Pain in the spine is provoked by injuries, diseases of the vertebrae, intervertebral discs, ligaments, adjacent soft tissues. It can be acute, dull, short-term, long-term, weak, intense. Often there is a connection with the position of the body, the level of physical activity. Sharp radiating shooting or burning pain is a sign of nerve root involvement. To determine the cause of pain in the spine, a survey, an external examination, x-rays, and other imaging techniques are prescribed. Until the diagnosis is clarified, rest is indicated, sometimes we can take painkillers.
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 in myositis. In order not to provoke an increase in their intensity, patients change the position of the spine slowly, 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 pains are first noted, which increase during motor activity, prolonged stay in a static position, and disappear in the supine position. The patient tries to limit movement. Then the symptom becomes constant, combined with pronounced muscle tension. Lumboischialgia develops, complications are possible.
For spondyloarthrosis, local pains that occur during movement are typical, decreasing or disappearing at rest. Then joins the morning stiffness, constant dull pain, discomfort, which increase with prolonged retention of the posture. Irradiation, as in osteochondrosis, is rarely detected, sometimes detected in the later stages of the disease.
Spondylosis is manifested by dull, aching local pain, which increases towards the end of the day, against the background of overload, hypothermia, sudden movements, sometimes at night. It is difficult for patients to find a comfortable position of the body, they choose a position for a long time, move slowly, smoothly. With Schmorl's hernia, the pain is not intense, chronic, aggravated in the vertical position, decreasing in the horizontal position.
There is no pain in the initial stages. With the progression of the process, aching or pulling pains arise, aggravated by the load, uncomfortable body position. Typical external deformations of varying severity are revealed. Pain syndrome is observed in such pathologies as:
Minor discomfort due to non-physiological posture and muscle weakness is noted in patients with postural disorders.
Pain in the spine
The symptom is often observed with malformations, sometimes combined with neurological manifestations. It appears under the following conditions:
Weak 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 loads, combined with non-intense pain in the ribs, pelvic region, and hip joints. The symptom slowly progresses over a number of years.
The symptom corresponds to the severity of the damage, may be combined with signs of damage to the nervous tissue. The following traumatic causes are distinguished:
With a pathological fracture that occurs against the background of diseases of the spine (tumors, osteoporosis), the pain is slight, aching, pressing, pulling, and remains almost unchanged for a long time.
With Bechterew's disease, patients first complain of dull pain, a feeling of stiffness in the lumbar region with a characteristic daily rhythm - the symptom appears at night, intensifies in the morning. Its intensity decreases after exercise, a hot shower. During the day, the pain syndrome also increases at rest, decreases with movement. Then the pain gradually spreads along the spine, the mobility of the spinal column is limited, and thoracic kyphosis is formed.
Pain in the spine is the most constant symptom of tuberculosis. There are two types of sensations. The first is deep local due to the destruction of the vertebrae. Increased with stress, combined with increased sensitivity of the skin over the affected area. The second - burning, shooting, irradiating. Occur due to compression of the nerve roots. The symptom develops gradually, supplemented by stiffness of movements, a typical general symptomatology.
Osteomyelitis of the vertebrae is diagnosed in children and adolescents, has a hematogenous character. Pain in the spine is clearly localized, deep, very intense, tearing, bursting, drilling. Increases sharply when trying to move, which forces the patient to freeze in bed. It is combined with hyperthermia, weakness, fever, pronounced local edema.
Other forms of osteomyelitis (post-traumatic, postoperative) can be found in patients of any age against the background of open injuries, operations on the spine. Symptoms are the same as in hematogenous osteomyelitis, but not so pronounced, progressing more slowly. In patients with chronic osteomyelitis, pain is aching, intensifies after the fistula is closed, decreases or disappears after the appearance of a discharge.
With a spinal epidural abscess, the pain is diffuse, rapidly increasing, combined with chills and fever. Tapping on the spinous processes is painful. A few days later, backaches, disturbances of sensitivity and movements appear. With progression, paresis, paralysis develop.
Diffuse spinal arachnoiditis manifests as transient pains radiating to the zone of innervation of the nerve roots. Then pain in the spine becomes permanent, reminiscent of the clinical picture of sciatica, supplemented by sensory disorders, motor disorders, loss of the ability to control the activity of the pelvic organs.
Benign neoplasms of the spine are latent or are accompanied by poor, slowly progressive symptoms. The most common hemangiomas are accompanied by pain in 10-15% of patients. Painful sensations are local aching, dull, increase after exercise, at night. With benign and malignant neoplasia of the spinal cord, radicular pains, disturbances of nerve conduction are noted.
Sarcomas of the spine at the initial stage are characterized by mild or moderate intermittent pain, which worsens at night. The intensity of the pain syndrome is rapidly increasing. Patients cannot sleep or wake up at night. The symptom is supplemented by restriction of movements, radicular syndrome. Taking into account the level of the location of the tumor, pains appear in the arms, legs, and internal organs.
Pain in the spine is the first sign of metastasis of tumors of distant localizations. Initially, local, dull, aching, increase when tapping on the corresponding spinous process. They resemble the pain syndrome in osteochondrosis, but differ in longer duration, progress rapidly, become constant, intensify at night, taking into account localization, they are given to the arms or legs. There may be acute shooting pains of the type of "electric shock" with constant background pain.
Soreness in the area of the spinal column is observed with the following pathologies:
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. In severe mental pathology, the symptom becomes pretentious.
Neurologists are most often involved in clarifying the causes of pain in the spine. Patients with traumatic injuries of the spinal column are referred to traumatologists or neurosurgeons. The following diagnostic procedures can be carried out:
Therapeutic exercises for the spine
In case of traumatic injuries, the victim should be laid on a shield, an anesthetic should be given. With pain of non-traumatic origin, functional rest is required. Patients should avoid sudden movements, take regular breaks when working in a static position. In the absence of signs of an acute condition, pronounced inflammatory phenomena, a short-term use of NSAIDs, the use of local agents is acceptable. Sharp growing pains, disorders of the general condition, neurological disorders are the reason for an immediate appeal to a specialist.
Therapeutic tactics is 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 the treatment of most traumatic and non-traumatic lesions are medicines, physiotherapy techniques. The following drugs are used:
Physiotherapy is prescribed after the elimination of acute events. Apply ultrasound, magnetotherapy, electrical stimulation, acupuncture, and other methods. Patients are recommended massage, exercise therapy, according to indications, manual therapy is performed.
Taking into account the characteristics of the disease or damage to the spine, the following surgical interventions can be performed:
After the operation, antibiotics, analgesics, neurotropic vitamins, and other means are used. Rehabilitation measures are carried out, including physiotherapeutic methods, massage, physiotherapy exercises.