Back pain examination. How to check the spine: basic diagnostic methods

Most spinal pathologies occupy a leading position among other pathologies. Many people do not pay attention to the symptoms of incipient spinal disease, which can lead to serious consequences. It is important to promptly examine the spine for possible pathologies.

If a person complains of pain in various parts of the spine, then this is a direct path to examination. If you experience frequent headaches, numbness in the limbs and a feeling of weakness, you should also consult a doctor. These symptoms are very common in combination with back pain, which makes it possible to suspect any pathology of the spine.

In addition, examination of the spine should be carried out in case of injuries, inflammatory processes, necrotic changes and degenerative processes.

The doctor may prescribe instrumental methods if a tumor is suspected, a violation of the integrity of the vertebrae, or a change in the curvature of the spine.A spine examination is also carried out if congenital anomalies in the structure of the spine are suspected.

Is preparation necessary?

No specific preparation is required for the examination. However, if or is prescribed, then certain recommendations for preparing for the examination should be followed. There are no restrictions on food intake, but it is advisable to refrain from eating several hours before the MRI. This should be especially taken into account if the diagnosis will be carried out with a contrast agent.

To obtain reliable results, it is necessary to remove all objects containing metal.

It should be remembered that preparation for the examination depends on which part of the spine is being examined. If a study of the lumbar region is carried out, then it is necessary to exclude from the diet foods that increase gas formation. A few days before the examination, it is recommended to take Espumisan.

The examination must be carried out on an empty stomach. If necessary, an enema is performed. If a woman is pregnant, she should definitely notify the doctor before the test.

Diagnostic methods for examining the spine

For a correct and accurate diagnosis, it is necessary to undergo a comprehensive examination of the spine. It consists of examining the patient, palpation, and additionally instrumental methods are prescribed.

It should be noted that laboratory tests are not valuable for making a diagnosis, but only allow us to examine the condition of the body as a whole.

The following instrumental methods are used to identify spinal pathologies:

. It is one of the main methods for examining the spine. Thanks to this method, it is possible to determine the deformities of the vertebrae, their size, as well as their general condition. There are functional radiography, i.e. the study is carried out with maximum movement of the spine. The patient performs extension and flexion, as well as bending the body. Using this type of x-ray, the functionality of the spine is determined.
X-ray tomography
. Magnetic resonance imaging and computed tomography help examine the spinal column, vertebrae, intervertebral discs and intervertebral canal. These methods make it possible to identify pathologies at an early stage of development and prevent possible complications.
. X-ray examination of the spine, in which a contrast agent is often used to obtain more reliable results.
Myelography is an instrumental method in which the subarachnoid space is examined
Epidurography is prescribed if it is necessary to examine the area between the periosteum of the vertebrae and the membrane of the spinal cord. A contrast agent is injected into this area and pictures are taken.
Echospondylography. P is an ultrasound examination of the spine. Makes it possible to detect pathologies in the spinal canal.

Back pain- a common complaint. Usually we talk about back pain when pain is felt in the lumbar region. Sometimes in such cases they say that " pinched my back"According to recent studies, out of every five people, four have experienced such pain at least once in their lives.

Another typical location of back pain is under the right or left shoulder blade or between the shoulder blades.

With age, back pain is more common - among older people, every second person experiences such pain from time to time.

Back pain can have a different character: it can be sharp, stabbing, burning, aching, pulling, and can radiate to other parts of the body (for example, to the chest, legs, abdomen, genitals). The pain may be occasional or constant.

When listening to pain, a person usually asks himself two questions: should he see a doctor, and which doctor should he go to for back pain? Let's try to answer these questions.

Causes of back pain

Back pain can be caused by various reasons. Only an experienced doctor, based on an examination of the patient and data from laboratory and instrumental studies prescribed by him, can correctly diagnose and prescribe an effective course of treatment.

Back pain can be caused by:

neurological diseases:
- spine (degenerative damage to intervertebral discs);
- spondyloarthrosis (degenerative changes in the intervertebral joints);
- spondylosis (deformation of the vertebrae due to the proliferation of bone tissue);
- herniated discs;
curvature of the spine (kyphosis);
endocrine diseases, for example (reduced bone density due to metabolic disorders). This disease often occurs secretly, and the complaint of back pain may be the patient’s only complaint);
respiratory diseases (for example, pleurisy);
kidney diseases: glomerulonephritis, ;
tumor diseases;
as well as many other diseases of internal organs, blood vessels and soft tissues.

Such a variety of possible causes makes a person think about which doctor to contact for back pain. But this should not be turned into an obstacle to the help that professional medicine can provide.

Factors contributing to back pain

If proper treatment is not carried out, back pain is most often of a recurring nature, with periods of relatively short-lived well-being followed by returning pain. An exacerbation of the condition can be provoked by:

lifting weights;
staying in an uncomfortable position for a long time;
hypothermia;
infection.

