Dorsalgia: what it is and complete information about the treatment of the disease. What is the characteristic of vertebrogenic dorsalgia? Traditional medicine

Everyone has experienced pain in various areas of the back at least once in their life. It is not surprising, since our spine carries a tremendous load every day. The main enemies of our back are sedentary work, laziness and neglect of physical activity and sports. And sometimes we ourselves cause harm to the spine: with weights and high heels. Knowledge about the characteristics of pain in the back, neck, and lower back—dorsalgia—will help to recognize the disease in a timely manner.

Back pain (dorsalgia) is a complex syndrome that manifests itself in many pathologies. It can accompany both diseases of the spine and damage to internal organs.

When turning to a specialist for help, you need to describe all complaints as accurately as possible: the nature of the pain, difficulty moving, convulsive manifestations, loss of sensitivity, and others.

Types of dorsalgia

The most important thing for making a diagnosis is to correctly classify the pain syndrome. Functional impairment can be easily restored if diagnosed early. Some types of pain are prone to chronicity, so the doctor’s task is to select the patient’s treatment that maximizes his quality of life.

Etiology of back pain

By nature, primary (mechanical) and secondary dorsalgia are distinguished.

Primary is caused by dystrophy - a metabolic disorder in the tissues of the spine. It is more common between the ages of 20 and 50, and women are more affected.
Secondary dorsalgia develops against the background of existing diseases and conditions. For example, pain due to infections, injuries and tumors. Secondary back pain is chronic and responds more slowly to therapy. Occurs in children or adult patients over 50 years of age.

Classification of pain

Based on the location of the process, the following types of pain are distinguished:

Local pain is usually constant, without a tendency to spread. The patient can indicate the exact boundaries of the lesion.
Projection pain, on the contrary, is diffuse, spreading or diffuse.
Radicular pain is described as piercing and shooting. Almost always it radiates and sharply intensifies with movement.
Muscular spastic pain is associated with a sharp increase in muscle tone. Patients usually describe it as cramps.

Based on its origin, dorsalgia is divided into:

1 vertebrogenic,
when dorsalgia is caused by existing spinal pathologies of various types (degenerative, traumatic, inflammatory);

2 nonvertebrogenic,
when back pain is provoked by muscle strain or spasm, somatic diseases, or psychogenic factors.

Causes of pain in the back and limbs

Most often, doctors are faced with the causes of vertebrogenic dorsalgia, when the nerve root extending from the spinal cord through the vertebral foramina is under pressure from bone growths on the bodies of adjacent vertebrae due to prolonged osteochondrosis or a deformed intervertebral disc when it bulges or herniates.

Other causes of vertebrogenic dorsalgia may include:

Non-vertebral causes cause dorsalgia less frequently.

It can be:

chronic inflammatory and dyshormonal processes, tumors of the genitourinary system (endometriosis, uterine fibroids, prostate adenoma);
pathologies of the gastrointestinal tract (ulcer perforation, inflammation and tumors of the pancreas, intestinal diverticulitis);
metastases of cancer tumors in the vertebrae;
psoriatic arthritis;
aortic aneurysm;
psychosomatic pain in depression and neuroses.

Pain syndromes in the back (dorsalgia) of a vertebrogenic nature

The predominance of compression or reflex syndrome depends on which structures are more involved in the pathological process.

Compression syndrome occurs due to compression of the spinal cord, nerve roots and blood vessels.
Reflex syndrome appears when tissues containing a large number of sensitive receptors are damaged.

Rich innervation is absent only in the bony part of the vertebral bodies and the vessels of the epidural membrane.

In the cervical region of the spine

Compression syndromes.

The level of compression of the nerve roots in the cervical spine determines the clinical symptoms of dorsalgia:

root C3 – pain and paresthesia (crawling sensation) in half of the neck on the affected side;
roots C4-5 – pain above the collarbone, unilateral atrophy of the neck muscles;
root C6 – pain in the cervical, supraclavicular and scapular regions, spreading along the edge of the hand to the thumb;
root C7 – pain in the same areas as with C6, only radiates along the outer surface of the hand to the middle and index finger of the hand;
root C8 – pain spreads along the inner surface of the arm to the little finger.

Compression of the spinal cord in the lower cervical spine leads to decreased tendon reflexes in the hand and forearm. If the vessels or spinal cord are subject to partial transverse compression, mixed paresis of the arms or upper spastic paraparesis develops - incomplete paralysis of both upper limbs, manifested by weakness and decreased severity of reflexes.

Reflex syndromes.

Clinical signs are lumbago and constant pain in the neck, radiating to the shoulder girdle and the back of the head. They appear immediately after waking up and get worse with movement, coughing, and sneezing. In this case, sensitivity and tendon reflexes do not change.

Anterior scalene muscle syndrome is common. It is characterized by a forced posture - the head is turned to the painful side and tilted forward. The patient cannot turn his head in the opposite direction due to intense arching pain.

Thoracic region

Compression syndromes.

This area is extremely rarely affected. Characterized by sensory disturbances, tingling and pallor of the hand. In severe cases - weakness, numbness and cyanosis of the hand. The cause of compression in this area is often an additional rib. It is a skeletal malformation and is a fibrous or bony plate attached to the seventh cervical vertebra and the first rib.

Reflex syndromes.

They also appear in the area of the ribs. Intensifies with deep inspiration. Pain in the anterior chest wall occurs less frequently. Patients note increased pain when lifting heavy objects.

In the lumbosacral region

Compression radicular syndromes.

Better known as or, as older people say, sciatica.

The so-called radicular pain is easy to recognize because it has a number of distinctive features:

irradiation from the lower back along the entire lower limb to the foot;
increased pain when coughing and straining;
almost always accompanied by autonomic-vascular disorders (numbness, paresthesia, chilliness).

In the lumbosacral region, the following are most often subject to compression:

L5 root with symptoms of intense pain spreading from the lower back through the buttock and outer thigh to the big toe;
When pinched, the S1 root causes pain from the lower back along the back of the thigh and lower leg to the little toe.

Reflex syndromes.

– acute pain in the lower back, provoked by awkward bending. Usually covers the lower back on both sides. The pain syndrome decreases in the supine position and does not allow you to bend your back - string syndrome.

Diagnostic measures

A preliminary diagnosis for dorsalgia is established on the basis of a survey, anamnesis and neurological examination. Sensitivity, muscle strength, and severity of movement disorders are examined. To clarify the causes and boundaries of the lesion, an x-ray examination of the relevant parts of the spine is performed. If this is not enough, resort to more informative examinations:

computed tomography (CT) and discographic examination for suspected disc herniations;
magnetic resonance imaging (MRI) for suspected stenosis, tumors and pathology of the spinal cord membranes;
radioisotope to detect metastases; non-contrast MR angiography for visualization of neck vessels;
myelography for spinal cord compression.

