Dorsalgia of the spine - what is it and how to treat it? Dorsalgia of the thoracic spine - symptoms, diagnosis, treatment Priority classification of dorsalgia in domestic medicine.

It has been established that in different periods of life, back pain occurs in 80% of the population. Among adults, more than half suffer from long-term chronic symptoms. This prevalence includes the disease in the group of social problems.

The most susceptible and prone to clinical manifestations are:

people without sufficient physical activity;
engaged in enhanced training or heavy physical labor;
addicted to alcoholic beverages;
smokers.

Dorsalgia is not called any pain. An accurate diagnosis is required to identify it.

What refers to dorsalgia according to the International classification?

Dorsalgia is defined in the ICD-10 as a group of conditions that present with the common clinical symptom of back pain. M54 is coded, it is included in the "Dorsopathies" block, the "Other dorsopathy" subgroup, the "Diseases of the musculoskeletal system" class.

It is important that dorsalgia does not apply:

osteocondritis of the spine;
spondylosis;
any damage to the intervertebral disc;
inflammation of the sciatic nerve.

It is interesting that in the ICD there are no such diagnoses as "spondylarthrosis" or "facet syndrome" at all. According to many scientists, they most fully reflect the nature of pathological changes. However, they are forced to "cover" the term "Other spondylosis" with the code M47.8.

What is hidden under the term "others"?

With this diagnosis, the patient can undergo examination and treatment until the cause and type of changes in the muscles, spine are clarified, or until reflected back pain is detected in diseases of internal organs (most often duodenal ulcer, duodenitis, pancreatitis).

For a thinking doctor, such “diagnoses” are impossible.

Differences by localization

Depending on the location of the lesion, dorsalgia is distinguished:

the entire spine, starting from the cervical region;
cervicalgia - a lesion only in the neck;
pain in the chest;
damage to the lumbar back in the form of sciatica;
lumbosacral sciatica (such as lumbago + sciatica);
pain in the lower back;
radiculopathy - when radicular syndrome clinically predominates;
unspecified other varieties.

Clinical forms

Neurologists distinguish 2 forms of dorsalgia:

acute - occurs suddenly and lasts up to three months, in 1/5 of patients it turns into chronic;
chronic - lasts more than three months.

Unilateral "long" pain speaks in favor of a radicular cause

One of the founders of Russian spinal neurology Ya.Yu. Popelyansky singled out a more accurate temporal description of pain:

episodic;
chronic relapsing with rare exacerbations;
chronic relapsing with frequent or prolonged exacerbations;
gradual or continuous (permanent type of flow).

Studies using diagnostic blockades have established that the main cause of chronic pain is spondyloarthrosis (facet syndrome):

with cervical localization - up to 60% of cases;
at the chest level of the lesion - up to 48%;
with back pain - from 30 to 60%.

Most of the patients are elderly people.

The transition to the chronic form is facilitated by hereditary predisposition, stress, mental illness with impaired perception, with pathological sensitivity.

Causes

For the clinical characteristics of the disease, 4 etiological varieties of back pain are distinguished:

nonspecific pain - associated with damage to the intervertebral joints, sacroiliac joint (facet);
muscle - from overstrain or injury to muscles, ligaments, fascia;
radicular - compression of the nerve roots emerging from the spinal canal;
specific - this is the name of pain caused by tumor decay, vertebral fractures, tuberculosis, infectious pathogens, systemic lesions in rheumatoid arthritis, psoriasis, lupus erythematosus.

Depending on the cause, dorsalgia is divided into 2 types:

vertebrogenic dorsalgia- includes all connections with the pathology of the spine, changes in the spinal column are more often associated with degenerative-dystrophic processes or adverse static and dynamic loads;
non-vertebrogenic- includes muscular, psychogenic, depending on various diseases.

Clinical manifestations

Symptoms of dorsalgia depend on the predominant mechanism in the pathology.

Radiculopathy is characterized by:

unilateral pain in the leg with changes in the lumbar region, or in the arm, shoulder - in the thoracic part of the back, stronger in intensity than in the back;
according to irradiation, it is regarded as “long” - from the waist to the fingertips;
numbness in certain areas;
weakness of the muscles that are innervated by the affected roots;
severe symptoms of tension (Lassegue);
increased pain when coughing, sneezing;
in the supine position, pain decreases, scoliosis caused by spastic muscle contraction levels out.

The most prone to injury to the intervertebral joints is the lumbar region, especially with sharp twisting to the side.

An additional negative factor is the weakness of the muscles of the abdominal wall, which allows you to change the shape of the spinal column in the lower part.

