Backache

What to do if severe back pain suddenly appears, how to relieve the 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: after the first emergency self-help, you should immediately see a doctor. In Paramita Moscow 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 suddenly, but it can subside a little and become chronic. This is unacceptable, it is better to seek immediate medical help.

Just don't panic

The onset of severe back pain does not mean that a person cannot be helped; in most cases, all of these 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 then immediately see a doctor. Contacting a specialist is necessary, because back pain is caused by many diseases and they require different treatment approaches.

How to reduce your own situation

Sometimes the pain syndrome is so severe that the person remains in the position where the attack caught him. In this case you need:

• Lie on your back on a hard surface, or on the floor, with a blanket on top; if you can't straighten your back, then you need to take a position that causes minimal pain.
• Ask your loved one to give you a tablet of any painkiller; all can be bought at the pharmacy without a prescription:
• Apply any pain reliever for external use to the skin in the painful area: application solutions, ointments, gels, emulgels and other non-prescription drugs:
• Call an ambulance; the doctor will give you an anesthetic injection (usually an NSAID injection solution) and advise you on the best course of action: call the doctor at home or go directly to a specialized clinic.

When you need to see a doctor immediately for back pain

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

• appears after injury;
• accompanied by high body temperature and feeling unwell;
• as a result, problems with urination and defecation appear;
• accompanied by impaired motor function of the limbs and their numbness;
• has a girdling nature, covering not only the back, but also the stomach (suspicion of acute pancreatitis);
• radiating to the left hand (suspicion of myocardial infarction);
• grow, cannot be removed with tablets and ointments.

It is impossible to help yourself in such a situation. To avoid serious complications, you need to consult a doctor.

What to do for back pain of various types

Back pain can be different: acute, radiating to different parts of the body, deep, aching, very strong, continuous or wave-like. It can also be located in different parts of the back: in the neck, chest, lower back, sacrum and tailbone. 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 the irritation of pain receptors in tissues (muscles, ligaments, bones). Irritants can be mechanical (injury), physical, chemical and inflammatory. Moreover, the degree of change in the spine does not always correspond to the intensity of the pain. Nonspecific pain accounts for approximately 80% of all back pain syndromes.

Neuropathic pain syndrome is associated with damage to nerve roots and nerve trunks. This pain accounts for 7-8% of all pain syndromes; their feature is a high probability of confirming the diagnosis during instrumental studies.

The third type of pain - a specific pain syndrome (for example, with spinal tuberculosis) is quite rare.

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

With any acute respiratory viral infection, accompanied by sudden attacks and fever, muscle pain in the back, pain in the whole body and severe weakness may appear. This painful sensation is 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, the pain in the back increases due to damage to the pleura, which has many nerve endings, as well as due to the 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 NSAID orally and applying it to the skin in ointment and gel form will also help.

Severe pain in the upper back (cervical spine)

Acute pain syndromes can be mixed nonspecific and neuropathic. Non-specific pain is often associated with an incorrect forced position on the desk during work, tension in the back and neck muscles. Short-term painful attacks can appear with angina and radiate to the left arm.

Neuropathic pain is acute, burning, radiating to the arm and shoulder blade on the affected side and is associated with pinched nerve roots of the cervical spine.

How can I help you:

• for pain due to spinal disease - NSAIDs;
• heart attack - nitroglycerin tablets 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

The back in the thoracic region and between the shoulder blades most often hurts because of a sedentary lifestyle and the body being in an uncomfortable position for a long time. Often, this condition appears in those who sit in front of the computer for several hours a day. Weak muscles cannot withstand the load and pain.

Children's development can be affected because of incorrect posture - lateral curvature of the thoracic spine occurs - scoliosis. If steps 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 space or to the left arm and resemble an angina attack, but it is not relieved by Nitroglycerin.

