In developed countries, almost 75 percent of the population see a doctor at least once because of back pain.Nine out of ten people will experience back pain at least once in their lifetime.Most often, back diseases 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 medications for pain relief.
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 one month.
If the pain lasts more 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 working age patients.The percentage of patients with chronic back pain is ten percent.
The reasons
It should be remembered that the reasons behind the development of the pathological process have been well studied.Back pain can occur both due to risk factors and due to developing diseases.Most often, pain in the back and spine occurs when:
- overweight;
- muscle tension;
- injury to the intervertebral joints;
- cramps;
- 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 body mass index by one unit.A sedentary lifestyle, prolonged exposure to static positions with incorrect posture, and lack of physical activity lead to acute and chronic back pain.
Osteochondrosis
In the first place among the causes of pain in the back is osteochondrosis of the spine.Osteochondrosis of the spine is a pathological destruction process that develops in the intervertebral disc.As the disease progresses, adjacent vertebral bodies, intervertebral joints and ligaments that support the spinal column are involved in the degenerative process.
Initially, the process develops in the core of the disk, which becomes less elastic due to loss of moisture.These processes in the region of a relatively localized segment of the spine lead to inevitable changes in adjacent vertebrae and intervertebral joints, which ultimately affect the mobility of the spine as a whole.
Herniated disc
Lumbar disc herniation is the most common.The patient feels pain in the back, which radiates to the legs, buttocks, reaches the legs, or is localized in the inner thighs.
Limited mobility.Sensitivity is affected, which can occur in the form of burning and tingling.
Neuralgia
The presence of muscular neuralgia can be assessed by the appearance of acute shooting pain in the back.It occurs due to nerve compression under the influence of the surrounding inflamed tissue.
The most common place for pain to occur is in the narrow space between the ribs in the back.Neuralgia occurs in childhood and adulthood.
Injections for back and waist pain
Today, the treating doctor in terms of therapy is guided by data from the scientific literature, his own experience and the experience of his colleagues, because there are no standards for the diagnosis and treatment of back pain that will be officially recommended by the Ministry of Health.
The following medications can be used to treat back pain:
- non-steroidal anti-inflammatory drugs;
- steroid anti-inflammatory drugs;
- muscle relaxants;
- chondroprotector;
- vasodilator and improves microcirculation;
- synthetic drugs;
- B vitamins.
Nonsteroidal anti-inflammatory drugs
This group of drugs is indispensable for diseases of the musculoskeletal system.Sold without a prescription.
Available in the form of ointments, gels, tablets, suspensions, capsules, rectal suppositories, injections for intravenous and intramuscular injection.
Determined:
- Anti-inflammatory drug from the group of phenylacetic acid derivatives with analgesic effect.Well tolerated and effective pain reliever.Side effects include inhibition of proteoglycan synthesis in cartilage tissue and ulcerogenic properties, that is, promoting the formation of gastric ulcers.
- Anti-inflammatory drugs from the sulfonamide class with analgesic effects.The difference from the previous drug is the prevention of the destruction of proteoglycans and cartilage tissue, a selective effect on inflammatory mediators, which reduces the risk of gastric ulcers, and increases the effect of corticosteroids.Ideal for quick relief of acute pain.Side effects include the risk of toxic liver damage.
Steroidal anti-inflammatory drugs
Used in cases where non-steroidal anti-inflammatory drugs do not have the desired effect.
They have a quick effect, 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 injection.
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.
Relax the muscles
They are used only as part of complex treatment with drugs from other groups.The action is based on muscle relaxation, that is, they themselves have no therapeutic effect.But muscle relaxation helps with prolonged spasms that lead to pain, and to improve the effectiveness of manual therapy, massage, and physical therapy.
They are used together with NSAIDs and in case of intolerance to them or the presence of contraindications to them.
It can only be obtained with a doctor's prescription, because it has side effects: sudden changes in blood pressure, seizures, muscle weakness, and depressive effects on the central nervous system.
Chondroprotectors
These include glucosamine and chondroitin preparations.Chondroitin promotes calcium retention and slows bone resorption.Glucosamine helps improve the function of affected joints by increasing the production of hyaluronic acid.Available in the form of ointments, tablets, injections for intramuscular and intra-articular injection.Prescribed in combination with NSAIDs.They have almost no contraindications or side effects.
In this case, for the best effect, oral administration should be combined with parenteral administration:
- Injection 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 food.
Vasodilators
Drugs based on hemoderivatives of calf blood deproteins help dilate blood vessels, reduce trophic and microcirculatory disturbances by increasing the delivery of oxygen and nutrients.There is a decrease in hypoxia in the pathological focus with radiculopathies, osteochondrosis, and intervertebral hernia.Available without a prescription in tablet and injection form.
Intravenous injection of purine derivatives is performed in the morning and evening, 200-300 mg of the drug.Intramuscular injection is done two to three times a day, 100 mg.Tablets, when taken simultaneously with injections, increase the effect of the drug and are taken one tablet two to three times a day.
B vitamins
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 recovery of the intervertebral disc.Pyridoxine prevents hypoxia and increases intervertebral disc trophism.Cyanocobalamin relieves inflammation, increases tissue trophism, and restores the structure of nerve tissue.
Available without a prescription.They have almost no contraindications or side effects.Available in tablet and injection form.Use one ampoule daily for ten days.If the pain is not acute, then a regimen is used where 3 ampoules are used weekly (every day) for three to four weeks.
The above medicines should be combined depending on the type of disease.But in any case, the main treatment will be aimed at eliminating pain, stopping inflammation and restoring the function of the musculoskeletal system at the source of the pathology.
The following are used as therapeutic measures:
- massage;
- manual therapy;
- physical therapy;
- physiotherapy;
- electrical nerve stimulation;
- therapeutic restrictions;
- surgical decompression and stabilization.
Adequate therapy is prescribed by a general practitioner after a complete examination.If necessary, he will refer the patient to a specialist: neurologist, gynecologist, urologist.
Block for back pain
Performing a paravertebral block makes it possible to ensure the delivery of drugs directly to the pathological focus, which is the cause of acute pain.The patient experiences immediate relief when the block is performed.But it can only be done in a hospital environment and only by competent specialists.Relief from pain is temporary, but significant.This procedure also has diagnostic value.If after the restriction there is no immediate relief from pain, then the reason is not related to spinal disease.
Blockages can be performed at biologically active points in muscles and tendons, in the soft tissue surrounding the affected spinal segment, in the nerve sheath, in nerve ganglia, joints, and articulations.In this case, the injection consists of one, two, three or more drugs.These may be local anesthetics, corticosteroids, NSAIDs, vitamins, ATP.The effectiveness of restrictions is undeniable for osteochondrosis, disc herniation, spondylosis and spondyloarthrosis, lumbago, radiculitis, acute and chronic pain in the spine.
Restriction procedure
When performing restrictions with any of the above drugs, the following points are observed:
- immediate feeling of the effect by the patient;
- almost complete absence of contraindications;
- creating a high concentration of drugs especially in the pathological focus.
Description of the procedure:
- pathological focus examination with localization of the site of maximum pain;
- the patient is placed on his stomach;
- treat the site of the blockage with an antiseptic;
- puncture site anesthesia and drug administration.
There are some contraindications for restrictions, but they exist: pregnancy, individual intolerance to drugs, infection in the area of the procedure.
There are many ways to get rid of back pain.You should use not only pills or injections for back and back pain, but also remember about home remedies.First aid at home is to apply cold to the back (ice from the freezer, frozen meat, dumplings from the freezer).Painful cramps are relieved with massage.