pain in the back

definition

Back pain is very common in Germany. A distinction is made between acute (sudden) pain in the back and permanent (chronic) pain.

Chronic back pain is when the pain persists for more than three to six months. There can be a variety of causes. Often muscles and bones - especially the spine - are the cause of back pain.

Lower back pain is particularly common and is mostly chronic. Sudden, severe back pain, especially in the chest area, can be a sign of a serious illness such as a heart attack. It is important to find the source of the pain.

Causes of back pain

The causes of back pain can be very different. Most of the time, the problem lies in tense muscles. Tense muscles can cause pain in the upper, middle and lower back and are usually provoked by poor posture and incorrect or excessive strain.

For example, long periods of sitting at work can lead to tension and pain in the back.

These disorders can lead to back pain

Incorrect, sudden movements can lead to a sudden shooting pain, popularly known as lumbago.

Read more on the topic: Poor posture of the spine or PC workstation analysis and ergonomics

Influenza infections can also be accompanied by back pain (body aches).

Furthermore, herniated discs, which mainly occur in the lower back, and vertebral blockages can lead to back pain.

Accidents can cause vertebral fractures and back pain.

So-called vertebral sliding (spondylolisthesis), in which one or more vertebrae slide forward, can also cause pain. Slipping in the vertebrae is often caused by sports such as gymnastics, dolphin swimming, javelin throwing or weight lifting, but can also result from spinal injuries or signs of wear and tear.

A bone loss (osteoporosis) can also be responsible for the pain. In addition, inflammatory changes caused by autoimmune diseases are the cause of back pain. Ankylosing spondylitis, psoriatic arthritis or enteropathic arthritis can cause inflammation in the back and the following pain. Psoriatic arthritis often occurs in connection with the skin disease psoriasis vulgaris, in which chronic flakes on inflamed skin occur, especially on the extensor sides of the arms and legs. Enteropathic arthritis can occur in the course of a chronic inflammatory bowel disease such as Crohn's disease.

Skeletal deformities such as scoliosis or changes in the rib and vertebral joints can also be responsible for back pain. A growth-related M. Scheuermann should be considered in children especially between the ages of 10 and 13 and back pain.

Tumors can rarely be responsible for pain. In some cases, diseases of internal organs such as the kidneys, heart, lungs or gall bladder can trigger back pain.

Concomitant symptoms

A herniated disc is accompanied by sharp pain. If the nerves are irritated, it can radiate into the arms, ribs or legs, depending on the severity of the incident. In addition, sensory disturbances, muscle weakness or paresis can occur.

Read more on the topic: Symptoms of a herniated disc

An osteoporosis is usually associated with diffuse back pain. In addition, it can lead to a hunched back, a reduction in body size and vertebral body fractures. The fractures of the vertebral bodies then mainly occur in women after the menopause.

Read more on the topic: What kind of pain occurs with osteoporosis?

The gliding of the vertebrae is usually associated with load-dependent pain, which may radiate into the buttocks and thighs. Furthermore, those affected usually have pain when leaning back.

Fatigue, weight loss, and fever can be common symptoms of ankylosing spondylitis. The back pain usually sets in slowly, is independent of position and is felt especially at night. In the morning, those affected usually describe stiffness of the back. The stiffness in the back and the pain usually get better with movement. In addition, pain at the junctions between bones and tendons (Enteropathies) come from the Achilles tendon, for example.

Read more on the topic: Inflammation of the Achilles tendon

Persistent diarrhea is usually a sign of inflammatory bowel disease, which can be associated with back pain associated with enteropathic arthritis.

Psoriatic arthritis is usually preceded by the skin symptoms of psoriasis vulgaris. Scaling, inflamed, sharply defined redness forms on the skin. These are mainly found on the extensor sides of the arms and legs, on the hairy scalp and the lower back. Sometimes the skin areas are also accompanied by itching.

Scoliosis can lead to impaired breathing if the spine is severely deformed.

If the heart or lungs are the cause of the pain, it usually occurs suddenly and very strongly and in most cases is accompanied by shortness of breath.

Read more on the topic: Signs of a heart attack

The gallbladder can cause pain in your right shoulder if you have stones or inflammation.

Diagnostics for back pain

When making a diagnosis, it is important to conduct an interview (anamnesis). Previous activities or accidents can indicate the cause of the back pain. On the other hand, it is important to describe accompanying symptoms, the course of the back pain and first appearance. In addition, the quality, severity, type and duration of the back pain should be inquired about and whether there are factors that improve or worsen the pain.

A physical exam that involves looking at, feeling, and patting the back can also provide clues as to the underlying cause. In addition, the lungs and heart should be monitored.

Furthermore, a blood sample can, for example, indicate possible inflammation. Specific antibodies in the blood that are specific for diseases, which are often formed in autoimmune diseases, can also suggest the possible cause.

In order to rule out osteoporosis, a blood sample should also be taken as well as a bone density measurement.

An ultrasound scan can reveal diseases of the internal organs.

Imaging procedures such as X-rays, MRI and CT help to identify muscular, skeletal and organic causes.

