Back pain, familiar almost every adult person, can bring a lot of trouble. Previously, pain in the back was mainly associated with osteochondrosis or radiculitis, and all were treated equally. Now doctors have learned to recognize many-sided pain in the back, correctly diagnose and cope with the disease.
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In the branch of pain and diseases of the peripheral nervous system of the clinic of nerve diseases of the Moscow Medical Academy. AND.M. Sechenov about the pain in the back know almost all. Approximately half of 750 patients, annually receiving treatment here, they turn here about the pain in the back.
Most often deprives a person performance pain in the lumbar-sacral region. In 80-90% of cases, it is safely cured, and after a month most patients can start work again. The remaining 10-20% pain goes into chronic and is treated longer.
«The source of pain, "says Catherine Podtofarov, Candidate of Medical Sciences, Assistant Department of Nervous Diseases MMA. AND.M. Sechenova, - can be any of the structures of the lumbar-sacral region: bones, joints, ligaments, intervertebral discs, muscles, peripheral nerves, nerve roots. Reflected back pain may occur with pancreatic diseases, aortic aneurysm, the pathology of the gastrointestinal tract, the retroperitoneal space, gynecological diseases. The reflected pain usually does not affect the movement of the spine, it does not decrease in the lying position, and its sharpness depends on the state of the patient.
Most patients (85%) suffer from pain associated with activation of recipe receptors of the intervertebral disk, muscles and spinal joints. As a rule, it is an acute pain that can be a consequence of long-term supercooling, reflex tension of muscles and spine.
Often pain occurs in the pathology of any internal organ, excessive physical exertion or, on the contrary, with a sedentary lifestyle. Often it is precisely the muscle spasms become a secondary source of pain, which, in turn, launches a vicious circle «Pain - Muscular Spasm - Pain» and can persist for a long time.
Another source of back pain can be intervertebral joints. At the same time, pain in the lumbar department increases when extension and may «give away» in the inguinal area, rear and outer surface of the hip, in the tailbone. This neurotic pain is often a non-permanent, it stops periodically, it appears again. In the overwhelming majority of cases, such pain is easily diagnosed, does not need additional expensive instrumental examinations and is well treatable.
It is much more difficult to diagnose psychogenic pain due to psychological disorders and social factors. They are often moving into a chronic form. The reasons for this transition are not clear, but it is noticed that it happens more often in men than women. Not only overweight or lack of physical activity may cause pain. But, for example, low incomes, dissatisfaction with work, depression, anxiety.
In this case, the memorial conversation of the doctor and the patient is simply necessary. Of course, to quickly change the social environment, raise the level of material wealth or get rid of anxiety and stresses is not easy, but find out what the reason for pain in the back lies precisely in this - half of the success. And if there is a clinical symptoms of psychological disorders - fear, irritability, fatigue and sleep disorder, decrease in appetite, - without psychotherapeutic treatment.
«Such serious diseases, as an infectious spine damage, tuberculous spondylitis, osteomyelitis, primary tumors and metastases, fortunately, are extremely rare, only 0.2% of patients, - says Catherine Pinchuchar. - The more important not to miss them. Symptom «horse tail» - Squeezing the set of roots - when the patient feels weakness in the muscles of the legs, a decrease in the sensitivity in the legs or suffers from pelvic disorders, for example, a retention of urination, is a reason for referring to a counseling for neurosurgeon.
If the pain is not associated with the movement, it is maintained at night and alone, the patient is fevering and his weight is shrinking unfortunately, it is also necessary for a detailed examination to eliminate the likelihood of serious pathology. It is seriously examined if the pain arose in a person who received injuries in the past, for example in autoavaria».
Compression radiculopathy or, simply speaking, radiculitis associated with the compression of lumbosacral roots and hernias of the intervertebral disk, is most often found in men aged 40-45 years who perform physical work. Her «Classical» painting: «Shooting» Pain at the bottom of the back, heading, and intersecting lameness. The foot is angry, does not feel less sensitive, man feels «Mural», Tingling, less often - burning pain.
Radiculopathy is treated both operational and conservative - to choose a patient. The operation faster eliminates pain and allows a person to start work before. Conservative treatment is longer, but about a year later the results of treatment are aligned.
In the acute period of radiculopathy, it is necessary to achieve maximum unloading of the lumbosacral spine, so 1-2 days are prescribed bedding. Simultaneously use medicinal therapy, and the choice of drugs is strictly individual. From severe physical activity, most likely, will have to refuse.
In the treatment of skeletal muscle pain, local impact is usually applied: injections in tense points in muscles, physiotherapeutic procedures, iggoreflexotherapy. Sometimes very effective manual therapy, soft, relaxing muscles techniques.
The chief advice of the doctor of the doctor is a refinement, who has a spin hurt: to fulfill all the prescriptions of the doctor and try to form a psychological attitude for recovery. If you holy and cherish your pain, it will almost inevitably turn into chronic. Try to forget about pain, and then the pain will forget about you.
Expression «Office spin Although it has not yet been a scientific term, but, apparently, firmly enters the casual turnover. To the one who is forced to sit in the workplace for a long time, do not acquaint the new back pain, feeling of numbness in the neck and other unpleasant symptoms.
No need to think that when the spine is resting. On the contrary, in the sitting position, intervertebral discs are experienced maximum load. To avoid this it is best to use a low office chair, whose seat is slightly inclined inward, and the back has a small bulge on the place of the lumbar bend of the spine. Computer monitor must be installed so that its upper border is at eye level. It will save your cervical vertebrability of additional voltage. Periodically get up and make gymnastics.
