Vertebrogenic dorsalgia. What is dorsalgia and how to treat pain in the cervical, thoracic and lumbosacral spine

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.”

The human spine, like most other parts of the skeleton, plays an important role in human life.

It performs different functions, but the main one is support, helping to maintain balance. But under certain circumstances, pain may occur in the thoracic spine area.

- a common phenomenon. Almost every person has encountered it at least once in their life. Although he might not have realized that this was precisely dorsalgia.

It is generally accepted that this phenomenon generally refers to any manifestation of pain in a given part of the spine. However, many doctors disagree with this. The disease occurs due to degenerative-dystrophic deformities of the vertebrae.

In this article you can learn more about this disease, its causes, diagnosis and treatment.

Dorsalgia of the thoracic spine

Osteochondrosis or dorsalgia of the thoracic spine is an inflammatory process occurring in the thoracic region. Among the many types of osteochondrosis, this disease is much less common and mainly affects people who lead a sedentary lifestyle.

With this type of disease, intervertebral discs are destroyed. But, despite the complexity of the disease, symptoms appear much less frequently than in cases with damage to other parts of the spine. This is due to the fact that the thoracic spine is a sedentary part of the human skeleton, so the symptoms are less pronounced.

This situation leads to the fact that patients seek help even when the disease is in an advanced and often chronic state. People who spend a long time in front of monitors, professional drivers, and those who have suffered from various types of scoliosis should regularly undergo medical examinations regarding the possible occurrence of the disease.

Classification

In real medical practice, the following classification is used:

vertebrogenic dorsalgia;
myofascial dorsalgia.

Relatively speaking, chronic dorsalgia of the first type develops due to diseases of the spine. And pain of the second type is caused exclusively by muscle tension. Sometimes, when dorsalgia is diagnosed, nonspecific back pain appears due to diseases of the internal organs (kidneys, gastrointestinal tract, pelvic organs, lungs).

The development of vertebrogenic dorsalgia occurs after pinching of the spinal nerve roots. Pinching is usually followed by inflammation and radiculitis develops. Radiculitis can be located between the vertebrae or at the site of a bulging disc. Pain usually occurs only after a degenerative change in the tissue of the intervertebral discs, which is called osteochondrosis.

Spasms of muscle tissue lead to vascular spasms, which impairs the nutrition of disc tissue. As a result, the intervertebral discs simply dry out. The space between the vertebrae becomes smaller, and this is followed by pinching of the nerve endings and pain attacks, which are stimulated by reflex pinching of the muscles.

Sometimes the nerve endings are pinched by the spasmed muscles themselves, causing the pain to become even more acute and difficult to bear. In the myofascial scenario, the cause of the development of pain is also muscle spasm. Tight muscles form pain points - triggers. It is in these areas that pain manifests itself. Based on the location of pain, the following are distinguished:

dorsalgia of the lumbosacral spine;
dorsalgia of the thoracic spine;
dorsalgia of the cervical spine.

Vertebrogenic dorsalgia

The main cause of pain, which can be called dorsalgia, is osteochondrosis. But the main prerequisites are degenerative, neoplastic, traumatic or inflammatory lesions of the spinal structure.

Osteochondrosis belongs to the group that is commonly called degenerative changes, but in addition to osteochondrosis, the causes of pain can be spondylitis, spondylosis, ankylosing spondylosis or a reflection of pain from the sacral region, vertebral fractures, which are very often not diagnosed.

A separate group includes neoplastic changes such as tumors and oncology, infectious and inflammatory effects (tuberculosis, brucellosis, etc.), as well as deforming scoliosis.

Dorsalgia of the thoracic spine

In the thoracic region, osteochondrosis is least pronounced. The development of the disease implies degenerative changes in the intervertebral discs. Thoracic osteochondrosis is widespread, but is rarely diagnosed, because this disease often resembles a heart attack, angina pectoris, or a disease of the gastrointestinal tract.

If you have pain when inhaling and exhaling, intercostal pain, difficulty bending your body, pain when raising your arm, you should turn your attention to the thoracic spine.

Dorsalgia of the cervical spine

Usually the cause of neck pain is an exacerbation of cervical osteochondrosis. Such dorsalgia can be accompanied by pain in the arm, in the shoulder area, and headaches.

Cervical dorsalgia occurs or worsens when staying in an uncomfortable position for a long time, during physical exertion, sudden bending and awkward movements of the neck. There is also a rarer case of the disease - osteochondrosis, in which the back hurts between the shoulder blades.

Causes and symptoms of dorsalgia of the thoracic spine

Based on the cause of the syndrome, it can manifest itself in different ways. Unpleasant sensations can be sharp and accompanied by numbness of the limbs and limited mobility.

A person may feel a pressing, aching pain. When walking, inhaling or bending, the symptom often intensifies. The causes of dorsalgia in 90% of cases are pathologies of the spine. Among them are:

herniated intervertebral discs;
protrusion;
osteoporosis;
spondylosis;
osteochondrosis;
traumatic lesions.

Often, vertebrogenic dorsalgia (that which is associated with diseases of the spine) occurs due to congenital diseases. This may be kyphosis, scoliosis, Sheirman-Mau disease.

Nonvertebrogenic dorsalgia of the spine appears due to pathologies not related to the spinal column. Its most common causes are:

infectious and inflammatory diseases;
immune system disorders;
disruptions in metabolic processes in the body.

Dorsalgia is often caused by pathological changes in internal organs. These could be diseases of the stomach, intestines, kidneys or liver.

Why is thoracic osteochondrosis dangerous?

Without timely and proper treatment, thoracic osteochondrosis can cause the following diseases:

protrusion and hernia of the thoracic spine;
spinal cord compression;
problems with the heart, intestines, liver, kidneys and pancreas;
disturbances in the duodenum, intestinal motility, gallbladder dyskinesia;
intercostal neuralgia - compression or irritation of the intercostal nerves.

