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Thursday, November 9, 2017

Back Pain. When Does It Mean More Than A Back Problem?

Back pain is a very widespread problem: according to the research carried out by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) in 2010, about 80% of Americans experience a back pain at least once in their lifetime, while on a larger scale, up to half the world’s population suffers from different kinds of a backache. It varies from a dull and consistent (or chronic) to sharp and intense pain, that eventually takes away the capacity for free movement. Once, you take your favorite pair of good crossfit shoes, go to the gym and suddenly pierces you. 

There are lots of reasons, causing it: back pain can appear suddenly as a result of injury, a fall, an effort to lift a heavy weight – or progressively increasing and getting worse because of natural age-related spinal changes. Whatever the reason, we often take the problem carelessly hoping that it’ll get better on its own, which is the worst strategy ever. Remember that pain isn’t our enemy, on the contrary, it’s a friendly signal that keeps us out of trouble, saying that something’s wrong, so never ignore it.

In more than 80% of cases, the back hurts because of muscular overload, long periods of being in the same position (when sleeping, using a computer), hypothermia, or old injuries. But about 20% of people have back problems as a consequence of other serious health problems and diseases, beginning from infections and bladder disorder, ending with cancer.

Thus, severe pain in the middle back or in one of the sides can be caused by kidney stones, which, as a rule, require a professional treatment: some of them are usually broken with ultrasound or the lithotripter, and the bigger ones can be removed surgically only. The stones must be sent to the lab in order to find out the cause of its formation.

Lower back pain is also often caused by kidney infections that need to be urgently treated with antibiotics and painkillers. If unpleasant feelings in the abdomen are turning into a pain in the back, this may be pancreatitis (inflammation of the pancreas). In the case of a sharp pain – again, an immediate surgery is required. Back pain can be a symptom of pancreatic cancer, usually along with other symptoms like a rapid weight loss.

If your back pain is moving to the ribs and shoulders, it may be caused by infection or inflammation of the bladder or gallbladder. The consistent ache in the pelvic and back in combination with frequent urination is often a signal of cystitis (more common for women). Patients may need painkillers, antidepressants, and even surgery.

So, when does it mean more than just a back problem? When there are some other changes in the body:

  • fever & chills (of course, in this case, the back pain may be a consequence of the flu, but! an unresponsive fever “is indicative of something more synthetic”, says orthopedic surgeon Richard Guyer, MD, founder of the Texas Back Institute and Associate Clinical Professor of Orthopedics at the University of Texas Southwestern Medical School);
  • redness;
  • changes in body functions;
  • swelling;
  • weight loss (it can be caused by infections and even tumors, especially when it’s unexplained, rapid, and unexpected);
  • blood in the urine;
  • numbness or tingling in the legs (“You might think that you can stop numbness or prickly tingling with over-the-counter medication, but this is usually an indication of nerve irritation or damage and is clinically more significant than your typical pain”, says New York City chiropractor Todd Sinett in his book The Truth About Back Pain. If those feelings won’t go away, it may be a signal of a herniated disc or spinal stenosis);
  • light tapping of the spine is painful.
What Is The Referred (Reflective) Pain?

According to Dictionary of Medical Terms (4th edition) by A & C Black, referred pain (same as synalgia) is a pain which is felt in one part of the body but is caused by a condition in another part. So that when the back pain means more than a back problem, it’s a reflective or referred pain.

“The problem with assuming is that we often see people who have medical issues that are mistaken as only a spine issue, when it could be a medical issue on its own — or a combination of the two,” says physical medicine/rehab specialist Tagreed Khalaf, MD.

Always keep it in mind that our body is wired in such a way that any type of health problem affects almost all organs, as our body is a unified system. That’s the reason why a back pain often has nothing to do with back problems, but actually, can deal with:

  • various urinary infections (chlamydia, ureaplasma etc.);
  • intestinal diseases, as well as problems with G.I.;
  • hemorrhoids;
  • cancer;
  • complications of a cold or flu;
  • radiculitis.
Unfortunately, most often, people ignore a backache until it begins to bother to live their usual lives. And that’s the real problem, as the more severe pain you have, the more serious stage of the disease is (and, of course, it’s more difficult to treat it).

Spinal Problems

Spinal issues also belong to the back problems group, usually they manifest themselves in lower back pains, but however, they can be extremely serious as well, so we cannot but mention them. If your ache is constant and strong, you’d better visit a doctor to exclude (or to confirm) the possibility of such spinal problems:

  • various spinal defects, including spina bifida;
  • the processes of the vertebrae are deformed (longer or shorter than normal);
  • osteoporosis;
  • arthrosis;
  • a pinched nerve;
  • spinal disc herniation;
  • spasm;
  • sclerosis.
The Most Frequent Referred Back Pain Reasons

Usually, back synalgia happens as a result of such health problems:

  • Appendicitis – You can feel the ache either only in the right side or somewhere further back, so that it’s hard to determine where is the exact location of the pain.
  • Problems with the intestine – Intestinal cancer, intestinal obstruction, irritable bowel syndrome, peptic ulcer etc.
  • Cholecystitis – An inflammation of the gallbladder, a small organ that plays a part in digesting food.
  • Pancreatitis – In this case, you’ll fill the ache all over your lower back.
  • Adhesions – They usually appear after a surgery, and may cause pain in different areas, including the back (when the adhesions are forming near the abdominal organs).
  • Kidneys problems – Back pain is a very common symptom of various kidney diseases. In this case, the pain is localized mainly in the side with the ill kidney. If the disease is systemic, the pain is vague and rather strong.
  • Infections – Some infections (like the urogenital system infection or intestinal infection) cause the back pain which is both a symptom and a consequence. So, with an intestinal infection, the lower back often hurts, and the pain is quite strong and constant so that it spreads all over the waist area.
  • Tumors – In cases of both benign and malignant tumors, back pains may arise, indicating the possible growth of the formations.
Women’s Referred Back Pain

