Our spine is the foundation of our health. Its condition affects general health, proper functioning of internal organs, and mood. A sore back provokes the development of a whole group of diseases, such as arthritis, arthrosis, surges in blood pressure, hypertension.
Thus, it can be noted that people who are far from advanced in age already have or only suspect the presence of such spinal diseases as: osteochondrosis, herniated intervertebral discs, scoliosis, vertebral displacement, spondylosis.
Each part of the spinal column influences the functioning of the entire body in its own way. If problems arise in the lower part of the spine (lumbosacral), then the entire coordinated work of the lower musculoskeletal system breaks down and disturbances in the functioning of the pelvic organs may occur.
If problems are in the cervical spine, then these are almost always severe headaches, dizziness, and migraines. Disturbances in the thoracic spine and the resulting pain are similar to pain in the heart and affect the general condition of the internal organs.
Symptoms of spinal diseases
Common complaints with spinal diseases are back pain, neck pain and headaches. But this is not the entire list, since very often the symptoms of spinal disease occur in different parts of the body, and even at the beginning the patient does not think that all the problems are in the back.
A neurologist is consulted with the following complaints:
- headache;
- migraine;
- dizziness;
- back discomfort or pain;
- pain and numbness in the arms and legs;
- pain when turning and bending;
- lumbago;
- pressure surges;
- hypertension and hypotension;
- pronounced stoop;
- neck pain;
- lower back pain;
- pronounced unilateral muscle tension along the spine;
- shoulder pain.
Causes
Deviations from the norm and the development of spinal diseases can occur due to the following reasons:
- old age, when metabolic processes are disrupted and bone tissue is prone to destruction;
- sedentary lifestyle;
- large, long-term and regular loads on the spine;
- incorrect body position when sitting, walking, while sleeping;
- excess weight, which increases the load on the spine;
- bad habits and unhealthy diet;
- chronic diseases;
- back injuries.
In order to prevent the development of abnormalities, it is important to monitor the health of the spine. This needs to be done from childhood, especially during school years, when the child spends a lot of time at a desk. This is no less important in adulthood. If it is not possible to eliminate the causes, and there are already changes, you need to seek help from a specialist as soon as possible.
Diagnosis of spinal diseases
To diagnose possible diseases in the spine, it is necessary that you consult a neurologist as soon as possible. What does comprehensive diagnostics include:
- conversation with the patient (to identify painful areas and determine the nature of pain);
- local palpation examination of the spine;
- special diagnostic (active and passive) tests to assess the functioning of the musculoskeletal system;
- reflex diagnostics.
- comprehensive examination to determine: muscle condition (hypertonicity, hypotonicity);
- presence/absence of sensory impairment;
- presence/absence of decreased joint mobility;
In addition, the doctor may prescribe additional examination methods, such as:
- MRI;
- Ultrasound;
- X-ray;
- lab tests;
Diagnostics
If your spine hurts in the lumbar region, you should make an appointment with a neurologist or vertebrologist. At the appointment, the doctor initially collects anamnesis, asking questions about the nature of the pain, the circumstances of its occurrence, the duration of its persistence, the presence of other symptoms, lifestyle, etc.
Then the specialist conducts an examination. As part of it, he not only palpates the spine, determines the localization of pain, evaluates the gait and posture that the patient takes unconsciously, but also conducts functional tests. With their help, you can detect signs of ankylosing spondylitis, neurological deficits, assess the degree of mobility of the spine and obtain other diagnostic data.
Based on this, the doctor can already suggest possible causes of pain. To clarify them, as well as to accurately determine the extent of damage, instrumental and sometimes laboratory diagnostic methods are additionally prescribed. Most often they resort to help:
- X-rays in frontal and lateral projections, sometimes with functional X-ray tests;
- CT scan – allows better visualization of bone structures, therefore it is more often used to diagnose spondylosis, fractures, bone tumors, etc.;
- MRI – makes it possible to most thoroughly assess the condition of cartilaginous structures and soft tissues, therefore it is more often used to diagnose osteochondrosis, protrusions, intervertebral hernias, spinal cord lesions, etc.;
- electromyography - indicated for neurological disorders of unknown origin, as well as to assess the degree of nerve damage;
- radioisotope osteoscintigraphy – used for the diagnosis of malignant tumors and metastases;
- X-ray densitometry is the optimal method for diagnosing osteoporosis;
- myelography - used to identify signs of compression of the spinal cord and nerves of the cauda equina.