What to do to prevent back pain? Prevention of back pain

In order to reduce the risk of diseases that can cause back pain, Family Doctor doctors recommend:

sleep on a comfortable bed with an elastic and hard mattress;
try to maintain correct posture;
do not stay in one position for a long time. When working at a computer or driving a car, you need to take breaks that give you the opportunity to stretch, warm up, and move around;
When working while sitting, organize your workplace correctly. The chair should have a back, preferably with armrests and a headrest, so that you can lean back and relax the muscles of your back and neck. The forearms should not be suspended; it is necessary to ensure that they lie completely on the table;
do not walk in high-heeled shoes for more than two hours at a time;
Avoid sudden turns and bends of the body. If you need to pick something up from the floor, it is advisable to sit down and not bend over;
when standing for a long time (when traveling on public transport or waiting in a public place), find a support point (lean on something with your hand or lean your back);
do not gain excess weight;
avoid lifting heavy objects;
engage in physical therapy, swimming or fitness.

When should you see a doctor if you have back pain?

If a symptom appears for the first time, it is usually not given any importance. Indeed, occasional pain is unlikely to indicate anything that seriously threatens our health. The pain may go away and never return. But much more often, back pain returns. And in this case, you should consult a doctor and not self-medicate.

Medical consultation required if you encounter one of the following situations:

you often feel back pain when straining or doing physical activity;
back pain occurs sporadically (from time to time);
the feeling of pain does not go away within 3-4 days.

Back pain may indicate advanced pathological processes and dangerous diseases. Don't delay seeing a doctor, If:

the pain is constant and localized in one place;
the pain does not decrease when lying down, or the pain occurs at night when you are sleeping;
back pain is accompanied by fever;
back pain is accompanied (this may occur in the morning) by muscle tension or a feeling of lethargy in the legs and arms.

If, in the case of persistent or recurring back pain, the disease is not diagnosed in time and treatment is not started, its development can lead to irreversible consequences and disability. Thus, a chronic or acute inflammatory process in the kidneys can lead to renal failure, and osteochondrosis left untreated can lead to the formation of Schmorl’s hernias.

Severe pain in the back and lower back, a feeling of tension and stiffness is a common condition that sooner or later appears in many people.

In most cases, pain syndrome appears in the lower back, since the lumbar spine is characterized by its mobility and takes on half the weight of the human body. may occur as a result of lifting heavy objects or making a sharp turn.

In some cases, unpleasant symptoms in the lumbar region appear over time due to regular exercise or incorrect posture. In some cases, it is not possible to determine the cause of the pain syndrome. The pain is most severe at night, when there is a load on the lower back, or after being in an uncomfortable position for a long time, for example, after a long trip in a car. In most cases, back pain in the lumbar region goes away if a person lies for a while on a hard surface.

Most often, the pain persists for several days or weeks, and after that the person’s general well-being improves, and the condition of the lower back is restored. You can speed up recovery by taking painkillers and optimizing daily physical activity: rest only in the first few days, and then a gradual return to normal. But in some cases, discomfort and discomfort in the lower back indicate the onset of a chronic disease, which will require complex treatment.

A person’s mood also plays a special role in this process. Due to pain, the patient’s general condition may deteriorate greatly, but according to statistics, a person who arrives in a good mood recovers faster than one who is depressed.

Main causes of the syndrome

The condition of the back directly depends on the functioning of the bones, nerves, muscles and joints. Most often, finding out exactly the cause of pain is quite difficult. Serious illnesses or injuries of the spinal region occur in rare cases.

In most cases, back pain at the lumbar level appears due to minor injuries, muscle strain, sprained ligaments and muscles, pinched nerves and at the beginning of the inflammatory process. Unpleasant back symptoms can occur suddenly or develop gradually intensifying. Causes of back and lower back pain:

too sudden movement: tilting or turning to the side;
lifting and carrying heavy objects, long bending of the body;
incorrect posture while walking or working at a desk;
severe muscle strain in the back;
long rides in a car without rest breaks.

In some cases, pain in this area appears for no particular reason, for example, in the morning after waking up.

Main Factors

There are factors that can cause severe back and lower back pain. Experts identify a large number of them; they can negatively affect the condition of the back. The main ones include:

Heavy weight - in this case the spine is greatly overstrained. To determine whether body weight affects the spine, total body mass index should be calculated.
Smoking - it can negatively affect the tissues of the back, which leads to pain.
Carrying a child - in this condition, the woman’s spine is subjected to severe stress, which only becomes stronger as the size of the abdomen increases.
Long-term use of medications that reduce bone density, such as corticosteroids.
Psycho-emotional overstrain, stress - regular anxiety leads to severe tension in the muscles of the neck and back, which provokes pain.

