Dorsopathy: what is dorsopathy of the lumbar and lumbosacral spine, treatment

Osteochondrosis is a disease that affects the skeletal system not only in adults, but also in children and adolescents. In adults, osteochondrosis develops as a result of exposure to negative factors, difficult and monotonous working conditions, trauma, stress; older people are susceptible to the disease. To prevent osteochondrosis from developing in children and adolescents, certain rules must be followed: promptly treat clubfoot, flat feet and other foot disorders, do not allow the child to lift weights, encourage sports to develop the back muscles, and maintain normal posture.

Specialists at the Yusupov Hospital deal with problems of musculoskeletal disorders, perform operations to restore normal function of the musculoskeletal system, rehabilitation measures, which include physical therapy, physiotherapeutic procedures, and other treatment methods. The hospital uses the international classification of diseases - ICD 10. The coding system uses special codes that contain complete information about the disease. Encoding allows you to protect the patient from disclosure of the diagnosis and is convenient in processing medical information.

The encoding system uses letters of the Latin alphabet and numbers. Varieties of the disease are indicated after the main classification code, separated from it by a dot. For example: ICD 10 code for osteochondrosis of the spine - M42, juvenile osteochondrosis of the spine (a type of osteochondrosis) - M42.0. In the disease classification system (ICD codes), osteochondrosis belongs to class 13. The disease belongs to dorsopathies, which cover codes from M40 to M54. All diseases of the musculoskeletal system and connective tissue are coded in the system under codes M00-M99.

Various subclassifications for dorsopathy that do not have classification in other headings are indicated in M40-43. Codes that are used to clarify the location of the disease (deforming dorsopathies M40-M43):

multiple lesions – 0.
occipital-atlanto-axial region -1.
cervical spine – 2.
cervicothoracic spine – 3.
thoracic spine – 4.
localization of the disease in the thoracic and lumbar region – 5.
lumbar region – 6.
lumbosacral region – 7.
sacrococcygeal and sacral department – 8.
department not specified – 9.

General information, what is this disease?

Modern medicine uses the collective term “dorsopathy” to unite various diseases of the spine and adjacent soft tissues, the main negative symptoms of which are manifested by a reflex pain syndrome in the back area, accompanied by various neurological complications. The ICD-10 dorsopathies code is encrypted in the alphanumeric range M40-M54, which in itself implies many pathological processes to which this concept applies. To varying degrees of severity, symptoms of dorsopathy are felt by approximately 70-90% of the planet's population after 35-40 years, and approximately 20-25% of all people suffer from a chronic form of this painful condition with periodic stages of acute exacerbation and relative calm.

Diagnosis of dorsopathy

A preliminary diagnosis is made during the initial examination of the patient. The examination is usually carried out by a neurologist in connection with the patient's complaints of local changes, which may manifest as pain, deformation or limited mobility. The spine is examined with the patient standing, sitting and lying, both at rest and in motion. The level of spinal damage is determined by counting the number of vertebrae from certain anatomical landmarks or according to a special scheme.

When examining the back, pay attention to posture, structural features of the body, note the line of the spinous processes (median groove of the back), the lower angles of the shoulder blades, the crests of the iliac bones, the lateral contours of the waist and neck, the position of the shoulder girdle, the deviation of the intergluteal groove from the vertical, and identify the protrusion of the spinous processes, pay attention to the relief of the muscles located next to the spine.

Feeling the spine allows you to supplement the examination data (presence or absence of deformation), determine the location, degree and nature of pain. When palpating, tension in the muscles located next to the spine is also noted, because Most injuries and diseases of the spine are accompanied by an increase in muscle tone.

Spinal flexion is used to determine the range of motion in various parts of the spine. The main role in the study of the spine is played by radiography, computed tomography and magnetic resonance imaging, with the help of which the level of damage is determined, the diagnosis is clarified and specified, and hidden pathologies are revealed. Diagnostic data allows the attending physician to determine treatment tactics and select the most effective treatment methods.

