebral column at the lumbar level of the division is manifested as low back pain is pain without irradiation in the leg, and back pain – when the pain extends over the outer surface of the hip. This happens when jamming roots of the nerves. Therefore, the doctor checks the so-called "root of the symptoms, or the symptoms of stress. The patient lies on his back and rises to one and other leg. When jamming of the nerve by the pain of the leg can be set with a small angle.



• Approximately at this level are here the kidneys. Here, the doctor checked symptom Pasternatskogo, that is to say, lightly beat the back in the supposed area of the kidneys, and if it is a pain, it means that the kidneys are sick. Often it is a sign of acute inflammation of the kidneys or the kidneys. Therefore, in the algorithm of the survey of pain in the lumbar region of the back necessarily includes an analysis of the urine. When the inflammation of the kidneys, acute pyelonephritis, acute or chronic, is high fever, lower back pain can be the slightest touch. In general, the analysis of urine increased the number of leukocytes – inflammatory changes.
• The stones are not only in kidneys but also in the gallbladder. Very often mistaken for the pain of the pathology is in the spine, and the pain of inflammation of the gallbladder. The gallbladder is located right beneath the rib and the pain in the right half of the back. But this organ is so treacherous that the pain in cholecystitis can occur in the right shoulder, in the kidneys and even in the leg. The stone can be "sit", not only in the gallbladder, but in the milk line. It may be that the stone can not be, and to be an inflammation of the gallbladder and ducts, caused, for example, Giardia lamblia, opisthorchis, and other parasites. Normally the inflammation of the gallbladder is revealed at palpation of the abdomen and the definition of special reflection of the symptoms of inflammation of the gallbladder. If they can identify the signs of acute cholecystitis, the patient is sent to do a sonogram of the abdomen, and a gastroenterologist. If zhelchekamennaya disease in the phase of exacerbation, as is the surgical treatment. Treacherous this disease that may not be the temperature, the bitterness in the mouth, deposition, and only the pain. This occurs when prolonged course, when it has already formed the chronic pain.
• Inflammation of the pancreas – pancreatitis. The pain often gives back as to the left. This happens when the inflammation covers the tail of the pancreas. If the inflammation in the area of the head, pain in the kidneys to the right and in the center. Here everything is more clear, the acute pancreatitis can not simply be carried out without dyspeptic phenomena. Here, in addition to severe pain, there is often a "dagger" pain in the stomach, which can be nausea, vomiting. And, of course, these pains always associated with the violation of the diet, it is a technique of liquor in combination with foods rich in fat. Acute of work processes for surgeons. Because the pancreas can start to digest itself, this is called pancreatic necrosis and requires an urgent intervention. If the process is chronic – this observation gastroenetrology. And the diet with the exception of the fat.
• Herpes Zoster – zoster. Occurs in the area of the back, over the waist. First appear pain, then of contact dermatitis herpetic precipitation in the form of small bubbles. Is called to one of the types of herpes infections. Cure typically, the therapist and the neurologist. The pain can be very intense, burning. It is a virus that spreads by way of the nerves. Sometimes, from the beginning of the pains to rashes a week passes and the diagnosis is difficult.

3. The pain in the lower part of the back

• The most usual cause is the manifestation of the osteochondrosis of the spine. The violation or degeneration of the vertebrae at the level of lumbar-sacral joint, the pain would shoot in the coccyx or above pozvonocna post.
• Gynecological causes can result in pain in the back (it all depends on the anatomical position of) — inflammatory diseases of the female organs.
• Urolithiasis, if the stone passes through the ureter, more common in the lateral departments of the lower abdomen, but may also be part of the back.
• The pathology is in the hip (as in our case, at the beginning of the article), arthritis, osteoarthritis, or even a hip fracture can give pain in the lower back.
• Disease of the colon – hemorrhoids, tumors, benign or malignant (if the tumor is malignant, give pain not only in themselves, but can be a pain and the metastases in the spine, the liver, the lungs).
• Finally, the disease of the prostate , which can be benign developmental dysplasia of the prostate gland, which may be a prostate cancer. These diseases develop in adulthood, so that they often give continuously, even without obvious symptoms, but the weakening of an organism can give metastasis in the lumbar spine, in the lungs, in the lymph nodes.

