There are primary and secondary pain sensations, each of which can be caused by a wide range of conditions and illnesses. In this article, we will try to consider only the most basic ones.
Nonspecific (primary). This type of pain is directly related to problems in the spine and surrounding tissues.
Causes of back pain associated with the spine:
- Scoliosis. Violation of posture, leading to a gradual curvature of the spine, displacement of the vertebrae and muscle tension.
- Osteochondrosis. The reason for the development of the disease is a decrease in the depreciation capacity of the spine: damage to the intervertebral discs, rupture of the annulus fibrosus and, as a result, violation of the disc nucleus. Pain sensations are located in the region of that part of the spine, in which pathological changes occur. So, with osteochondrosis of the thoracic spine, the back pain is located in the thoracic region (the back hurts between the shoulder blades and under the ribs), with osteochondrosis of the lumbar spine, a person feels pain in the lower back.
- Intervertebral hernia. Due to damage to the intervertebral disc, the soft structures of the vertebrae protrude with the possibility of violation (normal and strangulated hernia). The pain is located at the site of the hernia.
- Ankylosing spondylitis. It is characterized by back pain and limited mobility in the spine, which leads to a forced "forward bend" position in the patient.
- Osteomyelitis. The cause of the disease is an infectious process that has developed in the spine. The patient feels that the pain covers not only the spine, but also the back muscles.
- Spinal injury. In this case, the cause of the back pain is an injury and the accompanying complications. The intensity of painful sensations and their location are directly related to the type of injury and the affected part of the spine.
In 40-50% of cases, the causes of back pain are damage to the joints and ligaments of the spine (skeletal pain). Another 3-5% of severe back pain is associated with damage to the spinal cord roots (radicular pain).
Back pain associated with pathological changes in the muscles:
- Fibromyalgia. The inflammatory process develops in the muscles around the spine, is characterized by symmetry and can be chronic. In this case, the back muscles hurt along the entire spine. The important point is that the peak of pain occurs when you press certain places.
- Polymyositis. Hypothermia can trigger the disease. As a result of the development of the disease, the patient experiences muscle weakness and pain, which increases when trying to make a turn.
- Polymyalgia rheumatica. The etiology of the disease is unclear. Infectious diseases that lower immunity can serve as a trigger. It is manifested by pains that increase with the development of the disease, capable of covering all parts of the back. Severe back pain impairs mobility to such an extent that the patient is unable to move independently. A clear asymmetry is visualized in the back.
- Charcot's disease. Symptoms are caused by inflammation in the peripheral nerves along the spine. As a result of the pathological process, in addition to the very intense pain, there is a change in the person's gait.
In 50-60% of cases of nonspecific back pain, its location is in the muscles.
Specific (secondary pain). This type of pain, despite its location in the back, is often not directly related to diseases of the spine or the surrounding muscular skeleton. The causes of specific pain are extremely diverse, but the most dangerous are cancer diseases. Thus, pain radiating to the back can be caused by a malignant neoplasm in the area of the mammary glands, lungs or prostate, which metastasizes to the spine.
Illnesses that cause specific pain include:
- Nerve roots compressed in the chest. Most often, this leads to the development of intercostal neuralgia. The pain in this case is located at the site of compression. So, intercostal neuralgia can manifest itself: pain under the shoulder blades, pain in the back under the ribs (on the side where the pinch occurred). Pain has a different degree - from aching to sharp, sharp. Most of the time, pain syndrome occurs when moving or pressing the affected area. This fact is the main difference between intercostal neuralgia and diseases of the heart and lungs, which can also manifest as pain under the left (or right) shoulder blade in the back.
- Diseases of the gastrointestinal tract. Most often they cause pain on the right side, in some cases it can also spread to the left side of the body. Most of the pain is located in the lumbar and sacral-lumbar regions. Sufficiently strong pain sensations are characteristic of pathologies associated with manifestations of diseases of the pancreas, colonic diverticulum, intestinal obstruction, retrocecal appendicitis, etc.
- ulcerative foci. Ulcerative lesions of the organs of the upper abdominal cavity (peptic ulcer of the duodenum and stomach) can manifest in the form of thoracic and lower lumbar back pain. If the lower part of the abdominal cavity is affected (ulcerative colitis), the pain is located in the lower back. The severity of pain can be different, but the peak usually hits at night.
- Appendicitis. In acute appendicitis, in cases where the appendix (appendix) is located behind the cecum, the back hurts in the lumbar region. The pains are variable in nature and can range from pain, mild to sharp, intense.
- Kidney diseases. Often they are manifested by pain in the lower back. Such manifestations are characteristic of pyelonephritis and chronic glomerulonephritis. The differentiation of pathologies that are directly linked to the spine is based on the analysis of other clinical manifestations and research results.
- Urolithiasis disease. With renal colic, the back hurts in the lower back. The pain is pronounced, intense, occurs suddenly and does not depend on the position of the body. The back hurts in the lower back and with deer antler nephrolithiasis. The manifestations of the pain syndrome are of low intensity, the pain is quite painful in nature.
- Diseases of the female reproductive system and menstrual pain. In these cases, the pain is most often located in the lower back.
- Neoplasms of the pulmonary system. In this case, the pain appears at the stage when the lungs undergo the germination of peripheral tumor elements (metastases) in the pleural region and in the chest wall. The nature of pain is intense, debilitating.
- Cardiovascular diseases. The most common causes of pain located in the thoracic back are myocardial infarction and stroke. As a rule, these diseases are accompanied by pain between the shoulder blades.
- Inflammatory processes in the joints. Infectious arthritis can cause pain radiating from the affected joint to nearby areas, including back pain.
