In developed countries, almost 75 percent of the population consult a doctor at least once because of back pain.Nine out of ten people will experience back pain at least once in their lifetime.Back diseases most often affect people between the ages of thirty and fifty, that is, in active working age.Of all patients who come to the clinic, more than a third come because of back pain.There are effective pain relievers.
Types of back pain
Back pain is acute if it is located in the spine and started no more than six weeks ago.Sharp pain is difficult for patients to tolerate, but in many cases it is a relatively benign symptom that can be treated.With timely treatment, patients return to professional activities within a month.
If the pain lasts longer than six weeks, then it becomes chronic, which is an equally dangerous problem, because there is a significant deterioration in the quality of life of able-bodied patients.The share of patients with chronic back pain is ten percent.
Reasons
It is worth noting that the reasons for the development of pathological processes in the back are quite well studied.Back pain can occur due to risk factors and due to a developed disease.Most often, pain in the back and spine occurs when:
- overweight;
- muscle strain;
- injuries of intervertebral joints;
- cramp;
- hypothermia;
- osteochondrosis;
- protrusion and herniation of the intervertebral disc;
- neuralgia.
It is known that the presence of excess body weight significantly increases the load on the musculoskeletal system: the load on the lumbar spine increases by forty kilograms with an increase in the body mass index by one unit.Sedentary lifestyle, prolonged exposure to a static position with incorrect posture and lack of physical activity lead to acute and chronic back pain.
Osteochondrosis
In the first place among the causes of back pain is osteochondrosis of the spine.Osteochondrosis of the spine is a pathological destructive process that develops in the intervertebral discs.As the disease progresses, the bodies of adjacent vertebrae, intervertebral joints and ligaments that support the spinal column are involved in the degenerative process.
Initially, the process develops in the core of the disc, which becomes less elastic due to loss of moisture.These processes in a relatively localized area of the spinal segment lead to inevitable changes in the adjacent vertebrae and intervertebral joints, which ultimately impairs the mobility of the spinal column as a whole.
Herniated disc
Lumbar disc herniation is the most common.The patient feels pain in the back, which radiates to the leg, buttock, reaches the foot or is localized on the inner side of the thigh.
Mobility is limited.Sensitivity is disturbed, which can occur in the form of burning and stinging.
Neuralgia
The presence of muscular neuralgia can be judged by the appearance of acute bursting pain in the back.It occurs due to nerve compression under the influence of inflamed surrounding tissues.
The most common place for pain to appear is in the narrow spaces between the ribs on the back.Neuralgia occurs both in childhood and in adulthood.
Injections for pain in the back and lower back
Today, the doctor is guided therapeutically by data from scientific literature, his own experience and the experiences of his colleagues, since there are no standards for the diagnosis and treatment of back pain that would be officially recommended by the Ministry of Health.
The following medications can be used to treat back pain:
- non-steroidal anti-inflammatory drugs;
- steroidal anti-inflammatory drugs;
- muscle relaxants;
- chondroprotectors;
- vasodilators and improve microcirculation;
- synthetic drugs;
- B vitamins.
Nonsteroidal anti-inflammatory drugs
This group of drugs is indispensable for diseases of the musculoskeletal system.It is sold without a prescription.
Available in the form of ointments, gels, tablets, suspensions, capsules, rectal suppositories, injections for intravenous and intramuscular injections.
prescribed:
- An anti-inflammatory drug from the group of phenylacetic acid derivatives with an analgesic effect.It is well tolerated and effectively relieves pain.Side effects include inhibition of proteoglycan synthesis in cartilage tissue and ulcerogenic properties, i.e. they promote the formation of stomach ulcers.
- An anti-inflammatory drug from the sulfonamide class with an analgesic effect.The difference from the previous drug is the prevention of destruction of proteoglycans and cartilage tissue, selective action on mediators of inflammation, which reduces the risk of stomach ulcers, and enhances the action of corticosteroids.Ideal for quick relief of acute pain.Side effects include the risk of toxic liver damage.
Steroidal anti-inflammatory drugs
It is used in cases where non-steroidal anti-inflammatory drugs do not have the desired effect.
They work quickly, have a systemic anti-inflammatory effect and reduce pain in the pathological focus.Available in the form of ointments, tablets, injections for intramuscular, intravenous, intra-articular injections.
It is used in severe cases.They are available only by prescription because they have many side effects: weight gain, edema, osteoporosis, ulcerative processes in the stomach and intestines.
