back pain

What should I do if severe low back pain suddenly occurs? How can I relieve the pain? Can I do it myself? Of course, it's good to know how to help yourself during a sudden, severe pain, but you shouldn't stop there: after your first emergency self-help, you should see a doctor immediately. At the Moscow Paramita Clinic they will always help you: they will determine the cause of the pain and eliminate it.

What to do if you have acute low back pain

60-80% of the population experience back pain on a regular basis. It is the second most common cause of temporary disability after acute respiratory viral infections. Acute back pain can start and end suddenly, but it can also subside slightly and become chronic. This cannot be tolerated; it is best to seek medical help immediately.

Just don't panic

Having severe back pain does not mean a person is hopeless; in most cases, it can be treated successfully, which means there is no need to panic. But it's important to know how to help yourself and relieve pain, and then consult your doctor immediately. Contacting a specialist is necessary because back pain is caused by many diseases and requires different treatments.

How to relieve symptoms on your own

Sometimes, the pain syndrome is so severe that the patient remains in the same position as the attack. In this case you need:

• Lie on your back on a hard surface or floor with a blanket; if you can't straighten your back, you'll need to assume a position that will minimize pain.
• Ask your loved one to give you a pain reliever; all pain relievers are available at the pharmacy without a prescription:
• Apply any type of topical pain relief medication to the skin of the painful area: topical rubs, ointments, gels, latex, and other over-the-counter medications:
• Call an ambulance; the doctor will give you an injection of anesthetic (usually an NSAID injection) and advise you on the best course of action: call your doctor at home or go directly to a professional clinic.

When you need to see a doctor urgently because of back pain

If you have severe back pain, you should contact the clinic immediately:

• Occurs after injury;
• With high fever and malaise;
• Problems with urination and bowel movements result;
• Accompanied by impaired motor function and numbness of the limbs;
• It has the nature of a ring, covering not only the back but also the abdomen (suspecting acute pancreatitis);
• Radiation to the left hand (suspected myocardial infarction);
• Growths that cannot be removed with pills and ointments.

In this state, you cannot save yourself. To avoid serious complications, you need to consult a doctor.

What to do about various types of low back pain

Back pain can be different: acute, radiating to different parts of the body, deep, painful, very intense, constant or wave-like. It can also be located in different parts of the back: neck, chest, lower back, sacrum, and coccyx. Even after a thorough examination, it's not always possible to find the cause of the back pain and then they say it's non-specific.This pain is called nociceptive pain and is related to the stimulation of pain receptors in tissues (muscles, ligaments, bones). Irritants can be mechanical (injury), physical, chemical, and inflammatory in nature. Also, 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 syndromes are associated with damage to nerve roots and nerve trunks. These pains account for 7% to 8% of all pain syndromes; they are characterized by a high likelihood of diagnosis by instrumental studies.A third type of pain—specific pain syndromes (such as spinal tuberculosis)—is relatively rare.

Severe back pain caused by coronavirus and other acute respiratory viral infections

With any acute respiratory viral infection, there may be sudden onset of fever, back muscle pain, body aches and severe weakness. These painful feelings are associated with general intoxication of the body. Back pain may be one of the first symptoms during a high-heat coronavirus infection.When coronavirus pneumonia occurs, back pain is exacerbated due to damage to the pleura, which has many nerve endings, and continued tension in the spinal muscles during forced coughing. Large amounts of lactic acid accumulate in the back muscles, causing irritation and pain.What helps: You can take paracetamol by mouth - it's a pain reliever and antipyretic. Taking any NSAID by mouth and applying it to the skin in the form of ointments and gels can also help.

