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When it arrives it certainly does not go unnoticed: it is the backache, a disorder that can affect anyone and at any age, therefore children, adults and the elderly. The development of back pain can also be favored from:
- poor physical activity;
- overweight.
It is very common and mainly manifests itself with muscle and joint pain in different areas of the back. Also by virtue of these characteristics, the Italian Society of Orthopedics and Traumatology (SIOT) in collaboration with the Superspecialistic Societies it affiliates, has established guidelines for the prevention of back pain and to establish the correct procedures for diagnosis and treatment, continuously updated.
So, when should back pain start to worry us and what tests should we perform? We talked about it with the Doctor Laura Scaramuzzo, Orthopedist, Specialist in Spinal Surgery.
What is that
«Back pain is a pain of musculoskeletal character quite common which, given the generic nature of the term “back”, may be of interest different areas of the back: from the lumbar area, which is located immediately above the buttocks, to the base of the head », explains the expert.
Causes
“In most cases, back pain is linked to a ‘muscle inflammation: the muscles, following an effort or a wrong position, become inflamed and painful. Most of the time it is a dull and constant pain, felt in the lower back and which is accentuated in changes of position or sudden movements. Back pain appears when the mechanisms that our body has put in place to make us feel good, fail. In any case, what happens is that our body is no longer able to defend itself and therefore unleashes the feeling of pain, which represents – it is good not to forget – an extreme defense mechanism of our body.
The disorder appears without a clear distinction of age, so both in adolescents and in adulthood, albeit in the older population – for various reasons – it is slightly more frequent. If it is possible to trace the movement or the cause that could have created the disturbance, if it remains an isolated episode and does not last very long, we should not be particularly concerned. On the other hand, when the problem becomes more serious, it is necessary to go to the specialist », continues the doctor.
When to worry
“Back pain must worry us when it lasts over time, perhaps for many days. This, even in the case of a single episode, especially if we are unable to reconstruct the triggering factor.
Let’s assume that you have taken an anti-inflammatory prescribed by the general practitioner, that you have observed absolute rest and that you have followed all the indications that have been given to us. That pain felt maybe lessens a bit, but it always remains present in the background and if we do something other than rest, it tends to increase. Well, this is a symptom not to be underestimated, even more so if the episodes begin to become more frequent over time. What does it mean? That I, perhaps, have a first episode of back pain that passes me with anti-inflammatory therapy. But after 2-3 weeks I begin to feel the symptoms of a new episode which, perhaps, takes longer to pass and so on.
Other element of concern must be when pain it no longer remains confined only in the back area, but tends to extend down the leg. Care should be taken if, in the presence of back pain, they are felt small jolts down the leg or tingling which can also be recognized as altered sensations when we put on socks or when we put the foot on the ground.
If the pain extends to one leg or both, it means that the nerves are also involved, and that perhaps there may be at the base a herniated disc (more frequent especially in young people), or one lumbar stenosis (that is, a narrowing of the area where the nerve roots pass) or other pathologies », Dr. Scaramuzzo specifies.
When to investigate
“When the episodes become frequent and when they increase in intensity over time, it’s worth it make inquiries because actually we are no longer in the field of muscle inflammation (which is the one that commonly appears to everyone or that we have all tried at least once in our life), but there could probably be something to investigate at the level of intervertebral discs or joints who may have suffered some resentment.
The most common one is a degenerative resentment, the classic consumption. A bit like the knees or hips, even the joints of the spine tend to wear out over time: perhaps because you are doing heavy work that requires you to lift weights or because you remain standing for a long time. These (and many more) can be the causes that lead both intervertebral discs and joints to wear out a little ahead of time and when this happens, the back pain becomes not only stronger, but above all more frequent. In these cases it is necessary to consult the specialist, make inquiries and go and investigate the cause that caused the back pain ».
Recommended exams
«The first exam to do, before going to the specialist, is generally one x-ray of the spine. It is a very simple test that can be performed both in hospitals and in diagnostic studies and which allows us to see the bone first. It allows you to exclude the main problems such as a vertebral fracture, or if there are bone changes in the spine such as spondylolisthesis (which is the sliding of a vertebra and is one of the most frequent causes of back pain in adolescents).
When, on the other hand, together with a back pain that has been going on for several weeks, some painful irradiation is recorded on the buttocks or legs, it is preferable to associate an X-ray, even a magnetic resonance because in this way it is also possible to observe the soft structures, such as nerves, and check for a herniated or narrowing of the canal or a worn or inflamed disc, which may be a cause of specific back pain.
Once these two exams are done, it’s much simpler make a diagnosis, then see if there is an actual problem with the spine, linked to an alteration of the same as it can be, for example, a scoliosis or other pathologies that very often the patient has been carrying with him for several years and that, at a certain point , they start to hurt because the column can no longer compensate alterations in posture », concludes the doctor.
In general, therefore, back pain can be triggered by several factors. If the pain does not persist and remains an isolated case, there is no need to be alarmed. Otherwise, it is good to investigate thoroughly by carrying out the necessary investigations and examinations.
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