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old man bad back Stock-Fotografie und Bilder. Oder starten Sie eine neue Suche, um noch mehr Stock-Fotografie und Bilder zu entdecken.mature man with bad back - old man bad back stock-fotos und bildersenior man with bad back - old man bad back stock-fotos und bildermature woman drying man's bare back, side view - old man bad back stock-fotos und bildersenior couple in bath together washing women back - old man bad back stock-fotos und bilderJohn, an old man who lives alone in $50- a month apartment in east Denver, lies back in his bed. Like many of the resi-dents of his neighborhood,...Man rides a horse around the fire, as rubbishes are set on fire which is believed to burn and end all of the problems, during the Kosa play within...Man performs near a fire, as rubbishes are set on fire which is believed to burn and end all of the problems, during the Kosa play within Nowruz...Man dressed up as the Green Kosa, who is believed to prevent famine and unhappiness and bring plentifulness and happiness for the whole year in case...Man dressed up as the Green Kosa, who is believed to prevent famine and unhappiness and bring plentifulness and happiness for the whole year in case...Man dressed up as the White Kosa, who is chased and challenged to be kicked out of the house by the Green Kosa to prevent famine and unhappiness and...Man dressed up as the Green Kosa, who is believed to prevent famine and unhappiness and bring plentifulness and happiness for the whole year in case...Man dressed up as the White Kosa, who is chased and challenged to be kicked out of the house by the Green Kosa to prevent famine and unhappiness and. ..Man dressed up as the Green Kosa, who is believed to prevent famine and unhappiness and bring plentifulness and happiness for the whole year in case...Local man poses for a photo during the Nowruz in Igdir, Turkey on March 20, 2017. International Nowruz Day, which marks the first day of spring and...Man reads the Holy Qur'an near a grave during the day of the dead stage of Nowruz in Igdir, Turkey on March 20, 2017. International Nowruz Day, which...Man gestures near a grave during the day of the dead stage of Nowruz in Igdir, Turkey on March 20, 2017. International Nowruz Day, which marks the...John, an old man who lives alone in $50- a month apartment in east Denver, lies back in his bed. Like many of the resi-dents of his neighborhood,...This combination of pictures created on September 6, 2019 shows Zimbabwean telecom engineer Farayinesu Madzimure Zimbabwean kindergarten helper Rita...Qarsim Alum-Zadam in Gosford hospital after his fail.Mr. Qarsim Alum-Zadam can think of only one explanation for his terrible run of bad luck. "I must...Mrs. Josephina Pulitano, mother of the murdered man .. "Things are bad when your children go out at night and they don't come back."John Pulitano... von 1

Low Back Pain Causes, Symptoms, Diagnosis, Treatments

All ConditionsBack Pain

The Universal Guide to Low Back Pain: Everything you ever wanted to know, straight from the experts.

Darcy Lewis

Richard D. Guyer, MD

Chairman, Texas Back Institute Research Foundation

Medical ReviewerRichard D. Guyer, MD

If you’ve ever had low back pain stop you from doing what you want, you’re not alone. It’s a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Disease—a significant study published in the Lancet medical journal—lower back pain is also a leading cause of disability.

You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.

Low Back Pain Causes

The most common causes of low back pain include:

Spasms, sprains and strains. Ligament sprains and muscle or tendon strains are the most common causes of lower back pain. They’re often related to overuse.

Degenerative disc disease. While the name sounds worrisome, it just means you have a damaged disc causing pain. Over time, discs become thinner and flatter due to wear and tear. That leaves them less able to cushion the vertebrae and more likely to tear (see below).

Herniated disc. The protective covering on intervertebral discs can tear over time. When this happens, the soft inner disc tissue may push through the outer layer. A disc that bulges or slips out of place is known as a herniated disc, bulging disc, or slipped disc. The herniation may press on nerve roots, leading to symptoms such as pain, tingling, numbness or weakness in the area that the nerve serves.

Sciatica. Pain that results from a pinched or irritated sciatic nerve. This nerve runs down your lower back through your hips and buttocks and down each leg. Sciatica is how laypeople refer to pain that travels down the leg from the lower back, although your doctor may use the term lumbar radiculopathy.