Acute pain in the shoulder blade area 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:

• in case of damage to the musculoskeletal system - NSAIDs (see the section "How to reduce your own condition");
• for spasm of the arteries that supply the heart muscle (angina attack) - Nitroglycerin tablets under the tongue;
• for diseases of internal organs - only a doctor can make a decision; in some cases, taking painkillers can lead to serious complications, for example, with appendicitis or cholecystitis, pain that indicates the need for surgery can be removed.

If you do not understand what hurts, it is better to call an ambulance.

My lower back hurts a lot

Acute lumbar pain syndrome is most often associated with conditions of the spine, is non-specific and accounts for approximately 80% of all pain in this area.

Neuropathic pain syndrome accounts for approximately 7 - 8%. Therefore, acute sudden pain in the lower back (lumbago) is usually associated with pinching of the spinal roots in the lumbar spine. Sudden acute pain in the back, radiating to the back of the thigh (sciatica) pinched 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 - depending on the diagnosis, which can only be established by a doctor.

Severe back and stomach pain

Such pain is dangerous, often it is associated with diseases of internal organs. When they appear, they first think about acute pancreatitis. Acute pain syndrome is girdling in nature, accompanied by nausea, vomiting and requiring emergency hospitalization of the patient. If this is not done, pancreatic tissue necrosis may occur and the patient will die.

Less commonly, girdle pain occurs with kidney disease. This condition also requires medical attention. With cholecystitis and attacks of cholelithiasis, pain may occur on the right side, radiating upwards to the collarbone.

Acute low back pain can occur with intercostal neuralgia caused by pinching the spinal roots of the lower part of the thoracic spine. The pain is so severe that it causes the patient to be unable to 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 to the legs

Radiating acute pain in the back and back surface of the right or left leg to the knee indicates a violation of the nerve root of the lumbar region with the involvement of the sciatic nerve in the process. The pain syndrome is very strong, has the nature of electrical discharge and is accompanied by painful convulsive twitches.

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 inhale too much

Painful breathing most often occurs:

• with intercostal neuralgia - pain increases from any movement, including inhalation and coughing;
• for acute diseases of the lungs and bronchi involving the pleura - pleuropneumonia, lung cancer.

How to help: contact the doctor at home and find out the problem; It is not impossible to do this yourself.

My back really hurts under my ribs

This localization is often associated with diseases of internal organs:

• sharp and strong pain that does not subside and cannot be eliminated, radiating to the abdomen and spreading to the back of the back; accompanied by nausea and vomiting - in acute pancreatitis;
• acute paroxysmal pain, often radiating to the groin area - with urolithiasis during the passage of stones through the urinary tract.

How to help: call an ambulance - this is an emergency situation that often requires hospitalization; Pain relievers can help relieve the pain a little.

Back pain

Acute pain in the back can also be associated with diseases of the musculoskeletal system and internal organs. Based on the location and nature of the pain, one can assume its origin. If there is pain on the right side:

Location in the center right back:

1. acute pain radiating along the intercostal nerve - it can be assumed that the root of the thoracic spinal nerve is pinched;
2. local pain - muscle inflammation;
3. deep, aggravated by deep inspiration and coughing - often associated with pleural disease - pleurisy, lung cancer with proliferation into the pleura.

Localization on the right side under the ribs:

1. intercostal neuralgia due to violation of the right nerve root;
2. diseases of the pancreas, liver and bile ducts.

Pain on the left side:

1. Severe burning pain along the ribs at any level is a neurogenic pain associated with spinal pathology.
2. Acute, sudden, short-term 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 are very sore

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

Any spinal disease (osteochondrosis, disc herniation, scoliosis, etc. ) is always accompanied by tension in the back muscles, because they protect the spinal column from any negative influence. At the same time, the tension in the muscles increases the pain in the back.

How to help: contact a neurologist, undergo an examination and find out the cause of pain; You can relieve severe pain yourself using an ointment or gel with NSAIDs, but it is difficult to completely eliminate the pain.

Severe back pain at night and 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, stiffness of morning movements up to half an hour or more, elimination of pain after the start of physical activity.

