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Back pain is an algony symptom related to the back of the chest, in the middle of the back or between the shoulder blades. This manifestation is less frequent in cervical disorders and lower back pain, but can be equally disabling for those who suffer from it. It is a discomfort that can be caused by a variety of pathologies, and it is therefore very important that doctor examines you and rules out any serious diseases underlying the pain in your back. If you would like to learn more about back pain and how to deal with it at home, read this article.
Acute back pain
Acute back pain is manifested or accentuated in certain positions, while it tends to diminish with the rest or mobilization. Usually, this symptom is due to incorrect postural attitudes, discus lesions, or alterations in the intervertebral joints. An acute episode of dorsal pain may also be the reflected expression of a pathology that occurs in other districts, such as pleurisy or pneumothorax (in this context, other symptoms such as fever and dyspnoea are generally found). When associated with painful skin manifestations, however, back pain may depend on a herpes zoster infection.
Chronic back pain
In most cases, chronic pain is caused by prolonged and abstinence of incorrect postures (for example, for professional reasons: drivers, tailors, etc.), arthrosis of the spine, scoliosis, and osteoporosis. This manifestation may also depend on the enhancement of the dorsal cyst (curved back), which may occur during the period of growth or postural alteration. In adolescents (12-18 years), pain may be a manifestation of dorsal osteochondrosis (Scheuermann’s disease).
Below you will find the list of possible conditions that cause middle back pain. Any of those may radiate to the left side, so those ailments should be ruled out before arriving at the final diagnosis.
1. Angina unstable
Unstable angina is a clinical syndrome caused, most of all, by an acute – almost complete, but not total – occlusion of a coronary artery by a platelet and fibrin-rich thrombus. The severity of this condition is intermediate between that of stable angina and that of myocardial infarction. Other risk factors for the development of such syndrome include atherosclerosis, hypertension and arterial embolism.
The patient with unstable angina can have three main clinical pictures:
- Angina of new onset (within the last two months): angina of grade 3 or 4 of Canadian Cardiovascular Society Classification (CCSC), angina at rest (often prolonged) or both of the first situations;
- Aggravation of a pre-existing angioin (within two months of onset): angina episodes are clearly more frequent, intense, of longer duration or with lower onset threshold;
- Post-infarction angina (within two weeks of infarction).
2. Ankylosing spondylitis
Ankylosing spondylitis is a form of inflammatory arthritis in which the joints of the spine become inflamed, often causing stiffness and back pain. The damage to the column and the hips caused by this pathology are visible to X-rays. Ankylosing spondylitis is a highly reversible rheumatic disease, targeting the spine and the skeletal muscle system in general: spondylitis is a systemic, chronic, and autoimmune disorder that, in the most severe cases, causes a true fusion of the joints.
Ankylosing spondylitis is inserted between spondylarthritis and, after rheumatoid arthritis, is the most frequent and severe degenerative disease. Ankylosing spondylitis is a subtle disease: in the initial stage, pain only affects the spine, then hits the lower extremities, knees and shoulders. In more severe cases, the disease could cause total disability to the patient.
Ankylosing spondylitis is a predominantly malignant disease: in fact, estimates have a 3-fold greater incidence of “the stronger sex” than women. Generally, ankylosing spondylitis affects children after 10 years of age and adult subjects aged between 20 and 40; however, there is a late form affecting the fifty and sixties. Generally, female ankylosing spondylitis has a less severe course than the male counterpart.
Ankylosing spondylitis is a genetic disorder, so some genes responsible for the pathological manifestation have been identified: in the 90% of Caucasian patients, the presence of the HLA-B27 gene was found, whereas in black-spondylitis patients the HLA-B7 gene is the most responsible. In addition, statistics show staggering data: it seems that 20% of healthy people with HLA-B27 are highly at risk of ankylosing spondylitis.
Only recently, two other genes implicated in the disease were discovered: ARTS1 and IL23R. As we have seen, genetic predisposition is absolutely essential to the manifestation of spondylitis: in any case, this does not mean that some environmental factors can play a significant role in its onset.
Osteoarthritis – also called osteoarthritis or not properly osteoarthritis – is a chronic disease affecting joints (arthropathy). It is a degenerative disease, as it leads to the progressive loss of normal anatomical components that form the joints.