Spondylolisthesis. A vertebra slides forward out of position, disrupting your spine’s alignment and sometimes compressing nerve roots. It is most common in the lumbar region, but can happen anywhere along the spine. This slippage is often caused by either disc degeneration or a fractured vertebra (pars fracture or spondylolysis).

Spinal stenosis. A narrowing of the inside spaces of your spine, most often from a herniated disc but sometimes from bone spurs caused by spinal osteoarthritis (aka spondylosis). This can result in painful pressure on your spinal nerves. Spinal stenosis can occur in anywhere in the spine, but lumbar spinal stenosis is the most common.

Scoliosis and other spinal deformities. Scoliosis, the most common spinal deformity, is one or more a side-to-side curves to the left or right. Other abnormal curves include:

  • Lordosis, in which the spine curves too far inward at the lower back

  • Kyphosis, in which the spine is abnormally rounded in the upper back

Normal and abnormal curves of the spine

Arthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include spondylosis (the most common by far), rheumatoid arthritis, and ankylosing spondylitis.

Less common causes can include:

Cauda equina syndrome. Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. Cauda equina syndrome is an emergency. The condition got its name from the fact that the fanned-out bundle of nerves resembles the base of a horse’s tail.

Discitis or osteomyelitis. Both infections of discs (discitis) and vertebral bone (osteomyelitis) can cause severe pain and require prompt medical attention.

Osteoporosis. Your bones lose mass faster than it can be replaced, making them brittle. They can even fracture with little or no warning. These fractures are especially common in the spine, where they're called vertebral compression fractures. Both men and women lose bone mass as they age, but postmenopausal women lose it much faster and so are more at risk for osteoporosis.

Spinal tumors. When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning they’ve spread from somewhere else in the body.

Low Back Pain Symptoms

Low back pain symptoms—and treatment—can vary based on the underlying cause.

Symptoms occurring with low back pain can include:

Low back pain can be categorized as acute, subacute or chronic. Acute episodes of lower back pain usually last from a few days to 4 weeks and subacute lower back pain lasts between 4 to 12 weeks.

According to the National Institutes of Health, about 20 percent of people with acute back pain go on to develop chronic back pain—defined as pain that lasts 12 weeks or longer. Most cases of back pain go away on their own within two weeks.

When to Seek Medical Attention for Back Pain

Most episodes of lower back pain eventually resolve on their own, but there are times when you should seek urgent medical attention. Some of these situations include:

  • Patient is a child

  • Accident, injury, other trauma

  • Fever or nausea

  • Weakness, numbness and/or tingling sensations develop in the legs and/or feet

  • Loss of bladder or bowel control

  • Pain is severe, constant, suddenly or progressively worsens, and/or doesn’t go away

  • Pain interrupts sleep

While some situations may warrant immediate intervention, most cases are not urgent and can be scheduled at a time convenient for the patient.

Low Back Pain Diagnosis

Getting diagnosed with a specific cause of low back pain is the first step to getting treatment. If you land in your doctor’s office hoping for back pain relief, they’ll use a variety of diagnostic tools and methods, such as:

  • A thorough medical history including any recent injuries, other diagnoses, family history of disease, and your job, activities and other lifestyle considerations

  • Physical exams, which may include manipulating the painful area or reflex or other neurological tests

  • Electromyography, which measures muscle and nerve function

  • Imaging—X-rays can show bone spurs and damage to bone, while CT scans and MRIs can depict damage to soft tissue like discs or ligaments

Low Back Pain Treatment

Home Remedies

Unless you’ve had a major injury, such as a fall or car accident, you probably don’t need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.

Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain – and recovered more slowly ­– than patients who stayed fairly active

Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you don’t injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury; then you can try a combo of ice and heat.

Try over-the-counter (OTC) remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.

Nonsurgical Treatments

Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.

Medications. When over-the-counter pills and topicals don’t do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:

  • Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain

  • Muscle relaxants, such as baclofen or carisoprodol

  • Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen

  • Opioids such as oxycodone or hydrocodone, on a short-term basis. (For a variety of reasons, opioids aren’t good long-term options for many patients.)