What can be confused with osteochondrosis of the chest?

Symptoms of osteochondrosis of the thoracic spine are varied; it can easily be confused with the following diseases:

angina pectoris, heart attack. Difference: after taking heart medications, the chest pain does not go away, the patient’s cardiogram is normal;
appendicitis, cholecystitis, renal colic;
gastritis, ulcer, colitis;
pathology of the mammary glands;
pneumonia. Pneumonia is distinguished from osteochondrosis by cough, shortness of breath and fever.

It is impossible to make a correct diagnosis on your own. Only a specialist can determine osteochondrosis of the thoracic spine.

What diseases cause dorsalgia?

Pain in the back can be caused by both pathology of the anatomical formations of this area and diseases of the internal organs. To establish the cause of any illness, you need to undergo an examination. This article discusses dorsalgia, which develops with diseases of the spine, and we will dwell on its causes in more detail.

Spinal diseases are divided into several large groups:

Degenerative diseases (osteochondrosis, disc herniation, spondylosis, spondylolisthesis and others);
Deformations (scoliosis, kyphosis, lordosis);
Consequences of injuries (fractures, sprains, dislocations);
Rheumatic diseases (Bechterew's disease);
Oncological pathology (osteoma, osteoclastoblastoma, osteosarcoma);
Infectious diseases (osteomyelitis, tuberculosis).

Clinical picture

As mentioned above, dorsalgia is a pain syndrome; it is a manifestation of the disease, not a diagnosis. This syndrome is characterized by two main symptoms - back pain and stiffness or limitation in movement. The clinical picture mainly depends on the disease in which we have dorsalgia.

Osteochondrosis

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.

Osteochondrosis is perhaps the most common disease, often occurring in people of working age. It is believed that degenerative processes that start in the cartilage tissue of the spine after 22-25 years are a normal phenomenon. All fabrics are prone to wear and tear and natural aging.

Osteochondrosis begins the development of more severe conditions such as spondylosis and disc herniation. In this case, the symptoms of dorsalgia are accompanied by neurological symptoms (paresthesia - changes in sensitivity and damage to internal organs).

Pain with osteochondrosis can be permanently dull, or it can be acute, paroxysmal, intensifying with movement.

Disc herniation

Intervertebral hernia often occurs in the lumbar region. Many of us have seen what a hernia on the anterior abdominal wall looks like when the internal organs protrude into the pathological cavity (hernial sac) through an opening in the peritoneum. So, approximately the same picture is observed in the spine. A defect appears in the lining of the intervertebral disc, through which the nucleus pulposus protrudes into the spinal canal.

As the protrusion grows, the hernia begins to compress the nerve fibers and irritate the spinal cord. With a small hernia, symptoms may be completely absent. Pain appears only when muscles, ligaments and nerve fibers are involved in the pathological process, when inflammation develops when the roots of the spinal nerves are pinched.

The pain can be either constant or in the form of an acute attack (lumbago - lumbar pain). With dorsalgia in the thoracic spine, the pain often radiates to the cervical spine.

Spondylosis and spondylolisthesis

This pathology most often affects older people. Spondylosis is manifested by deformation of the vertebrae due to bone growths (osteophytes) formed against the background of degenerative processes in the bone and cartilaginous structures of the spine. The pain in this disease is constant, can be very intense, and is difficult to treat.

Spondylolisthesis occurs in the lumbar region and, in addition to varying pain intensity, is characterized by changes in the functions of the pelvic cavity organs.

Spinal deformities

The spine has natural curves (cervical lordosis, thoracic kyphosis, lumbar lordosis and sacral kyphosis), deviation from which should be considered a deformity (curvature). Such deformations include pathological lordosis, pathological kyphosis, as well as scoliosis, which is a lateral curvature.

At the same time, the center of gravity shifts, and the tone of the back muscles also changes. The back is under constant tension, so pain in these conditions will be moderately chronic.

I prick my finger - it hurts, but here my back is intact!

After any injury, residual effects can be a concern. So, even after sprains, dislocations and fractures of the spine, sluggish pathological processes in the tissues persist, which can periodically manifest as pain after prolonged stress or overexertion.

And again the infection

Microbes enter the spinal tissue mainly through the hematogenous (blood) and lymphogenous (lymph) routes. Of all infectious diseases, the most common are osteomyelitis and spinal tuberculosis.

In the first case, a nonspecific process takes place (can be caused by any pathogenic microbe), in the second - a specific process (caused by a microbe of one type). The painful attack is accompanied by symptoms of intoxication (fever, chills, muscle weakness).

Oncological pathology

There are two types of tumors in the spine: those growing from bone and those growing from cartilage. Both types can be malignant or benign.

In addition, according to their origin, formations are distinguished between primary and secondary or metastatic. The main symptom of a mass formation in the spine is pain, the intensity of which depends on the type of tumor and its size.

Mechanism of development of dorsalgia

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 roots, blood vessels or the 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 hand 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 microtraumas 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 often occurs with 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.

Symptoms

The exacerbation period will last 2-3 weeks. At the same time, the pain gradually increases. Mild pain appears in the affected part of the spine. As a rule, pain manifests itself especially actively when breathing deeply and bending forward, backward, or to the sides.

The specific symptoms of dorsalgia will directly depend on the disease and its stage. For example, in the case of an intervertebral hernia, the pain can be quite acute at first, but at the final stage it can hardly be felt. This will be associated with atrophy of the pinched nerve.

When diagnosed with dorsalgia, the symptoms can be so different that the severity of the disease is not always related to the intensity of the pain. There is a widespread, but completely erroneous opinion that if it doesn’t hurt too much, then nothing bad is happening.

The price to pay for such a mistake may be disability, the need for urgent surgical intervention, and the inability to live a full life. If your back hurts, you should urgently go to the doctor and get examined.