For facet syndrome are typical:

each exacerbation changes the nature of the pain;
pain in the lower back of aching, squeezing or pressing nature;
strengthening during extension, turning to the side, standing up;
stiffness in the mornings and evenings with the maximum severity of pain;
localization in the paravertebral zone, one- or two-sided;
with a lumbosacral lesion, it radiates to the gluteal region, along the back of the thigh to the coccyx, to the groin, does not “go down” below the knee;
from the upper parts of the lower back pain radiates on both sides of the abdomen, into the chest;
from the cervical vertebrae - extends to the shoulder girdle, shoulder blades, rarely below;
unlike radiculopathy, it is not accompanied by impaired sensitivity.

Diagnostics

Diagnosis of vertebrogenic dorsalgia is based on the experience of a neurologist. On examination, pain is detected in certain areas of innervation. Checking reflexes, sensitivity, symptoms of stretching allows you to suspect the nature of the lesion.

To exclude osteochondrosis of the spine, prolapse of the intervertebral disc are carried out:

radiographs in different projections;
magnetic resonance imaging;
CT scan.

The only standard way to prove the pathology of the facet joints is to observe the disappearance of pain after a blockade of the spinal nerve under the control of computed tomography. The technique is used only in specialized clinics.

It should be borne in mind that the patient may have manifestations of both vertebral and muscular symptoms. It is impossible to distinguish them.

Treatment

In the treatment of dorsalgia, doctors use the standards of the European recommendations for the treatment of non-specific back pain. They are universal in nature, do not depend on the source, calculated taking into account the maximum level of evidence.

non-steroidal anti-inflammatory drugs in short courses or up to three months;
a group of muscle relaxants to combat muscle spasm;
analgesics (drugs based on Paracetamol).

With persistent pain, paravertebral blockades with hormonal agents and anesthetics are used.

Dissolve 1 sachet in half a glass of water before taking, the dosage is convenient for teenagers and the elderly

The use of chondroprotectors for treatment is justified by damage to cartilage tissue. But serious studies of their effectiveness in dorsalgia have not yet been conducted.

It is strongly suggested not to put the patient to bed, but to maintain physical activity, to engage in physiotherapy exercises. It is even considered as an additional risk factor for chronic pain.

The negative effect of non-steroidal drugs are exacerbations of diseases of the stomach and intestines. The most effective and safe is currently considered Nimesulide (Nise) in combination with Ketorol.

Most doctors approve of the use of physical therapy:

phonophoresis with hydrocortisone;
magnetotherapy.

Surgical treatment methods are used for persistent pain. They are associated with the blockade of the transmission of pain impulses through the nerve roots. This is achieved by radiofrequency ablation. The method can be performed on an outpatient basis under local anesthesia.

Prevention of exacerbations

The information component of the treatment plan is to explain to the patient the nature of the disease, in the fight against stress. It has been proven that the prognosis for treatment is much better if the patient himself participates in rehabilitation.

exercises that strengthen the muscular frame of the spine;
swimming lessons;
repeated courses of massage;
the use of orthopedic pillows, mattress, cervical collar;
taking vitamins.

In the case of prolonged back pain, there are ways to help, so you should not endure and suffer. Self-treatment with various compresses and warming up can lead to the opposite result.

With gout on the legs, alcohol is incompatible with taking medications, because they contain potent substances. The result of this combination may be internal bleeding or toxic liver damage.

With exacerbation, the use of alcoholic beverages contributes to the growth of crystals of uric acid salts on the joints. It is alcohol-containing products that have the largest number of purines, an excess of which provokes the deposition of sodium urates in the tissues of the body.

if you drink even a small glass of vodka, it can cause a severe gouty attack, which will begin after a few hours. During such an inflammatory process, the pain is felt doubly stronger.

The disease is more difficult to treat if you drink alcohol more often. Due to the negative impact of alcoholic beverages, the therapeutic effect of drugs is blocked and the process of removing toxins from the body slows down.