Arthrosis mainly affects the spine (vertebrae) and the joints of the limbs, and is characterized by the loss of articular cartilage, which is replaced by new bone tissue; This causes pain and a limitation in movements. It has not yet been clarified whether the primitive lesion affects the cartilage or the bone just below it.
The prevalence of arthrosis is directly related to age: it is present in the majority of human beings at the age of forty years and in almost all of the seventy, with a peak peak rate between 75 and 79 years. Despite only a minority of affected warts, osteoarthritis is by far the most important cause of pain and disability for joint diseases. Before the age of 45 is the male sex more affected, after that age – the female. The prevalence of injuries increases as the age increases.
According to a more precise scientific definition, arthrosis is a degenerative pathology of articular cartilage.
The main features of the disease are:
- Degenerative, chronic and progressive disease.
- It affects especially older people.
- The most commonly affected joints of osteoarthritis are the spine, hip, knee, fingers and toes.
The human skeleton is made up of numerous bones (about 208) that are classified, in size, into long, short, and short bones. Bones are static bodies and must articulate together to make movement possible. This union between the various bone segments is called articulation.
The bones of the human skeleton are connected by different types of articulation: immobile (synarthrosis), semimobile (joints, or articular surface) and mobile (diarthrosis). Synarthrosis, joining the skull bones, does not allow any movement. Mobile or semi-mobile joints differ in shape and type of movement allowed. Tricycles (knee or elbow joints) ensure bending and extension movements on a single plane; enarthrosis (those of the shoulder and the hip) allow free movements in all directions; arthrodial joints, which combine the bones of the carus in the hand and the tarsus in the foot, only allow small movements of flexural extension.
Each mobile “articulation” is formed by peripheral cartilages of the bones; the space between them is filled with liquid (synovial fluid), an articular capsule and tendons. The articular cartilage is soft, compressible, extensible and deformable. The synovial fluid has a damping and nourishing function, facilitates the sliding between the two articulated surfaces and is secreted by the synovial membrane. The joint capsule is made up of connective tissue that completely covers the two outer bone segments. Muscles and tendons along with the joint capsule allow to increase joint stability.
The main risk factors for the development of osteoarthritis are:
Age: Changes in senile cartilage result in loss of elasticity and resistance to stress and favor the injurious activity of other factors.
Mechanical factors: Very important for joint equilibrium. Malformations or joint maladies are especially important in the knee’s arthritis, which is rather common in the female population, probably due to excessive use, repeated microtraums and loosening. Professional and sports activities have been seen to be responsible for the onset of the disease.
Workers include arthrosis of the shoulders, elbows and hands in pneumatic hammers, hip arthrosis in professional dancers, knee injury in miners and lumbar in trucks or bus drivers. For athletes, judgment is more difficult, as there are a number of causes at stake. In footballers, for example, one of these may be the frequent rupture of menus.
A weakness of the ligaments can explain the arthrosis of the shoulders of the tennis players. It is also suggestive to note the increased frequency of hands arthrosis in judoists. Regarding trauma, violent fracture trauma can generate indirect arousal due to instability or incongruity of joint heads. However, it seems that a liability can also be attributed to bruising on cartilage, without fracture.
Inheritance: Some hereditary diseases such as hemochromatosis, Ehlers-Danlos syndrome and Marfan syndrome compromise metabolism and / or articular function and may cause some types of secondary arthrosis. It has long been known that arthrosis of the fingers often recognizes a family transmission.
Obesity and endocrine disorders: Obesity is undoubtedly the most important risk factor for the development of knee lesions in both sexes. Instead, there is some doubt about its role in determining that of the hip, which however influences the type of evolution, aggravating it. Some endocrine system disorders, such as diabetes mellitus and gout, regardless of obesity, have been called into question as potential risk factors.
Inflammation: Its role is greatly enhanced, both in the ability to cause osteoarthritis and the influence on its progression. In the first case, arthritis forms arthritis, especially rheumatoid arthritis, and, in the latter case, the intervention of a true inflammatory process in arthrosis-associated joints is considered.
4. Cervical arthrosis
In the previous episode we started talking about arthrosis. We have seen how this disease is characterized by degenerative cartilage lesions that cover and protect the bone extremities involved in the joints. We have also seen that this process is not limited to cartilage but it tends to involve, gradually, the whole articulation. This results in localized pain and a limitation of movements that over the years become more and more aggravated. Today, we see more in detail what happens when the arthrosis hits the vertebrae of the neck.