4. Some diseases affect the entire spine or of its departments

• The osteochondrosis is the most frequent degeneration of the spinal column, affecting all the departments of the vertebral column. There are polysegmental the osteochondrosis. Its manifestations the symptoms in all the departments of the vertebral column, therefore, for the diagnosis may be special difficulties, very often, this happens because of treating osteoporosis.
• The treating osteoporosis – the reduction of the content of calcium in the bones, it is more common with age. Men and women, sometimes for different reasons, but it's the same. Women after the menopause, this is related to low levels of estrogen, which in of child-bearing age regulate the exchange of calcium, men often by the defeat of the gastrointestinal tract and the poor absorption of calcium. When there is loss of bone become fragile, delicate. This includes the spine. Arise microfractures of the minor injury when far have come in stages.
• The myeloma disease – that belongs to the group of leukemias or tumors of the blood, when the tumor is developed at the level of the bone marrow. Increases the number of cells of the hematopoiesis, which grow the leukocytes, the pressure of the mass causes pain in the bones. In this disease the impairment of flat dice, most often the chest, but can be pain in the spine. Now has increased the number of cases of this leukemia. It is diagnosed by the presence in the urine of the protein ben jones, of alteration of the protein produced by the tumor cells.
• The disease behtereva and other autoimmune diseases — when the inflammation of the vertebrae are autoimmune, that is to say, when the body produces antibodies against its own cells. Now we observe an increase of the autoimmune diseases.
• Diseases infectious diseases of the spine – tuberculosis (may be combined with infection by the hiv, syphilis, osteomyelitis are very rare, but the physician must take into account and know. Osteomyelitis, tuberculosis is difficult to diagnose more frequently the diagnosis definitely is not drawn, but the treatment must be carried out seriously. Tb is an insidious disease, any weakening of the immunity can penetrate the body and manifest symptoms of unexpected. During the last year I witnessed two of these patients.

5. Persistent pain in the back can indicate a serious illness

During the following symptoms the doctor suspected cancer and directs a survey:

• the pain in the back ill and undergoing treatment medications for the pain,
• the decrease of the mass of the body,
• a low-grade fever (37-37,5 degrees for a long time does not pass),
• anemia, decreased hemoglobin, the appearance is like the paleness, or the yellowish tint of the skin, cyanosis of lips, circles under the eyes,
• the increase of the erythrocyte sedimentation rate (esr), in general, analysis of blood,
• the propensity to bleed.

The algorithm of the survey to the pains in the back

1. First of all, you must pass routine tests – a blood test, urine analysis. This will give us an idea about the state of the organism, inflammatory processes in it, the state of the urinary system. If we see the change in the analysis of the urine, immediately suspected that the pain caused by the kidney disease.

2. Biokhimicheski analysis of blood, count liver function tests (alt, ast, bilirubin, shchf), sop (c-reactive protein), rheumatoid factor — activity indices of inflammation, the amount of protein, the ratio of the different types of blood proteins – albumin and globulins, and other indicators, if the doctor suspects any disease.

3. Tumor markers – if suspect tumor the process.

4. Tests of infectious diseases: hiv, viral hepatitis, tubercules, syphilis.

5. An x-ray of the spine – shows the change in the spinal pillar, the presence of hernias of vertebrae, the metastasis of tumors, of inflammatory phenomena.

6. The ct scan of the spine and internal organs – very important survey, it is better and more in ray are visible changes in the tissues.

7. Magnetic resonance imaging – the most expensive and complete method is applied to clarify the results of the ct scan. You can carry out the co-infections of the survey, that capture the internal organs and one's spine. This study allows to determine the origin of the damage to the internal organs.

8. If the doctor thinks a little bit, the disease, appoints special poll (in an autoimmune disease rare infection, detailed studies to determine the state of the organism).

The treatment of the pains in the back, of course, it is assigned depending on the cause. But starting we are always with pain relievers – nonsteroidal anti-inflammatory or anti-spasmodic.

Despite the diversity of the causes of back pain, our medicine is developed enough to establish a diagnosis and begin treatment. The most important thing – do not run the disease and seek medical advice if the pain is not carried out during three days, not to mention long intense pains.

Greetings!