Very often the gender plays a huge role in revealing the cause of back pain. It is a direct symptom of several female illnesses:

  • Gynecology-related – Inflammation of appendages or a common cold, which can be accompanied by severe pain in the lower abdomen, reflecting on the lower back.
  • Pregnancy – The pressure on the spine becomes much stronger and therefore women often complain about the pain in the lower back, which obviously causes great discomfort. Unlike the previous one, this reason is almost harmless. Nevertheless, back pain during pregnancy can indicate a premature birth, but in this case, there will also be other, more specific symptoms.
  • Climax – Because of the imminent serious changes in the woman's body, back pain can arise as one of the symptoms of menopause.
  • External factors impact – Rather often women’s back pain can be just a sign of stress, depression, lots of pressure, fatigue.
  • PMS – Virtually all women complain about lower back pain a few days before and during the first days of menstruation.
Men’s Referred Back Pain

There are several specific reasons that can cause back pain in men:

  • The heavy physical workload on the male body, overloading, stretching of the muscles.
  • Prostatitis – swelling and inflammation of the prostate gland.
  • Epididymitis – an inflammation of the epididymis, a tube near the testicles that stores and carries sperm.

Mostly, men tend to endure pain and go to the doctor only if it becomes impossible to stand it. In this case, you should realize that the longer you bite the bullet, the more difficult and longer it is to treat your illness.

Classification or Variety of Pain

There exist lots of different back pain classifications, but the most substantial one distinguishes two main forms of it: constant and acute back pain. The first kind usually says about gradual, sustained changes in the body (like dystrophy), signals about spinal injuries, or may warn of possible cancer, osteomyelitis, and other serious diseases. The second one deals with regular temporary “shots” of ache, which can be the symptom of strained muscles, spinal disc herniation, nephritis, PMS, and hundreds of other “non-relevant” illnesses.

Constant back pain

When the back pain is constant, getting worse and continues for more than 4-6 weeks, it may indicate such illnesses:

  1. Cancer (a tumor near the spine) - the pain doesn’t depend on the position or activity, getting worse at night and when pulling weights.
  2. Spinal infections - tuberculosis, osteomyelitis, syphilis and other diseases.
  3. Myalgia (a chronic inflammation of muscle tissue).
  4. Ankylosing spondylitis - long term back pain accompanied by prolonged morning stiffness (more common for men).
Acute back pain

Sharp, severe, and unexpected pain attacks also be an indicator of a serious disease:

1. In the lower back

This is the most popular location of acute back pain – lower back pain is the reason to visit a doctor (finally!) for many. It doesn’t disappear, regularly showing up at the worst possible time. It can be caused by totally back problems:

  • hyperextension of the muscles (you’ll feel a strong, piercing pain, blocking your movements, that’s not going to pass as soon as you want)
  • fracture (the pain is so strong that a person’s not able to move, as any effort of doing a motion provokes even more painful attack)
  • deviation column or displacement of vertebrae (the pain is acute, harsh, and restricting the movement so that the person is forced to stay in the same position)
  • abscess, facet syndrome.
  • Acute pain in the lower back says about such “irrelevant” health problems: kidney stones, intestinal issues, urinary tract, cyst breakout (for women), pyelonephritis, pancreatitis aggravation, gallstones, myocardial infarction, esophagus break, aortic aneurysm.
2. In the blades area

Pain is a warning signal of possible osteomyelitis, benign tumors and blade sarcomas, myocardial infarction.

3. Under the left blade

This one also is an indicator of myocardial infarction, ruptured peptic ulcer.

4. Upper back pain

Acute pain in this area may be caused by pneumothorax, pleurisy, lung cancer and many other serious diseases, which require urgent treatment.

Is It Physical or Mental?

In addition to the reasons described above, the physical pain (especially, in the lower back) doesn’t necessarily have (only) physical causes, but can also be caused by psychological factors. Mental reasons of pain are scientifically proven and recognized by modern medicine. Doctor John Sarno explains in his book Healing Back Pain: “It is an interesting fact that the overwhelming majority of emotional and mental activity occurs below the level of consciousness. The human mind is something like an iceberg. The part that we are aware of, the conscious mind, represents a very small part of the total. It is in the subconscious mind that all of the complicated processing goes on…… This condition begins and ends in the unconscious.”

How to Prevent?

In order to avoid back pain or at least ease it, following a healthy lifestyle is the first thing to do. It includes a complex of daily actions and habits aimed at improving your physical condition, but the essential issues are a balanced diet and doing exercises regularly.

Thus, if you exercise 20 minutes a day (at home, on the street, at the gym, whatever), you will strengthen your back muscles well. If you don’t eat too many high-fat products, you can avoid G.I. problems, which often cause different illnesses, including back pain.

In addition, never forget to visit a doctor at least once a year, even if you feel perfect and it seems like nonsense.

Final Word

Constant back pain is a good reason to visit a doctor because you can’t determine exactly if it’s just a back problem or a symptom of some other, more serious and dangerous disease. Without timely investigation and treatment, it may lead to serious consequences. Better safe than sorry, right?