In cervical arthrosis wear and erosions typically affect both the vertebral joint surfaces and the cartilage discs interposed between one vertebra and the other. In practice, such structures are experiencing slow deterioration, which causes pain and other problems, including neck stiffness, nausea, headaches and limited mobility. The cervical tract is in fact the most mobile part of the spine, which guarantees the correct movements of the neck and the head.
The cartilage and articular damage typical of arthrosis is at least partly a physiological consequence of aging. However, with regard to cervical arthrosis the age factor is not so decisive as the arthrosis process often affects young people as well. It would therefore be correct to consider it, more a consequence of a wrong lifestyle than an inevitable effect of aging.
Cervical arthrosis is a chronic and progressive disease; It tends to worsen over time. If not adequately treated and treated, it may also involve the nerve and vascular structures protected by the same cervical spine, with all the negative consequences of the case. For example, annoying pains and tingles can arise from the neck to the arms and hands; In the worst cases, there are also serious difficulties in making certain moves.
The causes of cervical arthrosis may be the most varied. Often, there are postural vices that cause abnormal compression on the joints of the cervical spine; So people who remain many hours or sit in front of a desk are at risk. Other times, excessive or repeated efforts of the cervical tract are implicated, perhaps due to heavy work or sports activities such as weight lifting.
Cervical arthrosis can also be caused by trauma, as can be the case in some contact sports or in the so-called “whiplash”, a typical consequence of car accidents with the dynamics of the tamponamento. Risk factors are also spinal lesions, such as scoliosis or cystitis, and other pathologies such as rheumatoid arthritis.
Among the symptoms of cervical arthrosis, the most well-known are the pain felt in the neck and neck, the feeling of stiffness and the difficulty of doing even trivial movements, such as turning or bending the head. A signal not to be underestimated is the perception of noise, similar to a “snap”, which is felt when turning your neck or lowering your head; Moreover, these noises are often associated with the feeling of internal friction, as if they had the “grain of sand” between the vertebrae.
This noise is basically due to the development of bone bumps on the vertebrae called osteophytes. Other symptoms that can occur with cervical arthrosis are: headache, dizziness, eye disorders, intolerance to noise, nausea, and head trauma in position changes. Cervical osteoarthritis tends to get worse with the advance of time and can cause a strong widespread pain. In addition to the neck, there may be a painful involvement that radiates from the shoulders to the fingers of the hand, with perforation of tingles or small shakes.
In this case, we talk more about cervical obstructions, which are sometimes associated with sensory disturbances such as numbness, tingling, loss of sensitivity and decreased muscle strength of the arm and the hand. These disorders are due to the compression of the roots of the cervical nerves, especially for the formation of osteophytes or a nerve to the disk. Their presence, in fact, can cause a decrease in the diameter of the vertebral boreholes.
This provides for possible inflammation or compression not only of the spinal nerves, as already mentioned, but also of the vascular structures of the cervical tract. Obviously, in the most serious cases, all this can be very debilitating. Let’s look at some examples together. If compression affects the blood vessels that pass through the vertebrae of the neck and feed the brain, stomach and drowsiness may develop unmotivated.
In very rare cases, excessive compression of the cervical spinal cord can cause problems with the lumbar and leg tracts, such as lower back and lower back pain, movement disorders, and even loss of bladder control. It is interesting to note however that in some patients the symptoms of cervical arthrosis may be minimal or even absent, although the presence of typical lesions of the arthrosis is well visible from the radiological examination.
In the presence of typical symptoms of cervical arthrosis, it is good to undergo a orthopedic visit; Will eventually follow more extensive examinations through imaging techniques such as radiographs, TACs and magnetic resonance imaging. Often, standard x-rays are sufficient to document the presence of cervical arthrosis, while any problems with soft tissues, such as hernias and nerve root compressions, are only well evidenced by magnetic resonance imaging.
In addition, a visit may be useful to evaluate any neurological problems or electromyography. Electromyography, in particular, is considered for those patients who continue to complain of persistent pain despite radiographic images do not reveal significant alterations.
Unfortunately, in the present state of medical science, cervical arthritis can not cure. Cartilage and joint degeneration is progressive, and it can only slow down; Moreover, there are very effective medications to relieve symptoms. Drugs such as painkillers, anti-inflammatory drugs and, sometimes, muscle relaxants, which are useful in the acute phase but which do not need to be abused because long-term side effects are not indifferent.
