Back and joint pain

Back and joint pain are among the most common health problems among middle-aged and elderly people. According to statistics, no fewer people seek medical help for such pain than for sore throats and colds. The constant increase in the incidence of the disease is due to many reasons: the back and joints can hurt due to physical overload, inflammatory and autoimmune processes in the body. What do you need to know about this problem, how to prevent or get rid of it? We hope that we can answer most of your questions.

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Causes back and joint pain

Doctors have long traced the influence of urbanization on the increase in the number of people complaining of pain in the joints and back. This trend is largely caused by both excessive physical overload and hypodynamia - two "extremes" that are the "scourge" of the modern world.

A considerable share of the blame falls on poor nutrition and a lifestyle with a lot of bad habits. For example, a surge in the frequency of requests for medical care often becomes a consequence of the so-called "whiplash injury": most people walk less and less, preferring to travel by transport. The busy city mode is characterized by intermittent movement of vehicles, with frequent jerks and abrupt braking. This is what causes injuries that almost always remain unnoticed, but are accompanied by micro-damage to the musculoskeletal system. Such damage gradually accumulates and over time "results" in a serious problem with the back and joints.

Nowadays, there are quite a lot of reasons that can cause problems that manifest themselves as pain. Most often, diseases of the back and joints arise in childhood and adolescence, and manifest themselves only after several decades.

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Risk factors

If we consider all known atrophic-degenerative disorders in the musculoskeletal system, we can see that the overwhelming majority of them are associated with overload. Overload entails not only slow or rapid mechanical destruction, which over time begins to worsen due to the slowdown of regeneration. There is also a deterioration in the nutrition of the anatomical sector, which includes intervertebral discs, articular cartilage, etc.

What risk factors are we talking about:

• excess body weight;
• heavy physical work;
• systematic sports practice with dominant axial overload (observed in weightlifters, runners, high jumpers or long jumpers);
• prolonged static overloads (“sedentary” processes in production, office work, constant and long-term driving);
• lack of conditions for comfortable sleep (sleeping on a bed that is not the right size, etc.).

Any of the listed factors can gradually disrupt the functioning of the musculoskeletal system.

The overload is aggravated by the influence of:

• altered spring functionality of the feet (for example, with transverse or longitudinal flat feet);
• impaired shock-absorbing properties of the spinal column;
• pathological curvatures of the spinal column (scoliosis, kyphosis);
• weakness of the paravertebral muscles.

Specialists also consider the hereditary factor, when the patient has patients with chronic diseases of the musculoskeletal system in the family. A significant role is also given to improper nutrition and ecology.

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Pathogenesis

Back and joint pain associated with the musculoskeletal system are most often provoked by myofascial and muscle spasm. As a result of such spasm, metabolism in the affected area is disrupted, blood circulation and tissue nutrition worsen, muscle-ligament structures become inflamed, and large joints suffer. This often happens in patients with poor posture or inflammatory processes in the muscles, as well as in those who are forced to stay in the same position for a long time. Back and joint pain often appears after lifting heavy objects, with high-amplitude or sudden motor activity, after hypothermia, and also against the background of diseases such as spondyloarthritis, interscapular syndrome, rheumatoid arthritis, etc.

A special role in the occurrence of back pain is played by imbalances in the structure of the spinal column, its curvature, osteochondrosis, spondylosis, spondylolisthesis, etc. A similar pain mechanism can be observed in patients with brucellosis, in women during pregnancy, in overweight patients, as well as in people suffering from hernias and protrusions of intervertebral discs.

Dystrophic metabolic disorders in the musculoskeletal system are in most cases caused by changes in metabolic processes in tissues, the formation of osteophytes. This phenomenon is not uncommon in patients with endocrine pathologies, gout. In this case, back and joint pain in patients is often combined with increasing limitation of motor capabilities, with hypermeteosensitivity.

Pathologies of the spinal column associated with infectious and inflammatory or tumor processes are also characterized by severe and constant pain. For example, back pain is found in patients with tuberculous spondylitis, and joint pain is found in neoplasms affecting bone tissue.