Physical therapy (PT). PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:

Injections. An epidural steroid injection or a selective nerve block may provide short-term pain relief when lower back pain causes sciatica symptoms, such as leg pain.

Low Back Pain Surgery

Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:

Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spine’s stability in severe cases of spinal osteoarthritis or herniated discs.

Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.

Discectomy and microdiscectomy. When a herniated disc in the lower back is causing severe symptoms like pain or loss of sensation, your surgeon might operate to remove a portion of the damaged disc. When the surgeon operates through standard incisions in your back, the surgery is known as a discectomy. When the surgeon uses a minimally invasive technique and small incisions, the surgery is called a microdiscectomy. Discectomies are rarely performed anymore due to the safety, effectiveness, ease and low rate of complications that microdiscectomy brings to the table.

Complementary, Alternative, Emerging Treatments

In some cases, doctors suggest therapies that are not considered current “standard of care.” They probably won’t be covered by insurance, but they may be worth considering. Examples include:

Platelet-rich plasma (PRP). PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints.

PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.

Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.

Acupuncture. Your doctor probably doesn’t perform acupuncture (some do), but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.

Chiropractic care. More than 50 percent of people with acute lower back pain see a chiropractor, a healthcare provider who specializes in spinal manipulation. Look for one that uses evidence-based techniques.

Prevalence of Low Back Pain: Spine. (1987.) “Descriptive epidemiology of low-back pain and its related medical care in the United States. ” https://pubmed.ncbi.nlm.nih.gov/2954221/

Global Burden of Disease: Lancet. (2012) Years lived with disability (YLDs) for 1160 of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)61729-2/fulltext

Lower Back Pain Causes: Johns Hopkins Medicine. (n.d.) “Lower Back Pain: What Could It Be?” https://www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/lower-back-pain-what-could-it-be

Pain Definitions: National Institute of Neurological Disorders and Stroke. (April 27, 2020). “Low Back Pain Fact Sheet.” https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Degenerative Disc Disease: Cedars-Sinai.org. (n.d.) “Degenerative Disc Disease.” https://www.cedars-sinai.org/health-library/diseases-and-conditions/d/degenerative-disc-disease. html

Strains and Sprains: American Association of Neurological Surgeons. (n.d.) “Low Back Strain and Sprain.” https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Strain-and-Sprain

Sciatica: Mayo Clinic. (August 1, 2020.) “Sciatica.” https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435

Spondylolisthesis: American Academy of Orthopaedic Surgeons. (n.d.) “Adult Spondylolisthesis in the Low Back.” https://orthoinfo.aaos.org/en/diseases--conditions/adult-spondylolisthesis-in-the-low-back/#:~:text=In%20spondylolisthesis%2C%20one%20of%20the,ranges%20from%20mild%20to%20severe

Spinal Stenosis: Mayo Clinic. (n.d.) “Spinal stenosis.” https://www.mayoclinic.org/diseases-conditions/spinal-stenosis/symptoms-causes/syc-20352961

Arthritis: Arthritis Foundation. (n.d.) “When Back Pain May Mean Arthritis.” https://www.arthritis.org/health-wellness/about-arthritis/where-it-hurts/when-back-pain-may-mean-arthritis

Osteoporosis: Arthritis Foundation. (n.d.) “Osteoporosis.” https://www.arthritis.org/diseases/osteoporosis

Spinal Tumors: American Association of Neurological Surgeons (n.d.) “Spinal Tumors.” https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Spinal-Tumors

Bed Rest for Low Back Pain: Cochrane Database of Systematic Reviews. (2010.) “Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica.” https://pubmed.ncbi.nlm.nih.gov/20556780/

Acupuncture for Low Back Pain: National Center for Complementary and Integrative Health. (2016.) “Acupuncture: In Depth.” https://www.nccih.nih.gov/health/acupuncture-in-depth

Epidural Injections: Spine Journal. (2015.) “Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?” https://pubmed.ncbi.nlm.nih.gov/26096484/

Platelet-Rich Plasma: Journal of Spine Surgery. (2018. ) “Platelet-rich plasma injections: an emerging therapy for chronic discogenic low back pain.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911760/#:~:text=The%20clinical%20studies%20that%20used,not%20cause%20any%20major%20complications.