Major diseases

Diseases that can lead to lower back and back pain include the following:

Osteochondrosis and its complications, for example, spinal hernia, is a degenerative process during which intervertebral cartilage is destroyed, which provokes pain. Such diseases appear in older people, especially in those who experience severe stress on their backs.
Sprained ligaments and muscles - most often occurs after prolonged physical activity or sudden movement.
Some types of arthritis are an inflammatory disease of the joints, in which, in addition to pain, stiffness is felt in the joints and there are problems with mobility in the morning
Kidney diseases, for example, pyelonephritis, can cause back pain on the right side of the lower back or on the left.

Carrying out diagnostic activities

Severe back and lower back pain can be managed at home by taking special medications that can be purchased at a pharmacy without a doctor's prescription. In-clinic therapy is usually not required.

If back pain radiates to the lumbar region and brings severe discomfort, then the patient should definitely visit a doctor. He will conduct an examination and prescribe treatment.

If back pain on the left side of the lower back prevents the patient from resting and moving normally, then you should call a doctor at home.

When examining the condition, the doctor will ask the person to sit, stand, walk, alternately raise his legs, and also determine the overall range of motion in the back. He will also require information about possible recent illnesses or injuries, learn about lifestyle, work characteristics, and also ask the following questions:

When did the pain start?
Where is pain common?
Has your back hurt before?
How does pain syndrome manifest itself?
For what reason does the pain become stronger or weaker?

During the examination, the doctor will try to exclude possible infection and fracture, since such manifestations occur in rare cases. If there are problems with making a diagnosis, the doctor may send the patient for additional diagnostic measures: magnetic resonance imaging (MRI) or x-ray of the spine. A urine test is performed to rule out kidney disease.

In many cases, pain in the spine is eliminated already on the third day of treatment. If therapy does not improve the condition, and the pain continues for six weeks (chronic process), or a serious illness has led to the lesion, then the doctor refers the person to a specialist. In most cases, treatment for back and lower back pain is prescribed by a neurologist. In addition, other doctors can join in examining the patient’s condition: an osteopath, a chiropractor, and a reflexologist.

Basic treatment methods

Treatment of pain will depend on its duration and severity, as well as on the individual characteristics of the person. In most cases, pain can be relieved with simple medications at home.

Main methods of treatment:

Mobility. Previously, doctors believed that with pain in the lumbar region it was important to ensure peace. It has now been established that in patients who begin to move earlier, pain goes away faster. Complete rest and bed rest should be observed only in the first days of acute pain, when it is severe and prevents normal movement. In this case, the person should lie on a hard and level bed. After the condition returns to normal, you should gradually return to a normal lifestyle and previous loads, adding more and more mobility every day. Over time, the person will be able to walk normally around the house or visit public places. But he will have to put up with some discomfort and try to avoid anything that could lead to pain again. After a few days, a person can return to work without waiting for severe pain in the back and lower back to completely go away (of course, if the person’s work does not involve stress on the lumbar region). Early mobility will help restore the condition and reduce the severity of pain.

Taking painkillers. When dealing with severe back pain above the lower back or directly in it, doctors prescribe the following painkillers: Diclofenac, Ibuprofen, Nimesulide and Indomethacin. Such remedies help eliminate pain and inflammation. Depending on the severity of the lesion, a specialist can prescribe various forms of these medications: injections, tablets, local preparations - ointments, gels and creams against back pain. Most often, initial treatment involves injections. After the pain syndrome passes, the administration of medications is stopped, and if necessary, tablets or special ointments are started. Such drugs have some contraindications, so before you start taking them, you must consult a doctor and study the instructions. Painkillers are best taken after meals with milk.
Muscle relaxants are drugs that help eliminate muscle spasms and relax muscles. They are prescribed when severe tension in the spinal muscles increases pain, for example, during an acute stage of osteochondrosis or a herniated disc. Muscle relaxants also have different side effects; for example, they are prohibited from being taken while driving a car. It is important to consult a doctor first.
Treatment with warm and cold compresses. In some cases, pain can be eliminated by taking a hot bath or applying heating pads to the painful area of the body. You can also improve your general condition with cold or a bag of frozen vegetables. But you should remember that you should not apply ice to the skin itself, as this can result in frostbite. A previously cold object should be wrapped in a towel and then applied to the affected area of the body. You can also alternate treatment with cold and heat, applying either ice or a heating pad to the body.
Choosing a sleeping position. Changing your sleeping position will help eliminate tension and pain. If the patient is used to sleeping on his side, then he should pull his legs to his chest and place a pillow between his legs. If he sleeps on his back, then a pillow should be placed under his knees, this will ensure a natural curve of the spine in the lower back.
Relaxing the body is a very important component in the fight against severe pain in the back on the left side above the lower back, since with strong excitement and overexertion the pain syndrome only worsens. As practice shows, people in a good mood recover much faster, and their pain does not become chronic. There are special techniques that help a person relax and forget about the discomfort in the back for a while. To do this, it is recommended to carry out special breathing exercises and perform a set of simple exercises with alternate tension and relaxation of the muscles in the body.
Physical activity, following a healthy lifestyle. It is important to eliminate the root cause of severe back and lower back pain to avoid its recurrence. The most common causes of pain in this area include excess weight in a person, poor posture, and regular emotional outbursts. In this case, a positive effect can be achieved if you start leading an active and healthy lifestyle, for example, walking more or visiting the pool. The main thing is to choose the activity that you like most. In some cases, classes are conducted under the guidance of a trainer. Most often, sets of exercises are used that help strengthen the back muscles and ensure straight posture and stretching.
If the pain syndrome does not go away within 6 weeks of treatment, then it automatically goes into the chronic stage. In addition to painkillers and a muscle relaxant, in this case you need to start complex treatment.

