What to do if hurt back

What causes pain in the back, really?

  • In most cases, back pain is caused by nonspecific mechanical causes: often damage to the ligaments and muscles that support the spine (70%), less compression fractures in osteoporosis (4%).
  • With the degenerative processes of the intervertebral discs and joints, which in Russian terminology is called degenerative disc disease, it is possible to link more than 10% of the cases.
  • Rarely, though aptly, the pain caused by protrusion of a herniated disk, compressing the nerve roots, then, for example, it starts to hurt and numb thigh or leg (sciatica). Such problems, which is called radiculopathy, due to more than 1-3% of acute lumbar pain.
  • Often faced with idiopathic pain without organic damage (mostly psychogenic in nature).
  • Very rarely identifies a specific cause: infection or tumor (0.8 percent) or diseases of internal organs, when the pain is projected in the back (1,5-2%).
  • Contrary to popular belief, congenital curvature of posture (kyphosis, scoliosis) do not by themselves cause pain, syndrome rarely (< 1%).

There are many other rare causes, which will only be considered a specialist.

So, most back pain is not associated with the spine and caused a tear of the muscle fibres and ligaments of the back caused by physical overload. Left untreated for a long time, which is itself at the center of inflammation, which further supports tissue ischemia and pain according to the vicious circle principle.


In our Kingdom-state that is not back pain — everywhere is to blame pain in the low back and known by a herniated disc.

How do you avoid improper treatment and "divorce" in the money

X-ray, MRI, CT scan for a pain in the neck and back is usually not required. Your doctor may prescribe these studies, if you have signs of severe injury to the spinal cord and roots in the form of external disturbances (paresis or paralysis of the muscles of the lower extremities, disturbance of sensation, impaired functions of pelvic organs). In 90% of cases of pain in the neck and back such studies it is not necessary and the default should not be named.

A neurologist may prescribe these studies, even in the absence of the violations described, if the pain does not lose its intensity for about 4-6 weeks, despite correct drug treatment, or if there is suspicion of a specific process, type of tumor or tuberculosis in the spine.

In our country the default find all types of hernias (which are just do not), and scare all the sick shots, but in developed countries has long been postulated: the correlation between back pain without peripheral symptoms and the pattern on x-ray or CT, no.

Smart people, only 1000 people with pain without peripheral symptoms, and 1000 completely healthy and all made of the tomography scans (CT and MRI). As a result, in both groups the number of people with herniated discs and those who have, were about the same. In addition to is among in the survey were those with a double hernia, which has not experienced pain in the back, and vice versa — many of those who suffer from pain did not have a hernia. This experiment was repeated several times for a particularly hard-nosed, so that no doubt remains — first of all take into account symptoms and signs, and then assign visual studies, if there is evidence. In other words, treat the patient, not his paintings.

A herniated disc is actually not so often involved in the development of other diseases. Only in 4% of cases of back pain may be some theoretical link with the existing hernia, and severe bulging disk, which requires radiographic imaging, and surgical treatment, are extremely rare.

Why in our country, or MRI of the spine not only called a lazy doctor? The first reason is the ignorance of some doctors (see the entry on the identity of the domestic medical schools). And the second is the economic interest of health facilities and/or attending physician.

In the last 10 years the main source of income figures from the health service and the head of the doctors from the hospital were earnings received from manufacturers of medical equipment and supplies. And here the real gold mine was the MRI (magnetic resonance imaging), CT (computed tomography), in the worst case, the digital x-ray devices. In the pullback from the average scanner is 100 thousand dollars per hour, but to prove the fact of this it is almost unreal. Here and bought everywhere, where this is necessary or not.


Other enterprising physicians to provide a current MRI queue for a month forward. For piping to work correctly, a lot of business clinics of doctors were put on the percentage of assignable research (test, ultrasound and, of course, expensive CT and MRI).

Lumbar pain is a difficult thing, but is usually in itself. Studies show that low back pain without treatment is a week from 30-60% of patients after 6 weeks healthy is 60-90%, and year to recover 95%.

How to speed up recovery

And here is a sad, sick breeds — Mother not to cry. Pain, because the whole brain analyses, and therefore the placebo effect for pain, it works in every case, although the leeches put, although the hot stones used, although the cups are beautiful. Especially suggestible will help you and the conspiracy, and the favourable horoscopes and homeopathy. One bad — placebo effect, by definition, limited.