Pathogenesis

Dorsopathy is not an independent disease, but in general is only a complex of vertebrogenic (arising from the spine) and/or non-vertebrogenic (developing in the soft spinal tissues) syndromes that occur in humans as a result of many back pathologies. If we translate this term from Latin (dorsum - back, pathia - disease), it will mean “back disease”, which automatically brings to the fore the pain syndrome, the development mechanisms of which in this case can be very diverse. Thus, the pathogenesis of dorsopathy will be determined by one or another primary disease present in the patient and the severity of its course.

In medical practice, there are three main types of degenerative processes occurring in the spine, which are directly associated with dorsopathy, namely: spondylosis , osteochondrosis , spondyloarthrosis . These pathomorphological variants of spinal column diseases can occur separately from each other or be combined with each other.

Spondylosis

A disease of the spine that deforms the surface structure of the vertebrae by the growth of spines or other protrusions on them, which occurs due to pathological growth of bone tissue in this area. Due to the formation of spondylosis, there is a fixation of a certain area of the spinal column, which is subsequently subjected to significant overload, which leads to irritation of the nerve fibers in the paravertebral ligaments, and hence to pain.

Osteochondrosis

The most common disease of the spine among all age categories, which is based on degeneration and a significant decrease in the height of the intervertebral disc, accompanied by sclerosis of the surfaces of the affected vertebrae and the growth of osteophytes . The cartilage tissue of the spinal motion segments, subjected to osteochondrotic changes, gradually degenerates and acquires the characteristics of bone. A disc that has hardened due to loss of natural moisture significantly decreases in size and ceases to serve as a shock absorber of the intervertebral space. As a result, pathologically altered edges of the vertebrae or herniated discs begin to compress the nearest nerve endings, which respond to this with pain and a number of neurological phenomena.

Spondyloarthrosis

This painful condition is a particular form of a disease such as osteoarthritis and is a heterogeneous type of pathology of the spinal column, during the development of which all elements of the facet joints and nearby tissues (cartilage, capsule, subchondral bone, periarticular muscles, ligaments, etc.) succumb to degeneration. As a result of such general damage, painful sensations arise in the problem area of the back (most often local), which negatively affects the patient’s quality of life.

Common Spinal Problems

In some cases, the root cause of the development of dorsopathies may be irritation of nociceptors located in paravertebral tissue structures (membranes, ligaments, muscles, paraarticular capsules). Quite often, due to ongoing chronic inflammatory processes, fascial compactions, foci of myofibrosis and trigger zones are formed, in other words, a characteristic myofascial syndrome , accompanied by pain and muscle spasm in response to excitation of trigger points. All this can be a consequence of both physical activity (weight lifting, sports, hard work, etc.) and physical passivity (prolonged sitting at a table, working in an uncomfortable position, etc.) of the patient and even the result of frequent stressful situations. In the absence of adequate targeted therapy, subsequent chronicization of such a pathological process occurs.

Often, spinal dorsopathy is accompanied by reflex syndromes originating from the posterior longitudinal vertebral ligament, the nociceptors of which are irritated by inflammatory products from the affected area of the spinal column. In this case, there is a blockage of the problematic motor sector of the spine due to constant muscle spasm, which in turn causes pain. Thus, within the framework of dorsopathy, a pathological vicious circle arises in which spinal pain leads to spasm of the nearby muscles, which also responds to this with pain. The longer such a painful process progresses, the more difficult it is subsequently to treat and the more reflex syndromes are added to it. Such syndromes can be neurovascular, muscular-tonic and neurodystrophic in nature (for example, glenohumeral periarthrosis ).

Often, dorsopathy is accompanied by compression syndromes that arise as a result of mechanical microtrauma by marginal osteophytes , intervertebral hernias and other pathological formations of the spinal cord itself, its membranes, nerve roots, and nearby vessels. Depending on the strangulated vertebral or paravertebral tissues, the clinical manifestations of such compression syndromes can be spinal ( myelopathic symptom complex with many neurological phenomena), radicular ( radiculopathy with severe pain and neurological disorders) or neurovascular (pathologies such as vertebral artery syndrome ) in nature.

What happens to the intervertebral disc during Dorsopathy?

The nucleus pulposus of the disc is under constant pressure. The height of the disc decreases due to the pressure of the body weight, which is in an upright position during the day. When the discs are young and healthy, they contain a lot of water - so much that at night, when they are saturated with moisture and we straighten out, we add up to two centimeters in height.