Stem Cell Therapy: Current Pain and Headache Report. (July 29, 2019.) Stem Cell Therapies for Treatment of Discogenic Low Back Pain: a Comprehensive Review. https://pubmed.ncbi.nlm.nih.gov/31359164/

Lower Back Pain Prevention: National Institute of Neurological Disorders and Stroke. (April 27, 2020). “Low Back Pain Fact Sheet.” https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Notes: This article was originally published October 28, 2009 and most recently updated September 12, 2022.

Darcy Lewis

Darcy Lewis is an award-winning Chicago writer who specializes in health and medicine. She is a recent Association of Health Care Journalists National Cancer Reporting Fellow who also writes about orthopedics, diabetes, and pain management. See her work here.

Richard D. Guyer, MDChairman, Texas Back Institute Research FoundationTexas Back Institute

Dr. Richard Guyer is Co-founder of the Texas Back Institute and Director of their Spine Fellowship Program. Dr. Guyer is Co-director of the Center for Disc Replacement at Texas Back Institute and was instrumental in bringing artificial disc replacement surgery to the United States after its creation and use in Europe. He is founder of the Texas Back Institute Research Foundation (TBIRF) and Chairman of the Board for the program. Also, Dr. Guyer is Associate Clinical Professor of Orthopaedics at the University of Texas Southwestern in Dallas.

Why do people have so many back problems

Why is scoliosis unique to humans, what causes problems most often in the lower part of the spine and how to increase the flexibility of the lumbar? The answers to these questions can be found in the book "Health according to Darwin" by Professor of Medicine Jeremy Taylor, an excerpt from which is given by the science department of Gazeta. Ru.

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What is our spine? Is it really, as some evolutionists claim, a hastily redesigned, imperfect design designed to serve the main purpose of freeing our hands? Discussing this issue with many orthopedic surgeons and comparative anatomy specialists has convinced me that a more subtle approach is required and that the human spine has been (largely unfoundedly) maligned by evolutionary anthropologists. Take, for example, back pain. John O'Dowd, a consulting orthopedic surgeon at London's St Thomas' Hospital, does not dispute the fact that low back pain is truly a worldwide epidemic, but explains the medical complexity of the situation. The problem is that spinal injuries may not be accompanied by low back pain, and vice versa, low back pain may not be accompanied by obvious signs of pathology. Many studies show that low back pain is equally common in people with both normal and diseased spine. The source of the pain may be in some muscle or ligament that is difficult to see with MRI or other diagnostic methods, or, as O'Dowd points out, the pain may be not so much the back as the brain is responsible for the pain. Although true psychosomatic back pain is rare, a psychological factor can also play a role. Imagine that you live with a partner who has to take care of you year after year because you have a bad back. One day you go to the doctor and he tells you that you don't have any back problems.

Your relationship with your partner will be in jeopardy.

In the same way, people "know" what their spine scan will show before they get one, because they know what they need to see to justify their back pain. The worst thing for these people is to see that their back is completely normal!

O'Dowd believes that the human spine is excellent for vertical loading. In most people, it performs its functions perfectly for eighty years or more and retains its strength, flexibility and elasticity even with significant damage. According to O'Dowd, the spine is a real miracle of natural engineering. Comparative anatomists tend to agree with him and, remarkably, argue that there is nothing special about the upright human spine and many of the problems we face are just as common in tetrapods.

One of the major evolutionary innovations in the human spine is its S-shape with physiological lordosis in the cervical and lumbar regions and physiological kyphosis in the thoracic region. Most hypotheses explain this bending by saying that it is necessary to maintain an upright position. But if you think about it, a rigid vertical rod would make it much better. Mike Adams, professor of comparative anatomy at the University of Bristol, believes the secret to the S-curve is its ability to absorb shock loads. S-bends are excellent at resisting compression, which in a very rigid, straight-line structure would create enormous stresses. With every step we take, these curves act like a spring. They are constantly in a state of elastic tension and easily absorb impact energy. But such a spring-like deformation of the spine is possible only to a limited extent: powerful muscles that run along the entire spine - the rectifiers of the back (paraspinal muscles) do not allow these bends to compress and stretch too much.