Few people know how to combine alcohol and gout. However, there are a number of recommendations that will help you have a good time without possible consequences. The main rule is only to prepare the body for a feast. This requires:

Do not take alcohol on an empty stomach;
Before the start of the feast, eat a little butter or vegetable oil (1 tablespoon). These products can reduce the absorption of alcohol through the gastric mucosa. The oil covers the mucous membrane with a thin film, which is a protection against the absorption of alcohol;
Drink activated charcoal or any other sorbent 30-60 minutes before the start of the banquet. These funds help reduce the dose of alcohol that has entered the body. The dose is calculated taking into account the patient's body weight - for every 10 kg of weight, 1 tablet of the sorbent is needed. Drinking plenty of water;
Do not mix different types of alcoholic beverages;
Do not eat large amounts of food;
Drink only high-quality alcohol, excluding the intake of cheap fake drinks;
Start the banquet with a hot meal. Hot dishes, mixed with alcohol, reduce the activity of its effect on the gastric mucosa. This makes it difficult for alcohol to enter the blood;
Do not drink alcohol during drug treatment, so as not to provoke a number of complications and side effects;
After alcoholic drinks, drink a large amount of alkaline mineral water (Essentuki, Borjomi).

Gout is a serious disease. The treatment of this disease requires a lot of patience from the patient and compliance with all the recommendations of the doctor. Alcohol aggravates the pathological process. Each patient must determine for himself whether a glass of alcohol is worth the possible complications.

Drinking strong drinks with gout is strictly prohibited. However, some doctors do not think so. Can you drink alcohol with gout? Small doses certainly won't hurt. It is desirable to drink drinks, in the structure of which there are no preservatives and flavorings.

To strengthen the immune system drink wine. The dosage should be selected by the attending physician, taking into account the severity of the disease and the individual characteristics of the organism. It is better to give preference to dry white wine (no more than 250 ml per week).

Abuse of strong alcohol in excessive doses is not recommended. It can give rise to a new gouty attack. However, it is allowed to use it as a rubbing or compress. There will be more benefits from this.

Many men drink alcohol for gout, although they are aware of its harm to the body.

What kind of alcohol is possible with gout? This question worries all patients with gouty arthritis.

In order not to harm health and not cause an exacerbation of the disease, it is allowed to replace alcohol with the following drinks:

alkaline water;
fruit drink;
compote;
chicory;
rosehip decoction.

Milk is also beneficial. It removes excess urates from the body. Particular attention should be paid to the drinking regimen. You need to drink at least 2 liters of fluid per day. Victims with a history of heart disease, hypertension, prostate adenoma, kidney failure, it is enough to drink 1.5 liters of fluid per day.

With an exacerbation of gouty arthritis, it is allowed to drink decoctions based on medicinal herbs:

nettles;
tansy;
series;
lilac;
mint;
chamomile.

It is recommended to drink clean water and herbal decoctions more often.

To prepare a decoction, you need to pour 1 tbsp. l. dry herb 250 ml of water. Put the container on the stove and bring the contents to a boil. Cool the finished broth and strain. Drink the drink throughout the day in small sips.

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Gout mainly occurs in men aged 40-50 years. Given the attitude of most men to alcohol, it is relevant that many patients are wondering - what kind of alcohol can you drink when you are sick?

There is only one answer: it is strictly forbidden to drink beer, wine, vodka.

As you know, gout develops as a result of a metabolic disorder, as a result of which uric acid accumulates in the body, this is what causes the development of the disease. In general, the disease is divided into two types: primary and secondary gout.

The primary disease is diagnosed, as a rule, in patients who have a genetic predisposition. In such people, an increased amount of sodium urate is independently produced in the body. This disease is often caused due to a malfunction in the kidneys, when they cannot cope with the removal of accumulated salts from the body. This form of gout is called congenital.
Secondary gout can develop with a negative effect on the body, which leads to a violation of the proper metabolism. By analogy with the congenital form, with this type of disease, the body is also not able to fully remove salts. Or, alternatively, the body produces an increased amount of uric acid.

During the detection of the disease, the doctor first of all studies the medical history, since most often gout begins to develop with psoriasis, hemoblastosis, myeloid leukemia, diabetes mellitus, hemolytic anemia.

The formation of the second form of the disease can lead to increased use of drugs that cause disruption of the functioning of the renal tubules and a decrease in the volume of blood circulation.

Including gout can develop with frequent consumption of food that contains lead, as well as alcoholic beverages.

During illness, it is forbidden to drink both regular and non-alcoholic beer. This is due to the fact that the intoxicating drink contains a large amount of purines, which is converted into uric acid inside the body.
Vodka, gin, whiskey and other strong alcohol, including fortified wine, are also not recommended. The fact is that such alcoholic beverages do not allow uric acid to be fully excreted from the body. You can only drink red or white dry wine, but the daily dose of drunk should not exceed two glasses.
It is important to know that alcoholic beverages should not be consumed if the patient is taking any medication to cure joint inflammation. In this case, you can provoke the appearance of gastrointestinal bleeding and damage the liver.

