Back pain

What to do if a 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, immediately consult a doctor. In the Moscow Paramita clinic, they will always help you: they will determine the cause of the pain and get rid of it.

What to do with acute back pain

Back pain periodically occurs 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 gradually subside 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 it can all be successfully treated, 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. It is necessary to contact a specialist, because back pain is caused by many diseases and requires different approaches to treatment.

How to alleviate your condition yourself

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

• Lie on your back on a hard surface, or on the floor, with a blanket; if you cannot straighten your back, then you must assume a position that causes minimal pain.
• Ask your loved ones to give you a pill of any pain reliever, all of which can be bought at a pharmacy without a prescription:
• Apply any topical pain reliever to the skin over the painful area: rub solution, ointment, gel, emulgel, and other over-the-counter medications:
• Call 911; the doctor will give you an injection of anesthetic (usually an injectable NSAID solution) and advise you on the best course of action: call the doctor at home or go straight to a specialist clinic.

When you need to see a doctor urgently because of back pain

Contact the clinic immediately if you have severe back pain:

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

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

What to do with back pain of various kinds

Back pain can be different: acute, spreading to different parts of the body, deep, painful, very strong, constant or wavelike. It can also be found on different parts of the back: in the neck, chest, lower back, 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.

Such pain is called nociceptive, associated with the irritation of pain receptors in tissues (muscles, ligaments, bones). Irritants can be mechanical (injuries), physical, chemical and inflammatory in nature. Moreover, the degree of changes in the spine does not always correspond to the intensity of the pain. Non-specific pain accounts for about 80% of all back pain syndromes.

Neuropathic pain syndrome is associated with damage to nerve roots and nerve trees. These pains make up 7-8% of all pain syndromes, and their characteristic is the great possibility of confirming the diagnosis during 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, followed by a sudden onset and fever, back pain, body aches and severe weakness may occur. 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 corona virus pneumonia occurs, the back pain intensifies 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: Paracetamol can be taken orally - it is an analgesic and antipyretic. Taking any NSAID by mouth and applying it to the skin in the form of ointments and gels will also help.

Severe upper back pain (cervical spine)

Acute pain syndrome can be of mixed non-specific and neuropathic nature. Non-specific pains are often associated with improper forced posture at the desk during work, back and neck muscle tension. A short-term painful attack may occur with angina and radiate to the left arm.

Neuropathic pain is of an acute, burning nature, radiates to the arm and shoulder blade on 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 disease - NSAIDs;
• heart attack - nitroglycerin tablet under the tongue; if the pain does not go away within a minute, take another pill and call 911.

Severe pain in the chest and shoulder blades

The back in the thoracic part and between the shoulder blades most often hurts due to a sedentary lifestyle and prolonged stay of the body in an uncomfortable position. Very often this condition occurs in those who sit at the computer for several hours a day. Weakened muscles cannot withstand the load and they hurt.

The child's development can be disturbed due to incorrect posture - lateral curvature of the thoracic spine - scoliosis. If measures are not taken in time, the vertebrae are displaced 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 to the intercostal spaces or to the left arm and resemble an angina attack, but is not relieved by nitroglycerin.

Acute pain in the area of the shoulder blades 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 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, it is better to call an ambulance.

My lower back hurts a lot

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

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

The lower part of the back can also hurt in 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, you must consult a doctor to prescribe the entire course;
• for diseases of internal organs - it depends on the diagnosis, which can only be made by a doctor.

Severe back and stomach pain

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

Less often, pain in the waist occurs with kidney disease. This condition also requires medical attention. With cholecystitis and attacks of cholelithiasis, the pain can occur on the right side, spreading upwards to the collarbone.

Acute girdle 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 strong that it deprives the patient of sleep.

How can I help you:

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

Severe pain in the back that spreads to the leg

Radiation of acute pain in the buttock and the back surface of the right or left leg up to the knee indicates an injury 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 jerks.

How to help: call an ambulance as soon as possible, and before that take an NSAID and put an anesthetic, but it is not very effective.

My back hurts when I inhale too much

Painful breathing occurs most often:

• with intercostal neuralgia - the pain intensifies from any movement, including inhalation and coughing;
• for acute lung and bronchial diseases affecting the pleura - pleuropneumonia, lung cancer.

How to help: call the doctor at home and solve the problem; It is impossible to do it alone.