Most often, the causes of the manifestation of back pain are identical for both sexes, but it is necessary to highlight several diseases that differ in sexual predisposition.
back pain in men
While the causes of back pain are basically the same for both sexes, there are a number of conditions that men are more susceptible to due to their lifestyle.
These predisposing factors include:
- lifting and transporting heavy loads;
- strength sports (including various martial arts, weightlifting, etc. );
- bad habits.
As a result, diseases of the musculoskeletal and cardiovascular systems in men may occur more frequently than in women.
Specific "male" diseases that can cause back pain are various prostate pathologies.
Prostatitis is an inflammatory disease of the prostate. At the beginning of the disease, the pain syndrome is located in the groin, scrotum and lower abdomen, but in the second stage and in cases where the disease has become chronic, the pain spreads to the back.
The location of the pain in this case can be concentrated in the lumbosacral region or spread to the entire back. This is due to the fact that the inflammatory process affects the nerve endings, which involve this organ in large numbers.
The intensity of pain is directly related to the stage of the disease. Thus, in the acute phase, pain is characterized as acute and short-lived. In the chronic form, the pain syndrome is not very pronounced and is often permanent.
Diagnosis and treatment in this case is carried out by a urologist.
back pain in women
In some cases, back pain in women can be of a specific nature associated with the characteristics of the body and the processes that take place in it. First, we are talking about the reproductive sphere.
As a rule, pain associated with gynecological diseases is located in the thoracic and lumbosacral regions. The most common reasons include:
- Menstrual cycle. During the period of menstruation, the hormonal background of a woman changes, which leads to the appearance of various negative manifestations. This is mainly due to the decrease in the level of progesterone, responsible for the intensity of the pain threshold. Lowering the pain threshold leads to the fact that even small sensations of pain become more pronounced. In addition, hormonal changes lead to irritation of the intestinal walls and fluid retention, which causes an increase in volume in some organs and, consequently, compression of the nerve endings of the lumbar spine. The combination of these factors causes the occurrence of back pain.
- Pregnancy. Low back pain in this case can be divided into two groups: Pain in the first trimester. If the painful sensations are accompanied by additional symptoms (bleeding, fever, etc. ), we can talk about the risks of miscarriage. Pain in the second half of pregnancy. Most often, these pains are associated with physiological changes, namely: the active growth of the fetus, which causes a shift in the center of gravity in the position of the body, and the preparation of the pelvis for the next birthing activity.
- Reproductive system diseases. Most of the pain is concentrated in the lower back, which is explained by the topography of the female reproductive organs. The most common causes of this manifestation of pain syndrome are ovarian cysts, adnexitis, ectopic pregnancy, endometriosis, etc.
- Menopause. During menopause, powerful changes and fluctuations in hormone levels occur. Such body restructuring leaves a mark on many systems of the female body. First of all, the skeletal system suffers, which, under the influence of hormonal changes, becomes more fragile and prone to various types of diseases.
- Large chest. The large bust size combined with poorly supported underwear creates an additional load on the spine and as a result the woman has back pain in the area of the shoulder blades and lower back.
- High heels. Wearing shoes with high heels leads to the development of various diseases associated with pathological changes in the musculoskeletal system and back pain.
back pain with coronavirus
Coronavirus infection affects many organs, but the lungs are the first to suffer. Therefore, pain between or under the shoulder blades is often a manifestation of inflammation that has developed in the lung tissue. Depending on which lung is most affected, the patient will feel pain under the left or right shoulder blade.
In addition to lung tissue damage, there is general intoxication of the body and an increase in temperature, which can also cause pain (pain) in the back and limbs.
Back pain after coronavirus is explained by the fact that the disease can not only damage the nervous system, but against the background of a general decrease in immunity, chronic diseases, including internal organs and the musculoskeletal system, worsen.
Back pain after sleeping
The reasons why your back hurts after sleeping can be:
- work associated with physical activity and weight lifting;
- lumbar muscle tone;
- intervertebral hernia and osteochondrosis in history;
- prolonged hypothermia of the back;
- curvature of the spine, which led to muscle tension and irregular contraction;
- excess body weight, resulting in increased load on the back;
- Stressful situations;
- uncomfortable bed.
Unpleasant sensations can have different intensity and appear under the ribs, in the lower back, between the shoulder blades and under them.
To eliminate pain that occurs after sleep, it is necessary to exclude all provoking factors and consult a doctor for treatment.
Back Pain - Which Doctor Should I Contact?
The primary diagnosis of back pain is performed by a general practitioner. If necessary, a number of additional examinations and consultations with highly specialized specialists may be prescribed:
To make an accurate diagnosis, it is necessary to carry out a detailed analysis of the patient's condition. For these purposes, the doctor may prescribe several additional studies:
- Laboratory tests. Most often, this list includes general and biochemical blood tests, urinalysis, stool, and in some cases, an analysis of hormone levels. These studies help to identify possible inflammatory processes and infections. If any disease or oncological component is suspected, the doctor may prescribe a series of specific studies (biopsy, tumor markers, etc. ).
- Hardware search. They help to get a more visual picture of the course of the disease that cannot be achieved by visual examination and palpation. The most commonly prescribed radiography, MRI, ultrasound.
Back pain treatment
For the purpose of qualified treatment, in-house consultation with specialists is required. Therapy is selected strictly on the basis of the diagnosis and taking into account the general condition of the patient. Self-management of back pain can lead to disease progression or transition to a chronic stage.
Prevention of back pain
The main preventive measures mainly depend on what exactly provoked the onset of back pain. General recommendations include:
- healthy lifestyle;
- complete and healthy diet;
- reasonable dose of physical activity;
- timely treatment of identified diseases;
- regular passing of preventive exams, including by specialists with a restricted profile.