Some patients believe that alcohol can be taken in small doses for gout, but this is an erroneous opinion. According to doctors, even a minimal amount of an alcohol-containing substance can cause a gout attack.

In this case, the disease will make itself felt literally on the same day, after the alcoholic drink has been drunk.

Affected joints will begin an inflammatory process, no matter what type of alcohol was taken. Often, doctors pay attention to the fact that the patient periodically has an attack of the disease, despite an intensive course of treatment.

First of all, this is due to the fact that the diet is disturbed and the person drinks alcohol.

To answer the question of whether it is possible to take alcoholic beverages with gout, a lot of scientific research has been conducted. According to their results, doctors can say for sure that when taking even a small amount of alcohol, the disease can worsen. It is important to bear in mind that gout is not completely curable.
Studies have shown that men who drink alcohol in the amount of five servings for two days were twice as likely to experience attacks of gout, compared with those patients who did not drink alcohol during this period. It turned out that when the dosage was increased to seven servings, the risk of exacerbation of the disease increased up to 2.5 times.
Beer, wine and other strong drinks contain purine, which negatively affects the state of the body. There is an opinion that when you are sick, you can drink a small amount of elite alcohol, for example, expensive dry wine. However, just one glass of even a high-quality drink can repeat a gout attack. Although in modern times there are still doctors who have a different opinion regarding alcohol, who believe that elite alcohol can be consumed.

READ ALSO: Plasmapheresis and hemosorption in gout

The disease causes a serious metabolic disorder, for this reason, relapses can occur regularly. To keep the body normal, the patient must adhere to the strictest diet. If you do not follow proper nutrition, exacerbations can happen quite often.

Gout and beer

Is it possible to drink vodka with gout? Despite the fact that it does not contain purines, it is still not worth drinking it. Vodka leads to dehydration, and this accelerates the synthesis of purines. If you drink alcohol often, then the level of uric acid increases markedly.

It crystallizes and begins to accumulate inside the tissues. This process serves as an impetus for the development of gouty arthritis or its exacerbation. Therefore, the risk group includes people who drink vodka often and in large volumes.

In addition, vodka is a toxic product. Due to the content of ethanol, it adversely affects the pancreas, which is responsible for the production of insulin. People who are prone to the disease are forbidden to drink strong strong drinks.

Vodka or any other strong alcohol is negatively displayed on the work of the kidneys. The excretory function is impaired. Urates are not completely excreted from the body. This can further lead to the development of renal pathologies. The liver also suffers from vodka. It ceases to perform an antitoxic function.

Besides the fact that vodka causes general dehydration, it promotes the synthesis of purines.

Beer has a diuretic effect. Many people think that due to this it cleanses the kidneys, but this is not so. The danger is both alcoholic and non-alcoholic type of drink. Beer contains a huge number of purines, so regular consumption of it increases the level of urea to alarming levels.

How many purines are in beer? In 100 gr. contains about 1900 mg of purines. This indicator is considered unsafe even for a healthy person. The daily norm is 600-1000 mg of purines. Exceeding the permissible norm is a step towards meeting gout.

The diuretic property of the drink leads to dehydration of the body and thickening of the blood. Urate and toxins remain in the tissues. Due to the viscosity of the blood, the cells no longer receive enough oxygen and other useful substances, very badly affecting the cartilage tissue.

Drinking beer in large doses can really face the following consequences:

the work of the kidneys is disturbed;
the risk of developing a new attack increases significantly;
urates accumulate in tissues.

You can't drink beer with gout

Is it possible to drink vodka with gout - this is a controversial issue, on which doctors have not come to a consensus. Most rheumatologists believe that drinking vodka with gout is possible because it does not contain purines and does not affect the deposition of urea salts in the joints.

Vodka can be useful only with a single use. That is, a random glass of vodka is less harmful than a glass of beer. Such a one-time use will not cause another exacerbation of gout.

However, regular abuse of vodka slows down the excretion of uric acid through the kidneys. Its salts begin to settle in the tissues and internal organs, after which the formation of tophi and the destruction of the joints begin.

A person develops an addiction to alcohol, which is sometimes impossible to get rid of. Taking medications and drinking vodka are also incompatible. Even a small amount of alcohol nullifies the effect of drug therapy, exacerbates the development of the disease.

It is believed that beer is one of the safest types of alcohol. Most often they drink it in the summer. But drinking beer with gout is strictly prohibited. This drink contains a huge amount of purines (1810 mg of purines per 100 g of beer), the concentration of which is dangerous for any person.