Acute back pain is not effective, the following treatment methods:

  • physiotherapy;
  • therapeutic massage;
  • extension of the spine.

In the acute stage of these methods are not only not recommended but potentially harmful.

Do not have advantages before usual drug therapy are costly in time and Finance methods:

  • manual therapy (manipulation of the bones changes from the massage);
  • physiotherapy;
  • osteopathy;
  • acupuncture = acupuncture.

In the acute period of some short-term effects can be methods of distraction therapy-the type of pepper patch, cans, all of the burns ointment. The same principle works and acupuncture. Here the effect is due to the movement of the brain from the pain of a new source of irritation. At the end, the brain is not focused in one place and the pain subsides.

A good effect of heat warming his muscles. The effect, however short-lived, but still.

That really helps with acute pain in the back/neck

Only 3 things that have been proven effectiveness:

  • medicines from the group of nsaids (non-steroidal anti-inflammatory drugs);
  • medicines from the group of Central muscle relaxants, are assigned along with nsaids;
  • maintenance of vigorous activity during the disease (bed rest does not help, but hinders recovery).

Cheap and cheerful. Everything else in the acute phase of placebo effect or a Scam. Although I have to say, that older people can recommend to go to the clinic for placebo treatment until the of the group. By itself, the way to the doctor, which has a healing effect.

Regardless of which NSAID to drink? Maybe make a shot? Maybe medicine is the best to RUB it into the affected area?

The answer to the first question is clear: the pain is effectively remove all of the nsaids. But everywhere there are nuances. Some nsaids better effect on pain, and other inflammation.

Regardless of how you take anti-inflammatory medications by mouth or by injection, with or without food side effect on the stomach works the same way. Ulcers are aggravated, because the pill irritates the gastric mucosa through direct contact, but because suppresses the synthesis of COX-1 after the drug has already been found in the blood.

Outside of the subcutaneous tissue and adjacent muscles and ligaments of these drugs almost does not penetrate, and what penetrates, is carried by the bloodstream and distributed evenly throughout the body. Also, when the blockade of medicines, administered with a long needle, that your right to the nerve — will not bring the cm and the effect can not be at all.


But, if you smear a lot, of blood in the whole body, sooner or later will create a sufficient concentration of the NSAID and then the analgesic effect is achieved, as if this would cure drank or injected. Here are just a pill to drink still easier, and the concentration of the active substance, which is thus ensured in a reliable manner. Such medicines with an NSAID are more effective for bruises and sprains of the surface muscles and ligaments.

If you are able to performed drug injections you absolutely nowhere – even so, even in this way, the drug that works the same way.

What to do when the acute period has passed,

Usually, back pain occurs on the background of the overall inactivity, which leads to weakness of muscles and ligaments that support the spine. With a weak back any overload (a violation of ergonomics and landing movements, or incorrect lifting of heavy loads by hand) lead to damage of the ligaments and muscles or for deterioration and protrusion of the intervertebral disc with all the consequences.

  • strengthening the back (if you are already sick, consult with experts for the selection of complex physical therapy, but if healthy do morning exercises, isometric exercises, swimming and generally lead an active way of life with physiologic activation of the entire musculature of the body);
  • pay attention to ergonomics (like sitting in the office, as a tool for use in manufacturing, such as digging the garden at the cottage).

Strengthening the back and proper ergonomics in daily and household activities are only for the non-surgical treatment of chronic back pain is worsening, and effective prevention of recurrences.

Tips for preventing overloading of the back:

  • Never lift weights in a standing position. Sit down, grab the suitcase handle and stand with him. Lift weights with your legs, not back.
  • Under no circumstances shall swear to tell the truth and do not pull at an angle of 45° to the axis of the spine. Of the spine under load needs to move only in 2 dimensions is strictly forward-backward or left-right.
  • You can not bend and straighten the back, at the same time rotate. This is especially dangerous when lifting and carrying heavy loads.
  • When you carry a heavy burden, on the one hand, his other hand firmly push against the thigh (this technique allows for the right to redistribute the load of the muscles of the back).
  • Ever since the APE stood up on its rear legs, her back was her weak point. Don't overload the back without special needs. Buying suitcases on wheels, use the carts at the airports and at stations, do not skimp on the tea porters. If in doubt, the correct orthopedic backpack, distribute the weight evenly throughout the body.
  • And, of course, for strengthening your back regular exercise as SOON as the ACUTE PAIN SUBSIDES. You may get rid of excess weight.