In the department of pain and diseases of the peripheralNervous System Clinic of Nervous Diseases, Moscow Medical Academy. THEM. Sechenov about back pain know almost everything. About half of the 750 patients receiving treatment annually here, turn here just about back pain.
Most often it deprives a person of the pain of efficiencyin the lumbosacral region. In 80-90% of cases, it is well cured, and a month later, most patients are back to work. The remaining 10-20% of the pain becomes chronic and treated longer.
"The source of the pain, - says EkaterinaPodchufarova, PhD, Assistant of the Department of Nervous Diseases MMA. THEM. Sechenov - can be any of the structures of the lumbosacral region: bones, joints, ligaments, intervertebral discs, muscles, peripheral nerves, nerve roots. Reflected back pain may occur in pancreatic disease, aortic aneurysm, diseases of the gastrointestinal tract, retroperitoneal, gynecological diseases. On reflection the pain usually does not affect the movement of the spine, it is not reduced in the supine position, and it depends on the severity of the patient's body condition.
Most patients (85%) suffer from painassociated with the activation of pain receptors of the intervertebral disc, muscles and joints of the spine. As a rule, an acute pain that may be caused by prolonged exposure to cold, reflex muscle tension and spine.
Pain often occurs when any pathologyinternal organ, excessive exertion, or, conversely, when a sedentary lifestyle. Often it is the muscle spasms are a secondary source of pain, which in turn triggers a vicious circle of "pain - muscle spasm - pain" and may persist for a long time.
Another source of back pain can beintervertebral joints. This pain in the lumbar region is amplified in extension and can "give" in the groin, back and outer thigh, in the coccyx. This neurotic pain is often unstable, it periodically that fades, then reappears. In most cases, such pain is easily diagnosed, no need for additional expensive tools surveys and respond well to treatment.
Much more difficult to diagnose psychogenicpain caused by psychological disorders and social factors. They often become chronic. The reasons for this shift are not entirely clear, but noted that it often occurs in men than in women. Not only overweight or lack of physical activity may be a cause of pain. But, for example, low income, job dissatisfaction, depression, anxiety.
In this case, the intimate conversation of the doctor and the patientIt is a must. Of course, quickly change the social environment, to raise the level of material wealth, or to get rid of anxiety and stress is not easy, but to find out what the cause of pain in the back lies in this - is half the battle. And if there is a clinical symptoms of psychological disorders - fear, irritability, fatigue, and sleep disturbances, decreased appetite, - not do without psychotherapeutic treatment.
"Such serious diseases, such as infectiousspinal damage, tuberculous spondylitis, osteomyelitis, primary tumors and metastases, fortunately, extremely rare, only in 0.2% of patients, - says Ekaterina Podchufarova. - Especially important not to miss them. Symptom "horse's tail" - squeezing the set of roots - when the patient feels weakness in the leg muscles, reduced sensitivity in the legs or suffering pelvic disorders such as urinary retention, - it is a reason for referral to consultation to the neurosurgeon.
If the pain is not associated with the movement are stored innight and at rest, the patient's fever and he unjustly reduced weight, also requires detailed examination to exclude the possibility of serious pathology. It should be seriously examined if there was pain in humans, has received in the past trauma, such as a car accident. "
Compression radiculopathy or, more simply,sciatica associated with compression of the lumbosacral roots and a herniated disc occurs most often in men aged 40-45 years who perform physical work. Its "classical" picture, "shooting" pain in the lower back, radiating in the leg, and intermittent claudication. Leg chilly, numb, becomes less sensitive, the person feels "chills", tingling, at least - a burning pain.
Radiculopathy treated as an operational andconservative way - on patient choice. The operation quickly relieves pain and allows a person to start work earlier. Conservative treatment for longer, but after about a year of treatment results are aligned.
In the acute period is necessary radiculopathyto achieve the maximum discharge of the lumbosacral spine, so for 1-2 days prescribed bed rest. At the same time use drug therapy, the choice of drugs is strictly individual. From heavy physical activity is likely to have to give.
In the treatment of musculoskeletal pain is usuallyapplicable local impact: the injection point in strained muscles, physiotherapy, acupuncture. Sometimes it is very effective manual therapy, soft, relaxing muscle techniques.
Chief Podchufarova doctor's advice to those who haveback pain: fulfill all the requirements of a doctor and try to form a mental attitude of recovery. If you cherish your pain, it almost inevitably develop into chronic. Try to forget about the pain, the pain, and then forget about you.
The term "back-office though and he was not yetscientific term, but, apparently, firmly embedded in the daily turnover. Those who have to sit for long periods at the workplace, are familiar aching back pain, numbness in the neck and other unpleasant symptoms.
Do not think that the sedentary workspine rests. On the contrary, in the sitting position intervertebral discs have a maximum load. To avoid this it is best to use a low office chair, the seat is slightly inclined inwards, and the back has a slight bulge at the site of the lumbar spine bending. Monitor your computer must be set so that the upper border was at eye level. This will save your neck vertebrae of the auxiliary voltage. Periodically, stand up and do gymnastics.