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Epidemiology

Doctors note that patients' complaints of back and joint pain in 90% of cases are associated with pathologies of the spinal column, and most often with osteochondrosis. According to statistics, the spread of this disease affects almost all age groups: doctors explain this by the launch of a physiological reaction of dehydration of the intervertebral discs already in childhood - from about six years. This process can proceed differently - in some people slowly, in others - rapidly. Therefore, back pain can occur both in 40-year-old men and in teenagers.

And a few more statistical facts:

• Every second patient in our country becomes temporarily disabled every year due to back and joint pain.
• More than 90% of cases of such pain are associated with pathologies of the spinal column (displacements, overstrain, disc herniation, etc.). The remaining cases are inflammatory processes, arthritis, injuries, etc.
• Back and joint pain is the second most common symptom for seeking medical help (ARI and ARVI are in first place).
• Eight out of ten people worldwide regularly experience joint or back pain.

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Symptoms

At the initial stages of the pathological process, pain in the back, joints and muscles may appear only periodically: at first - after motor or other physical activity, then - in a calm state. Over time, the pain syndrome becomes longer lasting or constant.

The first signs of pain vary from patient to patient, which allows them to be classified into several groups:

• Acute pain appears unexpectedly and does not last long, while the victim can clearly indicate its location.
• Aching pains, as a rule, are characterized by the extent of the lesion. They make themselves known only periodically, and it is difficult to accurately determine the pathological focus in many cases.
• Chronic pain in the hip joints and back is usually of a protracted nature and can bother for six months or more. Such patients should definitely undergo a detailed diagnostic examination: often the causes of chronic pain are diseases that require surgical intervention.

If the inflammatory process affects the joint, the pain can spread to other areas, which significantly "confuses" the clinical picture. Thus, pain in the hip joint is often noted, radiating to the back, ankles, buttocks, groin, as well as to the inner, back or outer surface of the limbs.

Symptoms that occur against the background of pain depend on their primary cause. Such a cause may be a disorder of the spine, neuralgia, radiculitis, muscle diseases. For example, one of the most common causes is osteochondrosis - we are talking about a pathology associated with degenerative changes in articular cartilage. With osteochondrosis, a person has back pain, radiating to the hip joint or limb, numbness, body aches, muscle cramps and spasms may occur. One of the manifestations of such a disease is radiculitis - an inflammatory process affecting the root of the spinal nerve.

Many specialists associate the occurrence of back pain with age-related changes. Deterioration of tissue nutrition and disruption of innervation lead to the fact that fibrocartilaginous intervertebral discs lose moisture and flexibility. As a result, even low-intensity movement causes discomfort and pain. Many elderly patients note that over the years their joints crunch and their backs hurt. As the tissues become dehydrated, compression and displacement of cartilage occurs. In the clinical picture, this is manifested by sharp pain in the joints and lower back.

Back and joint pain in a child

In childhood, visits to the doctor about back and joint pain occur much less frequently than in adults. It would seem that where could a dystrophic process come from in a child, since the baby does not experience any excessive loads, does not receive stress or hypothermia. However, there are still reasons for the appearance of pain:

• incorrect posture, incorrect body position while sleeping or sitting;
• injuries, falls;
• chondropathy, intervertebral hernias;
• spondyloarthritis, spondylopathies;
• infectious diseases (including tuberculosis, osteomyelitis);
• tumors of bones, cartilage, ligaments, spinal cord;
• blood diseases (hereditary hematological pathologies);
• diseases of the digestive tract or genitourinary system that cause pain to radiate to the back or joints.

It is worth noting that the spectrum of childhood pathologies, which are characterized by such a clinical symptom as back and joint pain, is quite extensive and diverse. The doctor must be very attentive, because competent and timely diagnostics are very important for the child's future health and quality of life.