Severe pain in upper back (cervical spine)

Acute pain syndromes can be of mixed nonspecific and neuropathic nature. Non-specific pain is often associated with incorrect exertion positions at a desk and tight back and neck muscles while working. Short-term episodes of pain may be accompanied by angina and radiate to the left arm.Neuropathic pain has an acute, burning sensation that radiates to the arm and shoulder blade on the affected side and is associated with nerve root compression in the cervical spine. how can I help you:

• Treatment of pain caused by spinal disorders - NSAIDs;
• Heart attack - Take a 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 chest and shoulder blades

The chest area between the back and shoulder blades is most susceptible to injury due to a sedentary lifestyle and the body being held in uncomfortable positions for long periods of time. This happens often to people who sit in front of a computer for hours every day. Weak muscles cannot bear the load and become injured.Incorrect posture can impair a child's development - develop thoracic scoliosis - scoliosis. If prompt action is not taken, the vertebrae can shift and compression fractures may occur.When the spinal nerve roots of the thoracic spine are pinched, severe pain can occur between the shoulder blades. It can radiate into the intercostal space or to the left arm, similar to an angina attack, but is not relieved by nitroglycerin.Acute pain in the shoulder blade area can be caused by diseases of various internal organs: heart, stomach, pancreas, lungs (pleural damage), kidneys, gallbladder.how can I help you:

• if the musculoskeletal system is damaged - NSAIDs (see section "How to relieve the condition on your own");
• For spasm of the arteries supplying the heart muscle (angina attack) - sublingual nitroglycerin tablets;
• For diseases of the internal organs - only a doctor can decide; in some cases, taking painkillers can lead to serious complications, for example, appendicitis or cholecystitis, with pain indicating the need for surgery to eliminate it.

If you don't understand what pain is, it's best to call an ambulance.

My waist hurts

Acute low back pain syndrome is often associated with spinal conditions and is nonspecific in nature, accounting for approximately 80% of all pain in this region.Neuropathic pain syndrome accounts for about 7-8%. Therefore, sudden acute pain in the lower back (low back pain) is often related to compression of the lumbar spinal base. Sudden, acute pain in the buttocks that radiates to the back of the thigh (sciatica) is caused by a pinched or inflamed sciatic nerve.Diseases of the kidneys, urinary tract, and reproductive organs can also cause lower back injuries.how can I help you:

• For myositis - NSAIDs;
• For neuropathy - NSAIDs do not always relieve pain and you will need to ask your doctor for a prescription for a full course of treatment;
• For diseases of internal organs - depends on the diagnosis and can only be determined by a doctor.

severe back and stomach pain

This pain is dangerous and often associated with internal organ disease. When they present, their first thought is acute pancreatitis. Acute pain syndrome is essentially colic, accompanied by nausea and vomiting, and requires emergency hospitalization. If this is not done, pancreatic tissue may die and the patient may die.Less commonly, lower back pain is associated with kidney disease. This condition also requires medical attention. In attacks of cholecystitis and cholelithiasis, pain may occur on the right side, radiating upward to the collarbone.Acute low back pain may be accompanied by intercostal neuralgia caused by compression of the spinal roots in the lower 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 - call an ambulance immediately; until the doctor arrives, you can take 2 tablets of No-shpa.

Severe back pain that radiates to the legs

Acute pain in the buttocks and the posterior surface of the right or left leg to the knee indicates invasion of the lumbar nerve roots, during which the sciatic nerve is involved. The pain syndrome is particularly intense, has discharge characteristics, and is accompanied by painful convulsions.How to help: Call an ambulance as soon as possible and take NSAIDs and numbing cream before doing so, but this is not very effective.

My back hurts when I breathe in too much

Dyspnea most commonly occurs:

• Intercostal neuralgia - pain worsened by any movement, including breathing and coughing;
• Used in acute diseases involving the pleura of the lungs and bronchi - pleuropneumonia, lung cancer.

How to help: Call your home doctor to find out what the problem is; you can't do this on your own.

My back hurts under my ribs

This localization is often associated with diseases of the internal organs:

• Severe, intense pain that does not subside or relieve, radiates to the stomach and spreads to the other side of the back; accompanied by nausea and vomiting - acute pancreatitis;
• Acute paroxysmal pain, often radiating to the groin area - Urolithiasis occurs when stones pass through the urethra.