Spine treatment
The Alan Clinic Center for Neurology and Orthopedics in Kazan specializes in the complex treatment of spinal diseases WITHOUT SURGERY. Mostly in the treatment program for our patients, we prefer to minimize the use of medicinal methods, selecting an individual course of treatment (taking into account the severity, age, presence/absence of concomitant diseases and contraindications, and much more) in such a way as to minimize all possible side effects of treatment .
During the entire course of treatment, you will be under the constant and vigilant supervision of the attending physician, who monitors all your body’s reactions to treatment and, if necessary, promptly intervenes and adjusts the program.
Treatment
Help before diagnosis
In case of traumatic injuries, the victim should be placed on a backboard and given an anesthetic. For pain of non-traumatic origin, functional rest is required. Patients need to avoid sudden movements and take regular breaks when working in a static position. In the absence of signs of an acute condition or severe inflammatory phenomena, short-term use of NSAIDs and the use of local agents are acceptable. Sharp, increasing pain, disturbances in general condition, and neurological disorders are reasons to immediately consult a specialist.
Conservative therapy
Therapeutic tactics are determined by the nature and stage of the pathology. In case of injuries, a protective regime is prescribed, and various methods of traction are occasionally used. The basis of treatment for most traumatic and non-traumatic injuries are medications and physiotherapeutic techniques. The following medications are used:
- NSAIDs
. Effective for acute and chronic pain. Eliminate pain, reduce the severity of inflammation. Prescribed in tablets, injections, and local forms. - Local anesthetics
. Local anesthetics alone or in combination with other drugs (usually glucocorticosteroids) are injected into the affected area during a therapeutic blockade. - Antibiotics
. Indicated for infectious processes. As a rule, they are administered by injection. They are selected taking into account the sensitivity of the pathogen. - Neurotropic vitamins
. A good result is provided by B vitamins, which enhance the effect of other medications and increase the amount of endogenous compounds with an analgesic effect.
Physiotherapy is prescribed after acute symptoms have resolved. Ultrasound, magnetic therapy, electrical stimulation, acupuncture, and other methods are used. Patients are recommended massage, exercise therapy, and manual therapy if indicated.
Non-surgical treatment methods:
- Various types of reflexotherapy - influencing active points of the body in various ways (helps relieve pain and muscle spasms): Acupuncture - influencing biologically active points with microneedles.
- Pharmacopuncture is the introduction of medicinal drugs of natural origin to the source of the problem.
- Tsubotherapy is a gentle effect on the reflex points of the body using metal balls.
Why does my spine hurt?
Degenerative pathologies
The most common cause of the symptom is osteochondrosis.
The localization of the pain syndrome corresponds to the level of the lesion. More often the pain is moderate, dull, constant, as with myositis. In order not to provoke an increase in their intensity, patients change the position of the spine slowly and carefully. When the root is compressed, the pain becomes sharp, shooting, very intense (lumbago). The slightest movements cause increased pain, so patients take a forced position. With a herniated disc, local transient dull pain is first noted, which intensifies during physical activity, prolonged stay in a static position, and disappears in a lying position. The patient tries to limit movements. Then the symptom becomes permanent, combined with severe muscle tension. Lumboischialgia develops and complications are possible.
Spondyloarthrosis is characterized by local pain that occurs with movement and decreases or disappears with rest. Then comes morning stiffness, constant dull pain, and discomfort, which increases with continued posture. Irradiation, as in osteochondrosis, is rarely detected, sometimes detected in the later stages of the disease.