Of course, the S-shape can lead to problems. People with "round" and hunchbacked backs are legion. More often, problems occur in the lower back - in the lumbar region. As a rule, this is due to compressive load - a vertical force that acts on the spine perpendicular to the intervertebral discs. This load is partly created by the earth's gravity, so it is greater in the lower part of the spine than in the upper part. But it is also created by the effort of the paraspinal muscles, which are always in tension to keep us upright. They generate the same compressive load as gravity, especially when we lift a significant load.

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The human spine is adapted to a certain extent to cope with this load. Our lower vertebrae are larger and more powerful than our upper vertebrae, and since the load is characterized by force per unit area, the compressive load remains the same at any point along the spine. Based on this, Mike Adams argues that most often the pathology of the lower spine is caused not by compression, but by flexion.

Donal McNally, professor of anatomy at the University of Nottingham, agrees and adds that quadrupeds have no less muscle contraction of the spine than we do upright. Imagine a cheetah hunting a gazelle. Instant acceleration, extreme speed, sharp turns and jumps make the paraspinal muscles work to the limit, creating huge loads on the spine. Spasm of these paraspinal muscles can be extremely powerful and destructive. For example, pigs raised for bacon have massive back muscles.

Sometimes in the slaughterhouse, due to improper application of electric shock, these muscles contract in such a violent, lethal spasm that they even crush the vertebrae (their splinters are often found in meat).

Even in humans, these muscles are so strong that, during an epileptic seizure, their convulsions can lead to compression fractures of the vertebrae.

Although it may seem surprising, changing the position of the spine from horizontal to vertical did not actually affect the compression loads that the spine is subjected to due to muscle action. For example, the lumbar region of a man, when lifting a load, experiences an average compressive load of about two thousand Newtons, of which only three hundred Newtons are accounted for by the weight of the head, shoulder girdle and chest, pressing down. The human spine is loaded in exactly the same way as a tetrapod, says McNally, and the transition to an upright posture did not change its original “design” and characteristics that much. In fact, McNally notes, humans are uniquely adapted to reduce this muscular load on the spine by significantly flattening our bodies anteroposteriorly (compare our rib cage with the round barrel rib cage in gorillas), which can significantly reduce bending moments.

What evolution has really given us, McNally explains, is a plastic musculoskeletal system that can change over time—functionally rearrange itself to cope with the stresses placed on it. Our muscles, bones, and soft tissues become stronger when constantly put to work. This is one of the reasons why back pain is not a particular problem for people whose jobs involve regular heavy lifting. Their back is rebuilt to successfully cope with such loads. The so-called “weekend soldiers” who on Sunday decide to dig up the entire garden or perform other labor feats in the garden are much more at risk in this regard.

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As McNally points out, many of the spinal problems that humans experience are similarly found in quadrupeds, especially "sporty" animals like horses and hounds, and long-lived animals. Thanks to improvements in veterinary care over the past few decades, the number of elderly animals has increased significantly. In chondrodystrophic dog breeds that have impaired cartilage formation, such as dachshunds, Pekingese, Beagles and poodles, early disc degeneration is a systemic disease and can begin as early as one and a half years of age, and even non-chondrodystrophic dogs, such as shepherds, retrievers, Labradors and Dobermans, by the age of eight, already often suffer from disc degeneration.

