There are primary and secondary pain sensations, each of these types can be caused by a wide range of conditions and diseases. In this article we will try to consider only the most basic ones.
Non-specific (primary). This type of pain is directly related to problems in the spine and surrounding tissues.
Causes of back pain related to the spine:
- Scoliosis. Disruption of posture, which leads to gradual curvature of the spine, displacement of the vertebrae and muscle tension.
- Osteochondrosis. The reason for the development of the disease is the decrease in the cushioning capacity of the spine: damage to the intervertebral discs, rupture of the fibrous ring and, as a result, disruption of the disc core. The pain sensations are localized in the area of that part of the spine in which there are pathological changes. So, with osteochondrosis of the chest, back pain is localized in the chest area (the back hurts between the shoulder blades and under the ribs), with osteochondrosis of the lumbar spine, a person experiences pain in the lumbar region.
- Intervertebral hernia. Due to damage to the intervertebral disc, the soft structures of the vertebrae protrude with the possibility of violation (normal and strangulated hernia). The pain is localized at the site of the hernia.
- Ankylosing spondylitis. It is characterized by back pain and limited mobility of the spine, which leads to a forced "leaning forward" position of the patient.
- Osteomyelitis. The cause of the disease is an infectious process that developed in the spine. The patient feels that the pain covers not only the spine, but also the muscles of the back.
- Spinal cord injury. In this case, the cause of the back pain is an injury and its accompanying complications. The intensity of pain sensations and their localization are directly related to the type of injury and the affected part of the spine.
In 40-50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3-5% of severe back pain is associated with damage to the roots of the spinal cord (radicular pain).
Back pain associated with pathological changes in the muscles:
- fibromyalgia. The inflammatory process develops in the muscles around the spine, is characterized by symmetry and can be chronic. In this case, the back muscles hurt along the entire spine. The important thing is that the peak pain occurs when pressing on certain places.
- Polymyositis. Hypothermia can provoke the disease. As a result of the development of the disease, the patient feels muscle weakness and pain, which increases when trying to turn.
- Polymyalgia rheumatica. The etiology of the disease has not been clarified. Infectious diseases that lower immunity can serve as a triggering factor. It manifests itself with pains that increase with the development of the disease, capable of covering all parts of the back. Severe back pain impairs mobility to such an extent that the patient cannot move independently. A clear asymmetry is visualized in the rear.
- Charcot disease. The symptoms are caused by inflammation of the peripheral nerves along the spine. As a result of the pathological process, in addition to quite severe pain, there is a change in the person's gait.
In 50-60% of cases of non-specific back pain, their localization is in the muscles.
Specific (secondary pain). This type of pain, despite the localization in the back, is often not directly related to diseases of the spine or the surrounding muscular skeleton. The causes of specific pain are extremely diverse, but the most dangerous are oncological diseases. So the pain that radiates to the back can be caused by a malignant neoplasm in the area of the mammary glands, lungs or prostate, which provokes metastases in the spine.
Diseases that cause specific pain include:
- Pinched nerve roots in the chest. Most often this leads to the development of intercostal neuralgia. The pain in this case is localized at the pinching site. So, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinching occurred). The pain has a different degree - from pain to sharp, shooting. Most often, the pain syndrome occurs when moving or pressing the affected area. This fact is the main difference between intercostal neuralgia and diseases of the heart and lungs, which can also be manifested by pain under the left (or right) shoulder at the back.
- Diseases of the gastrointestinal tract. More often they provoke pain on the right side, in some cases it can pass to the left side of the body. Most of the pain is localized in the lumbar and sacro-lumbar region. Sufficiently strong sensations of pain are characteristic of pathologies associated with manifestations of diseases of the pancreas, diverticulum of the large intestine, intestinal obstruction, retrocecal appendicitis, etc.
- Ulcerative outbreaks. Ulcerative lesions of the organs of the upper part of the abdominal cavity (peptic ulcer of the duodenum and stomach) can manifest themselves in the form of pain in the chest and lower lumbar back. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is localized in the lumbar region. The severity of the pain can be different, but the peak is often reached at night.
- Appendicitis. In acute appendicitis, in cases where the appendix (appendix) is located behind the cecum, the back hurts in the lumbar region. The pains are of a variable nature and can vary from pains, mild to sharp, intense.
- Kidney diseases. Quite often they are manifested by pain in the lumbar region. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. Differentiation from pathologies that have a direct connection with the spine is based on the analysis of other clinical manifestations and research results.
- Urolithiasis disease. With renal colic, the back hurts in the lumbar region. The pain is pronounced, intense, occurs suddenly and does not depend on the position of the body. Back pain in the lower back and with deer nephrolithiasis. Manifestations of the pain syndrome are of low intensity, the pain is rather painful.
- Diseases of the female reproductive system and menstrual pains. In these cases, the pain is more often located in the lower back.
- Neoplasms in the pulmonary system. In this case, the pain appears at the stage when the lungs undergo germination of peripheral tumor elements (metastases) in the pleural area and chest wall. The nature of the pain is intense, debilitating.
- Cardiovascular diseases. The most common causes of pain localized in the thoracic back are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
- Inflammatory processes in the joints. Infectious arthritis can cause pain that radiates from the affected joint to nearby areas, including back pain.
For the most part, the causes of the manifestation of back pain are identical for both sexes, but it is necessary to highlight a number of diseases that differ in sexual orientation.
back pain in men
Although the causes of back pain are mostly the same for both sexes, there are a number of ailments that men are more susceptible to due to their lifestyle.