Muscle relaxants
They are used only as part of complex treatment with drugs from other groups.The action is based on muscle relaxation, i.e. they do not have a therapeutic effect by themselves.But muscle relaxation helps in the presence of long-term spasm that leads to pain, and to increase the effectiveness of manual therapy, massage and physical therapy.
They are used in combination with NSAIDs and in cases of their intolerance or the presence of contraindications to them.
They are available only with a doctor's prescription, because they have unwanted effects: sudden changes in blood pressure, convulsions, muscle weakness and a depressing effect on the central nervous system.
Chondroprotectors
These include glucosamine and chondroitin preparations.Chondroitin promotes calcium retention and slows bone resorption.Glucosamine helps to improve the functions of the affected joint by increasing the production of hyaluronic acid.Available in the form of ointments, tablets, injections for intramuscular and intra-articular injections.It is prescribed in combination with NSAIDs.They practically have no contraindications and side effects.
In this case, for the best effect, oral administration should be combined with parenteral administration:
- Injections for intramuscular administration: one ampoule three times a week for one to two months.
- Powder: dissolve in water and take half an hour before meals.Take one packet once a day for one to three months.
- Tablets: Take two tablets three times a day with meals.
Vasodilators
The medicine based on deproteinized hemoderivative of calf blood helps to expand blood vessels, reduce trophic and microcirculatory disorders by improving the delivery of oxygen and nutrients.There is a decrease in hypoxia in the pathological focus with radiculopathy, osteochondrosis and intervertebral hernias.Available without a prescription in the form of tablets and injections.
Intravenous injections of purine derivatives are carried out in the morning and in the afternoon, 200-300 mg of the drug.Intramuscular injections are given two to three times a day at 100 mg.Tablets, when taken at the same time as injections, enhance the effect of the drug and are taken one tablet two to three times a day.
B vitamins
It is used as part of complex therapy.Only three vitamins from this group are used.Thiamine is involved in energy metabolism, improves the conduction of nerve impulses, relieves pain and promotes the restoration of intervertebral discs.Pyridoxine prevents hypoxia and improves intervertebral disc trophism.Cyanocobalamin relieves inflammation, increases tissue trophism and restores the structure of nerve tissue.
Available without a prescription.They practically have no contraindications and side effects.Available as tablets and injections.Use one ampoule daily for ten days.If the pain is not acute, then a regimen is used in which 3 ampoules are used per week (every other day) for three to four weeks.
The above mentioned drugs should be combined depending on the type of disease.But whatever it is, the main treatment will be aimed at removing pain, stopping inflammation and restoring the functions of the musculoskeletal system at the source of the pathology.
The following are used as therapeutic measures:
- massage;
- manual therapy;
- physical therapy;
- physiotherapy;
- electrical neurostimulation;
- therapeutic blockade;
- decompression and surgical stabilization.
Adequate therapy is prescribed by a general practitioner after a complete examination.If necessary, the patient will be referred to a specialist: neurologist, gynecologist, urologist.
Block for back pain
Performing a paravertebral block allows to ensure the delivery of the drug directly to the pathological focus, which is the cause of acute pain.Patients experience immediate relief when the block is performed.But it can only be performed in a hospital setting and only by a competent specialist.Relief from pain is temporary, but noticeable.The procedure also has diagnostic value.If there is no immediate pain relief after the block, then the reason is not related to spinal disease.
Blockage can be performed in biologically active points of muscles and tendons, in soft tissues surrounding the affected segment of the spine, in nerve sheaths, in nerve ganglia, joints and articulations.In this case, the injection consists of one, two, three or more drugs.These can be local anesthetics, corticosteroids, NSAIDs, vitamins, ATP.The effectiveness of blockades is indisputable in osteochondrosis, disc herniation, spondylosis and spondyloarthrosis, lumbago, radiculitis, acute and chronic pain in the spine.
Blocking procedure
When performing a blockade with any of the above-mentioned drugs, the following is observed:
- the patient's immediate sense of performance;
- almost complete absence of contraindications;
- creating a high concentration of the drug, especially in the pathological focus.
Description of the procedure:
- examination of the pathological focus with localization of the place of maximum pain;
- the patient is placed on the stomach;
- treating the site of blockage with an antiseptic;
- anesthesia of the puncture site and administration of the drug.
There are several contraindications for blockade, but they do exist: pregnancy, individual intolerance to drugs, infection in the procedure area.
There are many ways to get rid of back pain.You should resort not only to pills or injections for pain in the back and lower back, but also remember home remedies.First aid at home is applying cold to the back (ice from the fridge, frozen meat, dumplings from the freezer).Painful spasm is relieved by massage.