We blame evolution for all our spinal problems, says Mike Adams, because of its stinginess. She gave us little room for error. We have developed massive lumbar vertebrae with thick shock-absorbing intervertebral discs that are highly elastic and resistant to injury. In fact, they are much more reliable than the artificial prostheses that orthopedic surgeons use to replace damaged discs. The problem is that once these discs are damaged, they are almost unrepairable. The intervertebral discs are virtually devoid of blood supply, since no blood vessels could withstand the colossal compressive loads. The situation is exacerbated by the very low density of cells in the cartilage tissue. Due to the lack of a good blood supply that would stimulate the formation of new cells at the site of injury, the discs are almost unable to recover, and degenerative processes begin in them. Not only did evolution provide us with the most complex "disposable" mechanism, but also our culture does not contribute to the correct handling of this mechanism. In Western society, we deprive ourselves of flexibility in the spine, especially in its lumbar region. We sit on chairs all day and lose our mobility. For comparison, Adams cites representatives of African and Indian tribes, who move a lot and often squat.

As a result, even in adulthood, they retain the same mobility of the spine as in childhood.

When you have a flexible lower back, your discs remain bouncy and resilient and are much harder to damage when bending and twisting. But, if you lose that mobility, any flexion puts significant strain on your spine, leading to weekend soldier syndrome.

Traumatic behavior of discs helps explain the global back pain epidemic. Healthy discs simply cannot feel pain. Since they are shock-absorbing pillows that take on all the compressive load on the spine, they are not supplied with either blood vessels or nerves. But when the vertebrae slip or herniate, radial cracks can form in the disc, through which blood vessels and nerves begin to grow inside it. As a result, vital molecules that are responsible for disc hydration can begin to be washed out, as well as immunological factors that cause local inflammation can enter the disc. It is this inflammation that causes pain.

Also, we are not designed to stay upright for very long periods of time, as is often the case today. The fact is that in this position, the load is concentrated on the back of the intervertebral disc and the vertebral arch. When we stand upright, much of the load is transferred through the small, fragile apophyseal joints at the back of the vertebrae. It is known that old people become noticeably smaller in stature. This is largely due to the fact that disc degeneration leads to a reduction in the distance between the vertebrae and increases the load on the vertebral apophyses. In young people, these apophyseal joints account for less than 10% of the total compressive load on the spine, but by the age of 50 this load increases to 20–30%, especially with lordotic posture. With flattening of the intervertebral discs, up to 90% of all compressive load. This leads to significant bone remodeling, excessive growth of bone formations (osteophytes) and osteoarthritis.

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But evolution has tried to compensate for these shortcomings with a significant advantage. It endowed our skeleton with the ability for rapid and significant adaptive remodeling. On the one hand, Andy Murray or Roger Federer's punching arm has 35% more bone mass than yours or mine; on the other hand, if you spend six months in bed, your bone mass will decrease by 15%. Adaptive remodeling allows our bodies to increase bone mass when needed and conserve valuable resources by reducing bone mass when not needed. It is this ability to rebuild muscles and bones that is one of the reasons why superathletes like Usain Bolt are now able to set new world records far beyond those of their predecessors—the human body has not yet reached its limits.

While I think we should be reasonably skeptical of Bruce Latimer's bleak view of the health of the human spine, there are three serious problems unique to man and his ancestors that our upright posture is largely responsible for.

These are osteoporosis, pregnancy and childbirth and scoliosis.

Osteoporosis is a complex metabolic and hormonal disease, but there is also a biomechanical factor involved. Bones are made up of two types of tissue: cortical tissue (hard and dense) that forms the outer part of the skeletal structures, and spongy or trabecular tissue that forms the inner part of the bone and is a network of many thin bony septa called trabeculae. In humans, the size of the vertebrae increases as we move from the neck to the pelvis, we also have a very large calcaneus. But, despite the larger size of the lower vertebrae, they are less dense and have much more spongy tissue and much less cortical tissue than similar vertebrae in tetrapods. The necks of our long bones—the narrow isthmuses between the bony body and the articular part that articulates the bone with other structures—have a similar structure. When force is applied to cancellous bone, it flexes, making it an effective shock absorber.

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But the same characteristics of cancellous bone that allow it to absorb shock well also make it more likely to develop osteoporosis. Thin, long, and sparsely spaced trabeculae make the bone firm and flexible, but at the same time create other problems. Spongy bones are living, dynamically changing structures, as special mobile cells called osteoclasts constantly consume bone tissue, thinning and reducing the number of trabecular septa. Thus, the giant inner surfaces of large trabecular bones have significant potential for remodeling—changes in density—in response to signals from the rest of the body. One such signal is the amount of stress the bone receives regularly. Although, as Mike Adams points out, today this issue has divided scientists into warring camps, the key idea is that the weakening and limited use of muscles as we age reduces the stress on our bones.