The nature of pain during dorsalgia can be very different. The pain can be pulling, burning, aching, cutting, and can radiate to the leg, arm, buttock, or shoulder blade. The location of the pain is no less varied. They can appear below, above, in the middle, on the right, on the left, between the shoulder blades. But, despite such diversity, all pain can be divided into sudden and chronic.

Sudden pain

A sharp, sudden pain, similar to a lumbago, is called dorsago. The cause of pain in the chest area will most often be thoracic osteochondrosis. Sometimes the pain is so strong that the person has difficulty breathing or freezes in a forced position. A lumbago in the lumbar region is called lumbago.

The most likely cause of such pain is lumbar osteochondrosis. If you immediately contact a specialist, it will be quite easy to relieve sudden pain. If the problems are not big, then one or several massage sessions will be enough for the pain to go away. Sometimes acupuncture and manual therapy are also used to quickly relieve pain.

Chronic pain

Chronic pain does not appear immediately. They usually develop gradually. At first, the pain occurs briefly when inhaling, exhaling and bending over. Gradually they become more and more frequent guests. The cause of chronic dorsalgia is dystrophic changes in the intervertebral discs. A possible cause is also inflammation of the intervertebral joints. This disease is called ankylosing spondylitis. In addition to these reasons, there are a dozen others.

Chronic pain is excellently eliminated by various methods of reflexology and physiotherapy. Of course, you will need patience to complete a full course of treatment, but with regular procedures you can achieve a powerful therapeutic effect, achieve increased blood supply and accelerate metabolic processes in the area of the intervertebral discs, joints, vertebrae, and muscles that surround the spine.

With sufficient persistence, you can not only stop degenerative processes, but also reverse them. With a competent approach to treatment, intervertebral discs can completely recover, and pain can completely go away.

Diagnosis of the syndrome

The causes that can cause pain in the back and spinal regions have a huge range, so it is impossible to make a specific diagnosis based on pain symptoms alone.

In order to make the most effective diagnosis and identify the processes that occur in the spine, it is necessary to use innovative imaging methods, such as MRI or tomography, as well as conventional x-rays in several projections.

The use of MRI is justified by the fact that X-ray imaging is not able to detect the presence of malignant and other tumors and myoplasia, which are detected using magnetic resonance imaging or ultrasound.

To identify and treat the disease in a clinic, you need to contact a neurologist, but when contacting more specialized specialized institutions, it is best to undergo diagnosis and treatment from a vertebrologist. Correct and timely diagnosis is a good prerequisite for effective treatment of the disease.

Treatment of dorsalgia

Treatment of dorsalgia of any location and origin can be divided into conservative and surgical. In case of exacerbation of dorsalgia, in the case of severe pain, bed rest is recommended.

To speed up the healing process and its maximum effect, the bed should have an orthopedic mattress and pillow, the patient should be comfortable and comfortable. It is necessary to receive a set of medications:

NSAIDs. They are basic in the treatment of dorsalgia. They are prescribed both in the form of tablets or capsules (for mild to moderate pain) and by injection (for intense pain). It is recommended to combine with local products 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. Relaxes the back muscles and smooth muscle fibers in the walls of blood vessels, reduces pain, restores posture and mobility of the spinal column. Representatives: Mydocalm, Tizalud, Tizanil, Baclofen, etc. Frequency of administration - 1-2 times a day.
Chondroprotectors. Accelerate the restoration of affected cartilage tissue and prevent further development of the disease. The course of treatment with these drugs is long, at least several months. Representatives: Mucosat, Chondroitin sulfate, Artron Complex, Arthra, 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 walls, and reduce tissue swelling. Representatives: Pentoxifylline, Detralex, Troxevasin, Ascorutin, etc.
Biological stimulants. Stimulate and accelerate metabolic processes and natural mechanisms of fighting the disease, increase the rate of tissue restoration, restore blood flow and conduction of nerve impulses. Representatives: Aloe, Plazmol, FiBS, etc.
Vitamins. They accelerate metabolism, blood supply to tissues, nerve conduction, improve tissue restoration processes, and reduce the development of the disease. Representatives: Milgamma, B vitamins (B1, B2, B6 and B12).
Metabolic agents. They accelerate metabolic processes, restore blood flow and gas exchange in tissues, and activate natural mechanisms to combat the disease. Representatives: Mildronate, Trimetazidine, etc.
Glucocorticosteroids. They are used in cases of pronounced clinical manifestations, when other means do not have the required effect. They enhance the effects of drugs, especially NSAIDs, reduce the severity of pain, reduce swelling, and restore physiological processes. These are Prednisolone, Prednisone, Dexamethasone, etc.

After the acute manifestations of dorsalgia have subsided, when the pain syndrome is less pronounced, physiotherapy is recommended:

Acupuncture;
Traction of the spine;
Laser therapy;
Magnetotherapy;
Osteopathy;
Electrophoresis;
Massage;
Apitherapy;
Mud therapy;
Swimming;
Manual therapy.

Surgical treatment of dorsalgia is practically not used. The exception is those cases when conservative treatment is not effective, or severe complications develop.

Complications

With a long course of dorsalgia and the absence of timely and correct treatment, complications of the underlying disease develop:

Pain that cannot be treated;
Cerebrovascular accident (including stroke);
Paresis or paralysis of the arms, legs, and entire body;
Dysfunction of the pelvic organs (impaired urination, defecation, sexual dysfunction).

Preventive actions

There are no specialized methods of prevention. Taking into account the number of preconditions that can cause pain in the spine, it is possible to give only very general and joint recommendations for the prevention of pain conditions and lesions of the spine.

The main thing that can have a positive effect is a careful attitude towards yourself, the use of normal and proportional loads. Gymnastics classes, exercises in the morning.

