Back pain, and especially in its lower third, is one of the most common reasons why patients turn to neurologists, surgeons, therapists, and orthopedists. Labor losses from pathology of the musculoskeletal system occupy one of the leading places, since, as a rule, the most active group of the population is affected, aged 20 to 60 years, and most often - 25-45 years.
Incorrect treatment often prolongs the disease for many months, which forces these patients to be referred to establish a disability group, and premature surgical treatment often permanently disables these patients. The number of disabled people due to so-called spinal osteochondrosis and joint diseases has reached alarming proportions.
How does the disease manifest itself?
The disease can begin with acute pain in any part of the back, which intensifies with active movements and bending. But more often it all starts with a “tolerable” feeling of discomfort in the interscapular, lumbar, and shoulder girdle areas. Discomfort intensifies in the evening, with weakness of the paravertebral muscles, or in the morning, as a result of poor sleep conditions.
The spinal column bears a colossal mechanical load, but at the same time it is a complex anatomical formation in which circulatory, supporting, and spinal structures innervating the entire human body are closely intertwined. That is why changes in the spine, which lead to compression or irritation of the spinal elements, can manifest as pathology of any internal organs (headache, vascular dystonia, hypertension, arrhythmia, sexual dysfunction, etc.). The ancients argued: “if there are many diseases and they cannot be cured traditionally, then there is only one disease and the spine needs to be treated.”
Main causes of joint pain
Diseases accompanied by intoxication
This is a wide range of acute and chronic diseases - acute respiratory viral infections, influenza, chicken pox, as well as chronic cholecystitis, chronic tonsillitis, oncological pathology, etc. The joint is affected by toxic products formed in the body. Joint pain is fleeting and disappears without a trace after the underlying disease is cured.
Rheumatoid arthritis
Arthritis is inflammation of a joint. The small joints of the hands and feet are affected, and subsequently the ankle, knee, hip, wrist and elbow joints may be involved. Acute pain occurs suddenly or gradually increases over several days. The affected joints swell and the skin around them turns red. A characteristic symptom is morning stiffness in the joints. Symptoms such as fever and rash are sometimes observed.
As the pathological process progresses, the pain becomes aching, and the stiffness of movement in the affected joints becomes persistent.
Rheumatic arthritis
Usually occurs 1-3 weeks after a sore throat or flu, but the connection with the infection may not be traced. It begins acutely and is accompanied by high fever. Large joints are symmetrically affected, they swell and become sharply painful. At the same time, heart tissue can be affected, which is much more dangerous than arthritis.
Gout
This is arthritis caused by the loss of small crystals of uric acid into the joint cavity. Usually the big toe is affected - more precisely, the joint farthest from the nail. Inflammation of other joints is also possible. The attack develops suddenly, often at night or in the morning. The pain is very severe, the joint and surrounding tissues swell. The duration of exacerbation ranges from several days to several weeks. After some time, the attacks are repeated. Nodes - tophi - appear in the joint area. As a result of the pathological process, the articular cartilage and ligamentous apparatus suffer, and joint deformation gradually occurs.
Reactive arthritis
Inflammation of the joint develops after some time against the background of chlamydia, pseudotuberculosis or any other infection. Small joints of the limbs (sometimes symmetrical) are affected; subsequently, large ones may also be involved. The symptoms are similar to gout. Sometimes these two diseases can be distinguished only by the results of a blood test: with reactive arthritis, C-reactive protein is detected, and with gout, an increased level of uric acid is detected.
Attacks alternate with remissions, changes in the joints are unstable, and in the intervals between attacks they can completely disappear. Complications rarely occur - the heart, kidneys and other organs may be affected.
Psoriatic arthritis
Sometimes it occurs without skin manifestations of psoriasis, which makes diagnosis difficult. It can be symmetrical or asymmetrical, affecting small (closer to the nail) and large joints, including intervertebral joints. In some cases, the symptoms resemble rheumatoid arthritis, in others - arthrosis or another disease.
Arthrosis
Premature wear and degradation of articular cartilage. Synonyms: osteoarthritis, osteoarthritis, deforming arthrosis. This joint disease is widespread. It affects people in old age, with excess body weight, most often women. Due to metabolic disorders (or due to injury), the nutrition of the articular cartilage deteriorates. The cartilage is destroyed, and other joint tissues also suffer.
The hip, knee, ankle joints and small joints of the fingers are affected. At first the pain is mild, but over time it becomes stronger. When the joints are loaded, the pain increases, and with rest it decreases. There is a crunch in the joints and swelling. Damage to large joints of the lower limb leads to gait disturbance. As the disease progresses, the range of motion in the joints decreases to the point of immobility.
