prof. Dr. Halil İbrahim Secer
Brain and Nerve Surgery (Neurosurgery)
Causes of back pain
Because of its less mobility, back pain is less common than low back pain. However, those who complain of back pain are too many to be underestimated. There may be pain originating from the back region, as well as pain reflected in the back region due to other diseases. The most important of these are gastric and intestinal ulcers and heart attacks. When the causes of back pain are evaluated according to age groups, the most common causes are:
-
In childhood: Back pain due to deformity of the back vertebrae, especially kyphosis (humpback) and scoliosis (side curvature of the spine), as well as back pain due to tuberculosis and tumors
-
In the adult period: Back pain due to thoracic disc herniation (back hernia), tuberculosis, ankylosing spondylitis and myofascial pain syndrome (culcus),
-
In old age: Osteoarthrosis (calcification), osteoporosis (bone loss) and back pain due to bone tumors.
Acute causes:
– Thoracic disc herniation (back hernia)
– Compression fractures
Chronic causes:
-
Thoracic disc herniation (back hernia)
-
Thoracic spondylosis (calcification)
-
Canal stenosis in the thoracic vertebrae
-
Inflammatory diseases of the spine
-
tumors
-
Ankylosing spondylitis
-
metabolic bone diseases
-
Myofascial pain syndrome (cushion)
-
Pain radiating from other areas
-
Psychological back pain
Thoracic disc herniation (back hernia):
It constitutes 2-3% of spinal hernias. It is mostly seen in the lower part of the back vertebrae. The pain may radiate to the chest, abdomen, or legs. Examination and imaging of that region are important in diagnosis. Analgesics (painkillers) and physical therapy applications are useful in treatment. In advanced cases, surgery may be required.
Spine compression fractures:
It can cause sudden and severe back pain, or it can be mildly painful or painless. Back tumors or tumors spreading from another region, osteoporosis (bone loss) and bone tuberculosis are the most common causes of compression fractures.
Thoracic spondylosis (calcification):
It causes pain and stiffness in the back. Over time, a hump can develop on the back. The pain increases with standing for a long time and carrying a load. Spondylosis may also be accompanied by thoracic spinal canal stenosis (canal stenosis in the vertebrae of the back). In this case, complaints and findings related to nerve and spinal cord compression can be seen. In the treatment, drug therapy and physical therapy, if the complaints do not improve and neurological disorders occur, surgical treatment can be used to relieve nerve compression and correct the deformities.
Infections:
Tuberculosis is most common, and there may be spread of other microorganisms to the dorsal vertebrae via blood.
tumors
Pain is the most common symptom. Characteristically, it is most common at night and the intensity of pain decreases with exercise. The pain is often stabbing and aggravated by coughing, sneezing, or heavy lifting. It often wakes the patient from sleep.
Postural deformities (deformities of the vertebrae):
Kyphosis (humpback), scoliosis (side curvature of the spine) are often causes of back pain. The treatment has two purposes. Correction of curvature and arrest of progression. Physical therapy applications or surgical methods can be applied in the treatment of scoliosis.
Ankylosing spondylitis
It is a rheumatic disease that causes back pain by impinging on the back vertebrae and restricting the movements of the rib cage.
Osteoporosis (bone loss):
It can cause acute (sudden onset) or chronic (developing over time) back pain. Acute pain is due to compression fractures of the vertebrae. Chronic pain is related to the deterioration of the balance in the spinal muscles. Unless there is a fracture, there is usually no sensitivity in the bones.
Myofacial pain syndrome (Kunç, muscle rheumatism):
It is a disease characterized by pain, tenderness and stiffness in the muscles. It is often confused with fibromyalgia syndrome. Whereas, pain is more common in fibromyalgia syndrome, while myofascial pain syndrome involves less muscle groups. Pain, stiffness and tenderness are common throughout the body in fibromyalgia, while in myofascial pain it is in one or more regions. Fatigue and insomnia are absent or milder in myofascial pain. The most important causes are traumas, posture disorders, repetitive movements, stress, excessive smoking, congenital disorders.
Referred pain:
-
Stomach and intestinal ulcers
-
kidney inflammations
-
Pancreatic diseases
-
Heart attack