A balanced diet and timely consultation with doctors is the key to ensuring that dorsalgia never manifests itself. At the same time, it is very important to prevent recurrent manifestations of those diseases that are already occurring. To do this, you must adhere to the recommendations given by the doctor.

As it was found out, dorsalgia is a cumulative manifestation of pain, which is caused by various reasons and can be effectively treated with various methods.

The main thing that everyone who has read this article needs to remember is that the body is a very “smart” creation that always responds with pain to various malfunctions in the functioning of internal organs or systems.

Therefore, if any signals arise, you must immediately contact a specialist for examination; excellent health also encourages periodic independent visits to the clinic for medical examinations.

Dorsalgia is a group of disorders characterized by mild, moderate, or severe pain that originates from the nerves of the muscles or joints associated with the spine. The pain may be constant or intermittent, localized or diffuse. There may be signs of burning. If it is associated with the cervical bone, then this pain can be transmitted to the limbs with a feeling of numbness.

There are several common causes of low back and leg pain, for example, for adults under 50 years of age, including herniated dysfunction and degenerative disc disease, for adults over 50 years of age, common causes include osteoarthritis and spinal stenosis. However, some researchers believe that 90% of back pain is caused by tension syndrome caused by stress and emotional disturbances.

Characteristics of the disease

With this type of disease, intervertebral discs are destroyed. But, despite the complexity of the disease, symptoms appear much less frequently than in cases with damage to other parts of the spine.

This is due to the fact that the thoracic spine is a sedentary part of the human skeleton, so the symptoms are less pronounced.

Dorsalgia of the thoracic spine - causes

Given the low mobility of the thoracic spine, the twelve discs present in this place are subject to less stress and there is little chance of possible injury.

This situation favors the fact that inflammatory processes in this metastasis develop much more slowly. However, when the disease occurs, the lateral or anterior part of the spine is affected. And it is these departments that are most often affected, manifesting themselves as osteophytes.

As a result of changes in the intervertebral discs, compression of the spinal nerve cells occurs, blood flow is disrupted and, as a result, the spinal cord is affected.

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

Spinal injuries (fractures, bruises, dislocations);
Staying in an uncomfortable or incorrect position for a long time;
Back overload;
Sudden changes in temperature;
Hypothermia of the body;
Frequent stress and negative emotions;
Long-term malnutrition;
Alcoholism;
Lack of physical activity and weakness of the muscular frame of the back.

Spinal diseases characterized by dorsalgia:

Osteochondrosis;
Spondylosis;
Intervertebral disc herniation;
Spondyloarthrosis;
Spondylolisthesis;
Instability of intervertebral discs;
Osteoporosis;
Ankylosing spondylitis;
Spinal fractures;
Spinal bruises;
Scoliosis;
Kyphosis;
Lordosis;
Spinal dislocations;
Malignant tumors of the spine;
Tuberculosis, bone form;
Vertebral osteomyelitis;
Radiculitis;
Congenital developmental anomalies;
Spondylitis;
Intercostal neuralgia;
Rheumatoid arthritis.

Classification

Dorsalgia is commonly referred to as back pain. The name of the disease comes from the Latin dorsalis, meaning back, and algos, meaning pain. Pain occurs for very different reasons and can have a different character. It can be acute, chronic pain, long-term pain, strong or moderate.

However, despite the above definition, there is still no consensus in the scientific community about dorsalgia. Most doctors believe that this concept can define any pain in the spine. And representatives of medicine with academic degrees object and give their opinions.

In general terms about the disease. The initial cause of pain can, as already mentioned, be different. However, the pain itself occurs due to hypertonicity and tension of the spinal muscles, after which muscle spasms appear.

Classification In current medical practice, the following classification is used: vertebrogenic dorsalgia; myofascial dorsalgia. Relatively speaking, chronic dorsalgia of the first type develops due to diseases of the spine.

And pain of the second type is caused exclusively by muscle tension. Sometimes, when dorsalgia is diagnosed, nonspecific back pain appears due to diseases of the internal organs (kidneys, gastrointestinal tract, pelvic organs, lungs). The development of vertebrogenic dorsalgia occurs after pinching of the spinal nerve roots.

Pinching is usually followed by inflammation and radiculitis develops. Radiculitis can be located between the vertebrae or at the site of a bulging disc. Pain usually occurs only after a degenerative change in the tissue of the intervertebral discs, which is called osteochondrosis.

Spasms of muscle tissue lead to vascular spasms, which impairs the nutrition of disc tissue. As a result, the intervertebral discs simply dry out. The space between the vertebrae becomes smaller, and this is followed by pinching of the nerve endings and pain attacks, which are stimulated by reflex pinching of the muscles.

Based on the location of pain, the following are distinguished: dorsalgia of the lumbosacral spine; dorsalgia of the thoracic spine; dorsalgia of the cervical spine.

Symptoms

Diagnosis of the disease is quite difficult, since many symptoms are similar to diseases associated with cardiovascular diseases, angina pectoris, pneumonia, and gastritis.

Therefore, to make an accurate diagnosis, a more complex examination of the patient is carried out.

Things to be concerned about:

pain in the chest area that increases with palpation or physical activity;
aching pain under the shoulder blades;
pain when raising your arms;
pain when bending or rotating the body;
pain when inhaling and exhaling;
intercostal pain;
feeling of tightness in the chest.

As this description shows, the same symptoms are characteristic of other diseases. In addition, there are often sensations that are similar to disorders in the digestive tract or neurological disorders, namely:

feeling of "goosebumps";
burning, itching, coldness of the hands or feet;
peeling skin and brittle nails;
diarrhea, constipation, nausea, vomiting.

