Back pain

What to do if you suddenly have severe back pain, 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: immediately after the first emergency self-aid, consult a doctor. At the Paramita clinic in Moscow, they always help: they determine the cause of the pain and get rid of it.

What to do in case of 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 just as suddenly, but it can subside slightly and become chronic. This should not be tolerated, it is better to consult a doctor immediately.

Just don't panic

The appearance of severe back pain does not mean that the person cannot be helped, in most cases it can all be treated successfully, that is, there is no need to panic. But it's important to know how to help yourself and reduce the pain, and then see a doctor right away. You should consult a specialist, as back pain is caused by many diseases and requires a different treatment approach.

How you can alleviate your condition yourself

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

• Lie on your back on a hard surface or on the floor with a blanket; if you cannot straighten your back, you should assume a position that causes minimal pain.
• Ask your loved ones to give you a pill of any pain reliever, all available at the pharmacy without a prescription:
• Apply any external pain reliever to the skin on the painful area: rubbing solution, ointment, gel, emulsion, and other over-the-counter medications:
• Call an ambulance; the doctor will give you an anesthetic injection (usually injection solutions of non-steroidal anti-inflammatory drugs) and advise you on the best option: call a doctor at home or go directly to a specialist clinic.

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

Contact the clinic immediately if you have severe back pain:

• appeared after injury;
• accompanied by high body temperature and malaise;
• as a result, problems with urination and defecation appeared;
• accompanied by damage to the motor function of the limbs and their numbness;
• girdle type, covering not only the back but also the abdomen (suspicion of acute pancreatitis);
• radiating to the left hand (myocardial infarction suspected);
• woman, cannot be removed with pills and ointments.

In such a state, it is impossible to help yourself. In order to avoid serious complications, you should consult a doctor.

What to do for different types of back pain

Back pain can be different: acute, radiating to different parts of the body, deep, aching, very strong, constant or wave-like. It can also be located in different parts of the back: the neck, chest, lower back, sacrum and coccyx. Even after a full examination, it is not always possible to find out the cause of the back pain, and then they say that it is non-specific.

Such pain is called nociceptive, which is related to the irritation of pain receptors in tissues (muscles, ligaments, bones). Irritating substances can be mechanical (injury), physical, chemical and inflammatory. In addition, the degree of changes 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. These pains account for 7-8% of all pain syndromes, and they are characterized by a high possibility of confirming the diagnosis during instrumental examinations.

The third type of pain - specific pain syndromes (for example, in the case of spinal tuberculosis) is relatively rare.

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

Any acute respiratory viral infection that comes on suddenly and is accompanied by fever, muscle pain in the back, aches and pains affecting the whole body and severe weakness can occur. These painful sensations are associated with general poisoning of the body. Back pain can be one of the first manifestations of a coronavirus infection with high fever.

With the onset of coronavirus pneumonia, back pain increases due to damage to the pleura, which contains many nerve endings, and 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 helps: Paracetamol can be taken orally - it relieves pain and reduces fever. Taking any NSAID by mouth and applying it to the skin in the form of ointments and gels also helps.

Severe pain in the upper back (cervical spine)

Acute pain syndrome can be mixed, non-specific and neuropathic in nature. Non-specific aching pains are often associated with incorrect forced posture at the desk during work, tension in the muscles of the back and neck. A short-term painful attack may occur with angina and radiate to the left arm.

Neuropathic pain is acute, burning, radiates to the arm and scapula on the affected side, and is associated with pinching of the nerve roots of the cervical spine.

How can I help:

• for pain caused by spinal diseases - NSAIDs;
• heart attack - Nitroglycerin tablet under the tongue; if the pain does not go away within a minute, take another pill and call an ambulance.

Severe pain in the chest and shoulder blades

The back hurts in the chest region and between the shoulder blades most often due to a sedentary lifestyle and an uncomfortable position of the body for a long time. Very often this condition occurs in those who sit in front of the computer for several hours a day. Weakened muscles cannot withstand the load and hurt.

The child's development may be damaged due to incorrect posture - lateral curvature of the thoracic spine occurs - scoliosis. If timely measures are not taken, the vertebrae will move and a compression fracture may occur.

Severe pain between the shoulder blades can occur when the roots of the spinal nerves in the thoracic spine are pinched. It may radiate to the intercostal spaces or the left arm and resemble an anginal attack, but is not relieved by nitroglycerin.

Acute pain in the area of the shoulder blades can occur due to various diseases of the internal organs: heart, stomach, pancreas, lungs (with damage to the pleura), kidneys, gall bladder.

How can I help:

• in case of damage to the musculoskeletal system - NSAIDs (see the section "How to relieve yourself");
• in case of spasm of the arteries supplying the heart muscle (anginal attack) - Nitroglycerin tablet under the tongue;
• in case of diseases of internal organs - only a doctor can decide; in some cases, taking painkillers can lead to serious complications, for example, in the case of appendicitis or cholecystitis, the pain that indicates the need for surgery can be removed.