In the absence of habitual loads, the bones begin to get rid of excess density in order to become lighter.

One of the key principles of evolution operates here - "what is not used is lost." Eventually, bones can become so brittle that an elderly person only needs to slip on a banana peel and fall from their height to sustain a severe, potentially life-threatening fracture.

⚕ Which doctor treats the back and spine❓

The latest statistics show that more than half of the adult population of the Earth (over 25 years old) periodically suffer from discomfort and back pain. What kind of doctor treats the back if the pain is constant and dull or has a sharp, excruciating character? Which specialist should I contact if I have back problems? This article is dedicated to answering these questions.

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Symptoms of diseases of the back

An alarming sign, in which it is necessary to consult a therapist first of all, should be not only severe pain in the back, spine or lower back, but also unpleasant, uncomfortable sensations after physical exertion, prolonged stay in one position or after sleep.

Causes of back pain:

  • pathologies of the spinal column;
  • diseases of the respiratory system, heart and blood vessels;
  • pathology of the pelvic organs;
  • kidney disease;
  • oncological lesions;
  • overweight;
  • hypothermia;
  • incorrect body position during sleep;
  • sleeping on a poor-quality mattress;
  • hypodynamia.

Back pain often accompanies physiological conditions such as pregnancy, pain in the back muscles after significant physical exertion, long stay in one uncomfortable position, etc. Painful symptoms, as a rule, disappear after the cause of the unpleasant condition is eliminated.

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Symptoms of diseases of the back and spine:

  • dizziness and headache;
  • pain after walking;
  • heart pain (with normal ECG), etc.;
  • digestive problems;
  • numbness, sensory disturbance in arms or legs;
  • inability to painlessly straighten the back;
  • shootings in the upper and lower extremities, limitation of movements;
  • stiffness of movements and pain in the cervical region;
  • back pain that occurs after exercise and is localized in the thoracic and lumbosacral regions;
  • back pain after a long static posture (prolonged work in a forced position, long sitting, etc. ).

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Pain can be of varying severity, may be severe, aching, acute, constant or variable. The nature of the pain (pressing, pulling, tingling or cutting) depends on the cause that caused it.

Pain in the back can be primary, which is caused by dystrophic and other pathological changes in the structures of the spinal column, muscles, ligaments and tendons, or secondary, caused by trauma, an infectious agent, a tumor, or other disorders.

In the modern world, such a disease as osteochondrosis, which is characterized by accelerated wear and premature aging of the bone apparatus, has become very "younger".

Each type of osteochondrosis has its own symptoms:

  • cervical region - dizziness and headaches, blurred vision, hearing loss, tinnitus, hoarse voice, snoring, numbness of the hands, crunching when turning the neck, constant feeling of heaviness and aching pain in the neck, tingling in the hands;
  • chest - "heart" pain, pain when bending over, during inhalation and exhalation, shortness of breath, a feeling of heaviness in the chest and back;
  • lumbar - acute or dull pain in the lower back, cold feet syndrome, sweating disorders, foot cramps, menstrual irregularities and erectile dysfunction.

Early treatment of the spine is very important for a successful recovery. So, with the progression of osteochondrosis, the destruction of the cartilaginous tissue of the spinal column is observed, which can no longer be restored in the later stages of the disease.

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Diseases of the back and spine

Dorsopathy is a group of pathologies of the musculoskeletal system, the main manifestation of which is back pain, which can radiate to the head and extremities. Dorsopathies include inflammatory, degenerative-dystrophic, post-traumatic, genetically determined changes in the spinal column.