Diagnostics

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

Survey (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 forced body positions, visible deformations of the spine, violations of active and passive movements in the affected part of the spine, etc.;
Palpation. Feeling the spine reveals tension in the muscular frame of the back, pain in the spine, any deformation, etc.;
Neurological examination. Checking for sensitivity of the skin and muscle fibers (pain, temperature, tactile sensations), preservation of physiological reflexes, paresis or paralysis, the presence of pathological reflexes;
X-ray of the spine in two projections (antero-posterior and lateral). Allows you to detect deformations of the spinal column, the condition of the spinal canal, fractures, dislocations and other changes in bone tissue;
CT (computed tomography). Layer-by-layer X-ray images make it possible to determine the pathological area with great accuracy, detecting 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 tap. 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 determines the condition of the spinal cord.

Treatment

Treatment of dorsalgia of any location and origin can be divided into conservative and surgical. In case of exacerbation of dorsalgia, in the case of severe pain, bed rest is recommended.

To speed up the healing process and its maximum effect, the bed should have an orthopedic mattress and pillow, the patient should be comfortable and comfortable.

It is necessary to receive a set of medications:

NSAIDs. They are basic in the treatment of dorsalgia. They are prescribed both in the form of tablets or capsules (for mild to moderate pain) and by injection (for intense pain).

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. Relaxes the back muscles and smooth muscle fibers in the walls of blood vessels, reduces pain, restores posture and mobility of the spinal column. Representatives: Mydocalm, Tizalud, Tizanil, Baclofen, etc. The frequency of administration is 1-2 times a day.
Chondroprotectors. Accelerate the restoration of affected cartilage tissue and prevent further development of the disease.
The course of treatment with these drugs is long, at least several months.

Representatives: Mucosat, Chondroitin sulfate, Artron Complex, Arthra, 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 walls, and reduce tissue swelling. Representatives: Pentoxifylline, Detralex, Troxevasin, Ascorutin, etc.
Biological stimulants. Stimulate and accelerate metabolic processes and natural mechanisms of fighting the disease, increase the rate of tissue restoration, restore blood flow and conduction of nerve impulses. Representatives: Aloe, Plazmol, FiBS, etc.
Vitamins. They accelerate metabolism, blood supply to tissues, nerve conduction, improve tissue restoration processes, and reduce the development of the disease. Representatives: Milgamma, B vitamins (B1, B2, B6 and B12).
Metabolic agents. They accelerate metabolic processes, restore blood flow and gas exchange in tissues, and activate natural mechanisms to combat the disease. Representatives: Mildronate, Trimetazidine, etc.
Glucocorticosteroids.
They are used in cases of pronounced clinical manifestations, when other means do not have the required effect. They enhance the effects of drugs, especially NSAIDs, reduce the severity of pain, reduce swelling, and restore physiological processes.

These are Prednisolone, Prednisone, Dexamethasone, etc.

After relief (cessation) of acute symptoms with medication, you can begin physical therapy. There are many options, you just need to carefully study the contraindications and get the approval of your doctor. Basic physiotherapeutic procedures useful for back pain:

Acupuncture is a method of Chinese traditional medicine, the essence of which is to influence acupuncture points of the human body; problem areas are stimulated using special thin needles.
They are placed along the so-called meridians, where the plexus of nerve endings, blood vessels and connective tissue is located.

Acupuncture activates blood circulation, reduces swelling, promotes the production of hormones: serotonin (pain-relieving effect) and cortisol (anti-inflammatory effect). The method is indicated for radiculitis and myositis.
Laser therapy is the effect of infrared radiation on diseased areas. The laser warms up and restores the neurovascular bundles of soft tissues and normalizes blood circulation. This treatment is indicated, in particular, for spinal hernia.
Magnetotherapy is the use of a static magnetic field for therapeutic purposes. Carried out through stationary or portable devices. Positively affects immune and metabolic processes. Used for neuritis.
Electrophoresis is a physiotherapeutic method when a medicinal substance penetrates the body through the skin using a special device that provides exposure to an electric field. The active substance is administered in the form of ions, in small doses, which demonstrate high chemical activity. Indicated for osteochondrosis and spondylosis.
Spinal traction (traction) - used in orthopedic medicine to increase the distance between the vertebrae, strengthen the spinal muscles, and straighten the spine.
The procedure takes place on a traction table (there are horizontal and vertical ones). You can stretch the patient's back using his own weight, or using weights.

Indications: hernias, spinal curvatures (scoliosis, kyphosis, lordosis).
Therapeutic exercise (physical therapy) - sets of exercises have been developed to solve problems of compression of intervertebral discs and strengthen the ligamentous-muscular apparatus of the back. Regular exercise reduces pain and helps remove harmful toxins and waste from the body. Prophylactically indicated for everyone, with the exception of acute painful conditions.
Manual therapy and massage - treatment with hands. This includes bone-setting. The essence of the techniques comes down to stretching, pressure, displacement and twisting of problem areas using specialized techniques. Indications: functional mobility disorders.
Swimming - relieves stress from the spine and trains the muscle corset. Has a beneficial effect on any person. People with existing problems benefit from backstroke swimming.

Surgical treatment of dorsalgia is practically not used. The exception is those cases when conservative treatment is not effective, or severe complications develop.

Therapeutic diet

It is highly advisable to follow certain dietary rules. With their help, it is easy to maintain optimal weight, qualitatively replenishing the body's need for nutrients. Cartilage needs collagen (jelly, jellied fish, milk jelly) and proteins (lean poultry, fish, eggs).

Minerals for bone health:

calcium (milk, kefir, hard cheese);
magnesium (fresh cucumbers, avocados);
phosphorus (white cabbage, peas);
zinc (wild rice, oatmeal, sunflower seeds);
manganese (legumes, celery).

To absorb calcium and phosphorus, vitamin D is needed; it is found in sea fish (fish oil), egg yolk, caviar, butter, and is also produced under the influence of ultraviolet radiation.

