Backache

What to do if severe back pain suddenly appears, how to relieve the pain and can you do it yourself? Of course, it's good to know how to help yourself in case of sudden and severe pain, but you shouldn't limit yourself to this: after the first emergency self-help, 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 in case of 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 ease slightly and become chronic. This should not be tolerated; it is best to contact your doctor immediately.

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 successfully treated, which means there is no need to panic. But it is important to know how to help yourself and reduce pain, so consult a doctor immediately. It is necessary to consult a specialist, since back pain is caused by many diseases and require different therapeutic approaches.

How to alleviate your condition yourself

Sometimes the pain syndrome is so severe 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 you; If you can't straighten your back, you need to assume a position that causes minimal pain.
• Ask your loved ones to give you a tablet of any painkiller; all can be purchased in pharmacies without a prescription:
• Apply any pain reliever for external use to the skin over the painful area: rubbing solution, ointment, gel, emulgel and other over-the-counter medications:
• Call an ambulance; your 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 need to urgently consult a doctor for back pain

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

• appeared after injury;
• accompanied by high body temperature and malaise;
• as a result, problems with urination and defecation appeared;
• accompanied by impairment of the motor function of the limbs and their numbness;
• has a waist-like nature, covering not only the back, but also the abdomen (suspicion of acute pancreatitis);
• radiates to the left hand (suspected myocardial infarction);
• grows, it cannot be removed with compresses and ointments.

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

What to do for back pain of various types

Back pain can be different: acute, radiating to different parts of the body, deep, painful, very strong, constant or wave-like. It can also be localized in different parts of the back: in the neck, chest, lower back, sacrum and coccyx. Even after a comprehensive examination, it is not always possible to find out the cause of back pain, and then they say that it is not specific.

Such pain is called nociceptive, associated with irritation of pain receptors in tissues (muscles, ligaments, bones). Irritants can be mechanical (injury), physical, chemical and inflammatory in nature. In addition, the extent 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 nerve trunks. These pains represent 7-8% of all pain syndromes; their characteristic 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 appear. These painful sensations are associated with general intoxication of the body. During a coronavirus infection with high fever, back pain can 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 due to 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: You can take paracetamol orally: it is an analgesic and antipyretic. It will also be useful to take any 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 of mixed nonspecific and neuropathic nature. Nonspecific aching pains are often associated with an incorrect forced position at the table during work, tension in the back and neck muscles. A short-term painful attack may manifest as angina and radiate to the left arm.

Neuropathic pain has a sharp and burning nature, radiates to the arm and shoulder blade of the affected side and is associated with pinching 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 tablet 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 remains in an uncomfortable position for a long time. Most often this condition manifests itself in those who sit at the computer for several hours a day. Weakened muscles cannot bear the load and hurt.

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

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

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

How can I help you:

• in case of damage to the musculoskeletal system - NSAIDs (see the section "How to alleviate your condition yourself");
• in case of 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 with appendicitis or cholecystitis, pain indicating the need for surgery may be removed.

If you don't understand what hurts, it's better to call an ambulance.

My lower back hurts a lot

Acute lower back pain syndrome is often associated with the condition of the spine, is nonspecific in nature and accounts for approximately 80% of all pain in this area.

Neuropathic pain syndrome accounts for approximately 7 – 8%. Therefore, sudden, sharp pain in the lower back (low back pain) is usually associated with pinching of the spinal roots in the lumbar spine. Sudden, sharp pain in the buttock, radiating to the back of the thigh (sciatica), due to pinching 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;
• for neuropathy - NSAIDs do not always relieve pain, it is necessary to consult a doctor to prescribe a full course;
• for diseases of internal organs - 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. Acute pain syndrome is girdling in nature, 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, girdle pain occurs in kidney disease. This condition also requires medical attention. With cholecystitis and an attack of cholelithiasis, pain may occur on the right side, radiating upward to the collarbone.