The most common diseases of the back and spine:

  • Kyphosis
  • Lordoz
  • Scoliosis
  • Osteoporosis
  • Spondylosis
  • Spondylarthrosis
  • Lumbalgia
  • Sciatica
  • Herniated disc
  • Spinal stenosis
  • Spinal protrusions
  • Destruction of the spinal column
  • Osteochondrosis of the spinal column
  • Tuberculosis of the spinal column, etc.

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Initial visit to a therapist

If you have a question about which doctor treats your back effectively, quickly and safely, the first thing to do is to contact a therapist. After the initial examination and examination, the doctor will refer you to a narrow specialist who is engaged in the diagnosis and treatment of specific diseases of the back, spinal column or internal organs. To exclude pathologies from the kidneys and urinary system, consultations with a nephrologist and urologist may be prescribed.

Spine specialist is a back doctor who specializes in the diagnosis, treatment and prevention of diseases of the spine. Most often, a vertebrologist is treated with problems of intervertebral discs, postural disorders, scoliotic changes in the spine, instability of the segments, and functional changes in the spinal column.

The vertebrologist seeks to choose the most optimal option for non-surgical treatment of the spinal column. The success of the ongoing conservative treatment, or the determination of objective indications for surgical intervention, depends on the qualifications and experience of the vertebrologist.

Allied specialists for the treatment of the spine

Treatment of the spine and a number of diseases of the musculoskeletal system is carried out by a neuropathologist, chiropractor, orthopedist or osteopath.

Back pain can be symptomatic of a range of neurological conditions. The main task of a neurologist is to exclude malignant tumors (tumors of the vertebrae, multiple myeloma, etc.), traumatic pain, metabolic disorders (osteoporosis), and some infectious diseases.

Neurologist must take into account the pathologies that may be a reflection of back pain, and manifested in diseases of the heart and blood vessels (pericarditis, heart attack, coronary heart disease, aortic aneurysm), pathologies of the respiratory system (pneumonia, pleurisy), diseases of internal organs and urinary tract (peptic ulcer, pancreatitis, cholecystitis), infectious diseases (infective endocarditis, herpes zoster).

Chiropractor in the treatment of diseases of the back and spine uses alternative medicine methods that exclude the use of pharmacological drugs. In manual therapy, various methods of restoring the health of the spine are used: massage stretching techniques, shock wave exposure, post-isometric relaxation, reflexology, etc. with osteochondrosis and brain injuries, pain syndrome with lumbalgia. Manual therapy helps to remove neurological disorders that are associated with compression of the spinal nerves, alleviate / cure conditions with myalgia and myositis, deforming arthrosis, spondyloarthritis, stenosis of the central spinal canal, radiculopathy and other pathological conditions.

Orthopedist diagnoses and treats diseases of the musculoskeletal system, considers developmental problems of the musculoskeletal system, congenital pathologies, injuries, and complications caused by infections. Often orthopedic doctors treat conditions of the post-traumatic period, occupational diseases associated with the musculoskeletal system.

Osteopath examines the disease in close connection with all organs and systems of the body. Its treatment is based on soft manipulations (palpation) with the bones of the skull, spine, coccygeal bone, on restoring blood and lymph flow, getting rid of clamps, adhesions, displacement of internal organs, normalization and tone of muscle tissues.

Traumatologist specializes in the treatment of sprains and injuries resulting from sudden movements, significant physical exertion or other impacts.

The article is for informational purposes only. Please remember: self-medication can harm your health.

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Sources

  • Website of the Ministry of Health of Ukraine / Zdorovye A-Z
  • World Health Organization Website / Fact Sheets
  • Website of the National Academy of Medical Sciences of Ukraine / Medical News

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The author of the article:

Kharlap Igor Vasilievich

Neurologist, vertebrologist, chiropractor of the highest category, reflexologist of the highest category

Expert in the direction:

Sagay Vladimir Aleksandrovich

Neurologist, vertebrologist of the highest category

Doctors

Are you tired of constant back pain? Do not know which doctor treats the spine? The best specialists in Kyiv in the branches of the MEDICOM clinic in Obolon and Pechersk will conduct a comprehensive diagnosis, identify the true cause of the pain syndrome and provide an individual treatment regimen based on the characteristics of the disease and the condition of the patient's body.


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