Back pain

What to do if severe back pain suddenly appears, how to relieve 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: you should immediately consult a doctor after the first emergency aid. 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. It 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 subside and become chronic. It cannot 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 this can be successfully treated, which means that 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, because back pain is caused by many diseases and requires different approaches to treatment.

How you can alleviate your situation yourself

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

• Lie on your back on a hard surface or floor, put a blanket on it; if you can't straighten your back, then you need to take a position that causes minimal pain.
• Ask your loved ones to give you any pain reliever tablets, all of which can be bought at the pharmacy without a prescription:
• Apply any pain reliever for external use to the skin of the painful area: rubbing solution, ointment, gel, emulgel and other non-prescription drugs:
• call an ambulance; the 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 specialist clinic.

When you need to see a doctor urgently for back pain

If you have severe pain in your back, you should immediately go to the clinic:

• appeared after the injury;
• accompanied by high body temperature and malaise;
• as a result, problems with urine and defecation appeared;
• is accompanied by a violation of the motor function of the limbs and their numbness;
• it has the character of a girdle that covers not only the back, but also the abdomen (suspicion of acute pancreatitis);
• radiates to the left hand (suspected myocardial infarction);
• grows, cannot be removed with tablets and ointments.

In such a situation, it is impossible to help yourself. In order to avoid serious complications, it is necessary to consult a doctor.

What to do for different types of back pain

Back pain can be different: sharp, spreading to different parts of the body, deep, aching, very strong, constant or wavelike. 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 non-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. Moreover, the degree of changes in the spine does not always correspond to the intensity of pain. Nonspecific pain accounts for approximately 80% of all low back pain syndromes.

Neuropathic pain syndrome is associated with damage to nerve roots and nerve trunks. These pains make up 7-8% of all pain syndromes, their feature is the high probability of confirming the diagnosis during instrumental studies.

The third type of pain - specific pain syndromes (for example, with spinal tuberculosis) is relatively rare.

Severe back pain due to coronavirus and other acute respiratory viral infections

With any acute respiratory viral infection with sudden onset and fever, back pain, body aches and severe weakness may appear. These painful sensations are associated with general intoxication of the body. High fever and back pain may be one of the first symptoms during a coronavirus infection.

When coronavirus pneumonia appears, pain in the back increases due to damage to the pleura with many nerve endings, as well as 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 NSAIDs by mouth 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 have a mixed non-specific and neuropathic character. Non-specific aching pains are often associated with wrong forced position at the desk during work, tension in back and neck muscles. A short-term painful attack may appear with angina and may radiate to the left arm.

Neuropathic pain has a sharp, burning nature, spreads from the affected side to the arm and shoulder blade, and is associated with compressed 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

In the thoracic region and between the shoulder blades, the back hurts most often due to a sedentary lifestyle and the body being in an uncomfortable position for a long time. Very often, this condition appears in those who sit at the computer for several hours a day. Weakened muscles cannot withstand the load and are damaged.

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

Severe pain between the shoulder blades can occur when the roots of the spinal nerves of the thoracic spine are compressed. It may spread to the intercostal spaces or the left arm and resembles an anginal attack, but is not relieved by Nitroglycerin.

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

How can I help you:

• if the musculoskeletal system is damaged - NSAIDs (see the section "How to alleviate your condition yourself");
• for spasm of the vessels supplying the heart muscle (angina attack) - one Nitroglycerin tablet under the tongue;
• for diseases of internal organs - only a doctor can decide; in some cases, taking painkillers can cause serious complications, for example, with 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 back 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 is about 7-8%. So, sudden sharp pains in the lower back (lumbago) are usually associated with compression of the spinal roots in the lower back. Sharp, sudden pain in the buttock that radiates to the back of the thigh (sciatica) is a pinched or inflamed sciatic nerve.

The lower back can also be damaged by diseases of the kidneys, urinary tract and genitals.

How can I help you:

• for myositis - NSAIDs;
• for neuropathy - NSAIDs do not always relieve pain, you should consult a doctor to prescribe a full course;
• for diseases of internal organs - depends on the diagnosis, which can only be prescribed by a doctor.

Severe back and stomach pain

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

Less often, girdle pain occurs with kidney disease. This condition also requires medical attention. With an attack of cholecystitis and cholelithiasis, pain may occur on the right side, spreading to the collarbone.

Acute girdle pain can occur with intercostal neuralgia caused by compression 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 - immediately call an ambulance; Before the doctor comes, you can take 2 tablets of No-shpa.

Severe back pain that radiates to the leg

Acute pain radiating from the hip and the back surface of the right or left leg to the knee indicates a disruption 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 character of electric discharge and is accompanied by painful convulsive twitching.

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

My back hurts when I breathe 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 surrounding the pleura - pleuropneumonia, lung cancer.

How to help: call a doctor at home and understand the problem; It cannot be done alone.

My lower back hurts a lot under my ribs

This localization is often associated with diseases of internal organs:

• sharp, severe pain that does not stop and cannot be relieved, radiating to the stomach and radiating to the opposite side of the back; accompanied by nausea and vomiting - in acute pancreatitis;
• acute paroxysmal pain, often spreading to the groin - 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 relieve some of the pain.

