Back pain

What to do if severe back pain suddenly 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-help, you should immediately consult a doctor. In the Moscow Paramita clinic they will always help you: they will determine the cause of the pain and eliminate it.

What to do about 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 quickly, but it can subside slightly 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 of this can be treated successfully, meaning there is no need to panic. But it is important to know how to help yourself and reduce pain, and then immediately consult a doctor. It is necessary to contact a specialist, since back pain is caused by many diseases and requires different treatment approaches.

How to alleviate your condition yourself.

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

• Lie face up on a hard surface or the floor, with a blanket on top; If you cannot straighten your back, then you should adopt a position that causes minimal pain.
• Ask your loved ones to give you a pill of any pain reliever, they can all be bought at the pharmacy without a prescription:
• Apply any externally used pain reliever to the skin on the painful area: rubbing solution, ointment, gel, emulgel and other over-the-counter medications:
• Call an ambulance; The doctor will give you an anesthetic injection (usually injectable NSAID solutions) and will advise you on the best course of action: call a doctor at home or go directly to a specialized clinic.

When you need to go to the doctor urgently for back pain

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

• appeared after an injury;
• accompanied by high body temperature and discomfort;
• as a result, problems with urination and defecation appeared;
• accompanied by deterioration of the motor function of the extremities and their numbness;
• It has a tight-fitting character and covers not only the back, but also the abdomen (suspected acute pancreatitis);
• radiates to the left hand (suspected myocardial infarction);
• grows, it cannot be removed with tablets and ointments.

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

What to do about back pain of various types.

Back pain can be different: sharp, radiating to different parts of the body, deep, painful, very strong, constant or wave-like. It can also be located in different parts of the back: in the neck, chest, lumbar area, sacrum and coccyx. Even after a complete examination, it is not always possible to discover the cause of back pain and then they say that it is non-specific.

This pain is called noceceptive and is associated with irritation of pain receptors in tissues (muscles, ligaments, bones). Irritants can be mechanical (injuries), physical, chemical and inflammatory in nature. In addition, the degree of changes in the spine does not always correspond to the intensity of the pain. Nonspecific pain accounts for approximately 80% of all back pain syndromes.

Neuropathic pain syndrome is associated with damage to nerve roots and trunks. These pains represent 7 to 8% of all pain syndromes; Its characteristic is the high possibility of confirming the diagnosis through instrumental studies.

The third type of pain, specific pain syndromes (for example, in 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 sudden onset and fever, muscle pain in the back, pain throughout the body and severe weakness may appear. These painful sensations are associated with general intoxication of the body. During a coronavirus infection with a high temperature, back pain may be one of the first manifestations.

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

What will help: You can take paracetamol orally, it is a pain reliever and antipyretic. It will also be useful to take NSAIDs orally and apply them to the skin in the form of ointments and gels.

Severe pain in the upper back (cervical spine)

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

Neuropathic pain has a sharp, burning character, radiates to the arm and shoulder blade on the affected side, and is associated with impingement of the nerve roots of the cervical spine.

How can I help you:

• for pain due to spinal diseases: NSAIDs;
• heart attack: nitroglycerin tablet under the tongue; If the pain does not go away within a minute, take another pill and call an ambulance.

Severe pain in the chest and shoulder blades.

The back in the thoracic region and between the shoulder blades most often hurts due to a sedentary lifestyle and the fact that the body is in an uncomfortable position for a long time. Most often, this condition appears in those who sit at the computer for several hours a day. Weakened muscles cannot withstand the load and hurt.

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 become displaced and a compression fracture may occur.

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

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

How can I help you:

• in case of damage to the musculoskeletal system: NSAIDs (see the section "How to relieve your condition yourself");
• for spasm of the arteries supplying 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, in case of appendicitis or cholecystitis, the pain that indicates the need for surgery can be eliminated.

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

My lower back hurts a lot

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

Neuropathic pain syndrome accounts for about 7 to 8%. Therefore, sudden sharp pain in the lower back (lumbago) is usually associated with pinching of the spinal roots in the lumbar spine. Sudden, sharp pain in the buttocks, radiating to the back of the thigh (sciatica), due to a pinch or inflammation of the sciatic nerve.

The lower back can also hurt in case of diseases of the kidneys, urinary tract and genital organs.

How can I help you:

• for myositis - NSAIDs;
• with neuropathy - NSAIDs do not always relieve pain, it is necessary to 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 the internal organs. When they appear, the first thing they think of is acute pancreatitis. Acute pain syndrome is of a girding nature, is accompanied by nausea, vomiting and requires emergency hospitalization of the patient. If this is not done, necrosis of the pancreatic tissue may occur and the patient will die.

Less commonly, pain in the waist occurs with kidney disease. This condition also requires medical attention. With cholecystitis and an attack of cholelithiasis, pain may appear on the right side, radiating to the clavicle.

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

How can I help you:

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

Severe back pain that radiates to the leg.

Radiation of acute pain in the buttocks and the posterior surface of the right or left leg to the knee indicates an infringement of the nerve roots of the lumbar region with the participation of the sciatic nerve in the process. The pain syndrome is especially strong, has the character of an electric shock and is accompanied by painful convulsive spasms.

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

My back hurts when I inhale too much.

Painful breathing occurs most often:

• with intercostal neuralgia - the pain intensifies with any movement, including inhalation and cough;
• for acute diseases of the lungs and bronchi that affect the pleura: pleuropneumonia, lung cancer.