Treatment of dorsalgia

The choice of treatment tactics and course duration is best left to a vertebrologist or neurologist. Pathogenetic drug treatment is aimed at:

Self-medication can be dangerous, since the use of these drugs requires mandatory medical supervision and dose adjustment!

They also use auxiliary non-drug and preventive measures - physiotherapy, physical therapy. Gives good results. If the above remedies are ineffective, the issue of surgical treatment is decided.

Competent diagnosis and a rational approach to the treatment of dorsalgia almost always lead to a positive result.

Dorsalgia — back pain is a clinical syndrome caused by many causes. The most common cause of dorsalgia is dystrophic lesions of the spine: osteochondrosis with damage to the intervertebral discs and adjacent surfaces of the vertebral bodies; spondylosis, manifested by arthrosis of the facet and/or facet joints; spondylitis

Along with vertebrogenic causes of back pain, there may be other causes not directly related to the spine.

Vertebrogenic pain in the back and limbs is caused by the following reasons.

Disc herniation.
Spondylosis.
Osteophytes.
Sacralization or lumbalization.
Arthrosis of the intervertebral (facet) joints.
Ankylosing spondylitis.
Spinal stenosis.
Instability of the spinal segment with spondylolisthesis.
Vertebral fractures.
Osteoporosis.
Vertebral tumors.
Ankylosing spondylitis.
Functional disorders of the spine.

Nonvertebrogenic back pain occurs due to the following reasons.

Myofascial pain syndrome.
Psychogenic pain.
Referred pain in diseases of internal organs.
Intra- and extramedullary tumors.
Metastatic lesions.
Syringomyelia.
Retroperitoneal tumors.

Osteochondrosis of the spine is one of the causes of vertebrogenic dorsalgia. The process is primarily localized in the nucleus pulposus of the intervertebral disc, which becomes less elastic due to loss of moisture. Under the influence of mechanical stress, the nucleus pulposus can sequester and protrude towards the annulus fibrosus of the disc. Over time, cracks form in the annulus fibrosus. A disc with an altered nucleus and fibrous ring can prolapse into the lumen of the spinal canal (disc prolapse), and masses of the nucleus pulposus penetrate through the cracks of the fibrous ring, forming disc herniations. The described processes in one spinal segment lead to reactive changes in adjacent vertebrae and intervertebral joints, resulting in disruption of the kinematics of the entire spinal column. In addition, the process may involve the ligamentum flavum, which becomes denser over time and puts pressure on the root or membranes of the spinal cord. Over the years, stabilization is possible due to disc fibrosis, but a reverse change is never observed.

The development of spinal osteochondrosis and its progression are caused by congenital bone anomalies, excessive physical activity and other reasons that contribute to the wear and tear of cartilage tissue.

Three main pathophysiological mechanisms of the development of dorsalgia have been studied.

Peripheral sensitization of pain receptors associated with their injury or other pathological effects. In osteochondrosis, these receptors are located in the fibrous ring of the intervertebral disc, the posterior longitudinal ligament, facet and facet joints, spinal roots and paravertebral muscles. Sensitization of these receptors occurs during trauma to the musculoskeletal tissues of the back, causing the release of pro-inflammatory and algogenic substances (prostaglandins, bradykinin), including mechanisms of peripheral sensitization.
Damage to nerve structures (nerve, root, intervertebral ganglion) due to various pathological processes (trauma, inflammation, vascular insufficiency). As a result, neuropathic pain develops.
Central sensitization, which in the first stages is a protective mechanism, and with long-term pain contributes to its intensification.

The processes described above are shown schematically in the figure.

Depending on which structures of the spinal column are involved in the process in each specific case, either compression or reflex syndromes predominate in the clinical picture.

Compression syndromes develop if altered structures of the spine deform or compress the roots, blood vessels or spinal cord. Reflex vertebrogenic syndromes arise as a result of irritation of various structures of the spine, which has powerful sensory innervation. It is believed that only the bone tissue of the vertebral bodies and the epidural vessels do not contain nociceptive receptors.

Based on localization, vertebrogenic syndromes are distinguished at the cervical, thoracic and lumbosacral levels.

Cervical syndromes. Clinical syndromes of cervical localization are largely determined by the structural features of the cervical spine: there is no disc between CI and CII, CII has a tooth, which in pathological conditions can cause compression of spinal structures. The vertebral artery passes through the transverse processes of the cervical vertebrae. Below the CIII vertebrae are connected using uncovertebral joints, the structures of which can be deformed and serve as a source of compression.

Compression syndromes of the cervical localization. At the cervical level, not only roots and vessels, but also the spinal cord can be subjected to compression. Compression of blood vessels and/or the spinal cord is manifested by a clinical syndrome of complete or, more often, partial transverse lesion of the spinal cord with mixed paresis of the arms and lower spastic paraparesis. Root compression can be clinically divided into:

root C3 - pain in the corresponding half of the neck;
root C4 - pain in the area of the shoulder girdle, collarbone. Atrophy of the trapezius, splenius and longissimus muscles of the head and neck; possible cardialgia;
root C5 - pain in the neck, shoulder girdle, lateral surface of the shoulder, weakness and atrophy of the deltoid muscle;
root C6 - pain in the neck, scapula, shoulder girdle, radiating along the radial edge of the arm to the thumb, weakness and hypotrophy of the biceps brachii muscle, decreased reflex from the tendon of this muscle;
root C7 - pain in the neck and scapula, spreading along the outer surface of the forearm to the II and III fingers, weakness and atrophy of the triceps brachii muscle, decreased reflex from its tendon;
root C8 - pain from the neck spreads along the inner edge of the forearm to the fifth finger of the hand, decreased carporadial reflex.

Cervical reflex syndromes. Clinically manifested by lumbago or chronic pain in the neck area with irradiation to the back of the head and shoulder girdle. On palpation, pain is detected in the area of the facet joints on the affected side. Sensitivity disorders, as a rule, do not occur. It should be noted that the cause of pain in the neck, shoulder girdle, and scapula can be a combination of several factors, for example, reflex pain syndrome due to spinal osteochondrosis in combination with microtrauma of the tissues of the joints, tendons and other structures of the musculoskeletal system. Thus, with glenohumeral periarthrosis, many researchers note in such patients damage to the C5-C6 discs, as well as injury to the shoulder joint, or myocardial infarction, or other diseases that play the role of triggers. Clinically, with glenohumeral periarthritis, pain in the periarticular tissues of the shoulder joint and limitation of movements in it are noted. Only pendulum-like movements of the shoulder in the sagittal plane are possible (frozen shoulder syndrome). The adductor muscles of the shoulder and periarticular tissues are painful on palpation, especially in the area of the coracoid process and the subacromial zone. “Sensory” disorders are not determined, tendon reflexes are preserved, sometimes somewhat animated.