Dorsalgia is a combined concept, literally translated from Latin as back pain. It includes all diseases of the spinal column, the main symptom of which is pain in any part of the back and spine. The condition is ubiquitous and affects people of all ages.

Causes

There are a number of predisposing factors that increase the risk and lead to the development of dorsalgia:

Diseases of the spine, which are characterized by dorsalgia:

Malignant tumors of the spine;
Tuberculosis, bone form;
Osteomyelitis of the vertebrae;
Congenital anomalies of development;

Classification

By localization of pain There are 4 types of dorsalgia:

Cervicalgia - back pain at the level of the cervical spine;
Thoracalgia (intercostal neuralgia) - back pain at the level of the thoracic spine;
Lumbalgia - back pain at the level of the lumbar spine;
Combined dorsalgia - back pain at the level of two or three sections of the spine.

Origin dorsalgia is of two types:

Vertebrogenic dorsalgia - back pain caused by diseases of the spine. Some experts distinguish subspecies:

traumatic - caused by injuries of the spine;
inflammatory - caused by inflammatory processes in the spine;
degenerative - caused by degenerative processes in the spine;
neoplastic - caused by tumor growth in the spine and its structures.

Non-vertebrogenic dorsalgia is back pain not associated with spinal pathology. Its subspecies:

myofascial - caused by changes in the muscular frame of the back (sprains, bruises, inflammation, etc.);
psychogenic - without physical causes, caused by mental and psychological factors;
other reasons.

Symptoms of dorsalgia

Symptoms of dorsalgia are quite diverse:

Pain in the back, in the spine. Localization - cervical, thoracic or lumbosacral spine, from point to extensive. Intensity - from mild to intense, disruptive. Character - aching, sharp, pulsating, constant or periodic, pulling, occurs at rest or after exercise, shooting, blocking, etc .;
gait disorder;
Numbness of the skin of the back;
Discomfort in the legs;
Weakness in the body;
Increase in body temperature.

Diagnostics

For a complete examination and diagnosis of dorsalgia, an integrated approach is applied to each patient:

Interrogation (collection of complaints and anamnesis of life and illness). Helps to establish complaints at the time of contacting a doctor, the chronology of their occurrence, the mechanism of development of the underlying disease and its complications, causes;
Inspection. Allows you to identify a forced position of the body, visible deformities of the spine, violations of active and passive movements in the affected spine, etc.;
Palpation. Palpation of the spine reveals the tension of the muscular frame of the back, soreness of the spine, any deformity, etc.;
Neurological examination. Checking for sensitivity of the skin and muscle fibers (pain, temperature, tactile sensations), the safety of physiological reflexes, paresis or paralysis, the presence of pathological reflexes;
Radiography of the spine in two projections (anteroposterior and lateral). Allows you to detect deformations of the spinal column, the state of the spinal canal, fractures, dislocations, and other changes in bone tissue;
CT (computed tomography). Layered x-rays allow you to determine the pathological area with great accuracy, detects a violation of the integrity of not only the spine, but also the spinal cord, etc .;
MRI (magnetic resonance imaging). The most accurate visual method. Determines any violations of the structure of the spine, spinal cord, soft tissues, blood vessels and nerves;
Spinal puncture. Allows you to detect hemorrhage in the spinal cord, the presence of tumor cells in the cerebrospinal fluid, purulent and inflammatory processes, etc.;
Myelography. A contrast x-ray image determines the condition of the spinal cord.

Treatment of dorsalgia

Treatment of dorsalgia of any localization and origin can be divided into conservative and surgical.

With exacerbation of dorsalgia, in the case of a pronounced pain syndrome, bed rest is recommended. To speed up the healing process and its maximum effect, the bed should be with an orthopedic mattress and pillow, the patient should be comfortable and comfortable. It is essential to receive complex of medicines:

NSAIDs. They are basic in the treatment of dorsalgia. They are prescribed both in the form of tablets or capsules (for pain syndrome of mild and moderate severity), and by injection (for intense pain). It is recommended to combine with local remedies from the same group (cream, gel, ointment). Representatives: Diclofenac, Nimid, Analgin, Indomethacin, Baralgin, Pentalgin, etc. The frequency of oral administration is 1-4 times a day, injections are 1-2 times a day.
Muscle relaxants. They relax the back muscles and smooth muscle fibers in the walls of blood vessels, reduce pain, restore posture and mobility of the spinal column. Representatives: Mydocalm, Tizalud, Tizanil, Baclofen and others. The frequency of admission is 1-2 times a day.
Chondroprotectors. Accelerate the restoration of the affected cartilage tissue, prevent the further development of the disease. The course of treatment with these drugs is long, at least several months. Representatives: Mukosat, Chondroitin sulfate, Artron Complex, Artra, etc.
Angioprotectors. They restore patency in blood vessels, normalize and accelerate gas exchange and metabolism between blood and tissues, improve the condition of the vascular wall, and reduce tissue edema. Representatives: Pentoxifylline, Detralex, Troxevasin, Ascorutin, etc.
biological stimulants. They stimulate and accelerate metabolic processes and natural mechanisms to fight the disease, increase the rate of tissue repair, restore blood flow and conduction of nerve impulses. Representatives: Aloe, Plasmol, FiBS, etc.
Vitamins. Accelerate metabolism, tissue blood supply, nerve conduction, improve tissue repair processes, reduce the development of the disease. Representatives: Milgamma, B vitamins (B1, B2, B6 and B12).
metabolic agents. They speed up metabolic processes, restore blood flow and gas exchange in tissues, activate natural mechanisms to fight the disease. Representatives: Mildronate, Trimetazidine, etc.

It is difficult to distinguish it from other diseases due to the similarity of concomitant symptoms with other diseases of the spine, as well as internal organs.

Characteristics of dorsalgia and its types

Depending on the cause of occurrence, dorsalgia is divided into:

vertebrogenic- occurs due to pathological changes in the components of the spine, which are accompanied by an inflammatory process, are the result of an injury to the spinal column, or are of a neoplastic nature (malignant tumors);
non-vertebrogenic- occurs against the background of muscle sprains, prolonged stress and other psychogenic factors, as a result of muscle spasms and prolonged tension of the back muscles.

According to the localization of painful sensations, the following types of pain syndrome are determined:

cervicalgia- soreness in the cervical spine;
thoracalgia- pain in the thoracic spine;
lumbalgia- Pain in the lumbar region of the spine.

Dorsalgia can be combined and simultaneously cover two or three sections of the spine.

At-risk groups

The following categories of people may be affected by dorsalgia:

those who lead a sedentary lifestyle (for example, office workers, drivers);
having an underdeveloped muscular corset of the back;
those who have suffered spinal column injuries;
having malignant tumors of the spine;
suffering from spondylosis;
suffering from scoliosis;
having displacement of the vertebrae from their anatomically correct position;
exposed to infectious diseases;
having diseases of internal organs;
suffering from osteoporosis;
being overweight;
back muscles subjected to hypothermia (myositis);
people with congenital diseases of the musculoskeletal system.

Neurological examination allows you to determine the safety of all physiological reflexes and identify the presence of pathological reactions.

After collecting an anamnesis of the disease and a neurological examination, the doctor sends the patient for an additional examination, which will help establish an accurate diagnosis and without the results of which it is impossible to prescribe the correct treatment.

Methods for diagnosing dorsalgia include:

radiography- performed in two projections: anterior and lateral. This method allows you to identify compression fractures (may be caused by osteoporosis, etc.), displacement of the vertebrae and other deformations of the spinal column. Also, this research method allows specialists to assess the condition of the patient's spinal canal.
Myelography- an X-ray with a contrast agent. Myelography allows you to determine the condition of the spinal cord.
Computed tomography (CT)- allows you to get layered images, with the help of which you can more accurately determine the location of the disease or injury, the presence or absence of spinal cord injuries.
Magnetic resonance imaging (MRI)- This research method is the most accurate and effective of all of the above. It allows you to identify all types of damage to the spinal column, spinal cord, spinal nerves and blood vessels.
spinal tap- cerebrospinal fluid is taken if the patient is suspected of having benign or malignant tumors in the spine. This method allows you to find out about hemorrhages in the spinal cord and identify the presence of purulent or inflammatory processes.

Treatment of dorsalgia and prognosis of recovery

And did you know that…

Next fact

If the patient has acute back pain, the treatment of dorsalgia must be comprehensive. Then the patient is prescribed drug therapy, it is recommended to visit the physiotherapy room and the exercise therapy room. In some cases, surgery may also be necessary.

