Upper back pain
Pain in the cervical spine requires the closest attention. The reason is the unique anatomical features of the cervical vertebrae: the vertebral artery passes through them, supplying blood to ⅓ of the brain; the first and second cervical vertebrae form a movable complex articulation with the skull, responsible for turning and tilting the head; Any disease that occurs at this level has the potential to cause serious neurological impairment, since damage or even minor compression of the spinal cord in the cervical spine immediately leads to impairment of motor and/or sensory function throughout the rest of the body.
Osteochondrosis of the cervical spine
Normally, intervertebral discs, joints, ligaments and tendons do not have their own blood vessels; their blood supply depends on how intensively the adjacent muscles and bones are supplied with blood. If this process is disrupted, for example in an office worker who leads a sedentary and sedentary lifestyle, degenerative-dystrophic changes begin in them. The nutrition of the cartilage of the intervertebral discs and joints is disrupted, the ligaments and tendons thicken, and due to sclerotic changes, the spinal canal narrows and the distance between the vertebrae decreases.
Among non-specialists, this disease is known as spinal osteochondrosis. Despite the fact that degenerative-dystrophic processes are characteristic of the entire spine, it is osteochondrosis that is the most common cause of pain in the cervical region. Moreover, as in other parts of the spine, this disease can be complicated by intervertebral hernia. However, due to the anatomy of the cervical spine, even a small hernia can cause serious complications.
Injuries
Although spinal cord injury is most often diagnosed in the lumbar spine, almost 50% of spinal cord injury cases occur with cervical spine injury. This is explained by the peculiarities of the anatomy of the neck: the absence of a developed muscular frame and massive vertebral bodies, greater mobility contribute to injury even without direct physical impact (for example, when stopping abruptly or being hit from behind during an accident, the so-called whiplash injury of the neck often occurs, caused by sharp bending followed by a sharp extension of the cervical spine). Pain is a constant companion to any spinal injury.
Myositis
Myositis or inflammatory muscle diseases is a whole group of diseases characterized by muscle pain. The most common cause of simple muscle inflammation is a forced posture when performing any work, hypothermia, or drafts. Muscle pain can be a consequence of osteochondrosis of the cervical spine, intervertebral hernia - the muscles take on most of the load on the neck, which ultimately leads to overstrain, muscle spasm with impaired microcirculation and inflammation.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Neuralgia
Neuralgia is a condition in which the nerve fibers themselves become a source of constant pain impulses. The pain is paroxysmal in nature and can intensify and be provoked by turning or tilting the head, or cold weather. The cause of neuralgia is associated with diseases of the spine - osteochondrosis, intervertebral hernia, scoliosis, etc. The immediate cause of pain is irritation of the spinal cord roots when they are pinched in the intervertebral space, muscle spasm that disrupts the metabolism in the nerves passing through the spasmed muscles. Unlike neuritis or inflammation of the nerve, with neuralgia the pain is periodic and there are no pathological changes in the nerve fibers themselves.
Heart diseases
Heart diseases, such as angina pectoris, coronary heart disease, atherosclerosis of the coronary vessels, are often accompanied by pain radiating to the neck, lower jaw, shoulder and forearm on the left. The pain may be accompanied by numbness and tingling on the skin, simulating the pain of osteochondrosis of the cervical spine with an intervertebral hernia. Patients often receive massage, physical therapy, and see other doctors, although an electrocardiogram is sufficient to diagnose the cause.
A characteristic sign of such pain can be considered the ability of antianginal drugs that improve blood flow through the coronary arteries (isoket, nitroglycerin) to relieve pain within a few minutes.
Causes
Let's look at the main causes of pain in the thoracic vertebrae:
- spinal pathology - scoliosis, osteochondrosis, disc herniation (rarely) and protrusion, myositis;
- back injuries - chest bruises and vertebral fractures (including osteoporosis), sprains;
- neurology - intercostal neuralgia, severe stress or prolonged depression;
- diseases of other organs - pancreatitis, stomach ulcers, heart disease, pneumonia/pleurisy, kidney stones;
- infections - tuberculous spondylitis, herpes zoster;
- malignant neoplasms - cancer or metastases in the lungs and mediastinum, oncopathology of the stomach, etc.
Mid back pain
The thoracic spine consists of 12 thoracic vertebrae, each of which has a pair of ribs attached. Together they provide protection for the chest organs. The size of the thoracic vertebrae gradually increases, starting from the 1st thoracic vertebra and further to the beginning of the lumbar spine - this is explained by a gradual increase in the load placed on them. The mobility of the middle part of the back is much lower than the mobility of the neck, the ribs provide additional protection, which is why traumatic spinal cord injuries in the thoracic spine are less common.