Flat feet
With this pathology, both articular cartilage and ligamentous apparatus are affected, and pain in the feet can be severe.
Radiculitis (“radix” – root)
Occurs with osteochondrosis of the spine, when a reduction in the space between the vertebrae leads to compression of the spinal cord root. Depending on the part of the spine affected by the pathological process, pain occurs in the neck, chest or back. They can be very strong and radiate to the arm or leg, simulating a disease of the joints of the extremities.
Inflammation of periarticular tissues
The joint capsule, tendons or ligaments become inflamed, but the tissues in the joint cavity are not affected. This happens with bursitis, tendinitis, periarthritis.
Injury
Damage to the articular cartilage and ligaments heals slowly, so pain in the joint may persist for a long time after the injury. The resulting damage to articular cartilage and other tissues can become a trigger in the development of a degenerative process - arthrosis.
Functional joint pain
They are caused by spasm of the vessels supplying the joint due to disruption of the autonomic nervous system under stress.
Other reasons
Joint pain can also be accompanied by other, more rare diseases: systemic lupus erythematosus, systemic sclerosis, ankylosing spondylitis, hallux valgus, avascular necrosis of the femoral head and others.
You can find out the causes of joint pain in consultation with our specialists. Our clinic address: St. Petersburg, st. Bolshaya Raznochinnaya, 27 metro station Chkalovskaya
Reasons for appearance
Almost all degenerative-dystrophic changes in the musculoskeletal system, in general, and the spine in particular, are a consequence of overload. As a result of overload, in addition to gradual mechanical destruction, which with age begins to prevail over recovery processes, a disruption in the nutrition of anatomical structures (intervertebral discs, joint cartilage) occurs.
Excess weight, heavy physical labor, regular sports with predominant axial loads (weightlifting, running, jumping), prolonged static loads (“sedentary” work, especially at the computer), poor sleep conditions - all these are factors that overload the musculoskeletal system. .
Overload of the supporting structures of the spine and joints is aggravated by: impaired spring function of the feet (longitudinal, transverse flatfoot), smoothness or absence of shock-absorbing physiological curves of the spine, the presence of pathological ones (scoliosis, hyperkyphosis), weakness of the paravertebral muscles. A predisposing factor is also burdened heredity - the presence of relatives suffering from “osteochondrosis”, “radiculitis”, “arthrosis”, etc.
Metastases in bones
The appearance of bone pain in cancer is not immediately observed. Sometimes years pass from the appearance of the primary tumor to the development of metastases in the bones. However, there are also more aggressive types of cancer, in which the spread of the tumor process occurs over several months. Most often (80% of cases) bone metastases are detected in breast cancer and prostate cancer. Other cancers include:
- Thyroid cancer.
- Lung cancer.
- Kidney cancer.
- Lymphoma.
- Melanoma.
Very rarely, bone damage is detected in malignant tumors of the stomach and intestines, cervix, and ovaries.
The location of bone metastases can also vary. As a rule, secondary tumors are detected in the femur, humerus, pelvic bones, spine, and ribs. That is, in those areas of bone tissue that are actively supplied with blood.
Treatment
The famous Russian doctor N.I. Pirogov said: “the future belongs to preventive medicine.” Unfortunately, this future has not yet arrived - now doctors more often have to treat patients with advanced, complicated pathology. The low medical culture of the population is partly to blame for this - until it becomes “unbearable”, the patient does not even think about visiting a doctor, or, even worse, self-medicates, which cannot be adequate. Partly to blame are the doctors themselves, who do not have specialized specialties, who undertake to treat such patients without understanding the true causes of the disease, without knowing the principles of influencing internal organs through the spine.
The multidisciplinary medical clinic is staffed by experienced orthopedists who practice manual medicine and are proficient in osteopathy, chiropractic, myofascial release, and local injection therapy. Here you can get real tangible help for pathologies of the musculoskeletal system with all the ensuing consequences. Complex treatment is carried out with further individual selection of physical therapy to consolidate the effect for a long time.
“SM-Clinic” has a wide range of possibilities: therapeutic massage, myostimulation. In addition to eliminating back pain, we also have extensive experience in the treatment of autonomic disorders, arthrosis, postural disorders and statics.
Primary bone tumors
In oncology, bone cancer is relatively rare. This group includes several diseases that have their own distinctive features. Examples of bone cancer include Ewing's sarcoma, osteosarcoma, chondosarcoma, etc. Primary bone damage is typical for an early age (up to 20 years), since at this time there is active growth of bone tissue. Symptoms of primary bone tumors include:
- Pain in the affected area. This symptom appears one of the first. At first, the pain is mild or moderate in nature and may disappear and reappear. In later stages, the pain becomes constant and severe.