Treatment for chronic pain

In this condition, doctors prescribe the following measures to patients:

Manual therapy is carried out by a chiropractor or osteopath and includes the use of various methods of therapy, massage, and mobilization.
Alexander Technique - helps eliminate severe tension in the muscles, teaches a person how to correctly assume body position in various situations and move. This technique will help you learn to maintain body balance and straight posture.
Acupuncture sessions are an ancient Chinese method of treatment, during which thin needles are inserted into various parts of the body, which help reduce pain and normalize a person’s condition.
Taking antidepressants. Such drugs are prescribed to the patient when painkillers and other treatment techniques do not bring a positive result. Doctors advise taking tricyclic antidepressants, for example, Amitriptyline, in small quantities. Such remedies are initially created to get rid of depression and problems with the nervous system, but they can also work to suppress certain types of pain.
Session with a psychiatrist. A positive effect from such a procedure can be achieved when other treatment methods do not help. Severe back pain in the lumbar region is a real condition. The way a person treats it can make it stronger or, conversely, significantly weaken it. Cognitive behavioral therapy can help eliminate back pain in the lumbar region on the right or left by changing your attitude towards it. According to statistics, people who have undergone psychotherapy sessions experience much less severe pain. In this case, a person becomes motivated to lead an active lifestyle and exercise regularly, which leads to a decrease in pain.

Carrying out the operation

Most often, surgery is used only when all other methods of treating back and lower back pain do not produce any effect. The operation is used when the pain syndrome is so strong or constant that it prevents the patient from working or even resting. The chosen method of surgical intervention will directly depend on the type of pain syndrome and the cause of its occurrence.

For example, in case of a herniated spine, the doctor prescribes a discectomy. Currently, doctors are able to perform surgery through a minimal incision using specialized microsurgical instruments. Such operations are complex, but they are characterized by minimal trauma.

Spinal fusion is a complex and quite rare surgical intervention. Its results do not always meet expectations. For example, after surgery, a person may continue to have severe back pain below the lower back.

With spinal fusion, the overall mobility of the spine is significantly reduced, since during the operation several vertebrae that provoke pain are fastened to each other in one position by implanting living bone tissue between them. At the end of the rehabilitation period, the bones are completely fused, and when a person moves, they do not affect the nerve endings that are located near them. It helps suppress severe back pain in the lumbar region on the left and right. Before deciding to undergo surgery, the patient should receive information about all possible complications and positive effects of therapy from the neurosurgeon.

When dealing with acute and chronic lower back pain, other alternative treatment methods can be used, the effect of which has not been proven in medical practice. The main non-traditional methods of treatment include:

laser treatment - minimum power lasers affect the inflamed area of the body and lead to tissue regeneration;
treatment with interference currents - the lower back is exposed to medium and low frequency currents, which provokes increased production of endorphins (pain-relieving hormones), as well as active restoration of damaged tissues;
ultrasound treatment - in this case, an ultrasonic wave is used aimed at the surface of the back: it ensures tissue restoration and active healing, which eliminates pain;
electrical stimulation of nerves through the skin - electrodes that are glued to the surface of the skin deliver electrical impulses of a certain strength, which provoke the active production of endorphins and help stop the transmission of pain signals along the spine to the brain;
lumbar braces - for this purpose, special pillows, bolsters, and corsets are used to maintain the condition of the spine;
spinal traction using specialized devices and sets of exercises;
injecting special injections into the spine - medications are injected into the intervertebral spaces.

The specialist can also send the patient to a “pain treatment school”, in which people are taught to independently cope with pain, perform special exercises, and lead an active and healthy life. Such institutions deal primarily with group therapy, relaxation and psychology.

Prevention measures

A healthy and strong back is the best solution to avoid any pain. It is for this reason that the most effective prevention will be regular physical activity in a rational amount, correct posture, and also the avoidance of lifting heavy objects.