The “straightening” of the disc occurs due to the properties of the nucleus pulposus and the elasticity of the ligaments. Liquids, as we know, are practically incompressible, so any pressure acting on the core is transmitted in all directions. The annulus fibrosus holds the core, that is, the pressure of the core is balanced by the tension of the annulus fibrosus, the ligaments surrounding the spine and the tone of the back muscles. The opposition of these two forces, according to doctors, is the key to understanding the degenerative-dystrophic osteochondrosis processes occurring in the spine. The muscles also play a huge role in this counteraction, creating a kind of tension field around the spine.

The emergence and development of dorsopathy is promoted by:

– physical inactivity (low motor activity);

– monotonous or meager food;

– constant work in unfavorable weather conditions, when low temperatures are combined with high air humidity;

– vibration;

– an imperceptible uneven load on the spinal column due to a variety of factors (for example, incorrect position of the spine during work and other daily activities);

– prolonged stay of the body in physiologically uncomfortable positions: sitting for many hours, bent over a desk at school, college, home, at work; sitting at the steering wheel of a car, at a computer console, at a drawing board, standing at a machine, at a counter, etc.

As a rule, age-related changes in intervertebral discs appear after 45 - 50 years. However, they can also occur at an earlier age, especially if there have been macro- and microtraumas, infectious lesions, or metabolic disorders. The causes of the disease can be an unfavorable hereditary predisposition, and weakness of the musculoskeletal system, cartilage structure, and muscle corset. The general situation is worsened by excess body weight.

At the same time, the blood supply and provision of nutrients to the tissues adjacent to the spine, vertebral bodies and intervertebral discs is almost 30 times worse than with a rational motor mode. As a result, the content of microelements, enzymes and vitamins in the tissues of the intervertebral discs, ligaments and muscles of the corresponding part of the spine decreases. All this gives rise to the emergence of the entire complex of disorders, which culminates in degenerative-dystrophic changes either in an individual intervertebral disc and vertebra, or in a group of discs and vertebrae, or in the entire spine as a whole.

Over time, the disc loses 70% of its previous properties and can no longer serve as a strong and reliable shock absorber. With age, the soft core of the intervertebral disc loses water and ceases to perform its functions. The mass of the core is reduced, thereby reducing the height of the disk.

The extensibility and elasticity of the disc shell (fibrous ring) also decreases. During this period, small cracks may appear in the fibrous ring around the nucleus and disc, and the substance of the nucleus will begin to press into these cracks. These cracks also appear as a result of malnutrition of the intervertebral discs and stress on the spine.

This is the first stage of the disease - chondrosis, when the pathological process is limited to the disc. It is very difficult to recognize the disease. At the beginning of the disease, a person experiences mild discomfort. X-ray does not show any changes.

Starting from the second stage - dorsopathy, characterized by further spread of the process to the bone base of the spine, adjacent vertebral bodies and intervertebral joints. Further destruction of the fibrous ring occurs, the fixation of the vertebrae among themselves is disrupted, and their pathological mobility appears. Further disc degeneration inevitably leads to a decrease in the height of the intervertebral space, thereby compressing the neurovascular endings, blood and lymphatic vessels, resulting in increased pain.

In the third stage of the disease, if a complete rupture of the fibrous ring occurs (for example, as a result of significant physical activity - heavy lifting), intervertebral hernias are formed (the deformed nucleus pulposus breaks through (falls out) through the fibrous ring outside the disc). Under pressure from the hernia, the irritated nerves send impulses to the central nervous system, and the person experiences severe pain. During this period of the disease, a fixed deformity of the affected parts of the spine may develop in the form of kyphosis (convexity of the spine backward), lordosis (bending of the spine forward) and the initial stage of scoliosis (lateral curvatures) of the spine. The physiological line of the spine is disrupted.

The fourth stage is characterized by painful compaction and displacement of the vertebrae. A deformed intervertebral disc does not provide complete connection of the vertebral bodies, and thus, slight displacements occur relative to each other, which, in turn, causes a reaction of the surrounding paravertebral muscles, which painfully contract and spasm.