If you don't understand what hurts, it's better to call an ambulance.

My waist really hurts

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

It accounts for approximately 7-8% of neuropathic pain syndromes. Thus, acute, sudden pain in the lower back (lumbago) is usually associated with pinching of the spinal roots of the lumbar spine. Sudden acute pain (sciatica) in the buttock, radiating to the back of the thigh, is pinched or inflamed sciatic nerve.

The lower back can also hurt due to diseases of the kidneys, urinary tract and genitals.

How can I help:

• for myositis - NSAIDs;
• in case of neuropathy - NSAIDs do not always relieve pain, a doctor should be consulted to prescribe the full course;
• in the case of diseases of internal organs - it depends on the diagnosis, which can only be established by a doctor.

Severe back and abdominal pain

Such pains are dangerous, most often associated with diseases of internal organs. When they appear, they first think of acute pancreatitis. The acute pain syndrome is encompassing, accompanied by nausea and vomiting, and requires urgent hospitalization of the patient. If this is not done, the pancreatic tissue may die and the patient will die.

Less commonly, belt pain occurs with kidney disease. This condition also requires medical attention. In case of cholecystitis and inflammation of the gallbladder, pain may appear on the right side, radiating upwards to the collarbone.

Acute girdle pain can occur with intercostal neuralgia, which is caused by pinching of the spinal roots in the lower part of the thoracic spine. The pain is so strong that it deprives the patient of sleep.

How can I help:

• in case of intercostal neuralgia - NSAIDs;
• in case of diseases of internal organs - immediately call an ambulance; Before the doctor arrives, you can take 2 tablets of No-shpa.

Severe back pain that radiates to the leg

Irradiation of acute pain in the buttocks and on the back surface of the right or left leg up to the knee indicates a violation of the nerve roots of the lumbar region with the involvement of the sciatic nerve in the process. The pain syndrome is particularly strong, electric discharge-like, and accompanied by painful convulsive twitching.

How to help: call an ambulance as soon as possible, first take an NSAID and apply anesthetic ointment, but this is not very effective.

My back hurts if I inhale too much

Most often, painful breathing occurs:

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

How to help: call a doctor at home and find out the problem; It is impossible to do this on your own.

My back hurts a lot under my ribs

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

• sharp, severe pain that does not subside or subside, radiates to the stomach and spreads to the opposite side of the back; accompanied by nausea and vomiting - in acute pancreatitis;
• acute paroxysmal pain, often radiating to the groin area - in urolithiasis, when the stone passes through the urinary tract.

How to help: call an ambulance - this is an emergency that often requires hospital treatment; A pain reliever may relieve the pain slightly.

Back pain

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

Location back center right:

1. acute pain radiating along the intercostal nerves - it can be assumed that the nerve roots of the thoracic spine are pinched;
2. painful local - myositis;
3. aggravated by deep, deep inhalation and coughing - often associated with diseases of the pleura - pleurisy, lung cancer with germination in the pleura.

Localization on the right side under the ribs:

1. intercostal neuralgia due to damage to the right nerve root;
2. diseases of the pancreas, liver and biliary tract.

Pain on the left side:

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

How can I help:

• in case of spinal diseases - NSAIDs;
• in case of angina pectoris - Nitroglycerin under the tongue;
• in case of attacks of pancreatitis, cholecystitis, urolithiasis - take 2 tablets of No-shpa.

If the pain does not go away, an ambulance should be called.

My back muscles hurt a lot

Back pain occurs after a cold, acute respiratory viral infections, or long training. People with a sedentary lifestyle can have muscle pain 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 all negative effects. At the same time, muscle tension increases back pain.

How to help: contact a neurologist, do an examination and find out the cause of the pain; You can relieve severe pain on your own by using an ointment or gel with NSAIDs, but it will be difficult to completely get rid of the pain.

Severe back pain at night and in the morning

Back pain at night and in the morning is a serious symptom, a sign of the inflammatory process. The pain is usually combined with other symptoms: age up to 40 years, gradual appearance, stiffness of movements in the morning for up to half an hour or more, cessation of pain after starting physical activity.

It is a serious symptom that deprives patients of sleep and develops in diseases such as ankylosing spondylitis (spondylitis ankylopoetica), reactive arthritis, psoriatic arthritis, juvenile chronic arthritis, arthritis associated with chronic inflammatory bowel disease.

How you can help: do not do anything on your own, you need to contact a rheumatologist, conduct an examination and treat the identified pathology.

Severe back pain during pregnancy

The pain syndrome during pregnancy is mechanical in nature. A growing fetus increases the load on the muscles and ligaments of the back. With constant tension in the back muscles, an increased amount of lactic acid is produced, which leads to the appearance of aching muscle pain.