Reflex cervical syndromes include the syndrome of the anterior scalene muscle, which connects the transverse processes of the middle and lower cervical vertebrae with the first rib. When this muscle is involved in the process, pain occurs along the anterior outer surface of the neck, radiating along the ulnar edge of the forearm and hand. When palpating the anterior scalene muscle (at the level of the middle of the sternocleidomastoid muscle, somewhat laterally), its tension is determined, and in the presence of muscle trigger points, pain distribution zones are reproduced in it - shoulder, chest, scapula, hand.

Vertebrogenic neurological complications in the thoracic spine with osteochondrosis are rare, since the bone frame of the chest limits displacement and compression. Pain in the thoracic region more often occurs in inflammatory (including specific) and inflammatory-degenerative diseases (ankylosing spondylitis, spondylitis, etc.).

In medical practice, the first place in terms of treatment is taken by lesions of the lumbar and lumbosacral spine.

Lumbar compression syndromes. Upper lumbar compression syndromes are relatively rare. Compression of the LII root (LI-LII disc) is manifested by pain and loss of sensitivity along the inner and anterior surfaces of the thigh, and decreased knee reflexes. Compression of the LIV root (LII-LIV disc) is manifested by pain along the anterior inner surface of the thigh, decreased strength, followed by atrophy of the quadriceps femoris muscle, and loss of the knee reflex. Compression of the LV root (LIV-LV disc) is a common location. It manifests itself as pain in the lower back with irradiation along the outer surface of the thigh, the anterior surface of the leg, the inner surface of the foot and big toe. Hypotonia and wasting of the tibialis muscle and decreased strength of the dorsal flexors of the thumb are noted. Compression of the SI root (LV-SI disc) is the most common location. It manifests itself as pain in the buttock, radiating along the outer edge of the thigh, lower leg and foot. The strength of the triceps surae muscle decreases, sensitivity in the areas of pain irradiation is impaired, and the Achilles reflex fades.

Lumbar reflex syndromes. Lumbago - acute pain in the lower back (lumbago). Develops after physical activity. Manifests itself with sharp pain in the lumbar region. The antalgic posture and tension of the lumbar muscles are objectively determined. Neurological symptoms of loss of function of the roots or nerves of the lumbosacral region, as a rule, are not detected. Lumbodynia is chronic lower back pain. It manifests itself as dull aching pain in the lower back. Palpation determines the pain of the spinous processes and interspinous ligaments and facet joints (at a distance of 2-2.5 cm from the midline) in the lumbar region, in which movements are limited. Sensory disorders are not defined.

Piriformis syndrome. The piriformis muscle begins at the anterior edge of the upper sacrum and attaches to the inner surface of the greater trochanter of the femur. Its main function is hip abduction. The sciatic nerve passes between the piriformis muscle and the sacrospinous ligament. Therefore, when the piriformis muscle is tense, compression of the nerve is possible, which occurs in some cases with lumbar osteochondrosis. The clinical picture of piriformis muscle syndrome is characterized by sharp pain in the subgluteal region radiating along the posterior surface of the lower limb. Adduction of the hip causes pain (Bonnet test), the Achilles reflex is reduced. The pain syndrome is accompanied by regional autonomic and vasomotor disorders, the severity of which depends on the position of the body - pain and autonomic disorders decrease in the supine position and intensify when walking.

Differential diagnosis of compression and reflex vertebrogenic syndromes. Vertebrogenic compression syndromes are characterized by the following features.

The pain is localized in the spine, radiating to the limb, right up to the fingers or toes.
The pain intensifies with movement in the spine, coughing, sneezing, and straining.
Regional autonomic-vascular disorders, often dependent on body position.
The symptoms of loss of function of the compressed roots are determined: sensory disturbance, muscle wasting, decreased tendon reflexes.

The following are characteristic of reflex vertebrogenic syndromes:

The pain is local, dull, deep, without radiating.
The pain intensifies with load on the spasmed muscle, its deep palpation or stretching.
There are no symptoms of loss.

Regional autonomic-vascular disorders are not typical.

Treatment of vertebrogenic pain syndromes. In the acute period of the disease, when the pain syndrome is severe, the main task of the doctor is to relieve pain. To successfully complete this task, certain conditions must be met.

The spine should be kept at rest. To do this, place a shield under the mattress or place the patient on a special orthopedic mattress. For 5-7 days, the motor mode is limited, and the patient is allowed to stand only in an immobilizing belt or corset and only for physiological necessity. The rest of the time, bed rest is indicated. The expansion of the motor regime is carried out carefully; the recommended movements should not cause pain.
Drug treatment should be structured taking into account all links in the pathogenesis of pain. The source of pain in compression syndromes is pathologically altered structures of the spinal column, which either irritate tissue nociceptors or compress the spinal roots. In reflex syndromes, the source of pain can be both the spine itself and reflexively spasmed muscles that form tunnel syndromes. In addition, with chronic (lasting more than 3 months) or recurrent pain, depressive, anxiety, hypochondriacal and other affective disorders develop. The presence of such disorders must be actively identified and treated, since they have an extremely negative impact on the course of the disease.
Non-drug treatment is recommended. Physiotherapy, manual therapy, kinesitherapy, etc. are widely used in the treatment of vertebrogenic pain syndromes.
Surgical intervention is used when conservative treatment is ineffective within 4 months or there are signs of spinal cord compression with dysfunction of the pelvic organs, sensory conduction disorders or damage to the central motor neuron (in the presence of pyramidal signs).

Drug treatment

Analgesics, anti-inflammatory non-steroidal drugs, anesthetics. To relieve pain, the use of analgesics metamizole sodium (Analgin), paracetamol, tramadol (Tramal) and nonsteroidal anti-inflammatory drugs (NSAIDs) enterally and parenterally is indicated. The use of NSAIDs is pathogenetically justified because, in addition to the analgesic effect, they have an anti-inflammatory effect (due to their effect on cyclooxygenase (COX-1 and COX-2), they inhibit the synthesis of prostaglandins, which prevents the sensitization of peripheral nociceptors and the development of neurogenic inflammation).

Among the well-proven drugs in this group, we note diclofenac, which is available in the form of tablets of 50 and 100 mg, rectal suppositories and solutions for parenteral administration. The drug ketorolac (Ketolac) has a powerful analgesic effect, which is recommended to be administered for severe pain syndromes at 30 mg IM for 3-5 days, and then switch to tablet forms, prescribing 10 mg 3 times a day after meals for more than 5 days. In addition to those listed above, you can use other drugs in this group: meloxicam (Movalis), lornoxicam (Xefocam), ketoprofen (Ketonal), etc. But it should be remembered that most NSAIDs are contraindicated for peptic ulcers of the stomach and duodenum, with a tendency to bleeding. If the patient is diagnosed with the above diseases, even in remission, the listed NSAIDs are contraindicated. In such cases, the drugs of choice are selective COX-2 inhibitors, which do not have such a significant effect on the gastrointestinal tract, in particular celecoxib (Celebrex), a selective COX-2 inhibitor. It should be prescribed at a dose of 200 mg 3 times a day after meals for 7-10 days.