This is a serious symptom that prevents the patient from sleeping and develops in diseases such as ankylosing spondylitis (ankylosing spondylitis), reactive arthritis, psoriatic arthritis, juvenile chronic arthritis, arthritis associated with chronic inflammatory bowel disease.

How to help: do not do anything yourself, you need to contact a rheumatologist, conduct 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 muscles and ligaments of the back. In the back muscles, with constant tension, an increased amount of lactic acid is produced, which leads to the appearance of painful muscle pain.

The pain syndrome can also have an acute, paroxysmal nature, which indicates a violation of the spinal roots against the background of a high load on the spine. A pregnant woman experiences severe pain, lacks sleep and is always in a state of stress.

How can I help you:

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

The most common disease that causes back pain

Back pain syndrome in most cases develops against the background of any disease 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 disc (a cartilaginous shock-absorbing plate with an elastic core in the middle). The disc cracks, loses its elasticity and can collapse completely. In this case, the core of the disc protrudes and compresses the nerve root or spinal cord - a herniated disc develops.

When the root is pinched, severe back pain appears, often radiating to a large nerve trunk. Most often this happens in the lumbar region, which can withstand the highest load. It hurts first in the lumbar region, and then radiates to the back surface of the lower limb (lumboischialgia). The sooner the treatment for this disease is started, the sooner the patient will get rid of the pain.

Ankylosing spondylitis

The correct name for this disease is ankylosing spondylitis. This is a systemic disease of chronic inflammation of the connective tissue associated with autoimmune processes (allergy to the patient's own tissue) and heredity that aggravates it. Most men under the age of 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). This process starts at the bottom of the spine and gradually goes up. The characteristics of the pain syndrome are: back pain at night and in the morning, morning stiffness, which disappears no less than half an hour after waking up and starting active movements. It is very important to pay attention to 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 bronchus. At first, the disease is asymptomatic, then a cough appears and the inflammatory process in the bronchi and lungs develops periodically. When the tumor grows into the pleura (the thin layer that covers the chest with one layer and the lungs with another layer), back pain appears, worsening with a deep breath, cough, or sneeze.

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

Diagnostics

The correct diagnosis of the disease is very important, because the treatment is determined based on the results. It is established based on surveys and examinations of patients by doctors and additional examination data, including:

• Laboratory tests - general and biochemical blood tests, urine tests; immunological blood test, rheumatoid factor;
• Instrumental studies: radiography of the spine; magnetic resonance or computed tomography (MRI or CT); radioisotope scintigraphy - performed at the slightest suspicion of oncological pathology.

But even with a full 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 of acute pathological processes to chronic ones. 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 – 5 days) in combination with drug therapy and reflexology (RT); long-term adherence to bed rest contributes to the transition of acute processes to chronic ones; it is possible to prescribe a short course of wearing orthopedic devices: cervical collar for pathologies in the upper back and neck or lumbar belt;
• semi-bed rest for the next 7 - 8 days; the course of drug therapy and RT is continued, light physical exercises and physiotherapeutic procedures (electrophoresis with pain-relieving drug solutions) are added;
• physical activity mode with small restrictions (10 – 20 days); drug therapy is carried out according to indications; physiotherapy (laser and magnetic therapy), RT; add manual therapy and massage courses;
• mode of physical activity without restrictions (but without weight lifting) with the performance of specially selected exercise therapy exercises;
• pain prevention – regular exercise and sports therapy that can be implemented to improve quality of life to a new level.

Drug therapy

Since examination does not always reveal the cause of pain, treatment takes into account its nature (noceceptive, neuropathic):

1. For very severe and sharp pain, paravertebral block with novocaine is performed. If the pain syndrome is not relieved, an epidural block is performed - relieves pain by injecting anesthetic 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 drugs is carried out individually, taking into account the properties of the drug and the individual characteristics of the patient. The most effective drugs can cause gastrointestinal complications, so if the patient has a stomach disease, more modern NSAIDs will help relieve back pain.
3. To eliminate back muscle spasms, 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 given as individual vitamin injections or as a solution containing all 3 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 the complex treatment. These medications help relieve pain.

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