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 don't limit yourself to that: 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 get rid of it.

What to do for 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 may start suddenly and end suddenly, but it may subside slightly and become chronic. This should not be tolerated, it is best to seek medical help immediately.

Just don't panic

The appearance of severe back pain does not mean that the person cannot be helped, in most cases all this can be treated successfully, which means there is no need to panic. But it is important to know how to help yourself and reduce the pain and consult a doctor immediately. It is necessary to consult a specialist, as 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 hit. In this case you need:

• Lie on your back on a hard surface or the floor, with a blanket on top; If you can't straighten your back, you need to assume a position that causes the least pain.
• Ask your loved ones to give you a tablet of any pain reliever; All of them can be purchased at the pharmacy without a prescription:
• Apply any analgesic medication for external use to the skin over 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 advise you on the best course of action: call a doctor at home or go straight to a specialized clinic.

When you need to see a doctor urgently for back pain

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

• appeared after an injury;
• accompanied by high body temperature and malaise;
• as a result, problems with urination and defecation arose;
• accompanied by impaired motor function of the limbs and numbness;
• has a ring-like character, covering not only the back, but also the abdomen (acute pancreatitis is suspected);
• 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 this state. To avoid serious complications, it is necessary to consult a doctor.

What to do for back pain of various types

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

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

Neuropathic pain syndrome is associated with damage to nerve roots and trunks. These pains represent 7–8% of all pain syndromes and are characterized by the great 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 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 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 can take Paracetamol orally - it is analgesic and antipyretic. Taking any NSAIDs orally and applying them to the skin in the form of ointments and gels will also help.

Severe pain in the upper back (cervical spine)

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

Neuropathic pain is sharp and burning in nature, radiates to the arm and shoulder blade on the affected side, and is associated with pinched nerve roots in the cervical spine.

How can I help you:

• for pain caused by 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 often hurts due to a sedentary lifestyle and the body being in an uncomfortable position for a long time. This condition often appears in those who sit at a 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 of the thoracic spine are pinched. It may radiate to the intercostal spaces or left arm and resemble an angina attack, but is not relieved by nitroglycerin.

Acute pain in the shoulder blade region can arise due to various diseases of 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 section "How to alleviate 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, with appendicitis or cholecystitis, pain indicating the need for surgery can be removed.

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

My lower back hurts a lot

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

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

The lower back can also hurt with 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 need 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

These 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 circular 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, waist pain occurs with kidney disease. This condition also requires medical attention. In cholecystitis and cholelithiasis attacks, pain may occur on the right side, radiating upwards to the clavicle.

Acute waist pain may occur with intercostal neuralgia caused by compression 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:

• for 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 down the leg

The irradiation of sharp pain in the buttock and the back surface of the right or left leg to the knee indicates infringement of the nerve roots in the lumbar region with the involvement of the sciatic nerve in the process. The pain syndrome is especially strong, has an electrical discharge character 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 it is not very effective.

My back hurts when I breathe in too much

Painful breathing occurs most often:

• with intercostal neuralgia - pain intensifies with 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 solve the problem; It's impossible to do this 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, radiating to the stomach and spreading to the opposite side of the back; accompanied by nausea and vomiting – in acute pancreatitis;
• sharp 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; An analgesic can help alleviate some of the pain.

Back pain

Acute 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:

Location on the right center of the back:

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

Left side pain:

1. Severe burning pain along the ribs at any level is 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 diseases of the spine - NSAIDs;
• for angina pectoris - Nitroglycerin under the tongue;
• for attacks of pancreatitis, cholecystitis, urolithiasis - take 2 No-shpa tablets.

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

Back muscles hurt a lot

Back muscle pain appears with a cold, acute respiratory viral infections or after a long workout. 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, as they protect the spine from any negative influences. At the same time, tension in the muscles increases back pain.

How to help: see a neurologist, get an exam and find out the cause of the pain; You can relieve severe pain on your own using an NSAID ointment or gel, but it will be difficult to get rid of the pain completely.

Severe 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, morning stiffness of 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 not do anything alone, you need to contact a rheumatologist, undergo 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 back muscles and ligaments. In the back muscles, with constant tension, an increased amount of lactic acid is produced, which leads to the appearance of muscle pain.

Pain syndrome can also be acute and paroxysmal in nature, which indicates infringement of the spinal roots against the background of a high load on the spine. A pregnant woman feels severe pain, does not sleep and is constantly in a state of stress.

How can I help you:

• contact a neurologist or antenatal clinic therapist, he will conduct an examination and prescribe the necessary treatment; You cannot take medication alone: many NSAIDs are contraindicated during pregnancy;
• The use of a bandage to support the abdomen is recommended.

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 disc herniation

This is a degenerative-dystrophic process that leads to the gradual destruction of intervertebral discs (shock-absorbing cartilaginous plates with an elastic core in the middle). The discs crack, lose their elasticity and can completely collapse. 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 lower back, which can bear the highest load. It hurts first in the lower back and then radiates to the posterior surface of the lower limb (lumbarischialgia). The sooner treatment for this disease is started, the faster the patient will get rid of the pain.

Ankylosing spondylitis

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

Damage to the joints and ligaments of the spine occurs, accompanied by severe back pain and the gradual formation of spinal immobility (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 be aware of these symptoms immediately and see a doctor as soon as possible.

Lung cancer

The tumor develops slowly from the mucous membrane 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 in the pleura (a thin film that covers the chest with one layer and the lungs with the other), back pain appears, which intensifies with deep breathing, coughing or sneezing.

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

Diagnosis

Correct diagnosis of the disease is very important, as treatment is prescribed based on its results. It is established on the basis of research 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: spine radiography; magnetic resonance imaging or computed tomography (magnetic resonance imaging or computed tomography); Radioisotope scintigraphy – carried out 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 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 to 5 days) in combination with drug therapy and reflexology (RT); prolonged adherence to bed rest contributes to the transition from an acute process to a chronic one; it is possible to prescribe a short period of wearing orthopedic devices: 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 continues, light physical exercises and physiotherapeutic procedures (electrophoresis with analgesic medicinal solutions) are added;
• type of physical activity with small restrictions (10 – 20 days); drug therapy is carried out as indicated; physiotherapy (laser and magnetic therapy), RT; add a course of manual therapy and massage;
• a mode of physical activity without restrictions (but without lifting weights) with the performance of specially selected exercise therapy exercises;
• Pain prevention – therapy with regular exercise and viable sports in order to raise the quality of life to a new level.

Drug therapy

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

1. For acute and very intense 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 medicines is carried out individually, taking into account the properties of the medicine and the individual characteristics of the patient. The most effective remedy can cause gastrointestinal complications; Therefore, if the patient has stomach ailments, 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 administered as individual vitamin injections or as a solution containing all three 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 treatment. These remedies help to relieve pain.

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