During painful crises, the neck should be kept at rest, possibly by temporarily resorting to an orthopedic collar. The function of this device is to support the neck in order to attenuate the pressure on the cervical nerves and blood vessels, and to prevent too sharp movements. In times between one crisis and another, it may be very useful to rehabilitate physical massages and therapies. In the most severe cases, however, surgery may be necessary, especially in the presence of severe nerve or spinal compression.
At a preventive level, the first useful measure is to change the bad habits that in many cases are themselves the cause of cervical arthrosis. For example, if you are forced to stay or sit for a long time, it is important to maintain a correct position to not cure the cervical area.
Stretch-specific stretching exercises are also recommended. For example, you can move forward and backward, left and right, and rotate slides on one side and another to run for a few minutes each day. During the acute phase of osteoarthritis, however, I remind you that it is best to avoid straining the cervical tract too much.
5. Cervical spondylosis
Spondylosis is a degenerative disease that involves the cervical spine, vertebral bodies, and contiguous intervertebral tissues. This is a generalized spine-like arthritis, which is characterized by progressive, though slow, deformation of the back vertebrae and the disk. Spondylosis should not be confused with spondylitis, despite the two terms mistakenly being mistaken for synonyms.
Cervical spondylosis outlines a very widespread pathological condition among adults and senescence patients; in particular, heavy-duty subjects represent the most at risk of spondylosis. In any case, it is estimated that about half of ultra-fifty and 90% of women over 60 suffer from spondylosis, although the condition is perceived differently by the subject; therefore, the resulting clinical expression is very heterogeneous.
When spondylosis is localized at the spine of the column, the pathological condition does not give any symptoms and discovery of the disorder, most often, is the result of a random event. Spondylosis may evolve causing vertebrae and / or calcification of the ligaments. In these cases, pain is generally bearable and not accentuated.
In other cases, spondylosis may cause pain located at a precise point, or generalized throughout the column, causing more intense suffering: it is the case of slipping of the vertebrae, which could also generate a pseudo-disability. Spondylosis patients often complain of “a widespread stiffness and intermittent back pain, which is accentuated in the morning”: pain and stiffness tend to be attenuated during the day, with rest and with heat applications.
6. Cervical stenosis
Cervical stenosis is a narrowing of the cervical vertebral canal, a structure containing the spinal cord and the origin of the cervical spinal roots. The stenosis of this bone channel consisting of the cervical vertebrae and the discernible intervertebral complex may be the result of the physiologic phenomenon of column aging (degenerative stenosis), of anatomical conditions already present at birth (congenital stenosis) or of a traumatic / (post-traumatic stenosis).
Forms of pure degenerative cervical stenosis are typical of the individuals aged above 60. When the stenosis phenomenon produces a compression of the nerve structures contained in the cervical column, clinical frameworks are characterized by the presence of signs and symptoms closely related to the type of compressed structure. With the term cervical myelopathy is meant a suffering from the cervical spinal cord responsible for a potentially irreversible clinical picture of disability.
Stenosis manifests itself with symptoms that vary depending on the nervous structures involved, but commonly there is cervical pain, with radius between the neck and shoulder blades, exacerbated by movement. Patients with cervical stenosis complain of painful tendencies similar to electric shocks, especially when flexing the neck by turning the chin in the direction of the chest. Cervical stenosis can also cause numbness, weakness, burning sensations and tingling in the arms.
Other symptoms include headache, nausea, and stroke in position changes, stiffness sensation and movement restriction (flexion, extension, lateral inclination, and rotation). Over time, cervical stenosis may evolve into a myelopathy for friction on the spinal cord, sometimes involving lower nerve roots (radiculopathy).
7. Disc hernia
The term hernia indicates the release of a viscus (that is, an internal organ in a body cavity) or part of it from the natural cavity that normally contains it. Specifically, the term hernia to the disc indicates the leakage of material of the pulverized nucleus of the intervertebral disc, caused by the breakage of the fibrous tissues forming the disk wall.
Disc hernia located in the lumbar region typically manifests itself with sciatica, i.e. pain along the gluteus, leg and foot. When the hernia is instead located at the cervical site, the patient typically suffers from cervical obstruction, that is, a pain from the cervical region radiating along the arm and the shoulder.
Erysipelas is the popular name of the pathology known as Herpes Zoster. It is an infectious disease caused by the reactivation of the same virus that causes the varicella: the Varicella-Zoster Virus (VZV).