Spondylosis manifests itself as a dull, aching local pain that intensifies towards the end of the day, against the background of overload, hypothermia, sudden movements, and sometimes at night. Patients find it difficult to find a comfortable body position; they take a long time to select a position, move slowly and smoothly. With Schmorl's hernias, the pain is mild, chronic, worsening in a vertical position, decreasing in a horizontal position.
Rachiocampsis
In the initial stages there is no pain. As the process progresses, aching or nagging pain occurs, intensifying against the background of stress and uncomfortable body position. Typical external deformations of varying degrees of severity are identified. Pain syndrome is observed in such pathologies as:
- pathological kyphosis;
- kyphoscoliosis;
- pathological lordosis;
- scoliosis;
- Scheuermann-Mau disease.
Minor discomfort caused by non-physiological posture and muscle weakness is observed in patients with poor posture.
Spinal pain
Developmental anomalies
The symptom is often observed with developmental defects and is sometimes combined with neurological manifestations. Detected under the following conditions:
- Spina bifida.
The closed form of Spina bifida is characterized by moderate local pain in the lumbosacral area. After some time, radicular syndrome occurs. - Sacralization and lumbalization
. When the roots are compressed, burning or shooting pain occurs, which is complemented by paresis and sensory disturbances. - Wedge-shaped vertebrae.
The pain is dull, aching, and develops with exertion or prolonged standing or sitting. Possible postural abnormalities and chest deformities.
Osteoporosis
Mild pain in the spine is often the only symptom of various forms of osteoporosis: juvenile, idiopathic, senile, postmenopausal. Localized in the thoracic and lumbar region. They intensify after significant exertion and are combined with mild pain in the ribs, pelvic area, and hip joints. The symptom progresses slowly over a number of years.
Injuries
The symptom corresponds to the severity of the damage and may be combined with signs of damage to the nervous tissue. The following traumatic causes are distinguished:
- Injury. Occurs with a direct blow or a fall on the back. The pain is local, minor or moderate, quickly subsides after injury, and completely disappears after 1-2 weeks.
- Traumatic spondylolisthesis.
The lumbar region suffers. Patients complain of moderate or severe pain in the lower back, radiating to the legs. Palpation of the spinous process is painful, the symptom of axial load is positive. - Compression fracture.
Develops when falling on the buttocks, jumping from a height and landing on the feet. The lower thoracic vertebrae are most often affected. At first the pain is sharp, then quite intense, intensifies with movements, jumping, shaking the body while walking. Pain in the spinous process is detected. - Comminuted fracture.
Observed in high-energy trauma. Along with intense pain in the spine, neurological disorders are determined. - Dislocations and fracture-dislocations.
The cause is high-energy exposure. Sharp pain is combined with disorders of sensitivity, movements, and general condition disorders.
With a pathological fracture that occurs against the background of diseases of the spine (tumors, osteoporosis), the painful sensations are insignificant, aching, pressing, pulling, and remain almost unchanged for a long time.
Inflammatory and infectious diseases
With ankylosing spondylitis, patients initially complain of dull pain, a feeling of stiffness in the lumbar region with a characteristic circadian rhythm - the symptom appears at night and intensifies in the morning. Its intensity decreases after physical activity or a hot shower. During the day, the pain also increases at rest and decreases with movement. Then the pain gradually spreads along the spine, the mobility of the spinal column is limited, and thoracic kyphosis is formed.
Spinal pain is the most consistent symptom of tuberculosis. There are two types of sensations. The first is deep local due to destruction of the vertebrae. They intensify with stress and are combined with increased sensitivity of the skin over the affected area. The second is burning, shooting, radiating. They occur due to compression of the nerve roots. The symptom develops gradually, complemented by stiffness of movements, typical general symptoms.
Vertebral osteomyelitis is diagnosed in children and adolescents and is hematogenous in nature. The pain in the spine is clearly localized, deep, very intense, tearing, bursting, drilling. It sharply intensifies when trying to move, which forces the patient to freeze in bed. Combined with hyperthermia, weakness, fever, severe local edema.
