Nocturnal Dyspnea & Back Pain

Nocturnal dyspnea and back pain can possibly occur simultaneously, resulting to a debilitating and potentially even life-threatening condition. It is not uncommon for people to experience back pain for several causative factors and to suffer from nocturnal dyspnea as well. Both are conditions that need immediate treatment as it can affect the functional daily living of affected individuals and can lead to other serious conditions that may arise over time.

Definitions

• Nocturnal dyspnea is a medical condition where a person suffers from breathing difficulty at night. According to the pathophysiological manifestation cited by McPhee and Ganong (Ref. 1), the person feels the sensation of breathlessness which can be attributed to the rise in the pulmonary capillary pressure. The condition can be caused by different conditions namely airway diseases such as asthma and obstructive pulmonary disease, cardiovascular disease, deconditioning, pulmonary vascular disease, interstitial lung disease and neuromuscular disease.

  Back pain is a common clinical manifestation of poor and improper back mechanism and posture. It is common in about 80 to 90 percent of the population to experience back pain. Back pain may arise due to spinal conditions aside from muscular imbalance.

Link Between Nocturnal Dyspnea and Back Pain

• It is possible for nocturnal dyspnea and back pain to occur as manifestations of variable diseases that result to the symptoms of difficulty in breathing and pain. Tuberculosis involving a miliary condition that spreads throughout different body organs and the paravertebral body can cause both symptoms to occur simultaneously.

  An acute pulmonary edema can also be the causative factor for nocturnal dyspnea to occur accompanied by back pain. The acute stage of edema may cause the extension of pain that is felt on the back. Edema usually occurs due to the weak pumping of the heart. Such condition stresses the chest that can lead to limited mobility of the spine. This results to overarching of the back, which leads to back pain.

Other Causative Conditions

• Varied conditions can promote the symptoms of dyspnea at night and may initiate back pain to occur as well. Most acute conditions are due to pulmonary causes such as embolism, asthma, restrictive pulmonary diseases, toxic airway damage, inhalation of foreign bodies and pneumothorax. Cardiac diseases can also be the culprit for both symptoms to occur such as heart failure, ischemia, myocardial infarction, and papillary muscle dysfunction. A paralysis of the diaphragm and anxiety disorders can also trigger both nocturnal dyspnea and back pain to manifest at the same time.

Diagnostic Measures

• In order to obtain a more reliable diagnosis of the conditions that can possibly cause the symptoms of dyspnea and back pain, accurate tests must be carried out to indicate a more established cause of the symptoms.

  The common diagnostic tests carried out are chest X-ray, ECG, ABG test, spirometry, chest CT, pulmonary function tests, echocardiography, cardiac stress test, WBC count and cultures for blood and sputum. These tests are carried out to establish accurate diagnosis.

Evaluation and Treatment

• Common evaluation procedures identify specific causes of nighttime breathlessness and back pain. The evaluation process is vital to cover all possible conditions that may provoke and initiate the symptoms of dyspnea and back pain. Evaluation procedures include taking the past medical history of the patient, the history of the present illness, physical examination and diagnostic procedures.

  Accurate evaluation and diagnosis are valuable for providing treatment. The focus of treatment is primarily to correct the underlying causes and the debilitating symptoms of back pain and dyspnea.