- General symptoms characteristic of any other oncology. These include weakness, loss of appetite, fatigue, causeless weight loss, and fever.
- Symptoms that are characteristic of bone damage: lameness, pathological fractures, impaired mobility in joints, etc.
As you can see, primary and secondary bone lesions are characterized by common symptoms, so it is impossible to make an accurate diagnosis based on the patient’s complaints alone. It is possible to identify the cause of bone pain and select the optimal treatment only after a comprehensive diagnosis.
Why do bones hurt during pregnancy?
Ossalgia during pregnancy most often occurs in the later stages. And there are several reasons. Firstly, the bones hurt due to the woman's growing weight. Therefore, it is extremely important to control weight gain and eliminate additional physical activity. Secondly, the cause of ossalgia may be a lack of calcium and vitamin D. In this case, it is recommended to take vitamin and mineral complexes under the supervision of a doctor.
Your doctor will tell you more about why bones hurt during pregnancy in a particular case during your consultation. You can make an appointment on our website Dobrobut.com or by phone. The specialist will answer questions and talk about prevention methods.
How to treat the problem
Naturally, there should be no self-medication, because you can simply waste time and complicate your condition. In addition, it is worth understanding that there are a large number of infectious pathologies of the skeleton, therefore, various methods are used in their treatment. For example, due to the infectious component, antibacterial therapy is usually started at the initial stage of therapy. An analysis should first be carried out to determine the sensitivity of the pathogen.
If antibacterial therapy does not show the desired effect, then surgical treatment may be required as prescribed by a doctor, which is aimed at achieving several goals, says Evgeniy Peretsmanas. “Firstly, the infectious focus is removed, and then everything depends on the location of the lesion. In case of destruction of the joint after resection of the articular ends, arthrodesis is performed (fusion of the resected bones in a functionally advantageous position) or, if possible, endoprostheses are implanted to restore the function of the joint, but basically these operations are two-stage in nature with the installation of a temporary cement prosthesis at the first stage until the inflammatory process subsides,” - explains the doctor.
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The doctor says that surgical treatment of the spine is particularly difficult. After all, first of all, it is necessary to remove the destructive infectious focus from the vertebral segments, and then the resected space is filled with either a bone autograft or an implant made of special bioinert materials. “In addition, to stabilize the affected part of the spine, posterior instrumental fixation is performed with special metal structures made of screws and rods. In case of complicated infectious spondylitis with compression of the spinal cord, these operations are complemented by decompressive interventions on the spinal canal,” explains the doctor.
Diagnosis of osteoporosis
You can check the condition of the body and confirm or exclude the diagnosis of osteoporosis using laboratory tests and instrumental studies, of which the simplest and most informative is densitometry.
Lab tests:
- calcium in urine;
- clinical blood test;
- alkaline phosphatase (biochemistry indicator);
- TSH;
- markers of bone destruction;
- for men – testosterone.
Instrumental methods:
- radiography;
- densitometry;
- bone biopsy;
- bone scintigraphy;
- MRI.
How to check for osteoporosis using densitometry?
Ultrasound densitometry is a quick and painless diagnostic method. During the procedure, the speed of propagation of ultrasound waves through bone tissue is measured. Ultrasound travels faster through denser bones. The result of the study is recorded by a computer, the indicators are compared with the norm. The session lasts 2-3 minutes, and a conclusion is immediately issued.
To carry out this diagnosis, a Sonost-3000 densitometer is used - expert-level equipment that can detect loss of even 2-5% of bone mass.
Densitometry is recommended:
- nulliparous women;
- women over 45 years old;
- women who have given birth to 2 or more children;
- during early menopause;
- in case of menstrual irregularities;
- if you have bad habits;
- men over 50 years old;
- in case of deficiency of sex hormones.
You definitely need to undergo ultrasound densitometry if:
- Fractures often occur;
- there was a long course of glucocorticosteroids, diuretics, anticonvulsants and anticoagulants;
- diagnosed with hyperparathyroidism or other dysfunction of the parathyroid glands.
Also indicated are:
- change in posture;
- bone and muscle pain due to changing weather;
- pain in the lower back and chest with static load;
- senile stoop;
- night cramps in the legs;
- tooth decay;
- decreased growth;
- body weight deficiency;
- osteoporosis in close relatives;
- low testosterone levels in men;
- and etc.