Diagnostics back and joint pain

As soon as the first signs of back and joint pain are detected, you should immediately visit a doctor for a consultation. Depending on the nature of the pain and the presence of other symptoms, a medical specialist will be able to suspect a particular disease. And to confirm the assumptions, the doctor will prescribe additional diagnostic measures, consisting of a number of laboratory and instrumental procedures. Such procedures include:

• Laboratory tests:
  • a general blood test, which will indicate the presence of inflammatory changes in the body, will help detect anemia and assess the quality of blood clotting;
  • urine analysis – a study that allows you to assess the level of protein, glucose and bilirubin;
  • blood biochemistry and determination of specific markers of rheumatoid diseases.
• Instrumental diagnostics:
  • X-ray and ultrasound examinations help to identify violations of bone integrity, dislocations, arthritis or arthrosis, as well as to determine the cause of such violations;
  • computed tomography – provides the opportunity to examine the affected area from different sides and at different tissue depths;
  • magnetic resonance imaging – allows for a layer-by-layer examination of the condition of cartilage, vascular network, muscles, periosteum and vertebral discs;
  • osteoscintigraphy – helps to assess the quality of blood circulation in the skeletal system and the intensity of metabolic processes, to detect violations of bone integrity, arthritis, tumors and osteomyelitis.

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Differential diagnosis

Differential diagnostics when back and joint pain occurs is quite complicated, as it requires a thorough analysis of all possible causes and the clinical picture of the disease. Thus, the doctor must analyze the possibility of development and exclude or confirm the presence of the following diseases:

• diseases of the joints, as well as muscles and ligaments that are located near the source of pain (this also includes injuries, inflammation and tissue degeneration);
• anatomical disorders in the joints and spine, congenital and acquired dislocations, contractures, chronic pathologies;
• systemic processes in the body (autoimmune, infectious and inflammatory processes, neurological disorders);
• so-called stress or psychological pain (appears as a result of stressful loads and goes away on its own over time).

The symptoms of these diseases are very similar, as they can all manifest as back and joint pain.

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Treatment back and joint pain

What to do if your back and joints hurt? Of course, see a doctor - a vertebrologist (for problems with the spine), a rheumatologist (for inflammatory joint diseases), an orthopedist (for degenerative joint lesions), a traumatologist (if back and joint pain is associated with an injury). You can also see a doctor with a broader specialty - for example, a surgeon or a family doctor, and he will then refer you to a specialist closer to your problem.

After determining the disease that caused the back and joint pain, treatment begins - not specifically of the pain, but of its root cause. The main line of concomitant treatment should be the elimination of pain syndrome.

For back and joint pain, medications are most often used to eliminate the inflammation process, to normalize the temperature, to relieve pain. Of the analgesics, the choice mainly falls on non-steroidal drugs such as Diclofenac, Ibuprofen, Indomethacin, Ortofen, etc. Depending on the situation, these medications are prescribed in injections, tablets, and also in the form of external ointment preparations.

In case of very severe pain, narcotic analgesics may be used as prescribed by a doctor, including Morphine, Fentanyl, Promedol, etc. However, such medications are prescribed only in extreme cases - for example, if severe pain is caused by a malignant disease.

The standard course of treatment with analgesics and NSAIDs can last no more than 10 days. Longer use of the listed medications can negatively affect the patient's health (for example, the digestive system is often affected, problems with the stomach and duodenum arise).

If the pain is caused by muscle spasm, then muscle relaxants – medications that relax muscles – will be needed to eliminate it. Such medications are especially often used for back pain: these can be medications based on tolperisone (Mydocalm), tizanidine (Sirdalud), etc.

In addition to drug treatment, special attention should be paid to the use of a special fixing belt, bandage. These devices are relevant if back and joint pain is caused by injuries or previous surgeries, as well as back pain in pregnant women.

To completely get rid of pain, you will need a comprehensive approach: medication, exercise therapy, massage, reflexology and physiotherapy.

Medicines for back and joint pain

If you are bothered by severe back pain, then in most cases the doctor will prescribe injections - these can be analgesics or blockades using glucocorticoids. The mechanism of action of such blockade injections is to suppress the transmission of pain impulses from the affected area to the brain.

Novocaine or lidocaine is injected into trigger points, which causes muscle relaxation and normalizes tone.

Paravertebral block is performed in case of spinal pathologies – in particular, in case of neurological disorders. Only a qualified experienced doctor can decide to perform such a procedure, and it is performed only in hospital conditions.

Below we will present to your attention the groups of drugs most frequently used for back and joint pain.