These predisposing factors include:
- work involving lifting and carrying heavy loads;
- strength sports (including various martial arts, powerlifting, etc. );
- bad habits.
As a result, diseases of the musculoskeletal system and the cardiovascular system in men can occur more often than in women.
Specific "male" diseases that can cause back pain are various pathologies of the prostate.
Prostatitis is an inflammatory disease of the prostate gland. At the beginning of the disease, the pain syndrome is localized in the groin, scrotum and lower abdomen, but in the second stage and in cases where the disease is chronic, the pain spreads to the back.
The localization of pain in this case can be concentrated in the lumbosacral region or spread to the entire back. This is due to the fact that the inflammatory process affects the nerve endings that surround this organ in large numbers.
The intensity of the pain is directly related to the stage of the disease. So, in the acute phase, the pain is characterized as sharp and short-lived. In the chronic form, the pain syndrome is not very pronounced and is often constant.
Diagnosis and treatment in this case is carried out by a urologist.
back pain in women
In some cases, back pain in women can have a specific character related to the characteristics of the body and the processes taking place in it. First of all, we are talking about the reproductive sphere.
As a rule, pain associated with gynecological diseases is localized in the chest and lumbosacral region. The most common causes include:
- Menstrual cycle. During the period of menstruation, the hormonal background of a woman changes, which leads to the appearance of a number of negative manifestations. This is mainly due to a decrease in the level of progesterone, which is responsible for the intensity of the pain threshold. Lowering the pain threshold leads to the fact that even minor pain sensations become more pronounced. Also, hormonal changes lead to irritation of the intestinal walls and fluid retention, which provokes an increase in the volume of some organs and, as a result, compression of the nerve endings of the lumbar spine. The combination of these factors provokes the appearance of back pain.
- PregnancyPain in the lower back in this case can be divided into two groups: Pain in the first trimester. If the painful sensations are accompanied by additional symptoms (bleeding, fever, etc. ), we can talk about the danger of miscarriage. Pain in the second half of pregnancy. Most often, such pains are associated with physiological changes, namely: active growth of the fetus, which provokes a change in the center of gravity in the position of the body and the preparation of the pelvis for the upcoming birth activity.
- Diseases of the reproductive system. Most of the pain is concentrated in the lumbar region, which is explained by the topography of the female reproductive organs. The most common causes of this manifestation of the pain syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
- Menopause. During menopause, there are strong changes and fluctuations in hormonal levels. Such restructuring of the body leaves an imprint on many systems of the female body. First of all, the skeletal system suffers, which under the influence of hormonal changes becomes more fragile and susceptible to various diseases.
- Big chest. A large bust, combined with poorly supporting underwear, creates an additional load on the spine, and as a result, the woman has back pain in the shoulder blades and lower back.
- High heels. Wearing shoes with high heels leads to the development of a number of diseases associated with pathological changes in the musculoskeletal system and back pain.
back pain with coronavirus
The coronavirus infection affects many organs, but the lungs are the first to suffer. Therefore, often the pain between the shoulder blades or under them is a manifestation of inflammation that has developed in the lung tissue. Depending on which lung is more affected, the patient will feel pain under the left or right shoulder blade.
In addition to the damage to the lung tissue, there is a general intoxication of the body and an increase in temperature, which can also cause pain (pain) in the back and limbs.
Back pain after coronavirus is explained by the fact that the disease can not only damage the nervous system, but also against the background of a general decrease in immunity, chronic diseases, including internal organs and the musculoskeletal system, worsen.
Back pain after sleep
The reasons why your back hurts after sleep can be:
- work related to physical activity and weight lifting;
- muscle tone of the waist;
- intervertebral hernia and osteochondrosis in history;
- prolonged hypothermia on the back;
- curvature of the spine, which led to muscle tension and uneven contraction;
- excess body weight, which leads to an increase in the load on the back;
- stressful situations;
- uncomfortable bed.
Unpleasant sensations can have different intensity and appear under the ribs, in the lower back, between the shoulder blades and below them.
To eliminate the pain that occurs after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.
Back pain - which doctor should I contact?
The primary diagnosis of back pain is carried out by a general practitioner. If necessary, a number of additional studies and consultations of highly specialized specialists can be prescribed:
- neurologist;
- gastroenterologist;
- gynecologist;
- urologist;
- pulmonologist.
In order to make an accurate diagnosis, it is necessary to carry out a detailed analysis of the patient's condition. For this purpose, the doctor may prescribe a number of additional tests:
- Laboratory researches. Most often, this list includes general and biochemical blood tests, analysis of urine, feces, and in some cases analysis of hormone levels. These tests help to identify possible inflammatory processes and infections. If you suspect some diseases or an oncological component, the doctor can prescribe a number of specific tests (biopsy, tumor markers, etc. ).
- Hardware research. They help to get a more visual picture of the course of the disease, which cannot be achieved by visual examination and palpation. Radiography, MRI, ultrasound are most often prescribed.
Treatment of back pain
For the purposes of qualified treatment, an internal consultation with specialists is necessary. Therapy is selected strictly based on the diagnosis and taking into account the general condition of the patient. Self-treatment of back pain can lead to the progression of the disease or to the transition to a chronic stage.
Prevention of back pain
The main preventive measures depend primarily on what exactly provoked the appearance of back pain. General recommendations include:
- healthy life style;
- full and healthy nutrition;
- reasonable dosage of physical activity;
- timely treatment of identified diseases;
- regular preventive examinations, including by specialists from a narrow profile.