If a person has temporary back pain that radiates to the lumbar region, then he should take the following preventive measures:

get rid of excess weight, if present: a large number of extra pounds can negatively affect the condition of the lower back, causing additional stress;
use correct and comfortable shoes with low heels, which will help evenly distribute the load on the foot and avoid overstraining the spine when moving;
it is also important to stop moving suddenly, as this can cause muscle strain;
learn to deal with stress, depression, nervous breakdowns, stop worrying too much, as all this can provoke pain.

Types of exercises for the back

A set of exercises is a good method of preventing and relieving lower back pain, but if the pain lasts longer than 6 months, then it is very important to consult a doctor before starting classes.

Walking and strengthening swimming will help improve muscle condition and support the spine without overloading it, which eliminates possible sprains. Pilates and yoga will help strengthen your back muscles and develop their flexibility, but they should be performed under the strict supervision of a professional trainer.

The most common simple exercises for back pain that can be performed at home:

Wall squats - to do this you need to straighten up, place your feet shoulder-width apart. Next, perform a squat until the body is in a 90-degree bend position.
Alternating leg raises. To perform the exercise, you need to lie on the floor and begin to raise your legs one by one without bending them. The exercise is repeated 5 times.
Pelvic lifts. The exercise is performed in a supine position. First, the knees bend, and then the pelvis rises with tension in the abdominal muscles. When performing the exercise, it is important to keep your back straight. Repeat 5 times.

At first, the exercises are carried out several times a day, over time the number of approaches increases to six, depending on how the person himself feels. This complex helps to warm up and strengthen the back muscles. Most often, people injure their lower back while doing everyday activities, for example, when lifting heavy objects or cleaning the house. Warming up your muscles thoroughly before performing work will help prevent injury.

Pain due to osteochondrosis

Osteochondrosis is a disease of the articular cartilage that connects the vertebrae. Due to this disease, pinching of the spinal cord roots occurs, which provokes pain. People over 30 years of age are especially susceptible to this condition, and recently the lesion is often diagnosed in young people.

The main cause of pain in the back and lower back is lifting heavy objects, monotonous work in an uncomfortable position (for example, in the garden). Osteochondrosis can occur as a result of a long trip without stopping, when a person is constantly sitting.

No person is immune from such a disease. It can be identified by the following symptoms:

back pain;
pain in the lower back, the right side of the back aches (or the left), the pain radiates to the leg;
the pain only intensifies with changes in position and load on the lower back;
a person may experience a strong burning sensation and painful lumbago;
after a long stay in an uncomfortable position, it is difficult to change it due to severe discomfort;
the sensitivity of the buttocks and legs decreases, a feeling of goosebumps occurs;
Problems with sweating appear, the lower extremities get cold.

If a person is sure that the pain syndrome comes from the spine, then he should perform the following therapeutic measures:

use a special woolen belt or scarf, tying it around the lower back;
lie down on a hard and flat surface;
start taking anti-inflammatory drugs;
apply anti-inflammatory ointments for back pain in the lumbar region.

It is important to remember that painkillers should not be taken on an empty stomach, as they irritate the mucous membrane and can cause ulcers and gastritis. If a person is not sure about the cause of pain in the back and lower back, then it is important for him to see a doctor - taking anti-inflammatory drugs for diseases of the stomach and pancreas is very dangerous, since they can only aggravate the overall situation.

What is prohibited?

In no case should the patient try to “straighten” his back on his own - this can only increase the pain syndrome and also cause great harm. In case of an acute form of osteochondrosis, you should not take warm baths or visit baths and saunas.

After warming up, a person may feel an improvement in his condition and relief from pain, but after that the state of health will only worsen. If pain occurs frequently in the back area, it is important to perform an MRI and seek help from a neurologist.

EXAMINATIONS AND TESTS FOR BACK PAIN

Because a variety of medical conditions can cause back pain, a thorough medical history will be part of the evaluation, and your doctor will ask you many questions regarding the onset of the pain (Have you lifted heavy objects and felt sudden pain? Has the pain gotten progressively worse?). He or she will want to know what increases or decreases the pain. Your doctor will ask you about recent illnesses and related symptoms, such as cough, fever, difficulty urinating, or stomach problems. For women, the doctor will want to know about vaginal bleeding, cramping, or discharge. In these cases, pelvic pain often radiates to the back.

The doctor will look for signs of nerve damage. Reflexes are usually tested using a neurological hammer. This is usually done on the knee and below the knee. While lying on your back, you will be asked to lift one leg, then both legs, with and without the assistance of a doctor. This is done to check the nerves, muscle strength and the presence of tension in the sciatic nerve. Sensation is usually tested by using a pin, paper clip, or other sharp object to test for loss of sensation in the legs.

Depending on what your doctor suspects, he may do an abdominal exam, a gynecological exam, or a rectal exam. These tests determine the presence of diseases that may cause back pain. The lowest nerves in your spinal cord serve as the sensory area for the rectal muscles, and damage to these nerves can cause an inability to control urination and bowel movements. Therefore, a rectal examination is necessary to check that there is no nerve damage in that area of the body.