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

How can I help you:

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

Severe back pain radiating to the leg

Irradiation of acute pain in the buttock and the back surface of the right or left leg up to the knee indicates a violation of 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 nature of an electric discharge and is accompanied by painful convulsive contractions.

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: pain intensifies from 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 find out the problem; It is impossible to do it alone.

My back hurts a lot under the ribs

This localization is often associated with diseases of internal organs:

• sharp, severe pain that does not diminish 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 can help relieve the pain slightly.

Pain on the back side

Sharp 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 in the right side:

Position in the middle of the right back:

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 violation of the right nerve root;
2. diseases of the pancreas, liver and biliary tract.

Left side pain:

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

How can I help you:

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

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

The back muscles hurt a lot

Muscle pain in the back appears in case of colds, acute respiratory viral infections or after long training. In people who lead a sedentary lifestyle, muscles may ache even with little physical activity.

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

How to help: contact a neurologist, undergo an examination and find out the cause of the pain; You can relieve severe pain on your own using an ointment or gel with NSAIDs, but it will be difficult to completely eliminate 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, pain is combined with other symptoms: age up to 40 years, gradual onset, morning stiffness of movements 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 diseases of the 'intestine.

How to help: do nothing yourself, you need to 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, an increased amount of lactic acid is produced, which leads to the appearance of aching muscle pain.

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

How can I help you:

• contact a neurologist or therapist of the antenatal clinic, he will carry out an examination and prescribe the necessary treatment; You cannot take drugs alone: many NSAIDs are contraindicated during pregnancy;
• It is advisable to wear 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 diseases 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

It is a degenerative-dystrophic process that leads to the gradual destruction of the intervertebral discs (cartilaginous plates that cushion impacts with an elastic nucleus in the center). The discs rupture, lose 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, a strong pain appears in the back, often radiating to the large nerve trunks. Most often this occurs in the lumbar region, which can bear the greatest load. It hurts first in the lumbar region, then radiates to the posterior surface of the lower limb (lumboischialgia). The earlier treatment for this disease is started, the faster the patient will get rid of pain.

Ankylosing spondylitis

The correct name of the disease is ankylosing spondylitis. This is a chronic inflammatory systemic disease of connective tissue associated with autoimmune processes (allergy to the patient's tissues) and aggravated heredity. Mostly men under 40 are affected.

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 progresses upward. Characteristics of the pain syndrome are: night and morning back pain, morning stiffness, which disappears no less than 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 slowly develops from the mucosa of the large or small bronchi. At first, the disease is asymptomatic, then a 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), pain in the back appears, which intensifies with deep breathing, coughing or sneezing.

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

Diagnostics

Correct diagnosis of the disease is very important, since treatment is prescribed based on its results. It is established 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: spinal 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 comprehensive 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 purpose, treatment of the underlying disease is prescribed, as well as symptomatic drug therapy 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 to a chronic process; it is possible to prescribe a short course of using orthopedic devices: a cervical collar for pathologies of the upper back and neck or lumbar belt;
• semi-bed rest for the next 7 - 8 days; the course of drug therapy and RT continues, light physical exercises and physiotherapeutic procedures are added (electrophoresis with pain-relieving medicinal solutions);
• physical activity mode with minor restrictions (10 – 20 days); drug therapy is carried out according to indications; physiotherapy (laser and magnetotherapy), RT; add a course of manual therapy and massage;
• a mode of physical activity without restrictions (but without weight lifting) with the performance of specially selected physical therapy exercises;
• pain prevention – regular physical therapy and doing sports to increase the quality of life to a new level.

Pharmacological therapy

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

1. For very severe 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, more 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 injections of individual vitamins or as a solution containing all 3 vitamins and the painkiller lidocaine. After the condition improves, you can take the tablets orally.
5. For neuropathic pain associated with involvement of nerve fibers in the process, antidepressants and anticonvulsants are included in the complex treatment. These remedies help relieve pain.

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