Other forms of osteomyelitis (post-traumatic, postoperative) can be detected in patients of any age against the background of open injuries or spinal surgeries. The symptoms are the same as for hematogenous osteomyelitis, but they are not as severe and progress more slowly. In patients with chronic osteomyelitis, the pain is aching, intensifies after closure of the fistula, decreases or disappears after the appearance of discharge.
With a spinal epidural abscess, the pain is diffuse, rapidly intensifying, combined with chills and fever. Tapping on the spinous processes is painful. After a few days, lumbago, disturbances in sensitivity and movement appear. As it progresses, paresis and paralysis develop.
Diffuse spinal arachnoiditis manifests itself with transient pain radiating to the area of innervation of the nerve roots. Then the pain in the spine becomes permanent, reminiscent of the clinical picture of radiculitis, supplemented by sensitivity disorders, motor disorders, and loss of the ability to control the activity of the pelvic organs.
Tumors
Benign neoplasms of the spine occur latently or are accompanied by scanty, slowly progressing symptoms. The most common hemangiomas are accompanied by pain in 10-15% of patients. The painful sensations are local, aching, dull, increasing after exercise, at night. With benign and malignant neoplasia of the spinal cord, radicular pain and nerve conduction disturbances are observed.
Spinal sarcomas at the initial stage are characterized by mild or moderate intermittent pain, worsening at night. The intensity of the pain syndrome increases rapidly. Patients cannot sleep or wake up at night. The symptom is complemented by limitation of movements and radicular syndrome. Taking into account the level of the tumor, pain appears in the arms, legs, and internal organs.
Pain in the spine is the first sign of metastasis of tumors at distant locations. Initially, they are local, dull, aching, and increase when the corresponding spinous process is tapped. They resemble the pain syndrome associated with osteochondrosis, but are longer lasting, progress quickly, become permanent, intensify at night, and, depending on the location, radiate to the arms or legs. Acute shooting pains of the “electric shock” type are possible with constant background pain.
Other diseases
Pain in the area of the spinal column is observed with the following pathologies:
- Spinal epidural hemorrhage.
The pain is sharp, local, reminiscent of radiculitis. It subsides over several hours, giving way to spinal conduction disorders. - Calvet's disease.
The pain is periodic, weak at first, and often radiates to the legs. They decrease while lying down and increase with exercise and palpation of the spinous process. They grow over many months. - Forestier's disease.
Pain appears in the thoracic region and spreads to the neck and lower back. Weak, short-term, less often permanent. Combined with pain in the pelvic bones, shoulder, elbow joints, stiffness of the spine up to ankylosis. - Spondylolysis.
The pain is long lasting but mild. Less commonly, severe pain occurs, forcing patients to significantly limit daily activities. A typical manifestation is that the symptom decreases when bending forward and increases when bending backward.
Sometimes pain in the spine is observed in mental disorders. A distinctive feature of this manifestation is an unusual clinical picture that does not fit into the symptoms of a particular disease. With severe mental pathology, the symptom becomes pretentious.
Causes of pain in the spine
- suffered injuries - these reasons can include household injuries, sports injuries, and injuries associated with professional activities;
- if the work involves constant and periodic lifting of weights;
- sitting at a computer for a long time, at home or in the office, or driving a car, especially if you do not maintain good posture;
- work associated with temperature changes or work in the cold;
- much more.
Probably, if we conduct a survey, then a larger number of the working-age population will reveal hidden or obvious diseases of the spine. And some, suffering from diseases that seem completely unrelated to the spine (for example, heart disease, stomach disease), do not even realize that the main cause of the disease lies in the spine.
Causes of spinal diseases
Spinal diseases can have various causes. Among them: excessive physical activity, carrying heavy objects, cancer, infection of the body as a whole, age-related changes in bone tissue.
Predisposing factors to the appearance of back diseases are:
- chronic hypothermia of the body;
- endocrine disorders;
- spinal injuries;
- overweight;
- sedentary lifestyle;
- sedentary work;
- any chronic diseases;
- exposure to toxic and chemical substances;
- stress, severe shock.