Doctors can use several tests to understand what is causing back pain. No test is 100% perfect for determining the absence or presence of disease.

The medical literature is clear: if there are no dangerous symptoms of acute back pain, there is no need to use imaging studies. Because 90% of people experience relief from back pain within 30 days, most doctors will not refer you for testing for acute, uncomplicated back pain.

X-ray examination not generally considered useful in assessing back pain, especially in the first 30 days. In the absence of dangerous symptoms, its use is contraindicated. X-rays are indicated for severe trauma, minor trauma for those over 50, people with osteoporosis, and those taking steroids for a long time.

Myelogram is an x-ray test in which an opaque dye is injected directly into the spinal canal. Its use has recently declined sharply as MRI is now used. This study is now performed in combination with CT and only in special situations when surgery is planned.

Magnetic resonance imaging (MRI) is a complex and very expensive study. The research does not use X-rays, but uses very strong magnetic radiation to create an image. MRI may be used after 1 month of symptoms to investigate more serious causes of the problem.

Nerve studies

Electromyogram, or EMG, is a test that involves inserting very small needles into muscles. Electrical activity is monitored. This test is usually used for chronic pain and to determine the extent of damage to the nerve roots. The test can also help doctors differentiate between nerve root disease and muscle disease.

Before your doctor treats your back pain, he or she may conduct tests to determine the cause of your back pain. The doctor will test your range of motion and nerve function and perform a manual examination to locate the area of discomfort.

Blood and urine tests will indicate whether the pain is due to infection or other systemic problems.

X-rays are useful in determining the location of a fracture or other bone injury.

Computed tomography (CT) or magnetic resonance imaging (MRI) may be needed to analyze soft tissue damage. X-rays and tomography are used only to check for direct spinal injury, back pain with fever, or nerve problems such as excessive weakness or numbness.

An electromyogram (EMG) may be done to determine possible muscle and nerve damage.

Because back pain has a number of causes, the goals of treatment are to relieve pain and restore mobility. Basic treatment is to relieve back pain from a sprain or minor injury. Applying ice may help, as may taking aspirin or another nonsteroidal anti-inflammatory drug to reduce pain and inflammation. Once the inflammation subsides, apply a heating pad to relax the muscles and connective tissue.

Prolonged bed rest is no longer considered necessary in most cases of back pain, but is considered potentially harmful, delaying recovery and causing further problems. In most cases, you are encouraged to continue normal, non-effortful activities (such as walking). After this, supervised exercise or physical therapy begins. Physical therapy treatment may include massage, ultrasound, whirlpool baths, controlled heat, and a customized exercise program to restore full range of motion to the back. Strengthening your abdominal and back muscles will help stabilize your back, and you can prevent further back damage by doing gentle stretches to maintain good posture.

If back pain interferes with normal activities, your doctor will recommend taking pain medications. Over-the-counter medications such as Tylenol, aspirin, or ibuprofen may help. Your doctor may prescribe a strong anti-inflammatory drug or an opioid/acetaminophen combination—Vicodin or Percocet. Some doctors also prescribe muscle relaxants. But remember that these drugs affect the brain first and then the muscles, and often cause drowsiness.

If your doctor is unable to help control your back pain, he or she may refer you to a spine specialist or pain management specialist. Sometimes these doctors use injections of steroids or anesthetics to control pain. Recently, new methods of treating pain have been developed. One is radiofrequency ablation, the process of delivering electrical stimulation to specific nerves to make them less sensitive to pain, or delivering enough electricity to kill the nerve and stop further pain. A similar procedure that applies heat to a herniated disc can seal the disc so that it no longer presses on the nerve roots, causing pain. Other medications, such as antidepressants and anticonvulsants, are sometimes prescribed to relieve pain associated with irritated nerves.

Some doctors believe that using transcutaneous nerve stimulation (TCNS) can help relieve back pain. Electrodes attached to the body deliver a low-voltage electrical current to help relieve pain. With appropriate training, patients can use PCSI on their own to relieve pain while recovering from a back strain or moderate spinal injury.

Surgery for nonspecific spinal pain is a last resort. In cases of persistent pain due to severe nerve damage, rhizotomy—surgical separation of the nerve—may be necessary to stop pain signaling to the brain. A rhizotomy can correct symptoms caused by friction between the joint surfaces of the spine, but it does not help with other problems, such as herniated discs.

Chiropractors play an important role in the treatment of back pain. The American Agency for Healthcare Research and Quality has recognized spinal manipulative therapy as effective in the treatment of acute low back pain. Some researchers suggest that early chiropractic adjustments for acute back pain can prevent the development of chronic problems. Other doctors caution against the use of certain chiropractic manipulations, especially those that involve harsh twisting of the neck.

