In developed countries, almost 75 percent of the population consults a doctor at least once because of back pain.Nine out of ten people will experience back pain at least once during their lifetime.Most often, back diseases affect people between the ages of thirty and fifty, i.e., in active working age.Of all the patients who come to the clinic, more than a third come because of back pain.There are effective medications to relieve pain.
Types of back pain
Back pain is acute if it is located in the spine and began 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, since there is a significant deterioration in the quality of life of working-age patients.The proportion 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 have been studied quite well.Back pain can occur both due to risk factors and due to developed disease.Most often, pain in the back and spine occurs when:
- overweight;
- muscle strain;
- injury to intervertebral joints;
- spasm;
- hypothermia;
- osteochondrosis;
- protrusion and herniation of the intervertebral disc;
- neuralgia.
It is well 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 a static position with incorrect posture, and lack of physical activity lead to both acute and chronic back pain.
Osteochondrosis
In first place among the causes of pain in the back is spinal osteochondrosis.Spinal osteochondrosis is a pathological destructive process that develops in the intervertebral discs.As the disease progresses, the bodies of adjacent vertebrae, intervertebral joints and ligaments supporting 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, buttocks, reaches the foot, or is localized on the inner side of the thigh.
Mobility is limited.Sensitivity is impaired, which can occur in the form of burning and tingling.
Neuralgia
The presence of muscular neuralgia can be judged by the appearance of acute shooting pain in the back.It occurs due to compression of the nerve under the influence of inflamed surrounding tissues.
The most common place for pain to occur is in the narrow spaces between the ribs on the back side.Neuralgia occurs in both childhood and adulthood.
Injections for back and lower back pain
Today, the attending physician in matters of therapy is guided by data from the scientific literature, his own experience and the experience 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.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.Well tolerated and effectively relieves pain.Side effects include inhibition of proteoglycan synthesis in cartilage tissue and ulcerogenic properties, i.e., promoting the formation of gastric ulcers.
- An anti-inflammatory drug from the sulfonamide class with an analgesic effect.The difference from the previous remedy 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 enhances the effect of corticosteroids.Ideal for quickly relieving 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 rapid 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 injections.
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 themselves do not have a therapeutic effect.But muscle relaxation helps in the presence of prolonged spasm leading to pain, and to increase the effectiveness of manual therapy, massage, and physical therapy.
They are used both in conjunction with NSAIDs and in cases of intolerance to them or the presence of contraindications to them.
They are only available with a doctor's prescription, as they have side effects: sudden changes in blood pressure, convulsions, muscle weakness, and a depressant effect on the central nervous system.
Chondroprotectors
These include glucosamine and chondroitin preparations.Chondroitin promotes calcium retention and slows bone resorption.Glucosamine helps 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.Prescribed in combination with NSAIDs.They have virtually no contraindications or 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 daily with meals.
Vasodilators
The drug based on deproteinized hemoderivative of calf blood helps to dilate 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 radiculopathies, osteochondrosis, and intervertebral hernias.Available without a prescription in the form of tablets and injections.
Intravenous injections of a purine derivative are carried out in the morning and afternoon, 200-300 mg of the drug.Intramuscular injections are performed two to three times a day, 100 mg.Tablets, when taken simultaneously with injections, enhance 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 restoration of intervertebral discs.Pyridoxine prevents hypoxia and improves trophism of intervertebral discs.Cyanocobalamin relieves inflammation, increases tissue trophism, and restores the structure of nervous tissue.
Available without a prescription.They have virtually no contraindications or side effects.Available in the form of tablets and injections.Use one ampoule per day 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 drugs should be combined depending on the type of disease.But whatever it is, the main treatment will be aimed at eliminating 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, he will refer the patient to a specialist: neurologist, gynecologist, urologist.
Block for back pain
Performing a paravertebral blockade makes it possible to ensure 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.The relief from pain is temporary, but noticeable.The procedure also has diagnostic value.If after the blockade there is no immediate relief from pain, then the reason is not related to a disease of the spine.
The blockade 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 medications.These may be local anesthetics, corticosteroids, NSAIDs, vitamins, ATP.The effectiveness of blockades is undeniable for osteochondrosis, disc herniation, spondylosis and spondyloarthrosis, lumbago, radiculitis, acute and chronic pain in the spine.
Blockade procedure
When performing a blockade with any of the above medications, the following is observed:
- immediate feeling of the effect by the patient;
- almost complete absence of contraindications;
- creating a high concentration of the drug specifically in the pathological focus.
Description of the procedure:
- examination of the pathological focus with localization of the site of maximum pain;
- the patient is placed on his stomach;
- treating the blockade site with an antiseptic;
- anesthesia of the puncture site and administration of the drug.
There are few contraindications for blockade, but they do 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 resort not only to pills or injections for back and lower back pain, but also remember about home remedies.First aid at home is to apply cold to the back (ice from the refrigerator, frozen meat, dumplings from the freezer).Painful spasm is relieved with massage.