To reduce pain, paravertebral blockades can be performed with an anesthetic (Procaine, Lidocaine, etc.) in combination with corticosteroids (50 mg Hydrocortisone, 4 mg Dexamethasone, etc.). Blockades using anesthetics and corticosteroids are recommended to be carried out once every 3 days. In most cases, 3-4 blockades are sufficient for a course of treatment (elimination of acute pain).

Vascular agents. Considering the mandatory participation of the vasomotor component in the pathogenesis of vertebrogenic syndromes, especially those of a compression nature, it is necessary to introduce vasoactive drugs into the treatment complex. The choice of drug depends on the presence of concomitant vascular disease and the severity of vasomotor disorders. In mild cases, oral administration of vasodilators (nicotinic acid preparations or their analogues) is sufficient. If the patient is diagnosed with severe compression radiculopathy, parenteral administration of drugs (Trental) that normalizes both arterial inflow and venous outflow is necessary.

Psychotropic drugs. Patients with chronic pain need correction of affective disorders. To carry out adequate correction of psychoaffective disorders, their diagnosis is necessary (consultation with a psychotherapist or psychodiagnostic testing). In case of predominance of anxiety-depressive and depressive disorders, the prescription of antidepressants is indicated. Preference is given to drugs that have, along with an antidepressant, anxiolytic effect: amitriptyline - from 25 to 75 mg / day for 2-3 months, tianeptine (Coaxil), mianserin (Lerivon), etc. If the patient has predominant hypochondriacal disorders, tricyclic antidepressants should be combined with antipsychotics that do not cause extrapyramidal disorders - tifidazine (Sonapax) - 25-50 mg/day, sulpiride (Eglonil) - 25-50 mg/day.

Non-drug treatment of vertebrogenic pain syndromes. Physiotherapy plays an important role in the treatment of pain syndromes. In the acute period of the disease, preference is given to the use of physical factors that reduce pain, improve regional hemodynamics, especially the outflow of blood from the area of compression, and relieve muscle spasm. At the first stage, diadynamic currents, microwave fields, magnetic therapy, UV irradiation, and acupuncture are used. As the pain subsides, physiotherapy is prescribed to improve tissue trophism and increase range of motion (laser magnetic therapy, massage, phototherapy, kinesitherapy). During the recovery period, it is recommended to actively involve the patient in the treatment process: expand the motor mode, strengthen the muscle corset, etc.

It should be remembered that complete comprehensive treatment of patients with vertebrogenic lesions of the nervous system allows one to achieve complete and long-term remission. During the period of absence of pain, it is necessary to recommend an active lifestyle, physical exercise (without significant vertical and “twisting” loads on the spine), and recreational swimming.

Literature

Belova A. N., Shepetova O. N. Guidelines for the rehabilitation of patients with movement disorders. M., 1998. P. 221.
Kukushkin M. L. Pathophysiological mechanisms of pain syndromes. Pain. 2003. No. 1. P. 5-13.
Podchufarova E.V., Yakhno N.N., Alekseev V.V. et al. Chronic pain syndromes of lumbosacral localization: the significance of structural musculoskeletal disorders and psychological factors // Pain. 2003. No. 1. P. 34-38.
Shmyrev V.I. Treatment and rehabilitation program for patients with dorsalgia: method. recommendations. M., 1999. 28 p.
Yakhno N. N., Shtulman D. R. Diseases of the nervous system. T. 1. 2001.

L. G. Turbina, Doctor of Medical Sciences, Professor
MONIKI, Moscow

The term dorsalgia (nonspecific back pain) has recently begun to be used to refer to benign nonspecific back pain. Usually the term dorsalgia used to refer to back pain syndromes of unknown origin (except when there are red flag symptoms, fibromyalgia or psychogenic pain). But basically the term dorsalgia refers to pain syndromes in the back, caused by dysfunctional degenerative-dystrophic changes in the musculoskeletal system; pain syndromes can be accompanied by irradiation of pain in the limbs.

Dorsalgia (nonspecific back pain) is very common. Only a few can state the absence of episodes of back pain in their lives; Most people experience back pain occasionally, and for some, back pain is chronic. Chronic nonspecific back pain ( chronic dorsalgia) is most often localized in the lumbosacral region and in the back of the neck. In industrialized countries, low back pain is the most common cause of disability in people under 45 years of age. If the pain syndrome lasts up to 6 weeks, then we are talking about acute dorsalgia. If the pain syndrome lasts more than 12 weeks, then the term chronic dorsalgia is used. And if acute dorsalgia, as a rule, has a good prognosis, then in the case of chronic dorsalgia, disability can be quite significant. For example, in the United States, approximately 80% of people will experience episodes of low back pain during their lifetime. Approximately 20% experienced prolonged pain, and in 2-8% of cases the pain became chronic. Every year, about 3-4% of people were temporarily disabled, and in 1% of cases there was permanent disability in patients of working age.

Dorsalgia is divided into acute and chronic dorsalgia and by localization (thoracalgia, cervicalgia, lumbodynia).

According to the genesis of development, they distinguish: spondylogenic dorsalgia, associated with degenerative changes in the spine, spinal injuries, infectious or oncological lesions of the spine, and non-vertebrogenic dorsalgia, which is caused by changes in muscles, ligaments or somatic diseases, since the pain syndrome can be of a reflected nature or of a psychogenic nature.

Vertebrogenic (spondylogenic) dorsalgia in most cases is caused by degenerative changes in the spine and a group of syndromes can be observed:

Reflex syndromes (lumbar ischialgia, cervicalgia, cervicobrachialgia)
Muscular-tonic syndromes
Compression syndromes (radiculopathies)
Spinal cord compression syndrome (myelopathy)

Causes of dorsalgia

The center of gravity of the human body is located in the lumbar spine and this section bears the greatest load. The lumbar spine, due to its slight forward bending, can withstand heavy loads. But unlike the thoracic spine, the lumbar spine does not have lateral support. The shock-absorbing (support) function in the spine is performed by intervertebral discs, which provide 70% support for the spine under load. The intervertebral disc consists of 90% water, but as the body ages, especially after 45-50 years, the water content in the disc decreases significantly, which leads to disruption of both the supporting and shock-absorbing functions of the intervertebral disc. Due to the disturbance in the distribution of loads, there is an increase in loads on the facet joints, which in turn leads to damage to the facet joints and compensatory growth of bone tissue (osteophytes). Such changes in the facet joints are a normal compensatory reaction of the body to degenerative changes in the intervertebral discs and clinical manifestations of this process appear only in case of an excessive reaction of the body and when osteophytes begin to affect nearby nerve structures.