While the varicella is typical of children, erysipelas strikes electively adults and especially elderly people. The disease is characterized by the appearance of areas of skin that peel and develop red spots, which evolve into vesicles or bubbles. The affected area (usually the trunk, more rarely the face) is painful, often pruriginal.
Sometimes middle back pain begins before boils appear. If the face is involved, especially in the eye area, the disease is called ophthalmic herpes zoster; in these cases, it is important to contact the physician immediately to receive the appropriate treatment, since in the absence of treatment the vision can be seriously affected. Sometimes chest and back pain persists for several months after skin lesions are resolved; in these cases it is referred to post-herpetic neuralgia, a serious complication, disabling and difficult to treat.
Chronic myelitis is a serious condition which means it is a chronic inflammation of the spinal cord. It is a very rare disease. The diagnosis is made after other similar diseases have been ruled out. The doctor who investigates this type of discomfort is a neurologist who is a specialist in nervous system diseases. The investigation includes magnetic camera surveys.
The symptoms of chronic myelitis remind symptomatically of multiple sclerosis (MS). Weakness and affect of feeling occur almost always and sometimes even pain. Sometimes there is an underlying cause of chronic myelitis, such as borrelia, syphilis, HIV and HIV-like viruses. The investigation includes examination of these diseases.
In rare cases a underlying disease is found. In that case, of course, it is treated. There is no special or cure for chronic myelitis. But sometimes cortisone is given in high doses to suppress the inconvenience. At the same time, myelitis manifests itself with more or less extensive muscle paralysis, loss of sphincter sensitivity and dysfunction, uncontrolled emission or retention of urine and stool.
Middle back pain is a common symptom of myelitis. During the course of the illness, pain may appear on the neck, back or skull. Within a few hours or a few days, the patient may experience an annoying feeling of constriction around the chest or abdomen. In addition, erectile tendons may develop in the limbs, tingles, muscle spasms, numbness and numbness of the feet and legs, sexual spasms, and evacuation difficulties.
Myelopathy is a condition where the spinal cord is affected at the neck level and is usually due to the tightness of the spinal cord due to degenerative changes. Sometimes large rupture of the throat can affect the spinal cord but it is more unusual. Myelopathy should be distinguished from the condition that gives an effect on individual nerve roots and only produces symptoms from these. The effect on the spinal cord is generally a more serious condition and with another symptom type. It mainly affects the older half of the population and can cause pronounced weakness and numbness in both arms and legs.
Patients with spinal cord interactions differ in such a way that they rarely seek because of pains in the first place. There are more often unspecific symptoms and can be quite widespread and difficult at first. In most cases, the symptoms gradually progress for a long time, which means that the patient does not always seek care directly.
Symptoms are associated with spinal cord affect which may cause widespread feeling of loss, fine motor disorder in hands and walking difficulties. During examination you often find advanced latex reflexes, sometimes with clonus (extra stroke when testing reflexes). Feeling should be investigated for different modalities (touch, press, heat, cold) and across different parts of the body. In the event of suspicion of spinal cord effect, MR is primarily done.
Osteochondrosis is a degenerative bone syndrome that fragmentates the extremities. Also known as osteochondritis, it is predominantly at the level of the joints and it mainly affects young people, athletes and those who, in general, are subject to repeated and frequent traumas. There has been a lot of debate on the causes of osteocondritis and it has come to the conclusion that there is a process of necrosis (tissue death) at the base. Osteocondrosis The symptoms of osteochondrosis evolve and worsen very slowly. Diagnostic tests, if done in time, allow non-invasive therapeutic intervention.
The term osteochondrosis identifies a series of short or oxalous pathologies, in which a small portion of the extremity, bone or cartilage, is separated from the remaining healthy bone. In other words, a small end of the bone is fragmented.
Osteochondrosis can afflict all bones with epiphysis or apophysis, but most affect those that make up a cartilage joint. In joint joints, the bone lesion separates a fragment composed of subcondral bone and adjacent cartilage (the subcondral bone term identifies the bone layer underlying the cartilage). Thus a free osteocartilagine body is formed. The articular joints most affected by osteoarthritis are located at the level of:
Osteoporosis is a systemic skeletal disorder characterized by a reduced bone mass and the deterioration of bone structure microarchitecture, resulting in increased fragility and predisposition to fractures, especially the hip, spine and wrist.