Curvature of the spine or scoliosis
Scoliosis or scoliotic disease is a pathological curvature of the spine in several planes. The exact causes of scoliosis are still unknown; the disease begins in childhood. Predisposing factors are considered to be lack of physical activity, weakness of the back muscles, incorrect posture and organization of the workplace for school-aged children. Due to pronounced curvature, disturbances in the distribution of loads and biomechanics of the spine, overstrain of the muscles that compensate for part of the load ,
chronic
back pain.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Arthritis (spondyloarthritis)
The intervertebral joints together with the intervertebral discs unite the spine into one whole. Each vertebra has 4 articular surfaces that form articulations with neighboring vertebrae. Like any other joint, intervertebral joints can become inflamed. This pathological condition is called spondyloarthritis. There are two main reasons that cause inflammation of the intervertebral joints. These are systemic rheumatic diseases (such as rheumatoid arthritis or ankylosing spondylitis) or reactive inflammation that occurs in response to increased stress due to osteochondrosis, scoliosis and other pathologies of the spine. Inflamed joints lose their function: stiffness of movement, stiffness of the spine, and prolonged back pain occur.
Gastrointestinal diseases and back pain
Diseases of the abdominal organs often cause referred pain in the back and spine. There is also a direct connection between pathologies of the gastrointestinal tract and diseases of the musculoskeletal system. Diseases such as chronic colitis or gastroenteritis are the background to spondyloarthritis or osteochondrosis of the spine.
Most often, referred pain in the back occurs with peptic ulcers of the stomach and duodenum, with a hiatal hernia, acute or chronic pancreatitis. This phenomenon occurs due to the characteristics of the sympathetic and parasympathetic systems, the nerve fibers of which are present in each organ of the abdominal cavity. Some of the pain impulses perceived by them return to the roots of the spinal cord, simulating pain in the spine and back.
Kidney disease and back pain
The kidneys are a paired organ located in the retroperitoneal space, which, as in the case of the abdominal organs, is intimately connected by nerves to the roots of the spinal cord. In the presence of inflammation, stones or other pathologies of the urinary tract, some of the pain impulses reach the spinal cord, simulating a spinal disease. Back Pain Symptoms
may occur with acute pyelonephritis, renal colic, kidney abscesses. A characteristic symptom is considered to be tension in the back muscles in the projection of the kidneys, which occurs due to inflammation of the kidneys or an abscess of the tissue surrounding them.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Diagnostic features
The presumable reason why the spine hurts in the middle of the back can be determined by the nature of the discomfort and additional symptoms, but only a doctor can make an accurate diagnosis. If you are only concerned about back pain, you should consult a neurologist or orthopedist. If discomfort appears after a bruise or other injury, you need to be examined by a traumatologist. If you have a cough and fever, you may need to consult a phthisiatrician. Various diagnostic procedures allow you to determine the exact causes of pain in the middle of the back:
- X-ray;
- MRI;
- CT;
- Ultrasound of internal organs;
- ECG;
- lab tests.
MRI or x-rays in several planes reveal curvature of the spine, changes in the width of blood vessels, damage to the intervertebral discs, and displacement of the vertebrae. ECG, ultrasound and tests help detect diseases of internal organs.
Pain in the lumbosacral spine
The lumbosacral spine bears the heaviest loads. Up to 60-70% of the adult population of developed countries complain of lower back pain. This is the favorite localization of intervertebral hernias. One patient is most often diagnosed with 2-3 hernias in the lumbosacral spine. Also, pain in the lower back and sacrum often occurs with gynecological and urological pathologies.
Intervertebral hernia
Intervertebral hernia is the result of long-term osteochondrosis of the spine. If in the cervical region the intervertebral discs bear relatively small loads, in the lumbosacral region each disc experiences colossal pressure. A healthy disc is able to compensate for any weight due to the semi-liquid core, which plays the role of a hydraulic shock absorber. However, due to osteochondrosis, the fibrous and durable cartilage (fibrous ring) running along the periphery of the intervertebral disc loses its elasticity and strength, and its individual sections may crack. With a sharp increase in load, for example when lifting weights, the pressure inside the diseased disc increases, which is why its contents can actually “shoot” through the damaged cartilage, entering the lumen of the spinal canal - this is how an intervertebral hernia is formed.
Fragments of the nucleus that fall out of the disc compress the spinal cord and spinal roots. As a result, swelling of the nerve tissues and poor circulation occur, which is accompanied by severe pain and protective muscle spasms. The pain can be unbearable, to the point of requiring the use of narcotic analgesics. A characteristic symptom is pain radiating to the lower extremities. Possible disturbance of sensitivity to pain, tingling and numbness of the skin of the lower leg and thigh.