Discogenic pain

Research has shown that the intervertebral disc and other structures of the motion segments can cause pain. At the same time, it is not clear why mechanically caused back pain tends to become chronic, since in theory the duration of the pain syndrome should fit within the period required for regeneration, as usually happens when soft tissues or joints are damaged.

Inflammatory factors may play a role in some cases of discogenic pain, and then the effectiveness of epidural steroids may be quite high. Corticosteroids inhibit the production of arachidonic acid and its metabolites (prostaglandins and leukotrienes) and inhibit phospholipase activity. A 2. Studies have shown high levels of phospholipase A2 in herniated discs (removed during surgical treatment).

It is hypothesized that phospholipase may have a dual function by initiating disc degeneration and sensitizing the nerve endings of the annulus fibrosus.

Radicular pain

The pathophysiology of such a well-known syndrome as radicular pain is still not clear.

Etiologically, the pain is thought to be due to nerve compression resulting from foraminal stenosis, ischemia, and inflammation. Radiculopathy often has a multifactorial origin and is more complex than just a reaction to mechanical compression. In clinical practice, structural nerve damage may play a role if inflammation is present. However, the administration of steroids epidurally or pararadicularly is practiced quite often, although the long-term effect of such manipulations is very controversial.

Facet joint syndrome

The superior and inferior articular processes of the vertebral plate form the facet joints. Together with the intervertebral discs, they withstand the effects of compression forces on the vertebrae. Following injury or inflammation of the facet joints, pain, joint stiffness, and degenerative changes may occur. Oddly enough, there is no clear correlation between the results of neuroimaging and pain, and therefore the diagnosis is sometimes made on the basis of clinical data (characteristic pain in the lower back with irradiation to the buttocks or anterior thigh, which intensifies with retroflexion of the back or rotation of the back). Unfortunately, both steroid injection and electrical ablation of the nerves innervating the facet joints do not provide lasting results.

Sacroiliac pain

The sacroiliac joints are innervated from a root that emerges at the level of the first sacral vertebra. Arthrography or injection of irritant solutions into the sacroiliac joint provokes the appearance of various local pain and reflected pain patterns in the buttock area, lumbar region, and lower extremities. Certain tests (such as the Patrick maneuver) may also cause typical pain. Local blockades and the use of physiotherapy and exercise therapy methods can sometimes achieve remission. If pain in the sacroiliac joints occurs in young men, then it is necessary to exclude ankylosing spondylitis.

Muscle pain

Muscle pain is the most common cause of back pain (including chronic pain). Pain receptors are very sensitive to various mechanical stimulation and biomechanical overloads. Anxiety and depressive states play an important role in the formation of chronic muscle pain due to the formation of cyclical persistence of muscle tension. Muscle pain is often referred to as myofascial pain syndrome if there are muscles in a state of spasm, increased muscle tone, stiffness and trigger points. In many patients, myofascial pain is the result of a combination of factors: individual hyperresponsiveness of muscle tissue, direct or indirect trauma, the accumulation of effects from repetitive muscle strain, postural dysfunction and deterioration of general physical condition. At the cellular level, this occurs due to abnormal and constantly increased release of acetylcholine at the neuromuscular junction, which leads to frequent muscle contraction and a pathological repeating cycle is formed. If muscle pain does not disappear within several weeks (up to 6 weeks), then we can talk about a complex chronic pain syndrome with physiological, psychological and psychosocial components. And therefore, in such cases, when local treatment is not able to provide a lasting effect, then the use of a complex of diagnostic and therapeutic measures (multimodal therapy) is required. If complete therapy is not prescribed in a timely manner, the effectiveness of even multimodal therapy may be low.

Symptoms

Back pain that lasts more than 3 weeks with the presence of functional impairment requires special attention, since it is necessary to identify serious causes of such pain, for example, malignant formations (metastases to bone tissue), inflammatory processes (for example, spondylodiscitis), instability of segments ( e.g. spondylolisthesis) or local compression (spinal or foraminal compression). Typically, serious causes of back pain occur in 5% of cases. The greatest alertness in case of pain for three weeks should be in relation to non-mechanical causes of pain - malignant diseases and infections. Typically, intense back pain at rest is most often a sign of a serious illness (cancer or infection). The presence of serious causes of pain (specific pain) in the back may include the following symptoms (red flags):

Paroxysmal pain or pain associated with visceral disorders.
A history of cancer, chronic fatigue, weight loss.
Fever or immunodeficiency.
Old age and the presence of osteoporosis.
Progressive neurological deficit or dysfunction of the pelvic organs.
Severe stiffness in the morning as the main complaint.
For nonspecific mechanical back pain, the following red flag symptoms are significant:
Dissociation between verbal and nonverbal expressions of pain
Affective description of pain.
Low pain modulation with prolonged intensity.
Presence of previous trauma.
Signs of depression (difficulty falling asleep, waking up earlier, decreased interest in life) and anxiety.
The need for the use of psychoactive substances
A history of unsuccessful surgical or conservative treatment.

Diagnostics

Intense pain at rest for 3 weeks and the presence of “red flag” symptoms usually suggest the presence of a serious illness (tumors or infections). In such cases, it is necessary to conduct instrumental research methods (visualization) using methods such as radiography, MRI, CT (MSCT). If there are signs of progressive neurological deficit, then imaging should be used as quickly as possible and the patient should be transported to a clinic where studies (MRI, CT, radiography) can be performed. X-rays can diagnose fractures, cancer, metabolic changes in bone tissue, infections and inflammatory changes in bone tissue. But it is often necessary to use more informative diagnostic methods, such as MRI or CT, especially when it is necessary to visualize in more detail changes in bone tissue and, especially, in soft tissue. In this regard, MRI is the most informative research method, allowing high-quality visualization of even minor morphological changes in both soft and bone tissues, this is especially necessary if it is necessary to diagnose damage to the nervous tissue of the muscles of the disc ligaments.

If it is necessary to identify focal changes in tissues, scintigraphy can be prescribed, which makes it possible to verify oncological or infectious diseases.

ENMG makes it possible to determine conduction disturbances in nerve fibers and is often used to monitor the dynamics of the disease and the effectiveness of treatment.

Laboratory research methods are used when it is necessary to verify inflammatory oncological and infectious processes.