Pain reliever for back and joint pain
	Method of administration and dosage	Side effects	Special instructions
Dolaren	Take the tablets after meals, one tablet 2-3 times a day.	Constipation, diarrhea, abdominal pain, stomach ulcer (with long-term use).	Dolaren is a combination of paracetamol and diclofenac. It is approved for use from the age of 6.
Ketoprofen	At the initial stage of therapy, the drug is taken in a "shock" dose of 300 mg/day, with food, 2-3 times. Then, maintenance therapy is carried out at 50 mg three times a day.	Nausea, diarrhea, abdominal pain, dizziness, drowsiness.	Ketoprofen can be taken from the age of 14. Contraindications: stomach ulcer, lactation period, second half of pregnancy.
Meloxicam	Take one tablet once a day, with breakfast.	Anemia, headaches, stomach pains, dyspepsia.	Meloxicam is not used during pregnancy and breastfeeding, as well as under 15 years of age.

Ointments and gels for joint and back pain
	Method of administration and dosage	Side effects	Special instructions
Diclofenac gel	Rub gently into the affected area 3-4 times a day. The course of therapy should not exceed 2 weeks.	Rarely – allergy, skin redness.	There is no data on the possibility of using the gel to treat children under 14 years of age.
Arthrosilene	Rub into the sore spot twice a day for 10 days.	Rarely – local irritation reactions, allergies.	The gel contains ketoprofen. Not used for treating preschool children.
Viprosal	Apply a thin layer to clean skin twice a day. The course of therapy is from 7 to 30 days.	Rarely – allergy.	Viprosal is well tolerated by patients of any age. The possibility of using the ointment during pregnancy is discussed with a doctor.

Injections for back and joint pain
	Method of administration and dosage	Side effects	Special instructions
Voltaren	Usually 75 mg (one ampoule) of the drug is administered once a day, intramuscularly.	Stool disorders, damage to the digestive tract.	Voltaren should not be used for more than two days in a row.
Diclofenac sodium	75 mg of the medication is administered intramuscularly up to 2 times a day for 4-5 days.	Dyspepsia, erosive and ulcerative processes in the stomach.	The drug is not used to relieve back and joint pain in children under 6 years of age.
Reumoksicam	The drug is administered intramuscularly at 7.5-15 mg once a day, for no more than five days in a row.	Dyspepsia, edema, colitis, gastritis.	The drug is not used to treat pregnant and lactating patients, as well as children under 15 years of age.

Candles for back and joint pain
	Method of administration and dosage	Side effects	Special instructions
Revmalgin	Use rectally, one suppository at night.	Dizziness, dyspeptic symptoms, tachycardia.	The drug is not used in pediatrics.
Dicloberl	It is used in the form of rectal suppositories at 100-150 mg per day.		For pediatric practice, there are special children's suppositories - for example, Nurofen.
Indomethacin	For adults, use 1 suppository (50 mg) up to 3 times a day, or 1 suppository (100 mg) 1-2 times a day.	Tinnitus, tachyarrhythmia, allergic reactions, dyspepsia.	Treatment with the drug should not last more than one week.

Tablets for back and joint pain
	Method of administration and dosage	Side effects	Special instructions
Ortofen	Take 25-50 mg orally up to 3 times a day.	Epigastric pain, nausea, headache.	Ortofen is not used to relieve pain in children under six years of age.
Ketorolac	Take one 10 mg tablet every 4-6 hours. The total duration of treatment is no more than a week.	Stomach pain, loss of appetite, diarrhea, nausea.	Ketorolac is not used to treat back and joint pain in children under 16 years of age.
Nimesulide	Take 100 mg of the drug twice a day, after meals.	Drowsiness, heartburn, dyspepsia, allergic reactions.	An absolute contraindication to treatment with the drug is pregnancy.

In order to never be bothered by back and joint pain, it is necessary that the body receives natural bioactive substances in the required quantity, which include vitamins and minerals. The skeletal system needs calcium, but its absorption is impossible without vitamin D ₃. For the coordinated work of the ligaments, collagen is needed, which is again absorbed in combination with vitamins A and E.