Drug therapy for dorsalgia involves the use of the following groups of drugs:

Non-steroidal anti-inflammatory drugs (NSAIDs)	They play an important role in the presence of a strong pain syndrome in a patient. With severe pain, they are prescribed in the form of intramuscular injections. For mild or moderate pain, they can be used in the form of tablets or capsules. For greater efficiency, gels and ointments can be used simultaneously with drugs of this group in tablet form or in the form of injections.	Indomethacin Analgin Nimid Ibuprofen
Muscle relaxants	They are prescribed to relax the muscles of the back, as well as the smooth muscle fibers of the blood vessels. Preparations of this group help to get rid of the pain syndrome (sometimes not completely), which allows you to restore the mobility of the spinal column, normal gait and posture.	Mydocalm Sirdalud Thezalud
Chondroprotectors	They help to restore the affected cartilage tissue, but treatment with these drugs should be carried out for several months.	Chondroitin sulfate Mukosat
Glucocorticosteroids	They are used to enhance the effect of drugs of other groups (especially NSAIDs). They help to get rid of pain and swelling of soft tissues. Glucocorticosteroids help restore physiological processes in the body.	Prednisolone Dexamethosone
Angioprotectors	They are prescribed to improve the metabolism between the blood and tissues of the body, improve the patency of blood vessels. Allows you to get rid of swelling of soft tissues.	Troxevasin Detralex Askorutin
Biostimulants	They are prescribed to stimulate metabolic processes in the body, improve blood circulation and transmission of nerve impulses. Helps speed up the recovery of body tissues. Strengthen the body's resistance to diseases.	Plazmol
vitamins	Vitamin complexes help to strengthen the body, slow down the progression of the disease, accelerate the exchange between the blood and tissues of the body, and stimulate the restoration of damaged tissues. Dorsalgia requires vitamin B complexes (B1, B2, B6, B12).	Milgamma

Attention! Non-steroidal anti-inflammatory drugs are not recommended for use for treatment longer than 5-7 days. Drugs in this group can cause complications, in particular diseases of the gastrointestinal tract.

Physiotherapy for dorsalgia involves the use of the following treatment methods:

apitherapy (use in the treatment of bee venom and bee products);
acupuncture;
magnetotherapy;
manual therapy;
electrophoresis.

For the treatment of dorsalgia used and manual therapy. But massage should be done only by a qualified specialist.

The chiropractor during the massage acts on the deep subcutaneous layers, improving blood circulation in the muscular corset of the back and returning the displaced elements of the spinal column to their places.

Exercise therapy is also effective for the treatment of dorsalgia. A set of exercises is selected by the exercise therapy instructor individually for each patient, taking into account the cause of back pain.

Surgery is rarely used.- in cases where complex therapy does not give a positive result. In some cases, vertebroplasty is used - a gentle surgical method that allows you to strengthen the elements of the spinal column percutaneously, using special equipment and medical cement.

At home, only exercise therapy can be used to treat dorsalgia. The remaining methods are cold or hot compresses, wraps, warming up, tinctures, etc. can only worsen the state of health if the exact cause of pain is not established.

In 90% of cases, dorsalgia and the underlying disease that caused the pain syndrome are successfully treated.. In 5% of cases, back pain can be accompanied by complications and treatment can take about 3 months. In only 2% of cases, dorsalgia may require surgery to treat.

Video: "Exercises for the spine from osteochondrosis"

Conclusion

Dorsalgia- not a disease, but a pain syndrome that arose against the background of any disease of the musculoskeletal system. For its treatment, only a complex technique is used.

If the cause of the pain syndrome is not treated in a timely manner, this can lead to serious consequences:

to circulatory disorders in the spinal cord and brain;
to partial or complete paralysis of the body;
to impaired mobility of the back;
to a significant decrease in performance;
to dysfunction of the pelvic organs.

To avoid the occurrence of dorsalgia, it is recommended to adhere to the following preventive measures:

strengthen the muscles of the back with exercises;
knead your back from time to time during prolonged sedentary work;
control the weight of the lifted weights and evenly distribute the load on both upper limbs;

Collapse

If there is pain in the back, you should think about the timely visit to the hospital. Such discomfort may mean that a person has vertebrogenic dorsalgia. What is it and how to get rid of it, we will consider below.

Definition

Vertebrogenic dorsalgia is pain in the back, which arose as a result of diseases of the spinal column, this also includes the psychosomatic nature of the pathology.

traumatism;

long stay in an uncomfortable position;

draft and hypothermia;

stress;

harmful production, etc.

People at risk include:

with a large body weight;
those who are inactive (drivers, office workers);
having hazardous production, where you have to physically work, lift heavy objects (loaders, miners, builders);
involved in weightlifting;
nervous and depressed individuals.

Common symptoms of dorsalgia

Dorsalgia of the spine has the following symptoms:

pain, discomfort when bending, turning, coughing, sneezing, when lifting heavy;
the impossibility of full motor activity;
radiating soreness (in the neck, leg, etc.).

The strength of pain depends on the stage, form of the disease. It can occur periodically, at certain times, or be present constantly.