The main postulates of rational nutrition for dorsalgia are as follows:

Eat 5-6 times a day, in small portions;
Reduce consumption of simple carbohydrates: sweets, baked goods, pasta;
Do not exceed the individual daily calorie content of food - approximately 2500 kcal (a nutritionist will calculate it more accurately);
Drink a lot of clean water (at least 1.5 liters per day);
Avoid fried foods and alcoholic drinks;
Introduce dairy products into your regular diet (in the absence of lactose intolerance);
Limit salt intake;
Take vitamin complexes (in courses).

The menu must include vegetable oil and butter in moderate quantities. Various cereals and fruits are useful as a source of carbohydrates.

You can choose any bread except wheat. Do not abuse strong coffee and tea.

Traditional medicine

Traditional medicine is not a panacea for any disease. However, it can provide significant assistance in therapy if combined with traditional methods of treatment.

Folk remedies for osteochondrosis mainly include various lotions, ointments and other “preparations” for external use. However, there are also those that are used internally.

The material from which these medicinal products are made is mainly plant-based - herbs, flowers, roots, etc. Non-plant components are also widely used - fats, bee products, etc.

It should always be remembered that it is impossible to get rid of osteochondrosis using traditional medicine alone. If you feel unwell, you must consult your doctor. And also you cannot use non-traditional methods of treatment if you have an allergy or individual intolerance to one of the components of the product.

Treatments for osteochondrosis include ointments, compresses and rubbing. There are a huge number of recipes. The most effective of them are the following:

You need to take 1 tbsp. spoon of wormwood flowers and fill it with 300 ml of water (90-100°C). Leave for 1.5-2 hours. Then strain. Apply the resulting tincture generously to gauze, previously prepared according to the size of the diseased area of the back. Unscrew so that the liquid does not drain. Place the gauze on your back, cover it with oilcloth (can be cut from any bag) and wrap it with a scarf, towel or any other warm material at hand. You need to walk with this compress for at least 2 hours, but it is better to leave it overnight. The course of treatment is up to 14 procedures. If necessary, repeat after 2 weeks.
You need to take a full glass of any lilac flowers (you can mix several different types), fill them with 500 ml of vodka (alcohol can be used) and leave for 10 days. After this, strain and use as a rub. Rub into the skin of the affected area of the back with massage movements 1-2 times a day. Then wrap your back warmly. The course of treatment is 10-14 days.
It is necessary to connect 6 tbsp. spoons of bay leaf ground into powder, 1 tbsp. a spoonful of ground juniper needles and 12 tbsp. spoons of butter. Mix everything thoroughly until smooth. Rub the prepared cream onto the affected area of the back 1-3 times a day. The course of treatment is from 2 weeks to 1 month.
Mix 50 g of aloe pulp, 100 g of any honey and 150 ml of vodka (or alcohol). Let it brew for 4-5 days. Apply a thin layer to the affected area of the back, put a layer of oilcloth on top (made from any bag) and wrap it with something warm (plaid, towel, scarf, etc.). You should walk like this for 2-3 hours, if possible - overnight. The course of treatment is 10 compresses.
Mix 2 tbsp. spoons of plantain and sage leaves crushed into powder, add 4 tbsp. spoons of sunflower or olive oil and 40 g of Vaseline melted in a water bath. To stir thoroughly. Apply the prepared ointment in a thin layer to the affected area of the back and rub in thoroughly 2-3 times a day. Then wrap your back in something warm. The course of treatment is 3-4 weeks.

Despite the fact that baths are the same as local means of therapy, like ointments with compresses, they can be classified as a separate group of non-traditional treatment of osteochondrosis.

In addition to the analgesic, calming and relaxing effect on the affected area of the back, baths also have a general strengthening effect on the entire body, improve tissue metabolism, and normalize sleep.

There are many recipes for preparing such therapeutic baths. The most effective of them are the following:

Mix 1 tbsp. spoon medicinal chamomile flowers, knotweed leaves, lavender and walnut leaves. Pour 250-300 ml of cold water and put on low heat. Bring to a boil, cook for 1-2 minutes. Leave for 40-60 minutes, then strain. Pour the resulting broth into a warm bath (37-38°C). You need to take this bath for 15-25 minutes. The course of treatment is up to 1 month, daily or every other day. If necessary, can be repeated after 14-21 days.
Mix 1 tbsp. spoon of spruce needles, valerian, chestnut fruits and lavender, add 4 tbsp. spoons of sea salt and 300-400 ml of water. Cook over low heat for 5 minutes after boiling. Then leave for 1 hour, strain and add to a warm bath (37-38°C). You need to take such a bath for 20-25 minutes. The course of treatment is up to 1-1.5 months daily or every other day. If necessary, can be repeated after 14-21 days.

Alternative medicine taken orally (through the digestive organs) promotes an analgesic, anti-inflammatory effect, relieves muscle spasms, improves blood flow, partially restores nerve conduction and helps remove deposited salts from spinal tissues.

The most effective recipes include the following:

Mix 1 tbsp. spoon of yarrow and tansy flowers, pour 200-250 ml of boiling water, cover and let steep for 2 hours. Then strain and take 1 tbsp. spoon 3-4 times a day, 30-40 minutes before meals. The course of treatment is 28 days.
Place lilac flowers (either fresh or dry) in a liter jar so that it reaches almost to the top, pour vodka on top, and close the lid tightly. Infuse in a warm and dark place for 10-12 days. Then strain and take 35-45 drops orally. You can drink it with water. The course of treatment is 14-28 days.
Squeeze 1.5 cups (300-350 ml) of juice from any type of radish, add to it 1 cup of honey, 1 tablespoon of crushed sea salt and 500 ml of vodka. Mix thoroughly until smooth. Take 50 g daily 30 minutes before bedtime. The course of treatment is 3 weeks.
You need to take 1 cup of unhulled oat grains, fill it with 1 liter of cold water and put on low heat with the lid open. Cook until a quarter of the liquid has evaporated. Cool and strain this slimy broth. Add 3 tbsp. spoons of honey. Take half a glass three times a day 30-45 minutes before meals. The course of treatment is 1 month.