Pain in the back

Acute pain in 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:

Right center back location:

1. sharp pain spreading along the intercostal nerves - it can be assumed that the nerve roots of the thoracic spine are compressed;
2. painful local - muscle inflammation;
3. aggravated by deep, deep inspiration and cough - often associated with pleural diseases - pleurisy, lung cancer with germination in the pleura.

Localization on the right side under the ribs:

1. intercostal neuralgia due to disruption of the right nerve root;
2. diseases of the pancreas, liver and biliary tract.

Pain on the left side:

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

How can I help you:

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

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

Back muscles are very sore

Back muscle pain appears after a cold, acute respiratory viral infections or a long workout. In people who lead a sedentary lifestyle, muscles can ache even with little physical activity.

Any disease of the spine (osteochondrosis, disc herniation, scoliosis, etc. ) is always accompanied by tension of the back muscles, as it protects the spine from any negative effects. At the same time, tension in the muscles increases pain in the back.

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

Severe back pain at night and in the morning

Back pain at night and in the morning is a serious symptom that is 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 half an hour or more, relief 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: do nothing yourself, you should 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 causes the appearance of aching muscle pain.

The pain syndrome can also have an acute, paroxysmal character, which indicates a violation of the spinal roots against the background of a high load on the spine. A pregnant woman experiences severe pain, sleep deprivation and constant stress.

How can I help you:

• consult a neurologist or antenatal clinic therapist, who will conduct an examination and prescribe the necessary treatment; You cannot take medicine: many NSAIDs are contraindicated during pregnancy;
• Wearing a bandage to support the abdomen is indicated.

The most common diseases that cause back pain

In most cases, back pain syndrome 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 the intervertebral discs (cartilaginous shock-absorbing plates with an elastic core in the middle). Discs crack, lose elasticity and can collapse completely. At this time, the core of the disc protrudes and compresses the nerve roots or the spinal cord - a herniated disc develops.

When the roots are compressed, severe back pain often appears, radiating to large nerve trunks. Most often, this happens in the lumbar region, which can withstand the highest load. First, it hurts in the lower back, and then radiates to the back surface of the lower limb (lumboischialgia). The sooner the treatment of this disease begins, the sooner the patient will get rid of the pain.

Ankylosing spondylitis

The correct name of the disease is ankylosing spondylitis. It is a chronic inflammatory systemic disease of connective tissue associated with autoimmune processes (allergy to the patient's own 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 starts from the lower parts of the spine and gradually moves upwards. The characteristics of the pain syndrome are: back pain at night and in the morning, stiffness in the morning, which disappears at least half an hour after waking up and starting active movements. It is very important to pay attention to these symptoms and see 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 occasionally inflammatory processes develop in the bronchi and lungs. When the tumor grows into the pleura (a thin layer that covers the chest with one layer and the lungs with the other), there is back pain that worsens with deep breathing, coughing or sneezing.

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

Diagnostics

The correct diagnosis of the disease is very important, because the treatment is prescribed based on its results. It is determined based on the examination and examination of the patient by the doctor and additional examination data, including:

• Laboratory tests - general and biochemical blood tests, urine tests; immunological blood tests, rheumatoid factor;
• Instrumental studies: X-ray of the spine; magnetic resonance or computed tomography (MRI or CT); radioisotope scintigraphy - is carried out with the slightest suspicion of oncological pathology.

However, even with a complete examination, it is not always possible to determine 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 of an acute pathological process to a chronic one. For this purpose, treatment of the main disease, as well as symptomatic drug treatment and non-drug treatment methods are prescribed.

Algorithm for the treatment of acute pain syndrome:

• short-term bed rest (2-5 days) along with medication and reflexology (RT); long-term adherence to bed rest contributes to the transition of the acute process to a chronic process; it is possible to determine a short course of wearing orthopedic devices: cervical collar for pathologies in the upper back and neck or waist;
• half-bed rest for the next 7-8 days; drug treatment and RT course continues, light physical exercises and physiotherapeutic procedures (electrophoresis with pain-relieving drug solutions) are added;
• physical activity regime with small restrictions (10-20 days); drug treatment is carried out according to the instructions; physiotherapy (laser and magnetic therapy), RT; add manual therapy and massage course;
• an unrestricted (but without weight lifting) physical activity regime with specially selected exercise therapy exercises;
• pain prevention - regular exercise therapy and possible 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. Paravertebral blockades with novocaine are performed for very severe, acute pain. If the pain syndrome is not eliminated, epidural blocks are performed - pain relievers by injecting anesthetics into the epidural space located between the dura mater and the periosteum of the spinal column.
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 characteristics of the drug and the individual characteristics of the patient. The most effective drug can cause complications of the gastrointestinal tract, so if the patient has stomach diseases, more modern NSAIDs will help relieve back pain.
3. Muscle relaxants are prescribed to relieve back muscle spasms.
4. B vitamins (B1, B6, B12) have a beneficial effect on the peripheral nervous system and increase 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. Antidepressants and anticonvulsants are included in the complex treatment for neuropathic pain associated with the involvement of nerve fibers in the process. These remedies help relieve pain.

The most important thing when treating severe back pain is to prevent acute pain from turning into chronic pain. Therefore, the patient should get medical help as soon as possible.