If you have osteoporosis, the skeleton is weaker and you are more likely to have bone fractures. Most common are bone fractures in the wrists, hips, spine or upper arms. Osteoporosis is due to the fact that the balance between degradation and bone structure in the body is rubbed, so that more bones are broken than re-formed. It is possible to reduce the risk of osteoporosis by being physically active and by not smoking.
Osteoporosis is most common in women who have had a reduced amount of sex hormone estrogen when they reach menopause. If you have osteoporosis, you can treat medicines that strengthen the skeleton and reduce the risk of bone fractures. Most bone fractures hurt in some way. But in some cases when the backbones are squeezed together, it may sometimes only cause moderate backache, which you may not even seek care for.
If multiple vertebrae in the back are squeezed together because of osteoporosis, the spine can change shape, which can eventually make you sick and shorter. Osteoporosis in children or adolescents is usually congenital and is called osteogenesis imperfecta. It should be investigated by a pediatrician.
Pleurisy is an acute or chronic inflammation of the pleura, the double serous leaf covering the inside of the chest cavity and surrounding the lungs. Often expressed as viral or bacterial insults, pleurisy is usually perceived as a strong chest pain, exacerbated by a deep breath and coughing. Pleurisy is synonymous with “pleural chest pain”, just to highlight the spasm caused by the stroke of the double inflamed membrane whenever the lungs expand to breathe.
The main symptom of pleurisy is in chest pain, described as “transfused, acute and lancinous,” exacerbated by coughing. This can be perceived in any area of the chest, depending on the inflammation site. The pain can radiate into middle back, causing additional discomfort.
In addition to the omnipresent chest pain, the pleurite patient reports other prodromes: chills, temperature, diarrhea, sore throat associated with joint pain and swelling, lack of breath, undesirable weight loss, quick and superficial breathing, influenza-like symptoms, sneezing, tachycardia, coughing, sometimes coughing with traces of blood.
Normally, pleurisy does not cause long-term damage, although inflammation may worsen or sometimes promote lung infections. Among the rare complications, we remember the formation of cicatricial lesions (adherence) that may hinder breathing. In principle, it is possible to state that complications do not depend much on pleurisy in itself, but rather on the root cause.
Radiculopathy is a pathological condition that affects the roots of the spinal nerves and their prolongations, resulting in the involvement of the motor functions and sensory organs. Radiculopathy can affect both a single nerve root and more nerve root at the same time. There are different forms of radiculopathy, but the most common ones appear to be those that manifest at the cervical (i.e., cervical radiculopathy) and at the lumbar and sacral level (in this case, it is referred to as lumbosacral radiculopathies).
Depending on the nervous root involved, and depending on the magnitude of nerve damage, the symptoms triggered by radiculopathy may be different and affect various parts of the body. In fact, spinal nerves control several body regions, and this is why cervical radiculosis produces typical symptoms at the neck level, while lumbar limbs cause a symptomatology characteristic of the lower limbs.
However, among the major symptoms that may occur in case of radiculopathy, we note asthenia hyperalgesia, pain in various areas of the body (neck, feet, lower and upper limbs, back, shoulders, joints) that can be exacerbated by the execution of various types of movements, hyperreflexia, hypoaesthesia, paresthesia, stiffness and muscular weakness and spastic tetraparesis. In addition, lumbos-sacral radiculopathy, when it affects multiple nerve roots at the same time, can give rise to serious complications such as sphincter alterations and sexual dysfunction.
15. Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic and disabling inflammatory disease, with etiology not clearly defined, but likely of autoimmune origin. It mainly affects symmetrical joints, but also tendons, synovium, muscles, bursas and other tissues in the body. Symptoms commonly associated with rheumatoid arthritis affect joint arteries and include swelling, feeling of heat, pain in palpation, and movement restriction. Also important are the extra-articulatory events.
The symptoms of rheumatoid arthritis are varied and may include: pain and swelling in the joints, which are held to the touch; joint stiffness, particularly pronounced in the morning and after activity; articular deformities (predominantly at the level of the small joints of the hands); fever, weight loss; muscular hypotrophy and tendon anomalies.
16. Scheuermann’s disease
Scheuermann’s disease is the state where the backbone is more curved than usual. The vast majority of people have a dorsal curvature, but in Scheuermann’s the curvature is greater than normal.