How to help: Call an ambulance - this is an emergency and usually requires hospitalization; painkillers may help provide some relief.

backache

Acute pain on both sides of the back may also be related to diseases of the musculoskeletal system and internal organs. Depending on the location and nature of the pain, one can speculate on its origin. If you have pain on your right side:Right back center position:

1. Acute pain radiating along the intercostal nerves - it may be thought that the nerve roots of the thoracic spine are compressed;
2. Local pain - muscle inflammation;
3. Deep, aggravated by deep breathing and coughing - often associated with pleural disease - pleurisy, lung cancer that sprouts into the pleura.

Location under the ribs on the right side:

1. Intercostal neuralgia due to invasion of the right nerve root;
2. Pancreatic, liver and biliary tract diseases.

Pain on the left side:

1. Severe burning pain at any level of the ribs is neuropathic pain associated with spinal pathology.
2. Acute, sudden, short-term pain in the upper and mid-back, often radiating to the left arm - an angina attack.

how can I help you:

• For spinal disorders – NSAIDs;
• For angina - sublingual nitroglycerin;
• For pancreatitis, cholecystitis, urolithiasis attacks - take 2 tablets of No-shpa.

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

Back muscles hurt

Back muscle pain occurs due to colds, acute respiratory viral infections, or after prolonged exercise. For people with sedentary lifestyles, muscle pain may occur even with little physical activity.Any spinal disease (osteochondrosis, disc herniation, scoliosis, etc. ) is always accompanied by tension in the back muscles, as they protect the spine from any negative effects. At the same time, muscle tension can worsen back pain.How to help: Contact a neurologist to get tested and find out the cause of the pain; you can relieve severe pain on your own using ointments or gels containing NSAIDs, but it's difficult to get rid of the pain completely.

Severe back pain at night and morning

Back pain at night and in the morning is a serious symptom and one of the signs of the inflammatory process. Often, pain is combined with other symptoms: up to 40 years of age, onset is gradual, morning stiffness on exertion lasts for half an hour or more, pain disappears after starting physical activity.This is a severe condition that deprives patients of sleep and is associated with ankylosing spondylitis (ankylosing spondylitis), reactive arthritis, psoriatic arthritis, juvenile chronic arthritis, and chronic inflammatory bowel disease. Diseases such as arthritis develop.How to help: You do not need to take any measures yourself, you need to contact a rheumatologist to have the identified pathology examined and treated.

severe back pain during pregnancy

Pain syndromes during pregnancy are mechanical in nature. The growing fetus places increased stress on the muscles and ligaments of the back. When the back muscles are continuously tense, a large amount of lactic acid will be produced, causing muscle soreness.Pain syndromes may also be of an acute, paroxysmal nature, indicating damage to the spinal roots in situations where the spine is subjected to high loads. Pregnant women experience severe pain, lack of sleep, and are constantly stressed.how can I help you:

• Contact a neurologist or prenatal clinic therapist who will perform an examination and prescribe the necessary treatment; you cannot self-medicate: many NSAIDs are contraindicated during pregnancy;
• It is recommended to wear a bandage to support the abdomen.

Most common conditions that cause back pain

Most often, back pain syndromes occur against the background of diseases of the musculoskeletal system, neuroendocrine system or internal organs. The most common ones are osteochondrosis, intervertebral hernia, ankylosing spondylitis, spinal tumors, etc.