How to help: call a doctor at home and solve the problem; It is impossible to do this on your own.

My back hurts a lot under my ribs.

This localization is often associated with diseases of the internal organs:

• sharp, strong pain that does not subside and cannot be relieved, 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 may help slightly relieve pain.

Back pain

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

Location in the middle rear right:

1. sharp pain radiating along the intercostal nerves; 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 cough, 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 infringement of the right nerve root;
2. Diseases of the pancreas, liver and bile ducts.

Pain on the left side:

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

How can I help you:

• for spinal diseases: NSAIDs;
• with angina pectoris: nitroglycerin under the tongue;
• for attacks of pancreatitis, cholecystitis, urolithiasis - take 2 No-shpa tablets.

If the pain does not go away, it is necessary to call an ambulance.

The muscles in my back hurt a lot.

Pain in the back muscles appears with a cold, acute respiratory viral infections or after prolonged training. In people who lead a sedentary lifestyle, muscles can hurt even with little physical activity.

Any disease of the spine (osteochondrosis, herniated disc, scoliosis, etc. ) is always accompanied by tension in the back muscles, since they protect the spine from any negative influence. At the same time, tension in the muscles increases back pain.

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

Intense back pain at night and in the morning.

Night and morning back pain is a serious symptom, one of the signs of the inflammatory process. As a rule, pain is combined with other symptoms: age up to 40 years, gradual onset, stiffness of morning movements for up to half an hour or more, elimination of pain after the start of 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, juvenile chronic arthritis, arthritis associated with chronic inflammatory bowel diseases.

How to help: do nothing on your own, you should contact a rheumatologist, conduct 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, a greater amount of lactic acid is produced, which causes the appearance of painful muscle pain.

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

How can I help you:

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

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 herniated disc.

This is a degenerative-dystrophic process that leads to the gradual destruction of the intervertebral discs (cushioning cartilaginous plates with an elastic core in the middle). The discs crack, lose their elasticity and can collapse completely. In this case, the nucleus of the disc protrudes and compresses the nerve roots or spinal cord: a herniated disc develops.

When the roots are pinched, severe back pain appears, often radiating to large nerve trunks. Most often this occurs in the lumbar region, which can withstand the highest load. It first hurts in the lumbar region and then radiates to the posterior surface of the lower extremity (lumboischialgia). The sooner treatment for this disease is started, the faster the patient will relieve pain.

Ankylosing spondyloarthritis

The correct name of the disease is ankylosing spondylitis. It is a chronic inflammatory systemic disease of the connective tissue associated with autoimmune processes (allergy to the patient's own tissues) and aggravation of heredity. The majority of those affected are men under 40 years of age.

Damage to the joints and ligaments of the spine occurs, accompanied by severe back pain and the gradual formation of immobility of the spine (ankylosis). The process begins in the lower parts of the spine and gradually moves upward. The characteristics of the pain syndrome are: night and morning back pain, morning stiffness, which disappears at least half an hour after waking up and starting active movements. It is very important to pay attention to these symptoms promptly and consult a doctor as soon as possible.

lung cancer

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

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

Diagnosis

Correct diagnosis of the disease is very important, since treatment is prescribed based on its results. It is established on the basis of an examination and examination of the patient by a doctor and data from additional examinations, including:

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

But even with a complete 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 from an acute to a chronic pathological process. For this, treatment of the underlying disease is prescribed, as well as therapy with symptomatic drugs and non-drug treatment methods.

Algorithm for the treatment of acute pain syndrome:

• short-term bed rest (2 – 5 days) in combination with pharmacological therapy and reflexology (RT); prolonged compliance with bed rest contributes to the transition from an acute process to a chronic one; it is possible to prescribe a short course of use of orthopedic devices: a cervical collar for pathology in the upper back and neck or lumbar girdle;
• semi-bed rest for the next 7 to 8 days; the course of drug therapy and RT is continued, light physical exercises and physiotherapeutic procedures (electrophoresis with analgesic medicinal solutions) are added;
• mode of physical activity with minor restrictions (10 – 20 days); drug therapy is carried out as indicated; physical therapy (laser and magnetotherapy), RT; add a course of manual therapy and massages;
• a mode of physical activity without restrictions (but without lifting weights) with the performance of specially selected physiotherapy exercises;
• Pain prevention: Regular exercise therapy and feasible sports to raise the quality of life to a new level.

drug therapy

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

1. For very intense and acute pain, paravertebral blocks with novocaine are performed. If the pain syndrome is not relieved, epidural blocks are performed - pain relief by introducing anesthetics into the epidural cavity located between the dura mater and the periosteum of the spine.
2. Less severe pain is 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 remedy can cause gastrointestinal complications, so if the patient has stomach diseases, the most modern NSAIDs will help relieve back pain.
3. To eliminate spasms of the back muscles, muscle relaxants are prescribed.
4. B vitamins (B1, B6, B12) have a beneficial effect on the peripheral nervous system and enhance the analgesic effect of NSAIDs. These medications can be given as individual vitamin injections or as a solution containing all 3 vitamins and the pain reliever lidocaine. Once 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 remedies help relieve pain.

In the treatment of severe back pain, the most important thing is to prevent the transition from acute pain to chronic pain. Therefore, the patient should seek medical help as soon as possible.