Scheuermann’s disease can develop due to a developmental disorder in the back of the back where the cows have a light wedge shape. Scheuermann’s disease is often discovered in patient’s teens. The curvature does not disappear after the teens, but on the other hand does not increase either. Sometimes Scheuermann’s disease is discovered as a bifurcation when making an X-ray of the back.
Scheuermann’s disease gives no problems at all. Sometimes pains occur but they usually go over. In adults, doctors expect that Scheuermann’s disease will not deteriorate the quality of patient’s life unless the back is very curved. Since Scheuermann’s disease does not usually cause an inconvenience, no treatment is required. In some cases, the curvature may be so grave that corset treatment may be relevant, but this is one of the rare things. Physiotherapy is usually recommended if you have a problem with Scheuermann’s disease.
However, in marginal cases this condition can be associated with the following symptoms, one of which is actually middle back (dorsal) pain: middle back pain, hyperkyphosis, hyperlordosis, backache, osteoporosis, scoliosis and vertebral stenosis.
17. Spinal stenosis
Vertebral (spinal) stenosis is a narrowing of one or more areas of the vertebral canal, formed by the overlap of the thirty-three vertebrae that make up our spine. Since there are fragile nervous structures inside this channel that give rise to bone marrow, it is generally a rather annoying disease.
In addition to the marrow, stenosis can also compress the spinal nerves, which emerge from it at the vertebral boreholes. Among athletes, sternum of the vertebral spectacle affects mainly former wrestlers and former weightlifters who for years have sustained heavy loads on their backs and especially in the lumbar region.
Stenosis, which electrically affects the cervical and / or lumbar spine of the column, can manifest itself through such symptoms as cramping, pain, numbness in the lower limbs, back, neck, shoulders, or arms; Signs of spinal cord suffering include bladder or intestine dysfunction.
In other cases, the symptoms are more nuisance and may include asthenia (muscular weakness), numbness or paresthesia (tingling) of the lower limbs, always aggravated by deambulation. Often, and especially when it is caused by a hernia to the disk, vertebral stenosis causes moderate backache (pain in the lower back), more or less accompanied by sciatica (pain that radiates at the back of the thigh and leg) or cruralgia (pain that radiates in the front of the thigh).
18. Kidney stones
Renal calculations – identified by the term “nephrolithiasis” or “kidney lithiasis” – are small aggregations of mineral salts that form in the urinary tract. Their presence is related to an inconsistent diet which necessarily associates an underlying genetic predisposition. Sometimes kidney stones are asymptomatic and are discovered by chance during a control radiography. Other times, acute and violent pain (renal colic) strongly signals their presence.
As a rule, the colic occurs suddenly. Localized in the left side of the middle back, the pain of kidney colic has a typically spasmodic character, intense and lasts several minutes. The severity of the pain is such that it is described as similar or even superior to that of a childbirth, and is a common cause that urges patients to turn to the emergency room.
If, however, the urine flow is able to expel the calculus, it is possible that during the passage in the urinary tract the pebbles cause lesions causing the blood to appear in the urine. In addition to colic pain, sometimes the presence of kidney stones may be associated with other symptoms such as difficulty urinating, mental urgency, nausea and vomiting. The presence of fever generally suggests an urinary tract infection.
Pancreatitis is a generic inflammation of the pancreas, an important gland for the digestive and glycemic balance of the entire body. Pancreatitis essentially recognizes two forms, acute pancreatitis, which appears suddenly and violently, and chronic pancreatitis, which persists for a long time, tend to worsen over time.
Acute pancreatitis occurs with a sudden and severe pain in the upper abdomen, anatomical pancreas, with tendency to radiating towards the back. Painful symptoms typically aggravate after meals, with deep inspiration and during palpation of the abdomen; Instead, they tend to relieve themselves by folding forward (the patient searches for and maintains a laxative position).
Pain is often accompanied by nausea and vomiting in the food and the bile (dark green), while the patient is particularly depressed, feverish, anxious and agitated, often with signs of shock (cold and pale skin, marked hypotension, increased and weak heartbeat). In the absence of treatment, the pain, which is often drug resistant, reaches the maximum progressively, remains intense for a long time and decreases gradually over days or weeks.
In chronic pancreatitis, the symptoms are more blurred, so that inflammation sometimes begins with very few symptoms; The patient complains of a pain in the upper part of the abdomen that radiates to the back and is localized in the left side, associated with inexplicable weight loss, lack of appetite, and digestive problems with steatorrea (fatty, oily fat, especially in conjunction with high-lipid copious meals).