In addition, the musculoskeletal system needs the following vitamins:

• Vitamin A – improves the absorption of phosphorus;
• ascorbic acid – enhances collagen formation;
• Vitamin B ₆ improves the absorption of magnesium and balances mineral-salt metabolism.

Other important active substances for joints are:

• chondroitin – strengthens cartilage, ligaments, tendon fibers;
• collagen – provides flexibility and strength to tissues;
• glucosamine – strengthens tendons and ligaments;
• methylsulfonylmethane – promotes the restoration of bones and cartilage;
• silicon – improves the quality of collagen, retains calcium in bone tissue;
• manganese – helps deliver oxygen to cartilage and bones;
• sulfur – ensures metabolic processes in cartilage tissue;
• Selenium – improves cartilage structure.

A pair of fatty acids, namely linoleic and γ-linoleic acids, are also considered essential for back and joint pain.

Physiotherapy treatment

Physiotherapy for back and joint pain is one of the basic methods included in the treatment plan. The procedures are necessary both to prevent complications and to restore damaged tissue, relieve pain, and enhance the therapeutic effect.

• Electrophoresis involves the use of direct current, which penetrates deep into the skin. Thanks to this, it is possible to deliver painkillers, anti-inflammatory and regenerating agents directly to the inflamed tissues.
• UV irradiation (UV irradiation) is skin irritation using electromagnetic waves up to 400 nm long. This helps eliminate back and joint pain in arthrosis, arthritis, bursitis, tendonitis, etc.
• Infrared laser treatment is used for osteochondrosis, arthrosis, polyarthritis, synovitis. The procedures help reduce the sensitivity of nerve roots, stabilize blood circulation, and stop the inflammatory process.
• UHF therapy involves the impact of high-frequency ultrasound on the joints. As a result of such treatment, pain becomes less intense, swelling subsides, and inflammation is suppressed.
• Magnetic therapy is based on the effect of alternating or constant, low and high frequency magnetic fields. This treatment is especially often used for pain in the hip, knee or elbow joints.
• Medicinal baths are prescribed to patients with arthrosis, arthritis, etc. The most useful baths for back and joint pain are considered to be:
  • hydrogen sulfide;
  • nitrogen;
  • radon.

Bath treatment courses can be repeated twice a year, approximately 10-12 daily procedures.

Physiotherapy treatment for back and joint pain is prescribed only by a specialist: it is important to make sure that there are no contraindications.

Folk remedies

Many good reviews have been received from patients practicing therapeutic cleansing of the spine and joints using bay leaves. To prepare a decoction, take 3-4 medium leaves, chop them, pour 300 ml of hot water and place on low heat. Boil for about three minutes, pour together with the pulp into a thermos and keep overnight. In the morning, filter the medicine and start taking it: 2 sips a quarter of an hour before meals. Drinking a large amount of decoction at a time is not recommended, as this can lead to gastric bleeding. Since such treatment is quite complex and dangerous, you must consult a doctor before carrying it out.

If you have sea buckthorn oil at home, you can rub it into the sore spots several times a day. At the same time, you need to brew tea based on sea buckthorn berries and drink it throughout the day.

Clay applications and aloe and honey compresses are good for relieving back and joint pain. To prepare a simple compress, take 150 ml of vodka, 100 ml of honey and 50 ml of aloe juice. Mix all ingredients and place in the refrigerator for 7 days. Rub the sore spots with the resulting medicine, then wrap them in a warm scarf. It is better to do this procedure before going to bed. To achieve a lasting effect, you need to do 8-10 procedures.

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Herbal treatment

For back and joint pain, it is very good to use infusions and tinctures of certain medicinal plants. The choice of such plants is quite wide:

• birch leaves;
• cherry leaves;
• marsh wild rosemary;
• elderberry blossom;
• nettle leaves;
• creeping thyme;
• coniferous trees (spruce, juniper);
• tansy;
• sweet clover;
• purslane.

Most infusions should be prepared as follows: take 2 teaspoons of leaves, brew with 200 ml of boiling water, leave for a quarter of an hour, filter and drink throughout the day in small sips.