The exact diagnosis that is performed depends on the initial medical history and physical examination, as these provide clues as to the underlying cause.

How is back pain treated?

Therapies depend on the cause of the pain and can range from performing physical therapy to taking medication to performing surgery. In general, drug and non-drug pain control should be used.

In general, the pain can be treated symptomatically with non-opioid analgesics such as ibuprofen, diclofenac, or naproxen.

Physiotherapy can also help, for example, to loosen tense muscles. For prevention, i.e. to prevent the recurrence of back pain, targeted training of the muscles and a back training should be carried out.

Osteoporosis should also be treated with mobilization exercises, physiotherapy and muscle strengthening on the one hand and, if necessary, medication with, for example, bisphosphonates on the other.

Read more on the topic: Mobilization of the thoracic spine

In the case of a herniated disc, early pain therapy is beneficial. It is also important that the person concerned moves, but without lifting heavily. In serious cases, such as severe motor failures, an operation must be performed.

Read more on the topic: Herniated disc surgery or treatment for a herniated disc

Whether vertebral body fractures have to be operated on depends on the stability of the spine.

The vertebral gliding is also treated through physiotherapy and strengthening the back and abdominal muscles. In addition, triggering sports such as artistic gymnastics should be avoided. It may be necessary to wear a corset temporarily. If the symptoms are severe and cannot be controlled by non-surgical therapies, an operation should be performed.

Consistent physiotherapy is also very important for Bechterew's disease. In the case of severe complaints, in addition to taking pain medication, it may also be necessary to take glucocorticoids (cortisone). In the case of particularly severe courses, treatment with so-called biologicals can become relevant. Biologicals inhibit the proteins in the body and thus counteract the autoimmune reaction.

Read more on the topic: Side effects of cortisone

In addition to physiotherapy to strengthen the muscles, a corset may be necessary for M. Scheuermann if the spine is severely deformed.

Arthritis in the course of inflammatory bowel disease is usually treated with drugs that suppress the immune system.

Scoliosis therapy depends on how much the spine is bent sideways. With a slight curvature, only physiotherapy is carried out. For more severe curvatures, a brace treatment and possibly an operation are possible.

Read more on the topic: Brace treatment for scoliosis

Duration of back pain

Although the symptoms of back pain can often be treated, there is a great risk that they will recur at some point. For example, lumbago is usually over after 1-2 weeks, but can often come back - especially without preventive measures. A herniated disc is also associated with frequent relapses.

Read more on the topic: How long does a lumbago last?

In autoimmune diseases such as Bechterew's disease, the aim of therapy is to delay the progression of the disease, as there is currently no cure. Therefore, symptoms of these diseases can occur again and again.

An M. Scheuermann can be treated well with early and adequate therapy and then usually does not lead to impairments in quality of life or performance.

Osteoporosis can only be reduced and not cured by therapy. The time it takes for a vertebral fracture to heal depends on the fracture itself.If the fracture is uncomplicated, the bone is usually firm again in weeks to a few months. In the case of more complicated processes, healing can take several months.

Read more on the topic: Duration of a vertebral fracture

Back pain - various localizations

Right back pain

One-sided back pain is often the result of an incorrect load and the resulting one-sided tension.

Shingles (Herpes zoster) can occur on one side in the area of ​​the back. Before the typical skin symptoms with blisters and reddening appear, there may be pain in this area days beforehand.

In addition, diseases of the internal organs on the right, such as the right kidney, gall bladder, liver, right intestine, right ureter, right fallopian tube or ovary, can lead to pain that radiates into the back. The kidneys often cause severe pain, which can usually be felt in the flank area. In this area, the person affected is often very sensitive to pain. Inflammation, cysts or stones in the kidney can be the cause. Kidney disease can be accompanied by problems and pain when urinating, and the urine can be bloody.

Read more on the topic: Kidney pain on the right side - causes and therapy

Pain in the right shoulder - especially after eating - may indicate stones in the gallbladder.

Read more on the topic: Therapy of gallstones

Inflammation of the right ovary or ovary can rarely cause lower back pain.

Read more on the topic: Ovarian Pain - These Are The Most Common Reasons!

In addition, appendicitis (appendicitis) in rare cases lead to right-sided back pain.

Pain in the left back

Left-sided back pain can also result from left-sided incorrect or excessive strain.

A herniated disc can also cause unilateral back pain. In addition to the pain, numbness often occurs on the left side.

Shingles on the left side can also be responsible for pain in a localized area on the back.

Diseases of the organs lying on the left side of the stomach, spleen, left intestine, left kidney, left ureter or left fallopian tube as well as the ovary can be accompanied by pain radiating to the back. Left kidney disease, such as pelvic inflammation, can cause pain on the left side of the flank. It is important to find a cause as it may be caused by bacterial inflammation and then antibiotic therapy must be given.

Inflammation of the left fallopian tube or ovary can also trigger severe pain that radiates to the lower back.

A gastric ulcer of the back wall of the stomach can also cause pain in the back, mainly on the left side.