The result is a restriction of movement in a specific segment, called a “blockade”. Sometimes such blockades occur suddenly. For example, in the cervical spine when turning the head - in bed, when reversing a car, or when moving the head suddenly (during a car collision). “Rejuvenation” of cervical osteochondrosis is associated with an intense increase in the frequency of motor vehicle injuries of the spine.

As a result of the described changes in the lumbar spine, the vertebrae are displaced posteriorly (pseudospondylolisthesis, or retrolisthesis), and in the cervical spine, subluxations occur. Feelings of pain and discomfort in the back or neck tend to intensify in uncomfortable positions. The connection between the vertebrae is disrupted, and the spine loses its flexibility and mobility.

If this entire process continues, which is inevitable if the load on the spine continues, then the vertebrae react with the formation of pathological bone growths (osteophytes), narrowing the intervertebral foramina. All this leads to irritation, compression and inflammation of the nerve roots (sciatica), vasospasm (impaired lymph circulation, arterial and venous circulation in the spine), compression (compression) of the spinal cord, resulting in damage to the central and peripheral nervous system.

A reduction in the space between the vertebral bodies leads to the development of a deforming disease of the spine, spondyloarthrosis (arthrosis of the intervertebral joints). The disease leads to a real disaster: motor activity decreases, the mobility of the spine is impaired, sudden movements cause acute, sometimes literally unbearable pain. In advanced cases, disability may occur at this stage of the disease.

All four stages of dorsopathy are inherent in any type of dorsopathy - cervical, thoracic, lumbosacral. The largest number of people suffer from dorsopathy of the cervical spine, since 40% of the height of the cervical spine falls on cartilaginous intervertebral joints, while in the thoracic region they account for only 20%, and in the lumbar region - about 33%. If we compare the specific loads on the discs, then in the cervical region it is 11 kg/sq. cm, and in the lumbar region - 9.5 kg/sq. cm. Therefore, the neck is most susceptible to this disease.

By taking on the weight of the head (support function), the cervical spine largely neutralizes shocks and concussions of the brain. The cervical spine is the most mobile, since the neck provides a large range of movement of the head, and therefore its muscles get tired much faster than the muscles of the rest of the back corset. This leads to accelerated wear of the intervertebral discs of the cervical spine. Degenerative changes in the discs are more common in the most mobile lower cervical parts of the spine (at the level of the 5th - 7th cervical vertebrae).

The cervical spine differs from other sections primarily in that, in addition to the canal for the spinal cord, there is a canal for the vertebral artery. At the level of the 6th cervical vertebra, the artery enters the canal of the transverse processes, and at the level of the 2nd vertebra it exits and, penetrating the cranial cavity, participates in the blood supply to the brain.

With pathological changes in the cervical spine, the vertebral artery spasms, thereby reducing the flow of blood to the brain. In addition, the vertebral artery is intertwined with fibers of the sympathetic nerve, and its functions include the transmission of pain signals. With osteochondrosis of the cervical spine, when the nerve fibers are irritated, a stream of pain impulses hits the brain. It is as a result of these features of the cervical spine that at the slightest changes in it we are tormented by headaches, weakness, increased muscle fatigue, and sleep disturbances.

Noise in the ears, numbness of the fingers, weakness of the hands, discomfort and pain in the arms, in the scapula, shoulder, in the heart area, impaired hearing, vision, fluctuations in blood pressure, impaired coordination of movements, dizziness and even fainting (syncope) - these are also neurological manifestations of osteochondrosis of the cervical spine.

Damage to the intervertebral discs with subsequent spondyloarthrosis of the lower parts of the cervical spine can affect the nerve roots, the fibers of which lead to the shoulder joints and upper limbs. Pain from the cervical spine radiates to the shoulder joint and arm, sensory disturbances occur, and the fingers of the affected hand become unruly. If the nerves serving the shoulder joint are damaged, its mobility is limited.

It is known that all the controlling and controlling neural connections of the brain with our organs pass through the spinal cord. As a result of dorsopathy (due to compression, that is, compression of the spinal cord), this connection is disrupted, the functions of vital organs, that is, the work of our entire body, are disrupted. That is why the spine is called the pillar of life.