A medicinal ointment has a good effect. To prepare it, take 2 tablespoons of St. John's wort, the same amount of hops and medicinal sweet clover. The listed plants are ground into powder, mixed with 50 g of vaseline oil and rubbed well. The resulting ointment is used for compresses, which are placed on the sore joint at night.

Homeopathy

Treating back and joint pain with homeopathy is an unconventional and difficult solution. You cannot practice such therapy on your own, as there are specifics of prescribing homeopathic remedies that only an experienced homeopathic doctor knows about. In addition, there are contraindications - for example, malignant tumors, individual intolerance to medicinal components. You should first undergo a diagnostic examination, take the necessary tests to clarify the diagnosis.

The most common homeopathic remedies for back and joint pain are:

• Rhododendron - if joint pain is accompanied by headaches and general weakness;
• Calcarea Carbonica – if you are bothered by pain in the knees and hip joints;
• Dulcamara - if back pain intensifies in damp and cold weather;
• Ruta – prescribed for osteochondrosis or polyarthritis;
• Bryonia - if back and joint pain intensifies while walking;
• Phytolacca - if pain occurs due to excess body weight;
• Rus toxicodendron - if the pain affects the ligamentous apparatus and appears even at rest;
• Apis - if the pain is combined with swelling and redness of the joints.

The dosage of the above drugs and the frequency of their administration are prescribed by the doctor on an individual basis.

Surgical treatment

Surgery for back and joint pain may be needed in cases where conservative and drug treatment have not improved the patient's condition, and the presence of constant pain worsens the patient's quality of life. In particular, surgery is prescribed if persistent back pain is associated with intervertebral hernia, spinal canal stenosis, spondylolisthesis, as well as with spinal column trauma. Degenerative processes in the intervertebral discs associated with age-related wear of the spine may also be indications for surgery.

The basic types of surgical intervention for joint pain are:

• punctures – play a diagnostic and therapeutic role (used to introduce medicinal solutions into the joint);
• arthrotomy – is the opening of the synovial articular layer for its medicinal treatment;
• arthroplasty – involves restoring the functionality and motor ability of the joint;
• resection is the removal of bone articular surfaces (for example, in case of purulent destruction of bone);
• arthroscopy – performed using an endoscope and has therapeutic and diagnostic value;
• prosthetics – replacement of parts of a joint, or its complete replacement with an implant (to restore motor ability).

Complications and consequences

Depending on the cause of back and joint pain, a variety of complications may arise.

General complications may be associated with the use of various medications for pain relief. Unpleasant consequences often include allergic reactions, fever, hypersensitivity reactions, and an autoimmune response (when using corticosteroids).

If back pain is associated with problems in the spine, then over time, without treatment, the following may occur:

• paralysis of the limbs;
• paraplegia;
• neurological signs;
• disorder of brain functions.

When nerves are compressed, pinching may occur - for example, sciatica. This pathology is accompanied by severe shooting pains in the back, which often radiate to the buttocks, thigh, limb.

Joint problems often cause impaired mobility: the patient may lose the ability to work and become disabled.

Diseases of the spinal column can provoke malfunctions of internal organs. In particular, pathologies of the lumbar region sometimes cause problems with the urogenital system.

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Prevention

What to do to ensure that back and joint pain never bothers you? Doctors have voiced the basic rules of prevention:

• weight control, proper balanced nutrition;
• regular, measured, moderate exercise;
• warming up before physical activity (whether it be sports or work);
• correct position of the back and body when standing, walking, sitting;
• properly selected shoes - high-quality, with a small heel, low heel;
• good sleeping conditions (adequate bed length, quality mattress, comfortable pillow);
• absence of bad habits;
• regular medical examination, preventive diagnostics.

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Forecast

The prognosis depends on the cause of the pain, as well as on how correctly the patient will follow all the appointments and recommendations of the attending physician. Both the spine and joints must be protected, not forgetting about therapeutic exercises, a healthy lifestyle and healthy nutrition. If you follow all the recommendations, this will speed up recovery for a significant period of time. You should also avoid any overloads - both physical and stressful.

If you have back and joint pain, you should urgently seek medical help. A timely visit to the doctor will help prevent the development of unpleasant consequences and ensure motor comfort for many years.

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