Read more on the topic: Therapy of a gastric ulcer

If the pericardium is inflamed one speaks of one Pericarditis. Typically, the pain in pericarditis can be felt behind the breastbone or in the left chest, but it can also radiate into the left shoulder blade.

Back pain on both sides

Back pain on both sides can also be caused by tension in the back muscles.

Read more on the topic: Hollow back - you can do that about it!

Herniated discs, which occur particularly frequently in the lumbar spine area, can also cause bilateral pain, which is often accompanied by tingling or numbness.

Read more on the topic: Symptoms of a herniated disc lumbar spine

Wear and tear on the spinal joints can also lead to back pain on both sides.

In men, inflammation of the prostate can cause lower back pain. Since the prostate is in the middle of the pelvis, the pain can usually be felt on both sides.

Pain in the lower back

Lower back pain is very common and can affect all ages. Most of the time, severe, shooting and sudden pain in the lower back is a lumbago. This is caused by tension in the muscles or vertebral blockages.

A herniated disc, which most commonly affects the lumbar spine, can cause lower back pain with numbness. Vertebral fractures in the course of osteoporosis also often occur in the lower spine and can cause discomfort there.

The inflammatory rheumatic disease M. Bechterew is mainly associated with pain in the lower back.

A narrowing of the spinal canal (Spinal stenosis) can also cause lower back pain. Here the pain can radiate into the legs. The back pain usually increases when the back is bent backwards.

Read more on the topic: Symptoms of spinal stenosis

Back pain on inhalation

Tension in the back muscles or lumbago in the thoracic spine area can be accompanied by severe pain when inhaling.

Read more on the topic: Mobilization of the thoracic spine

There is often pain when breathing during a flu-like infection in which the lungs are also infected. Pneumonia can also be painful. On the one hand due to the overuse of the muscles by coughing, on the other hand due to accompanying pulmonary inflammation (pleurisy). This covers the inside of the chest and is very sensitive to pain. So if the lung membrane becomes inflamed, it is especially painful when you breathe in because it is stretched.

Read more on the topic: Signs of pneumonia

Accidents that cause bruises or even fractures of the back ribs or spine can also cause pain in the back when inhaling.

Read more on the topic: Bruised Rib - What To Do?

Deformation of the spine, such as scoliosis, can also cause breathing difficulties. The deformation means that the chest is no longer flexible enough, which leads to impaired breathing mechanics.

Back pain when eating

Back pain when eating can have various causes, but most of them are not in the back. For one, a pain in the right shoulder while eating or after eating is a sign of gallstones. These occur particularly often after high-fat meals.

Furthermore, pain in the back when eating can be caused by the so-called Abdominal angina to be triggered. This is arteriosclerosis of the arteries in the abdomen.

Read more on the topic: Circulatory disorder in the intestine

Another possibility is an ulcer in the back wall of the stomach, which can also trigger pain during or after ingestion, which radiates into the back.

Another important differential diagnosis is one caused by partial occlusion of the coronary arteries Angina pectoris. A Angina pectoris is also known as a heart. It is pain that can last for seconds to minutes and, in addition to chest pain, can also cause back pain, although it originates from the heart. Difficulty breathing is also typical here. Angina pectoris can occur after eating, especially after large meals. Since these complaints are based on serious illnesses, a doctor should be consulted so that adequate therapy can be given.

Read more on the topic: Symptoms of Angina Pectoris

Back and chest / chest pain

Chest pain, which can also be felt in the back, can be caused by intercostal neuralgia. This is an irritation of the nerves that run under the ribs. This can be triggered by various causes. These include spinal diseases but also herpes zoster.

If the pain occurs suddenly after physical exertion and is accompanied by shortness of breath, a heart attack (Myocardial infarction) can be excluded. Especially if you have pre-existing conditions such as arteriosclerosis, coronary artery disease, diabetes mellitus and other diseases that increase the risk of heart attack, a heart attack should definitely be considered as the cause of the pain.

Another life-threatening cause of severe, sudden pain in the back and chest can be a so-called aortic dissection, in which the inner vessel wall of the main artery tears. Typically, the pain is so severe that it is also referred to as annihilation pain. If they radiate into the back, they are mostly perceived between the shoulder blades. Urgent therapy is also required for this clinical picture.

Back pain when lying down

Tension in the back can increase when lying down, especially if you are lying on the spot that is painful, for example. On the other hand, pain when lying down can also indicate injuries to the bones, which should be considered especially after accidents.

If the pain occurs primarily at night and it is actually independent of the position, an M. Bechterew should also be considered. This is especially the case if the pain keeps recurring and is accompanied by other symptoms such as morning stiffness, fatigue, weight loss and fever.

Pain in the back when swallowing

Blockages or tension in the muscles in the cervical spine or shoulder muscles can be noticed by pain when swallowing. A herniated disc in the cervical spine can also make itself felt through pain in the cervical area when swallowing.

A spasm of the esophagus can be triggered by swallowing in addition to spontaneous occurrence. The cramp-like pain can radiate into the back.

Rarely, a tumor in the esophagus can be the cause of upper back pain.