Back Pain

The back region is the region where pain complaints are frequently observed due to its location between the neck and waist region and its relationship with the chest cavity and abdominal region. The back region, which has a dense muscle layer, is frequently affected by occupational and postural factors such as poor posture, stationary work, and heavy lifting. It is one of the musculoskeletal areas that causes the most complaints after low back pain.

Causes of back pain

It originates from the muscles, bones, joints and ligaments in the back area. Pain: Among these, the most important situation is the pain that occurs as a result of working in a wrong posture, working in a fixed manner, and lifting heavy objects. Inappropriate sleeping postures and bad beds are among the reasons that come to mind for back pain.

Disc slippage (herniation) in the back area: In fact, since the back area is not a mobile area such as the shoulder and waist, there is a possibility of herniation. is lower.

Waist and neck problems: Pain may be felt in the back in both waist and neck complaints.

Infection in the back bones (such as tuberculosis), traumatic processes such as fractures, tumoral formations, and collapse due to bone rupture are reasons that should always be kept in mind.

Diseases arising from the organs in the chest cavity: Lung diseases, fluid accumulation in the lung membranes, adhesions, heart pain, diseases of the large vessels in this region, and esophagus problems such as reflux can also cause back pain.

Diseases arising from organs in the abdomen: Aortic aneurysm, kidney diseases, gallbladder and bile duct diseases, stomach diseases (such as ulcers, perforation), pancreatic diseases are among the causes of back pain.

Infections: Especially when shingles affects the back area, it may manifest itself only as back pain until the lesions appear.

Scoliosis (spine curvature), kyphosis (hunchback) and other spinal deformities may also occur. It can cause back pain because it disrupts the mechanics of the spine.

Diagnosis of back pain

Considering the reasons listed above, diagnosis of back pain is It can be understood how difficult it is. In patients with back pain, symptoms such as weight loss, weakness, fever, and night pain should be questioned. These symptoms may indicate that there is an important cause of back pain, such as infection, tumor, or inflammatory rheumatic disease. Night sweats, cough, respiratory distress and presence of fever should be added to the questioning of lung diseases. The patient's presence of pain on exertion may indicate heart and lung diseases. Findings related to the digestive system should also be questioned. Sometimes the patient may not express these complaints, thinking that they are not related to back pain. Pain and burning pain during urination may indicate problems with the kidneys and urinary tract.

During the examination, both the neck and waist should be evaluated, and all back vertebrae and related structures should be examined. The patient should be undressed so that if there is a cause such as shingles, it can be seen. There are many trigger points for myofascial pain syndrome in the back region, especially around the shoulder blades, and these should be examined and evaluated whether they cause pain radiating to the back.

Since there are many diseases that can be diagnosed in back pain, the diagnosis can be supported by direct radiography and MRI. Blood tests may be performed to rule out conditions such as organ problems, rheumatological diseases, and infections, and a urine test may be performed to rule out kidney problems.

Warning reasons to see a doctor for back pain:

• Serious trauma within the last 3 months

• Presence of a disease affecting the immune system

• Long-term cortisone use

• Night sweats

• Back pain that increases at night

• Presence of respiratory distress

• Weakness

• Height reduction

• Increasing back pain

• Back pain that occurs with minor trauma and sudden movements in people with osteoporosis

• Pain lasting longer than a month lasting

• Numbness in the legs, weakness and threshold of urinary incontinence

Treatment of back pain

    Back pain relief Determining the cause of pain is actually the most important key to treatment. If the patient has a lung infection or a tumor, a fracture due to osteoporosis, or a gallstone, the pain will not go away no matter what is done. For this reason, treatment of the causative disease is a priority.

The treatment methods that can be recommended in the presence of pain originating from the structures in the back area are as follows:

What can be done to reduce the pain

-Medications: Medications can be used to reduce pain in back pain. For this purpose, painkillers/antirheumatic drugs, muscle relaxants, adjuvant drugs, weak opioids can be used. These medications can be taken orally or applied externally as a gel/cream.

-Rest: Another treatment method is rest. Since the back is a load-bearing area, rest can be applied to reduce the load on the area. For this purpose, short-term bed rest and the use of a back corset may be recommended.

-Complementary medicine methods: Complementary medicine methods such as acupuncture, neural therapy, ozone therapy, mesotherapy and prolotherapy can be used to control back pain. Among these treatments, acupuncture, neural therapy and ozone therapy are used in our clinic.

-Physical therapy: It can control the pain in the waist area by reducing muscle spasm, reducing edema, and increasing blood flow.

-Manipulation, mobilization: It can be applied to patients with dorsal segment blockage.

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Exercise and back protection techniques

Exercise in back pain is as effective as a medicine after the acute period has passed. The aim of exercise is to strengthen the back muscles, shorten the muscles that are shortened due to spasm, and stretch the ligaments. In this way, a balanced and natural corset is formed around the back.

In case of back pain, in addition to exercises for the back area, exercises that work on large muscle groups, called aerobic exercises, and increase the heart rate and respiratory rate should also be performed. These exercises also contribute to weight control. It also improves the patient's mood and relieves pain by increasing endorphins, called happiness hormones. reduces heat. These exercises are exercises such as running, walking, swimming and dancing. The patient should do whichever he/she likes more. Because aerobic exercises must be done for at least 8 weeks for the expected effects to occur.

Exercises that increase body flexibility such as pilates and yoga can also be done. It is recommended to avoid movements that cause pain while performing these exercises and to increase the exercise intensity slowly. It is recommended to explain the situation to the relevant sports instructor for exercises performed in gyms outside of the physician's control, to increase the exercise intensity slowly, to avoid lifting weights inappropriately, and to avoid movements that cause pain.

Back protection techniques can be used both while performing daily life activities. It should also be taught to be applied while performing professional activities. For this reason, when it is necessary to learn the patient's profession and what body movements he makes while doing this profession, ergonomic arrangements should be made and patients should be warned in this regard.

 

Back pain, neck and waist problems. Secondly, depending on the pathologies of the back vertebrae and surrounding tissues, it can be caused by many reasons such as pain reflected in the lungs and other intrathoracic organs, gallbladder problems. It should be investigated whether back pain attributed to fatigue, especially in working people, is actually muscle pain caused by fatigue or whether there is an underlying cause. In elderly people and people with osteoporosis, a wide spectrum of evaluations should be made, including silent spinal fractures, all kinds of infections, and large vascular problems in the rib cage and abdomen. In addition to treatments such as neural therapy, acupuncture, ozone, and dry needles, in patients who do not have internal organ problems, they should be supported with exercises that stretch and strengthen the back and abdominal muscles, neck and shoulder girdle muscles, and studies should be carried out to evaluate and eliminate factors that may cause posture disorders and pain in the working environment.

 

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