Treatment

Bed rest is necessary only for acute radiating pain (for example, sciatica) and should not last more than 1-3 days, as this avoids the progression of a decrease in physical activity and the appearance of pathological behavioral dominants.
With all nonspecific myofascial pain, lack of physical activity will have a devastating physiological effect, leading to muscle and other soft tissue wasting, joint hypomobility, decreased muscle strength, and bone demineralization. Therefore, bed rest is generally not recommended. Patients are advised to maintain normal physical activity as much as possible. Bed rest leads to the patient developing a fear of movement and the formation of a pathological behavioral cycle.

Drug treatment often prescribed for dorsalgia and, moreover, long-term, unjustified prescription of NSAIDs is carried out, which not only do not have a pathogenetic effect, but also cause a lot of side effects. The use of NSAIDs is justified for acute pain and for a short period of time. For dorsalgia (nonspecific pain), central muscle relaxants are also prescribed to relieve muscle spasm. If we are talking about chronic pain syndrome, the prescription of antidepressants is justified, since in chronic pain syndrome the central link of pain sensations is in the foreground. Strong analgesics such as opioids are indicated for pain caused by spinal cancer or serious degenerative changes.

Blockades with the introduction of local anesthetics and steroids are quite effective if there are clear indications for their use (for example, blockades in the area of trigger points or paravertebral blockades).

For dorsalgia, non-drug treatment methods, such as physiotherapy, massage, manual therapy and exercise therapy, have become widely used. The use of a complex of these treatment methods often allows one to achieve good results (stable remission).

Dorsalgia, or back pain (in the thoracic, lumbar, sacral or cervical spine), occurs for various reasons. This is one of the common reasons for visiting a neurologist or vertebrologist. Most often, such a symptom can be prevented or alleviated on your own. In case of acute pain that does not go away longer than 72 hours, you should definitely consult a doctor for examination and treatment.

What is dorsalgia

Dorsalgia is pain in the back of varying intensity.

Dorsalgia is not a disease, but a symptom that manifests itself as a pathological process in the spine or surrounding tissues. Therefore, it is not the pain itself that needs to be treated, but the cause that caused it.

Unpleasant sensations can be in different parts of the spine, spread to the lower or upper extremities, and be combined with a headache. Dorsalgia reduces the quality of everyday life, a person temporarily loses ability to work and experiences significant difficulties.

Classification: dorsalgia of the thoracic, lumbar, sacral, cervical spine

Depending on the location of pain, several types of dorsalgia are distinguished:

pain in the cervical spine - cervicalgia;
in the thoracic region - thoracalgia;
in the lumbar region - lumbodynia;
in the sacrum - sacralgia.

If the pain syndrome is observed for a short time (up to 6 weeks), then they speak of acute dorsalgia, if for more than 12 weeks, then the chronic form occurs.

Depending on the cause of the syndrome, the following are distinguished:

vertebrogenic dorsalgia, that is, caused by pathologies of the spine (trauma, inflammation, degenerative and neoplastic changes);
nonvertebrogenic (not related to the spine itself), which occurs due to:
- somatic diseases (pathologies of other organs);
- muscle or ligament sprains;
- psychogenic factors;
- fibromyalgia (chronic musculoskeletal pain of unknown origin);
- myofascial pain syndrome (pain that develops due to dysfunction of a certain muscle due to its overstrain, which is manifested by spasm and muscle tightness).

Causes of back pain

In 90% of cases, the cause of back pain is pathological changes in the spine.

Most often, dorsalgia is caused by:

In addition to the listed pathologies, pain can be caused by sprain of the ligaments of the spine or back muscles during strong physical exertion, sudden awkward movement (bending, turning) or myositis - inflammation of the spinal muscles.

Non-vertebrogenic causes of dorsalgia also include somatic diseases - intestines, stomach, liver, kidneys (so-called referred pain).

Factors that provoke back pain:

Who is at risk

Anyone can experience back pain - a child, a young person or an elderly person. The following are at greater risk of developing dorsalgia:

people leading a sedentary lifestyle;
men and women who are overweight (obese);
persons of certain professions:
- office workers, drivers, that is, those who sit for a long time;
- loaders, builders, whose work involves repeated heavy lifting and heavy load on the back;
- athletes - weightlifters;
patients with psychological problems, prone to depression and increased anxiety.

Video - back pain during exercise

Symptoms of acute and chronic dorsalgia

Dorsalgia can have a different character depending on the reasons that caused it.

In any case, the cause of dorsalgia is a pain impulse from the area of inflammation or the site of a pinched nerve.

If the causes are vertebrogenic, then the pain can be compression or reflex:

Dorsalgia of any origin can be mild or severe, transient or permanent.

The pain is sometimes so severe that a person is unable to perform usual activities, even get out of bed, sit down or roll over to one side.

The pain may radiate to the leg (lumboischialgia) if the sciatic nerve is damaged. With thoracalgia, discomfort often spreads to the arm, sternum or intercostal space.

Since dorsalgia is a manifestation of many diseases, doctors always analyze the accompanying symptoms:

Back pain should not be taken lightly, following the principle “it hurts and it goes away.” Even initially tolerable unpleasant sensations can be a signal from the body about the development of functional and then structural disorders both in the spine and in other organs.

When you need to see a doctor urgently

Dorsalgia, especially caused by common overstrain of the back muscles, goes away quite quickly with treatment at home. After 2-3 days from the start of therapy, pain should disappear or decrease significantly. If no improvement is observed, a mandatory consultation with a doctor is necessary.

Indications for urgent medical attention:

having problems emptying your bowels or bladder;
simultaneously pain or throbbing in the abdomen;
the temperature has risen;
the pain arose due to injury: a fall, a strong blow to the back;
it hurts severely and constantly, even when lying down;
radiates to one or both legs;
pain causes severe stiffness of movement, numbness and weakness in the legs;
weight loss occurs;
pain syndrome accompanies redness of the skin of the back.

In addition, it is necessary to consult a doctor if the patient is over 50 years old, has a history of cancer, taking hormonal drugs, osteoporosis or alcoholism.

Diagnosis of the causes of pain syndrome

Back pain is a reason to visit a neurologist. If necessary, the patient can be referred for consultation to a vertebrologist or rheumatologist surgeon. The doctor clarifies with the patient the nature, location, duration of discomfort, and accompanying symptoms. Carrying out an examination, the specialist evaluates the person’s ability to sit, stand, and limb reflexes.

Instrumental examination includes:

radiography - to evaluate bone tissue, detect arthritis or fracture;
MRI - to analyze the condition of intervertebral discs, muscles, nerves, ligaments, and blood vessels.

CT (computed tomography) is prescribed if MRI is not possible. In severe situations, the patient is referred for bone scintigraphy (radionuclide diagnostics) - a skeletal scan to identify bone tumors or osteoporosis.

Sometimes electromyography is prescribed - diagnostics of neuromuscular connections; the method is used to detect compression of a nerve by a hernia.