Osteopathic treatment combines drug therapy with spinal manipulation or traction, followed by physical therapy and exercises.

Acupuncture can provide temporary or complete relief from back pain. It can be used alone or as part of a comprehensive treatment plan that includes medications. Clinical advances along with positive research results from the National Institutes of Health have identified acupuncture as a viable treatment option for people suffering from low back pain.

If you are consulting with a therapist about cognitive behavioral therapy (CBT), your treatment may include stress management, behavioral accommodation, and relaxation techniques. CBT can reduce the intensity of back pain, change the perception of pain levels and disability, and even relieve depression. The National Institutes of Health considers CBT useful for relieving low back pain.

Other behavioral programs have shown the same result - their participants were able to reduce their medication use, changing their views and attitudes towards pain.

If low back pain is due to muscle tension or spasm, biofeedback may be effective in reducing pain intensity, reducing medication use, and improving quality of life. Biofeedback can help you train your muscles to respond better to stress or movement.

The Pilates technique and the Feldenkreis method are specialized forms of physical activity that help you learn to move more coordinated, flexible and graceful. They can help reduce pain and relieve stress. Some of the yoga asanas can help reduce lower back pain, improve flexibility, strength and balance. Yoga is a good stress reliever and can help with the psychological aspects of pain. Aquatic therapy and exercise can also improve flexibility and reduce chronic low back pain. The unique properties of water make it a particularly safe environment for exercise with a sore back; it creates little resistance, comfort and relaxation.

From the book Oddities of our body. Entertaining anatomy by Stephen Juan

Why do doctors tap my back during an examination? Ask any therapist about this - by tapping on your back, the doctor will find out about the condition of your lungs in the simplest, fastest, cheapest, most painless and reliable way, and you won’t even need an X-ray for this

From the book Back and Spine Health. Encyclopedia author Olga Nikolaevna Rodionova

Ice massage for back pain Mention of the use of natural cold in the form of ice and chilled liquids for pain relief and relief of swelling in closed injuries, burns, headaches was found in ancient papyri. Cryotherapy (CT) since the time of Hippocrates and

From the book Encyclopedia of therapeutic movements for various diseases author Oleg Igorevich Astashenko

From the book Overhaul for the spine author Oleg Igorevich Astashenko

Therapeutic movements for back pain The exercises suggested below will help get rid of back pain that occurs due to various diseases. Doctor P. N. Kramskov, to get rid of pain with lumbosacral radiculitis, suggests performing the movement,

From the book Hernia of the spine is not a death sentence! author Sergei Mikhailovich Bubnovsky

Do you need a corset for back pain? I would like to remind you of the history of the development of osteochondrosis with herniated intervertebral discs. Many people suffering from back pain at first do not attach serious importance to their occurrence. A person is inclined to come up with a wide variety of excuses

From the book Ginger - a universal home doctor author Vera Nikolaevna Kulikova

Ginger compress for back pain Ingredients: 2 teaspoons of ginger powder, 0.5 teaspoon of chili pepper, 1 teaspoon of turmeric, 2 drops of sesame or mustard oil. Method of preparation and use Combine all ingredients, add a little hot water and

From the book Back Pain. How to determine the cause and eliminate the attack author Angela Valerievna Evdokimova

Chapter 7 Massage for back pain The author thanks professional massage therapist Mikhail Klebanovich for providing photographs for this chapter. You can read more about massage techniques in M. Klebanovich’s books “Classical therapeutic massage” and “Big

author Irina Nikolaevna Makarova

From the book How to get rid of pain in the back, lower back joints author Bozena Meloska

KUZNETSOV'S APPLICATOR FOR BACK PAIN The applicator (or applicator, from the Latin applico - I press, I apply) is a device for personal use designed to relieve pain in the muscles, joints, spine, to normalize the functioning of the cardiovascular,

From the book Women's Health During Pregnancy author Valeria Vyacheslavovna Fadeeva

ULTRAVIOLET RADIATION FOR BACK PAIN Ultraviolet (UV) rays are part of the optical range of electromagnetic waves with a wavelength from 400 to 180 nm. They penetrate to a depth of 0.1 - 1 mm, causing redness and pigmentation of the skin, reducing its sensitivity,

From the book Massage and Physical Therapy author Irina Nikolaevna Makarova

PEPPER PLASTIC FOR BACK PAIN Pepper patch is successfully used for back pain. An analgesic effect is provided by a plaster containing capsicum extract, thick belladonna extract, arnica tincture, natural rubber, pine rosin,

From the book Spine Health author Victoria Karpukhina

BEE VENOM FOR BACK PAIN Bee and snake venoms, which have an analgesic and anti-inflammatory effect, are widely used to treat pain in the joints and spine. Their therapeutic effect is associated mainly with reflex reactions arising in connection with