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 cannot be relieved, spreads to the abdomen and spreads to the opposite side of the back; followed by nausea and vomiting - in acute pancreatitis;
• acute paroxysmal pain, which often spreads 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 that often requires hospitalization; A pain reliever can help ease the pain a little.

Back pain

Acute back pain 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:

Location on the right middle of the back:

1. acute pain radiating along the intercostal nerves - it can be assumed that the roots of the nerves of the thoracic spine are pinched;
2. local pain – muscle inflammation;
3. deep, aggravated by deep inhalation 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 right nerve root injury;
2. diseases of the pancreas, liver and bile ducts.

Pain in the left side:

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

How can I help you:

• for spine diseases - 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, it is necessary to call an ambulance.

The back muscles hurt a lot

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

Any disease of the spine (osteochondrosis, disc herniation, scoliosis, etc. ) is always accompanied by tension in the back muscles, because they protect the spinal column from all negative influences. At the same time, muscle tension increases back pain.

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

Severe pain in the back 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, morning stiffness of movement up to half an hour or more, removal 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, juvenile chronic arthritis, arthritis associated with chronic inflammatory bowel diseases.

How to help: don't do anything on your own, you need to contact a rheumatologist, get 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 created, which leads to the appearance of painful muscle pain.

The pain syndrome can also have an acute, paroxysmal nature, which indicates an injury to the spinal roots on the background of a large load on the spine. A pregnant woman experiences severe pain, does not sleep and is constantly in a state of stress.

How can I help you:

• contact a neurologist or prenatal clinic therapist, he will perform an examination and prescribe the necessary treatment; You can't take medicines yourself: many NSAIDs are contraindicated during pregnancy;
• It is indicated 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 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 cartilage plates with an elastic core in the middle). Discs crack, lose elasticity and can completely collapse. In this case, the core of the disc protrudes and compresses the nerve roots or the spinal cord - a herniated disc develops.

When the roots are pinched, severe back pain appears, which often spreads to the large nerve trunks. Most often it happens in the lumbar region, which can withstand the greatest load. It first hurts in the lumbar region, and then spreads to the back surface of the lower limb (lumboischialgia). The sooner the treatment of this disease begins, the faster 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 associated with autoimmune processes (allergy to the patient's own tissues) and difficult inheritance. Most of the patients are men under the age of 40.

There is damage to the joints and ligaments of the spine, accompanied by severe back pain and gradual immobility of the spinal column (ankylosis). The process starts in the lower parts of the spine and gradually moves upwards. 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 that you pay attention to these symptoms as soon as possible and that you consult a doctor as soon as possible.

Lung cancer

The tumor slowly develops from the mucous membrane of large or small bronchi. At first, the disease is asymptomatic, then a cough appears and occasionally inflammatory processes 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 occurs, which intensifies when taking a deep breath, coughing or sneezing.

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

Diagnostics

Correct diagnosis of the disease is very important, because 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 data on additional examinations, including:

• Laboratory tests - general and biochemical tests of blood, urine; immune blood tests, rheumatoid factor;
• Instrumental studies: radiography of the spine; magnetic resonance 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 prevent the transition from an acute pathological process to a chronic one. 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 of an acute process to a chronic one; it is possible to prescribe a short course of wearing orthopedic aids: cervical collar for pathology in the upper back and neck or lumbar belt;
• half-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 medicinal solutions for pain relief);
• way of physical activity with less restrictions (10-20 days); drug therapy is carried out according to indications; physiotherapy (laser and magnetic therapy), RT; add a manual therapy and massage course;
• way of physical activity without restrictions (but without lifting weights) with the performance of specially selected exercise therapy exercises;
• pain prevention - regular exercise therapy and feasible sports to raise the quality of life to a new level.

Drug therapy

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

1. For very strong, sharp pains, paravertebral blockades with novocaine are performed. If the pain syndrome is not alleviated, epidural blocks are performed - pain relief by introducing anesthetic into the epidural cavity, which is located between the dura mater and the periosteum of the spinal column.
2. Slight pain is alleviated by intramuscular administration of drugs from the NSAID group. Medicines are selected individually, taking into account the properties of the medicine and the individual characteristics of the patient. The most effective drug 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 pain reliever lidocaine. After the condition improves, you can take the tablets orally.
5. For neuropathic pain associated with the involvement of nerve fibers in the process, antidepressants and anticonvulsants are included in complex therapy. These medications help relieve pain.

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