Differential diagnosis is aimed primarily at determining the nature and cause of pain. Compression syndrome (pinched nerve) differs from reflex syndrome in its localization in the spine, irradiation (spread) to the limb, aggravation with movement, and associated symptoms: decreased tendon reflexes, muscle wasting, and sensory impairment.

How to treat

Therapy depends on the underlying disease. Key methods aimed at treating dorsalgia of any origin:

rest during exacerbation;
medicines;
physiotherapy;
kinesitherapy - “treatment with movement” (health-improving physical education, massage, manual therapy, breathing exercises, water procedures).

The patient must be prescribed bed rest for 2–3 days (sometimes up to a week) to ensure rest for the spine.

Drug therapy

The drugs of choice for the treatment of acute back pain are NSAIDs - non-steroidal anti-inflammatory drugs and muscle relaxants.

Table - drugs for the treatment of dorsalgia

Group of drugs	Drugs, action
NSAIDs	Diclofenac or products based on it are usually prescribed - Olfen, Diclak (in tablets, injections, suppositories). Ketorolac (Ketolak), Ketoprofen (Ketonal) have a strong analgesic effect. Most drugs from this group are contraindicated for diseases of the stomach and duodenum; for peptic ulcers, NSAIDs can cause internal bleeding. In such cases, medications are prescribed with a weaker analgesic effect, but a smaller range of contraindications: Celebrex (Celecoxib); Meloxicam (Movalis); Denebol; Nurofen (Ibuprofen); Nimesil (Nimesulide).
Analgesics	The drugs metamizole sodium (Baralgin, Renalgan), Tramadol (Tramal) are prescribed. In cases of severe pain, blockades with Lidocaine (Procaine) in combination with corticosteroids (Dexamethasone, Hydrocortisone) are indicated.
Muscle relaxants	Essential for relieving painful muscle spasms. These are tizanidine preparations (Tizalud, Tizanil, Sirdalud), Mydocalm (Tolperisone), Baclofen (Baklosan).
Vascular agents	Needed to normalize blood circulation in the area of the pathological process; in mild cases, vasodilators such as nicotinic acid are prescribed; in severe compression radiculopathy, medications that normalize venous outflow (Detralex) and arterial inflow (Trental).
Chondroprotectors	Indicated for the restoration of cartilage tissue in the diagnosis of articular damage - Artron, Mucosat, Chondroitin, Sinarta are prescribed.
Metabolic agents and biostimulants	Biological stimulants are prescribed to stimulate metabolic and regenerative processes - FiBS, Aloe, Plazmol. For the same purpose, metabolic agents are prescribed - Trimetazidine, Mildronate.
Vitamins	Vitamin preparations are used to quickly restore damaged tissues, improve metabolism, nerve conduction, and blood supply to tissues - vitamins B1, B12, B6, Milgamma.

Photo gallery - medications for the treatment of back pain

Celecoxib is an analgesic, anti-inflammatory drug used for the symptomatic treatment of mild dorsalgia Trental is a drug that affects the condition of blood vessels and circulatory processes in the affected area Diclofenac is a non-steroidal anti-inflammatory drug that has a pronounced analgesic effect. Chondroxide is prescribed for the prevention and treatment of dystrophic changes in articular cartilage, including intervertebral discs Sirdalud is a muscle relaxant necessary to relieve muscle spasms during dorsalgia

Physiotherapy

Physiotherapy plays an important role in the treatment of any pain syndrome. In the acute period, the following are usually used:

microwave fields;
diadynamic currents;
phonophoresis with hydrocortisone;
electrophoresis with novocaine;
magnetic therapy;
UV irradiation;
acupuncture.

These methods eliminate pain, improve blood circulation, and relieve muscle spasms.

In the subacute period, procedures are prescribed that improve tissue nutrition and restore range of motion:

massage;
phototherapy (ultraviolet);
laser magnetic therapy;
manual therapy;
pharmacopuncture (microinjections of homeopathic remedies);
hirudotherapy (treatment with leeches).

After pain relief, the patient is prescribed health-improving exercises. Treatment with medications and physical procedures can be combined with wearing an orthopedic semi-rigid corset, which will support the back muscles and spinal column in an anatomical position.

Diet

Since vertebrogenic dorsalgia is not associated with the digestive organs, there is no need to follow a specific diet. The only requirement that must be made to the patient's diet is the exclusion of foods that can cause constipation, since excessive strain during bowel movements can aggravate the condition.

Folk remedies

Along with pharmacological drugs, physiotherapy and health-improving exercises, to alleviate the condition of dorsalgia, you can resort to traditional methods of treatment.

For inflammatory diseases of the spine, an elixir (extract) from lilac flowers is effective, dandelion acts as an analgesic and relaxant, and comfrey promotes the regeneration of muscle and nervous tissue.

Elixirs from medicinal plants can be prepared as follows:

Freshly harvested plants are placed in a vessel with clean filtered water (volume 400 ml) so that the raw materials completely cover the water, and left for 3-4 hours.
A glass bottle with a volume of 100 ml is filled halfway with medical alcohol or cognac diluted 50 to 50.
Top up with strained flower infusion, seal and leave for 2-3 days.

The finished product is taken daily, 4 drops under the tongue. You can add the elixir to a massage cream or oil, into a bath, or rub directly into a sore spot.

Herbal tincture:

Dry grass of strawberries, burdock, knotweed and horsetail are mixed in equal parts.
Four large spoons of the mixture are poured with alcohol (200 ml) and left for at least 2 weeks.

You need to take the tincture three times a day, 5-7 drops.

Lingonberry infusion is used as an anti-inflammatory and tonic. Pour a tablespoon of plant leaves into a glass of boiling water and leave for 1–2 hours. You need to drink the product 3 times daily, half a glass.

Pain-relieving potato compress: grate raw potatoes, mix with honey in equal proportions, and apply to the sore spot for 15–20 minutes.

Gallery - folk recipes for back pain

Medicinal herbs are used both individually and in collections: for the treatment of dorsalgia, a collection of strawberries, knotweed, horsetail, and burdock is suitable
Raw potatoes are used for compresses on sore spots. Lingonberry has an anti-inflammatory, restorative effect Dandelion has antispasmodic and anti-inflammatory effects Comfrey has antispasmodic and anti-inflammatory effects

Gymnastics

To stabilize muscle, cartilage and bone tissue, medications are often not enough; physical education is indispensable in this case. Physical training complexes are aimed at normalizing the functions of the spine and completely eliminating back pain.

Conventionally, all exercises for the back can be divided into 3 groups:

Strengthening the muscular frame that holds the spine in the correct position and prevents its curvature and bulging of disc cartilage.
Eliminating pain by releasing pinched nerves.
Relaxing muscles, aimed at relieving muscle tension (spasms) and stretching the spine; Some yoga asanas (postures, exercises) do an excellent job with this task.