Intervertebral disc protrusion
The main difference between intervertebral disc protrusion and hernia is the preservation of the integrity of the fibrous ring. The cause of pain is compression of the spinal cord and its roots by protrusion along the periphery of the intervertebral disc. However, if the process continues, the protrusion can easily turn into a hernia. Symptoms and pain are similar to those with a herniated intervertebral disc, since the severity of the pain syndrome depends not only on the size, but also on the location of the protrusion or hernia.
Spondylosis of the spine
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Excessive loads and degenerative-dystrophic processes in the spine can lead to ossification of cartilage tissue, which is saturated with calcium salts and turns into sharp beak-shaped bone outgrowths or growths that arise along the periphery of the vertebral bodies. As the process progresses, these growths can merge with similar growths on the body of neighboring vertebrae. Over time, all vertebrae fuse with each other, the spine loses flexibility and elasticity. Pain occurs due to irritation of the spinal cord and its roots, reactive inflammation and degeneration of the soft tissues, ligaments and muscles surrounding the spine.
Radiculitis
Radiculitis is the name given to intense pain that occurs due to circulatory disorders and ischemia of the spinal cord roots, pinched by a hernia or protrusion due to spinal osteochondrosis. There may be a variety of skin sensitivity disorders in the buttocks, perineum, thighs and lower legs. Advanced radiculitis leads to muscle atrophy and weakness. A characteristic symptom is shooting pain along the sciatic nerve, aggravated by movement, lifting heavy objects and in cold weather. This condition is called sciatica or sciatica.
Spinal infection
Vertebrae consist of spongy bone tissue rich in bone marrow. When an infection enters the bloodstream in the vertebral body, an inflammatory process - osteomyelitis - can occur. The gradual breakdown of bone tissue is accompanied by necrosis - this picture is also characteristic of spinal tuberculosis. Pain can occur either due to irritation of the nerve endings or due to pathological compression fractures of the spine weakened by inflammation.
Gynecological and urological diseases
Pathologies such as cervical cancer, endometriosis or adnexitis (inflammation of the uterine appendages) in women, prostatitis or prostate cancer in men are often accompanied by severe pain in the lumbosacral spine. The nature of the pain is explained by irritation of the nerves caught in the area of inflammation, or the germination of nerve trunks by a tumor.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Who is at risk?
More often, pain in the upper spinal zone may occur in older people. Their bones and muscles become thinner. Therefore, physical activity with calcium intake, vitamin D and other multivitamin preparations is indicated for them. Discomfort often occurs in pregnant women. Their organs are displaced, and their high body weight puts stress on the spinal column.
If work involves prolonged sitting, the spinal column will always be overstrained. Gymnastics and walks in the fresh air are required. Pain syndrome should not be tolerated; self-medication will only aggravate the general condition and cause complications that are difficult to cure. Therefore, it is better not to take risks, but to seek help from professionals.
Back muscles along the spine hurt
Well-developed back muscles are a sign of a healthy spine, since the muscle corset relieves some of the stress and further stabilizes the spine. With chronic diseases of the spine, excessive loads are placed on the muscles, which weak and atrophied muscles are not able to withstand. As a result, muscle spasm occurs, and due to metabolic disorders in the muscles, pain occurs. This condition is called myofascial syndrome, which is characteristic of spinal osteochondrosis, hernias and protrusions of intervertebral discs.
Postoperative pain
Spinal surgeries are usually accompanied by extensive trauma - to stabilize and restore the integrity of the vertebrae, doctors may resort to installing metal structures, screwing screws into the vertebrae and removing non-viable tissue. The pain in this case is caused not only by the disease itself, but also by the surgery undergone. With proper rehabilitation and postoperative care, the pain will gradually go away. However, if in the postoperative period you neglect the instructions of doctors and ignore mandatory exercises, the pain can become chronic.
Weakened muscles and poor posture
People can train their muscles over time to become stronger or more resilient through exercise and strength training.
But if you use your muscles incorrectly or irregularly, you may experience a loss of muscle tone.
Some muscles, including your back muscles, can become weak as easily as sitting at a desk with poor posture for too long.
Bending over a desk in a chair can cause a loss of strength in the muscles. Over time, weakening muscles can lead to pain in the area as they experience constant tension or irritation.
When a person slouches, pressure from gravity and the body itself puts pressure on the spine, neck, discs and ligaments. Over time, this pressure can lead to pain and other complications.
In most cases, you can make the muscles stronger and more durable. This process begins with correcting your sitting posture and taking regular breaks from movement and stretching.
However, muscle conditioning requires patience, and anyone with chronic upper back pain from weak muscles can benefit from seeing a physical therapist to find exercises that are right for them.
How to diagnose the causes of pain in the spine
To diagnose pain in the back and spine, it is necessary to promptly seek medical help from a qualified neurologist. At the first stage, a neurological examination, a survey of the patient, and a study of reflexes and symptoms are carried out. An experienced and competent doctor knows well the diseases in which pain in the back and spine has certain causes and characteristic features.