From the author's book

SNAKE VENOM FOR BACK PAIN Snake venom released when bitten by a poisonous snake can be deadly. It kills thousands of people around the globe every year. At the same time, snake venom can treat many diseases. It is known that small amounts of cobra venom have

From the author's book

Examinations and tests First trimester Until the 28th week, you will be asked to come for examination to the doctor once a month. Later, visits will become more frequent: 2 times a month - until the 36th week, then - weekly. Already at the first appointment, the doctor may refer you for an ultrasound (ultrasound examination), in order to

From the author's book

Therapeutic exercise for back pain Treatment and prevention of back pain is impossible without the patient performing special physical exercises, which are prescribed after examining the condition of the muscles, ligaments, fascia and joints. When examining patients with dorsalgia

From the author's book

Exercises for back pain: a useful shock For prolonged back pain, Dr. Bubnovsky recommends that his patients wash the floors, peel potatoes, and cut salad. Physical movement plus a psychological attack on pain gives a good healing effect. Here

When faced with back pain, you should not resort to self-medication until a high-quality diagnosis of back pain is carried out.

In addition to the obvious pain caused by damage to muscle and bone tissue, discomfort can also be caused by inflammatory processes in other organs.

All diseases of the spine and back muscles can be congenital or acquired. Among acquired diseases, it ranks first in the world among others. An example of a congenital disease is or.

Where to start

Where does the diagnosis of back pain begin? First of all, the doctor must collect all possible information about the patient:

Patient's age.

Degenerative diseases of the spine, such as osteochondrosis and osteoarthritis, are most common in older people, as are tumor diseases. Unfortunately, in older patients, the possibility of fractures cannot be ruled out: calcium is washed out with age, and this makes bones extremely fragile.
Young people and middle-aged people, of course, can also be susceptible to all this, since there is a trend toward “rejuvenation” of spinal diseases due to the poor lifestyle of the population. However, active age is also a time for sprains and microtraumas: industrial and household, and in this case it is worth thinking about diagnosing the back muscles.
If severe pain overtakes a child under the age of 8 years, and the anamnesis does not clearly suggest a particular disease, medical manipulations, as a rule, begin with determining the condition of the baby’s internal organs.

How long has he been experiencing pain?
Is there irradiation to neighboring organs, and if so, where?
Do you have a history of injuries, surgeries, or other injuries?
Are there other diseases that can create the same effect? For example, with pelvic pain, pain in the lower part of the lower back may be observed, heart disease can radiate to the left arm as well as osteochondrosis, etc.
Nature of pain: aching, pulling, sharp, sudden, stabbing, etc. Burning, aching are usually more symptoms of tumors, while sharp, crippling pains are more typical of radicular syndromes. Dull and intermittent pain may indicate...
Does the condition worsen at certain times of the day? Most degenerative spinal diseases have a circadian rhythm (osteochondrosis, etc.), while organic lesions of the spine (tuberculosis), as well as tumors (malignant or benign, for example) usually lack a circadian rhythm, and the patient feels pain throughout the day with approximately the same force.
Does patient comfort depend on posture? Is it more convenient to lie down or move? Spondyloarthropathy manifests itself as pain at rest and relief during movement, while radiculopathy is exactly the opposite.

For an accurate differential diagnosis, such a list of questions is not enough, but a specialist will nevertheless be able to draw some initial conclusions.

Separately, it is worth mentioning the diagnosis of injuries to the spine and spinal cord, in other words, spinal injury with a fracture.

There are a number of specific palpation manipulations that make it possible to diagnose a fracture, its nature and location with a high degree of probability.

At the same time, the presence of extensive hematomas, characteristic of trauma survivors, may hinder the study. In addition, during the examination there is a high risk of spinal cord damage.

There is a method for determining the location and type of damage based on the nature of movement disorders - the presence and location of parasthesias and paralysis. Of course, this provides some information, but never complete information.

It is also important to pay attention to a number of anatomical characteristics, such as the most prominent position of the spinous process of the VII cervical vertebra, the IV and VII thoracic vertebrae at the level of the crest and lower angle of the scapulae, respectively, the crests of the iliac bones between the IV-V lumbar vertebrae.

Diagnostic methods

Regardless of the pathology, the most accurate diagnostic tools remain CT, MRI and the like.

Among the listed methods are X-ray and computed tomography - radiation, MRI uses magnetic waves, and ultrasound can be used for small children and pregnant women - it is completely harmless.

Among modern diagnostic methods one can also call computer-optical. The study allows us to make a conclusion about the condition of the muscles, the symmetry of the limbs and vertebrae, and all kinds of deviations.

The novelty and convenience of the method lie in its relative accuracy (at the same level as radiography) and absolute harmlessness.

Disclaimer

The information in the articles is for general informational purposes only and should not be used for self-diagnosis of health problems or for therapeutic purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know the exact cause of your health problem.

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