It is important to remember that in the acute phase of the disease, full-fledged sets of exercises are contraindicated. For severe pain, bed rest and minimal exercise are recommended, aimed at maintaining general tone rather than treating a specific disease. You can start physical education classes during the period of remission, and preferably carry them out under the supervision of an experienced exercise therapy instructor.

It’s worth mentioning separately about classes in the gym. Forceful loads can provoke an exacerbation of spinal disease if the discomfort is caused by an inflammatory process, injury or degenerative changes in cartilage tissue. In this case, active sports exercises are contraindicated.

Pain that occurs due to weak back muscles and a sedentary lifestyle may intensify after the first exercise, which is caused by the natural process of lactic acid accumulation in the muscles. With each session, the discomfort will bother you less and less.

Many back problems arise from poor tone in the muscles that support the spine. To prevent and treat existing diseases, you need to do gymnastics every day, which will strengthen muscles, eliminate pain and prevent destructive processes in cartilage.

Video - strengthening the back muscles

Exercises to prevent dorsalgia (if spinal diseases are not detected)

Exercises to prepare and relax your back:

It is useful to hang on a horizontal bar; if possible, it is worth installing it at home. Ideally, you need to hang in the morning and evening, at least for 20–30 seconds. It is especially good to do this after physical activity.
"Rug":
- lying on your back, bend your legs;
- press your back tightly to the floor, tilt your legs to the right so that they lie on the floor, fixate for a few seconds;
- repeat the same in the other direction;
- do 10 repetitions in each direction (five is enough for a start).
  The sensations that should be felt when performing the exercise are pleasant warmth in the lower back; if pain occurs, the exercise should not be repeated.

Basic complex for the back

The complex consists of exercises for the abdominal and back muscles.

Strengthening the abs is just as necessary as the spinal muscles: together they make up a muscular corset that keeps the spine in a natural position.

Abdominal strengthening:
Strengthening the spinal muscles:
- invisible hula hoop:
  - in a standing position, rotate the pelvis amplitude in one direction, then in the other;
- boat:
  - lying on your stomach, arms extended above your head;
  - raise your upper body and legs above the floor; if you can’t do it with your arms raised, you can press them to your body;
  - repeat the exercise 10 times in total;
- back stretch:
  - starting position - on all fours;
  - move your pelvis back so that your buttocks touch your heels, while keeping your palms on the floor;
  - slowly bend over - stretch forward, then back again;
- strengthening the lower back:
  - lying on your stomach, legs straight, arms above your head;
  - raise your legs one by one as much as possible;
  - Fix the raised leg for 1–2 seconds, lower it, repeat with the other leg;
- "wall":
  - you need to use a flat wall for the exercise; lean against the surface with the back of your head, shoulder blades, buttocks and heels;
  - fixate in this position (you should start with 1 minute, gradually increasing the exercise time to a quarter of an hour, add 0.5–1 minute every day).

The complex must be repeated daily (maybe every other day) for a month, while focusing on your feelings: it’s hard or painful - don’t do it or do as many repetitions of each exercise as possible.

Surgical intervention

Surgical treatment of dorsalgia is required in rare cases. If long-term conservative therapy is ineffective and a person suffers from constant back pain caused by compression of the spinal nerve, then surgery is recommended to the patient.

Video - how to get rid of back pain

Exacerbation of the syndrome

With chronic pathological processes in the spine, dorsalgia can periodically worsen. During this period, it is necessary to carry out active drug treatment and provide the spine with a minimum load, physiological (horizontal) traction - bed rest for 2-3 days.

Consequences and complications

If a person has chronic back pain and is not examined or treated, vertebrogenic dorsalgia can be complicated by the following conditions:

persistent pain syndrome that cannot be treated;
cerebrovascular accident (up to stroke);
significant limitation of mobility;
paresis or paralysis of the limbs;
encopresis (fecal incontinence), incontinence (urinary incontinence), sexual disorders (erectile dysfunction in men).

Prevention

Back pain is easier to prevent than to cure, so the following activities should be given enough attention:

Back pain is common. If dorsalgia occurs, you should not waste time and wait until everything goes away on its own. Timely treatment can quickly relieve an unpleasant symptom. To ensure that your back never becomes a reason to visit a doctor, you need to lead an active lifestyle and do special gymnastics.

The most common manifestation of serious problems with the spine is vertebrogenic dorsalgia - back pain caused by various factors that are traumatic, degenerative, neoplastic and inflammatory in nature.

Causes of vertebrogenic dorsalgia

The reasons why the disease occurs are quite numerous. They can be associated either directly with spinal problems or appear as a result of various diseases that have arisen in the human body. However, there are several main factors that contribute to the onset of the disease:

Frequent and prolonged stay in an uncomfortable position
Various injuries
Diseases of the joints and internal organs
Heavy physical activity
Hypothermia
Osteochondrosis
Spondyloarthrosis and other diseases of the spine

Symptoms of vertebrogenic dorsalgia

Often the disease manifests itself gradually, and symptoms may not be noticeable until after 2 weeks. Among the main signs that may signal the onset of the disease:

Discomfort and pain in the spine
Worsening pain with movement, coughing, sneezing, or deep breathing
The occurrence of pain after physical activity, due to careless or sudden movement

Treatment methods

The clinic’s specialists provide high-quality and successful treatment for this disease. Vertebrogenic dorsalgia will be effectively and quickly defeated with the help of centuries-tested methods of oriental medicine, including:

Acupuncture is an effective method that helps quickly eliminate pain and muscle spasms, as well as relieve swelling.
Acupressure is a method that achieves complete relaxation and nutrition of muscle tissue, activates the recovery of the body as a whole and improves blood circulation.
Pharmacopuncture is a method of oriental medicine that promotes a speedy recovery of the patient.
Manual therapy is an effective method that helps improve the flow and outflow of blood to the spine, releasing pinched nerves and blood vessels.
PRP therapy is the latest method of stimulating recovery processes. It is used to restore the functions of various organs after diseases and injuries, including to restore the function of the musculoskeletal system.

Treatment of vertebrogenic dorsalgia at the Paramita clinic

The clinic’s doctors use proven oriental methods for treating vertebrogenic dorsalgia. They are the safest and most gentle, do not cause pain and give good results.

The main focus of the course is a combination of progressive therapy techniques with effective Eastern methods. For each patient, a special course of treatment is drawn up in accordance with the degree of development of the disease and the general condition of the body.

“You have thought about your own health and contacted us - with this step you trusted us with their lives. We highly appreciate your choice, and on behalf of the Paramita clinic team, I want to assure you that we will do everything possible to justify it.”