The pain syndrome can be acute, paroxysmal in nature, which indicates a violation of the roots of the spine due to a large load on the spine. A pregnant woman experiences severe pain, does not sleep and is constantly under stress.

How can I help:

• contact a neurologist or a therapist at a pregnancy clinic, who will conduct an examination and prescribe the necessary treatment; You cannot take medicines on your own: many NSAIDs are contraindicated during pregnancy;
• It is recommended to wear a bandage that supports the abdomen.

The most common diseases that cause back pain

In most cases, back pain syndrome develops against the background of any disease of the locomotor system, neuroendocrine system or internal organs. The most common are osteochondrosis, intervertebral hernia, ankylosing spondylitis, oncological processes of the spine, etc.

Osteochondrosis and disc herniation

It is a degenerative-dystrophic process that leads to the gradual destruction of the intervertebral discs (cartilaginous shock-absorbing discs with an elastic core in the middle). The plates crack, lose their elasticity and can completely collapse. In this case, the core of the disc protrudes and compresses the nerve roots or the spinal cord - a disc herniation occurs.

When the roots are pinched, severe back pain occurs, often radiating to large nerve trunks. Most often, this occurs in the lumbar region, which withstands the greatest load. It first hurts in the lumbar region, then radiates to the back surface of the lower limb (lumboischialgia). The sooner the treatment of the disease is started, the sooner the patient gets rid of the pain.

Ankylosing spondylitis

The correct name of the disease is ankylosing spondylitis. It is a chronic inflammatory systemic disease of the connective tissue, associated with autoimmune processes (allergy to the patient's own tissues) and aggravated heredity. Men under the age of 40 are most often affected.

Damage to the joints and ligaments of the spine is associated with severe back pain and the gradual development of immobility of the spinal column (ankylosis). The process begins in the lower parts of the spine and gradually moves upwards. Characteristics of the pain syndrome: back pain at night and in the morning, morning stiffness, which disappears at least half an hour after waking up and starting active movement. It is very important to pay attention to these symptoms immediately and consult a doctor as soon as possible.

Lung cancer

The tumor develops slowly from the lining of the large or small bronchi. At first, the disease is asymptomatic, then a cough appears, and periodically inflammatory processes develop in the bronchi and lungs. When the tumor grows into the pleura (a thin membrane that covers the chest and the lungs), back pain occurs that worsens with deep breathing, coughing, or sneezing.

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

Diagnostics

Correct diagnosis of the disease is very important, as treatment is prescribed based on the results. This is determined based on the assessment and examination of the patient by the doctor, as well as additional test data, including:

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

But even with a complete 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 the acute pathological process into a chronic one. For this purpose, treatment of the underlying disease as well as symptomatic drug therapy and non-drug treatment methods are prescribed.

Algorithm for the treatment of acute pain syndrome:

• short-term bed rest (2-5 days) combined with drug therapy and reflexology (RT); long-term adherence to bed rest contributes to the transition of the acute process to a chronic one; it is possible to prescribe the wearing of a short orthopedic device: cervical collar in the upper back and neck or in the lumbar belt;
• semi-bed rest for the next 7-8 days; drug therapy and RT continue, light physical exercises and physiotherapy procedures (electrophoresis with pain-relieving drug solutions) are added;
• mode of physical activity with minor restrictions (10-20 days); drug therapy is carried out according to the indications; physiotherapy (laser and magnet therapy), RT; add a manual therapy and massage course;
• physical activity without restrictions (but without weight lifting) by performing specially selected gymnastic exercises;
• pain prevention – regular exercise therapy and feasible sports to raise the quality of life to a new level.

Drug therapy

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

1. In case of very severe, sharp pain, paravertebral blocks are performed with novocaine. If the pain syndrome does not subside, epidural blocks are performed - pain relief by injecting anesthetics into the epidural cavity located between the dura mater and the periosteum of the spinal column.
2. Less severe pain is relieved by intramuscular administration of drugs belonging to the NSAID group. Medicines are selected individually, taking into account the properties of the medicine and the individual characteristics of the patient. The most effective medicine can cause gastrointestinal complications, so if you have stomach problems, more modern NSAIDs can help relieve back pain.
3. Muscle relaxants are prescribed to eliminate back muscle spasms.
4. B vitamins (B1, B6, B12) have a beneficial effect on the peripheral nervous system and enhance the pain-relieving effect of NSAIDs. These medications can be given as injections of individual vitamins or as a solution containing all 3 vitamins and the pain reliever lidocaine. After the condition improves, you can take the tablets orally.
5. In the case of neuropathic pain involving nerve fibers, antidepressants and anticonvulsants are part of the complex treatment. These medications help relieve pain.

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