Complications

As for the complications of thoracic osteochondrosis, over time this disease can lead to various diseases of the internal organs. The most serious complication is pathology of the cardiovascular system and dystrophic changes in the heart muscle.

They appear due to irritation of the receptors of the neck and chest and all the sympathetic formations that are associated with them.

Disturbances in the functioning of the duodenum, the appearance of dyskinesia of the gallbladder, and impaired motility of the intestinal tract are also possible. Needless to say, how important it is to promptly identify osteochondrosis of the thoracic spine in order to treat this insidious disease?

What is intercostal neuralgia called? This is a pain syndrome that, although not very common, is the cause of one of the most severe pain sensations. It can be compared to pain during acute renal colic. The cause of this syndrome often lies precisely in osteochondrosis of the chest.

Pinching of several roots can lead to damage to the intercostal nerve, resulting in very severe pain of a girdle nature. They often spread in the intercostal space as the affected nerve itself does.

In this case, there may be a loss of sensitivity, paleness or redness of the skin, a significant increase in sweating, and, in addition, muscle twitching or spasms, which makes the pain even worse

Intercostal neuralgia is also called thoracalgia. It manifests itself as neuropathic pain, which in nature is very similar to the pain syndrome during cardiovascular diseases.

Intercostal neuralgia, despite the fact that the cause of its appearance is degenerative-inflammatory diseases of the spine, is called the brightest “deceiver” in medicine, since its symptoms often resemble the symptoms of diseases of almost all organs located in the chest and abdominal cavity.

This pathology usually develops due to irritation and compression of the intercostal nerves. Intercostal neuralgia is often recorded in older people; we can associate this with age-related changes that occur in the body. This disease almost never occurs among children.

It is worth noting that intercostal neuralgia cannot be called a separate disease, since it is only a concomitant symptom of some serious pathology. Often it develops precisely against the background of osteochondrosis, as well as scoliosis, various tumor diseases, or appears due to displacement of the vertebrae.

About intercostal nerves However, in this case, not only the pain sensation is dangerous, but also the fact that intercostal neuralgia is successfully “masked” as other diseases. For example, pain similar to that of angina pectoris may occur, and in the same way radiate under the shoulder blades.

The only noticeable difference is the fact that during angina pectoris the pain is usually short-lived, often disappearing after a few minutes, while pain with neuralgia can persist even for several days.

Another option for “masking” neuralgia is pain that mimics an ulcer. In this case, the duration of pain is the same as with a real ulcer, but unlike it, usually effective medications that relieve spasms do not work.

Unfortunately, incorrect diagnosis often occurs and a course of treatment is prescribed that will not help the patient in any way. And only after some time the doctor realizes that he was mistaken and refers the patient to additional studies, which may provide another opportunity to find the real cause of the pain syndrome.

Prevention

To prevent the occurrence of dorsalgia, it is recommended to adhere to simple measures and rules:

Exercise regularly (at any time of the day);
Strengthen the muscular frame of the back (special exercises);
Take daily walks in the fresh air (5 km or more);
Adhere to the rules of a balanced diet;
If you have a sedentary lifestyle or sedentary work during the day, do 5-minute warm-ups every hour;
Follow safety rules in the workplace, when playing sports, etc.;
Maintain correct posture at the table, when walking, resting, etc.;
Rationally and evenly distribute the weight of heavy objects when lifting with your hands;
Consult a doctor promptly if any symptoms occur.

Sources: spinomed.ru, etospina.ru, moyaspina.com, spinomed.ru, spina-sustav.ru, pozvonkoff.ru

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...

Ekaterina A week ago

I tried drinking a decoction of bay leaves, it didn’t do any good, I just ruined my stomach!! I no longer believe in these folk methods - complete nonsense!!

Maria 5 days ago

I recently watched a program on Channel One, it was also about this Federal program to combat joint diseases talked. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully finances the treatment for each patient

Main symptoms:

Dorsalgia is essentially the fact of the presence of pain of varying degrees of intensity in the back. It follows from this that this is not a separate pathology, but a syndrome that occurs in any age category and regardless of gender.

In almost all cases, the source of such a disorder is the course of one or another disease affecting the skeletal system or spinal column. In addition, clinicians also identify a category of predisposing factors.

As for the symptoms, they will be dictated by the disease that served as the source of dorsalgia. The main clinical manifestation is, against the background of which other symptoms gradually develop.

The clinician will be able to make a diagnosis of dorsalgia based on data from instrumental examinations of the patient, which can also be supplemented by a physical examination and laboratory tests.

Treatment tactics are dictated by the etiological factor, but are often based on conservative techniques.

The International Classification of Diseases, Tenth Revision, has allocated a separate meaning for such a syndrome. The ICD 10 code is M 54. However, it is worth noting that unspecified dorsalgia has a value of M 54.9.

Etiology

A large number of predisposing factors can cause the appearance of pain in the back or dorsalgia, which is why they are usually divided into several groups.

– this is an infectious-inflammatory disease that primarily affects the bone marrow, after which it spreads to the bone tissue;
benign or malignant neoplasms, as well as cancer metastasis;
– in this case, a herniated disc is formed;
– this pathology is characterized by increased fragility of all bones;
– in such cases, there is a displacement of one vertebra in relation to the others;
narrowing of the lumen of the spinal canal;
fractures and injuries.

The second group of reasons includes muscle diseases, among which it is worth highlighting:

Crick;
muscle spasms.

Dorsalgia can also be caused by:

hemorrhages in the pelvic area;
hematomas located in the retroperitoneal space, in which a purulent process occurs;
injuries and ailments of the pelvic organs;
pathologies of the gastrointestinal tract and kidneys;
rheumatological disorders.