Classification of vertebrogenic dorsalgia by department

If we consider the localization of the disease, then several types of it should be distinguished.

Dorsalgia, which occurs in the thoracic region, is called thoracalgia. Discomfort is observed in the chest area. Pain can radiate to the area of the shoulder, arms.
The cervical region is affected by vertebrogenic dorsalgia - cervicalgia. This type is characterized by soreness in the neck, the muscles of the corresponding department are tense. Pain in cervicalgia can be throbbing or tingling. In parallel with them, there is dizziness, discomfort in the occipital region and tinnitus.
If the lumbosacral zone suffers, then vertebrogenic dorsalgia is called lumbalgia. Pain is localized in the lower back. It is sharp, aching and becomes stronger during physical activity, mainly after physical work and after hypothermia. If the form is acute, there are backaches.

Flow forms

There is an acute and chronic form.

In the acute period, the pain is sharp, severe, unbearable. Leading a normal life will not work. Human movements are constrained.

The chronic form is characterized by moderate pain that is constantly present.

Diagnosis of vertebrogenic dorsalgia

If there is pain in the back area, you need to seek help from a neurologist. If the specialist considers it necessary, he will send the patient to a rheumatologist or vertebrologist. The doctor will examine the patient, take an interest in the symptoms and their duration. Will evaluate reflexes, see how successfully a person performs certain actions (walks, squats, etc.).

Then the direction is given to:

X-ray examination. The picture will examine the condition of the bones. If there is a fracture or arthritis, his doctor will immediately detect.
Magnetic resonance imaging. Here, the ligamentous and muscular apparatus, choroid plexuses, intervertebral discs, and nerves will be examined.

If MRI fails to be performed for any reason, it is interchanged with computed tomography. In severe cases, it is advisable to do a scintigraphy (with such a scan, all neoplasms, osteoporosis will be revealed).

Treatment

Vertebrogenic dorsalgia can be cured with medication. But such therapy will be appropriate only in unopened cases. If conservative therapy does not work, they begin to think about surgical intervention.

If the doctor decided to try to remove the disease with the help of drugs, then in parallel with them you need to attend massage sessions and various physiotherapy sessions.

acute form

In the acute phase, they are limited to anti-inflammatory, analgesic drugs, corticosteroids. These include muscle relaxants and non-steroidal anti-inflammatory drugs (these are drugs in the form of Prednisolone, Prednisone, Dexamethasone, etc.). They come in tablet, capsule or injection form.

Local remedies (gels or warming ointments) will help to remove soreness. These include:

Nise;
Finalgel;
Finalgon, etc.

They should be used 1 or 2 times a day, applied directly to the site of inflammation.

During the first days, and sometimes weeks, complete rest is required. All loads are excluded. Will complement all the use of an orthopedic mattress and a special pillow.

Of the muscle relaxants, Baclofen, Mydocalm, Tizanil or Tizalud are prescribed. Take no more than twice a day. The doctor will say for sure.

To prevent the progression of the disease, chondroprotectors are prescribed. Such funds contribute to the restoration of cartilage. These are drugs such as Artra, Mucosat, Artron Complex. The course of admission is at least a month.

To tidy up the vessels and improve gas exchange, angioprotectors will be good. Detrales, Troxevasin, Pentoxifylline are popular.

It is important to take vitamin complexes. Particular preference is given to group B.

If the acute period is gone, you can resort to physiotherapy.

chronic form

If the pathology has become chronic and the acute period is over, the treatment is based on physiotherapy exercises, massage therapy, physiotherapy procedures. Reflexology and manual therapy are popular in modern medicine.

The duration of the therapeutic course will be determined by the specialist.

Complications of vertebrogenic dorsalgia

If vertebrogenic dorsalgia is not treated for a long time, various complications may develop. These include:

constant soreness that medications do not remove;
improper cerebral circulation, strokes;
deviations in the work of the intestines (manifested in the form of encopresis - spontaneous emptying), bladder (implies incontinence - urinary incontinence) and genital organs (problems with erection - in males);
paralysis of the limbs;
disorders in the mobility of the arms and legs.

There is also a risk of developing diseases of the internal organs. If dorsalgia is localized in the thoracic region, then dystrophy of the heart muscle may appear.

Prevention

To prevent vertebrogenic dorsalgia, you need:

avoid hypothermia;
do exercises in the morning;
do not forget about sports;
If discomfort occurs in the back area, seek medical attention immediately.

It is also necessary to remove a heavy load, abandon a sedentary lifestyle, eat normally.