Osteochondrosis and disc herniation

This is a degenerative dystrophic process that causes the progressive destruction of the intervertebral discs (cartilage shock-absorbing plates with an elastic core in the middle). The disc ruptures, loses its elasticity, and may collapse completely. In this condition, the core of the disc bulges and compresses the nerve roots or spinal cord—forming a herniated disc.Severe back pain occurs when the roots are pinched, often radiating to large nerve trunks. Most commonly, this occurs in the lumbar area, which can withstand the highest loads. The pain starts in the lower back and then radiates to the back surface of the lower limb (lumbar pain). The sooner treatment for this condition is started, the faster the patient will be free of pain.

ankylosing spondylitis

The correct name for this disease is ankylosing spondylitis. It is a chronic inflammatory systemic disease of connective tissue associated with an autoimmune process (hypersensitivity to the patient's own tissues) and aggravated genetics. Most men under the age of 40 are affected.Damage to the joints and ligaments of the spine occurs, along with severe back pain and the gradual development of spinal immobility (ankylosis). This process starts at the lower part of the spine and works its way 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 getting up and starting active exercise. It is important to pay attention to these symptoms and consult a doctor as soon as possible.

lung cancer

The tumor develops slowly from the mucous membrane of the large or small bronchi. At first, the disease is asymptomatic, then cough appears, and inflammatory processes occur periodically in the bronchi and lungs. When the tumor grows into the pleura (a thin layer of membrane covering the chest and another covering the lungs), back pain occurs and worsens with deep breathing, coughing, or sneezing.If you develop back pain that worsens with breathing and coughing, you should see your doctor immediately!

diagnosis

The correct diagnosis of the disease is very important, since treatment is based on its results. It is established based on physician surveys and examinations of patients and additional examination data, including:

• Laboratory tests - general and biochemical blood tests, urine tests; immune blood tests, rheumatoid factor;
• Instrumental studies: Spine radiography; magnetic resonance or computed tomography (MRI or CT); radioisotope scintigraphy - performed in case of the slightest suspicion of tumor pathology.

But even with a thorough examination, it's not always possible to identify or rule out one cause or another of the pain.

How to Treat Back Pain

The main goals of treatment are to relieve pain and inhibit the transition from acute to chronic pathological processes. To do this requires treatment of the underlying disease, as well as symptomatic pharmacological and non-pharmacological treatments.Treatment algorithm for acute pain syndrome:

• Short-term bed rest (2-5 days) combined with pharmacotherapy and reflexology (RT); long-term adherence to bed rest facilitates the transition from an acute to a chronic process; a short course with orthopedic devices may be prescribed: for the upper back and neckor cervical collar for lumbar pathology;
• Semi-bed rest for the next 7-8 days; medication and radiotherapy are continued, with the addition of light physical exercise and physiotherapy procedures (electrophoresis with analgesic drug solutions);
• Physical activity with mild restrictions (10 – 20 days); medication as indicated; physical therapy (laser and magnet therapy), RT; additional manual therapy and massage sessions;
• A pattern of unrestricted (but non-weightlifting) physical activity and performance of specifically selected exercise therapy exercises;
• Pain Prevention – Regular exercise therapy and feasible exercises to take quality of life to the next level.

medical treatement

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

1. For very severe severe pain, a paravertebral block with Novocaine may be used. If the pain syndrome does not resolve, an epidural block is performed - pain relief is achieved by introducing an anesthetic into the epidural space located between the dura mater and the periosteum of the spine.
2. Less severe pain can be relieved by intramuscular injections of drugs from the NSAID group. The selection of the drug is made individually, taking into account the properties of the drug and the individual characteristics of the patient. The most effective treatments may cause gastrointestinal complications, so more modern NSAIDs will help relieve back pain if the patient suffers from stomach problems.
3. To eliminate spasms in the back muscles, it is necessary to use muscle relaxants.
4. B vitamins (B1, B6, B12) have beneficial effects on the peripheral nervous system and enhance the analgesic effects of NSAIDs. These medications can be given as an injection of the individual vitamins or as a solution containing all 3 vitamins plus the pain reliever lidocaine. After the condition improves, oral tablets can be taken.
5. For neuropathic pain associated with the involvement of nerve fibers in this process, complex treatment includes antidepressants and anticonvulsants. These therapies can help relieve pain.

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