In addition, there are the following risk factors:

extensive injuries;
lifting weights by a physically weak person;
prolonged stay in an uncomfortable position;
prolonged hypothermia of the body.

In addition, in female representatives, dorsalgia can be caused by the period of gestation and menstruation.

Classification

Depending on the location of pain, there are the following forms of this syndrome:

cervicalgia– has the second name “dorsalgia of the cervical spine”;
lumbodynia– in this case, the pain is localized in the lumbar area, which is why the disorder is also known as dorsalgia of the lumbar spine;
thoracalgia- differs in that the main symptoms do not extend beyond the sternum, which means that in such cases dorsalgia of the thoracic spine will be diagnosed.

Depending on the duration of expression of unpleasant sensations, the syndrome can occur in several forms:

acute dorsalgia– is such if pain bothers patients for no more than one and a half months. It differs in that it has a more favorable prognosis in comparison with the sluggish variety;
chronic dorsalgia– diagnosed if pain in one or another part of the spine persists for more than twelve weeks. Such a course is fraught with loss of working capacity or disability of a person.

By origin, this violation has two types:

vertebrogenic dorsalgia– characterized by the fact that it is directly related to injury or diseases of the spine;
non-vertebrogenic dorsalgia– the occurrence of this type is caused by other etiological factors, for example, somatic ailments or psychogenic causes.

Symptoms

Clinical manifestations of dorsalgia consist in the expression of pain, which can be either constant or paroxysmal in nature, aching or sharp. However, in all cases the pain intensifies with physical activity.

Given the fact that such a syndrome develops due to the course of various diseases, it is natural that the symptoms in each specific case will be different.

In the course of rheumatological pathologies, clinical manifestations will be as follows:

localization of pain in the lumbar area;
irradiation of unpleasant sensations to the area of the buttocks and thighs;
increased pain with prolonged rest;
bilateral spinal lesions.

In cases where the source is infectious processes, then among the characteristic symptoms will be:

severe pain throughout the spinal column;
foci of pain in the lower back, buttocks or lower extremities;
swelling and redness of the skin in the problem area.

For muscle pathologies that cause spinal dorsalgia, the symptoms will be as follows:

spread of pain along the left or right half of the body;
increased pain with climate change or in cases of exposure to stressful situations;
the occurrence of painful points located in various areas of the body, which are detected when accidentally pressing on them;
muscle weakness.

For osteochondrosis and spondyloarthrosis, clinical signs are presented:

back pain - aggravation occurs when turning or bending;
discomfort that occurs when staying in one position of the body for a long time;
numbness or tingling in the hands or feet;
decreased muscle tone;
headaches and dizziness;
impaired hearing or vision;
tonic syndrome;
motor function disorders.

In cases of damage to other internal organs, the following will be expressed:

abdominal pain and frequent urination - with kidney pathologies;
girdling nature of pain – in diseases of the gastrointestinal tract;
pain in the chest and under the shoulder blades - with lung diseases.

Diagnostics

If you experience back pain or dorsalgia, you should seek qualified help from a neurologist. It is this specialist who will conduct the initial diagnosis and prescribe additional examinations.

Thus, the first stage of diagnosis includes:

collecting a life history and analyzing the patient’s medical history - this will help determine what pathological condition provoked the appearance of such a syndrome. Symptoms and treatment will vary depending on the disease identified;
general physical examination aimed at palpating the spine and assessing the range of movements in it;
a detailed survey of the patient - to establish the nature of pain, the presence and severity of additional symptoms.

Laboratory diagnostic measures are limited to a general clinical analysis of blood and urine.

The most valuable in establishing the correct diagnosis are the following instrumental examinations of the patient:

radiography - to detect pathological changes in the vertebrae;
electromyography – will detect muscle pathologies;
densitometry – determines bone density;
CT and MRI – to obtain a more detailed picture of the spine. It is thanks to this that it is possible to distinguish non-vertebrogenic dorsalgia from the syndrome of vertebrogenic genesis;
radioisotope osteoscintigraphy - in this case, a radiopaque substance is distributed over the bones. The presence of foci of excess accumulation will indicate the localization of the pathology, for example, the sacral spine.

In addition, you may need consultation:

vertebrologist;
rheumatologist;
orthopedist

Treatment

In the vast majority of cases, eliminating the underlying disease is sufficient to relieve back pain.

However, the treatment of dorsalgia involves the use of a whole range of conservative techniques, including:

compliance with bed rest for two to five days;
wearing a special bandage designed to relieve stress from the spine;
taking non-steroidal anti-inflammatory drugs - orally, by injection or used as ointments;
the use of muscle relaxants are medications that relax muscles;
therapeutic massage course;
physiotherapeutic procedures;
performing physical therapy exercises - but only after the pain subsides.

The issue of surgical intervention is decided individually with each patient.

Prevention and prognosis

To reduce the likelihood of developing a syndrome such as dorsalgia, it is necessary:

monitor correct posture on a regular basis;
engage in timely treatment of those diseases that can lead to back pain;
rationally arrange the working and sleeping space;
completely eliminate hypothermia;
prevent injuries to the spine, back and pelvic area;
eliminate the influence of heavy physical activity;
monitor body weight indicators - if necessary, lose a few kilograms or, conversely, increase your body mass index;
undergo a full preventive examination at a medical facility several times a year.

Dorsalgia itself does not pose a threat to the patient’s life. However, we should not forget that each disease that causes back pain has its own complications. The most unfavorable prognosis is observed with vertebrogenic dorsalgia, since in such cases it is possible that the patient will become disabled.

Is everything in the article correct from a medical point of view?

Answer only if you have proven medical knowledge

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.

Three main pathophysiological mechanisms for 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 due to 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.

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 microtraumas 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.

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.
Symptoms of loss of function of compressed roots are determined: impaired sensitivity, 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