Back pain without an obvious cause should cause particular concern. This can happen with referred pain in other organs and systems, with tumors and diseases of the spinal cord.
To find out why your back and spine hurt, a neurologist may prescribe magnetic resonance imaging. This is the most effective and safe method for diagnosing almost all possible causes of back pain. The procedure is based on the ability of magnetic fields and radio waves to produce clear and detailed images of the spine and spinal cord without the use of X-rays or other harmful factors.
Spinal infections
Rarely, infection may be the cause of upper back pain. A spinal epidural abscess is a collection of germs and pus that forms between the spinal cord and the bones of the spine.
The abscess may grow and swell, resulting in pain. Early diagnosis is critical so that doctors can quickly remove the spinal abscess and avoid serious complications.
In some cases, surgery may be necessary to clean out the abscess area and reduce the risk of complications. But sometimes antibiotics are enough.
A study published in BioMed Research International notes that mortality can range from 2 to 25 percent in people with spinal epidural abscess, typically because diagnosis of the condition is delayed for many patients with the problem. This is not something to joke about.
How to relieve an attack of pain in the spine
To relieve, but not cure, back pain, it is permissible to take analgesics for several days, which is necessary to wait for a consultation with a specialist. Most often, non-steroidal anti-inflammatory drugs or NSAIDs are used for this purpose. However, it is important to remember that this group of drugs can cause dangerous side effects, the likelihood of which increases with long-term use. This is why it is important not to delay your visit to the doctor and examination for further treatment
diseases
of the spine
and causes of
back pain.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Muscle overload
Overuse of the back muscles is another common cause of upper back pain. It usually occurs due to repetition of the same movements over a period of time.
A classic example of how this happens is a baseball pitcher who makes the same motion every time he pitches, which can often cause damage to his shoulder.
Any other repetitive activity can cause similar pain. For example, someone who has to do the same movement all day or lift things over their head throughout the day may experience muscle irritation, tightness, or tension. This can turn into chronic pain if the signs are ignored.
Treatment usually begins with rest and the use of heat or ice packs to improve blood circulation in muscle tissue. A physical therapist may recommend exercises to improve flexibility and strength in this area.
Treatment of spine pain
As was said at the very beginning, the effectiveness of treating spinal pain depends on how accurately the diagnosis was made. Despite the obvious, many patients spend years “treating” the pain, but not the disease itself, each time postponing a visit to the doctor, turning to traditional healers, osteopaths, and chiropractors. Moreover, for some diseases of the spine such procedures are not only contraindicated, but also dangerous.
There are effective and scientifically proven methods of treating various types of
diseases that cause
back pain
. Many of them require the patient’s perseverance and perseverance in the fight against the disease. It is important to remember that there are no pills or injections that can cure osteochondrosis - only you can do this through persistent training and physical exercise, which a neurologist will show you.
What are there
Musculofascial pain has its own characteristics and is divided into:
- intensity - represented by acute (strong) and weak (aching).
- duration – divided into one-time, periodic and permanent.
- origin - associated with pathologies of the spine or not related to it.
- localization - depending on the location of the lesion.
These characteristics allow you to make a preliminary diagnosis and indicate in which direction you should look for the cause of the disease. Unlike acute pain, the cause of which is identified in a short period of time, aching pain causes anxiety, since such a manifestation often hides a serious illness.
Prevention
Pain in the back muscles often becomes an unbearable torment, and treatment takes time and money. It is almost impossible to completely avoid the manifestation of this syndrome, but it is possible to reduce the likelihood of its occurrence. It is enough to follow the rules that are included in the preventive measures. To maintain your back muscles in normal condition you need to:
- Do strengthening gymnastics. This will reduce the risk of injury and protect the spine from diseases.
- Take multivitamins. A lack of micro- and macroelements leads to a weakening of the musculoskeletal system and reduces immunity, which contributes to pathologies of internal organs. The selection and administration of medications should be done only after consultation with a specialist.
- Optimize physical activity. Excessively active sports, especially at the initial stage, is a direct path to overexertion, stretch marks and injuries to the broad muscle, which are inevitably followed by pain. A gradual increase in the intensity of classes and training under the supervision of an experienced trainer will help avoid the manifestation of this syndrome.
- Spend less time in one position. Sedentary work requires an hourly 10-15 minute break, which should be accompanied by light exercises. Rest will provide an opportunity to relieve muscles and normalize blood circulation.
- Make sure that your back and especially your lower back are not exposed to hypothermia. To do this, you need to avoid drafts and, when going out into the open air, dress according to weather conditions.
After sudden pain in the back muscles, even if it has completely subsided, it never hurts to see a doctor and get examined. This measure will help avoid relapse, and even more so will prevent the syndrome from becoming chronic.