To diagnose spinal diseases, clinical and radiological studies are carried out, sometimes using contrast agents (discography, myelography) and computed tomography and magnetic resonance imaging methods.

Classification

Using the international classification, all types of existing dorsopathies are divided into 3 broad groups, namely:

deforming dorsopathies - pathological conditions of the spinal column caused by its deformation ( kyphosis , scoliosis , lordosis , etc.) and/or dystrophic damage to the intervertebral discs, occurring without the formation of protrusions and hernias (uncomplicated osteochondrosis , spondylolisthesis , etc.);
spondylopathies – diseases of the spine directly related to disruption of the natural bone structure of the vertebrae ( ankylosing spondylitis , osteoarthritis , arthrosis , rheumatoid arthritis , etc.);
other dorsopathies - predominantly discogenic pathologies with degenerative-dystrophic progressive degeneration of intervertebral discs with the phenomena of protrusions and hernias , as well as various forms of dorsalgia (pain syndromes of different localizations).

Along with the international classification, the following categorization of this pathological condition is often used:

vertebrogenic dorsopathy (primary) – directly all degenerative changes occurring in the structure of the spinal column;
non-vertebrogenic dorsopathy (secondary) – disorders in the soft tissues surrounding the spine (ligaments, muscles, etc.) that arise for various reasons ( anomalies , injuries , tumors , etc.).

According to the mechanism of origin and development of pain syndrome, the following types of dorsopathies are distinguished:

local - as a rule, pain that constantly haunts the patient, felt by him in the area of the spinal motion segments affected by one or another disease and changing intensity depending on the position of the body;
projection (reflected) - pain in nature similar to local pain, which is felt along the entire affected nerve and its branches;
radicular (neuropathic) - a sharp pain of a “shooting” nature (popularly referred to as “lumbago”), which suddenly occurs during any movement of the back, lifting weights, sneezing, severe coughing, etc.;
non-radicular – a pain syndrome most often of muscular origin, developing as a result of hypertonicity of the spinal muscles (this also includes psychogenic pain).

Another classification of dorsopathies is used to indicate the location of the existing pathological process. In general, there are 3 main localizations:

cervical dorsopathy - affects the spine in the segment of its 7 cervical vertebrae with frequent involvement in the pathological process of the upper spinal motion segments of the thoracic region;
thoracic dorsopathy is the most rare type of vertebral pathology that develops at the level of the 12 largest thoracic vertebrae;
Lumbar dorsopathy is the most common pathological condition of the spine in terms of localization, affecting one or more of the 5 lumbar vertebrae (it can also extend to the sacrococcygeal segment of the spinal column).

In clinical practice, mixed forms of this pathological condition of the back are also often diagnosed, for example, dorsopathy of the lumbosacral region or dorsopathy of the cervicothoracic spine.

Treatment approaches in adults

There is no single system for treating dorsopathy of the thoracic spine. Features of therapy depend on the specific pathologies included in the diagnosis of dorsopathy and the causes of their occurrence. The most effective is an integrated approach to the treatment of dorsopathy.

Treatment methods for dorsopathy:

Medicinal

For any type of dorsopathy, a course of non-steroidal anti-inflammatory drugs is prescribed.
They relieve inflammation and relieve pain. Analgesics are prescribed for intense, vivid pain. They should only be taken when pain occurs. For muscle spasms, a course of muscle relaxants is prescribed; it is recommended to take until the symptoms disappear. But the above medications can only eliminate the pain syndrome, but do not have any therapeutic effect. Mandatory courses for dorsopathy are prescribed chondroprotectors and calcium supplements every 6 months. They are designed to restore the structure, elasticity of cartilage tissue and strengthen bone tissue.

The patient is prescribed the following medications: Movalis, Ibuprofen, Diclofenac. They are used for a short course. In addition, muscle relaxants and B vitamins are prescribed. They help relax the muscles, do not cure, but only eliminate pain.

IMPORTANT! Treatment with drugs such as analgesics is carried out only with a doctor’s prescription.

Physiotherapy

Electrophoresis – promotes rapid delivery of the therapeutic substance directly to the lesion. Allows you to relieve pain and inflammation in a short time.

Paraffin therapy has a relaxing and analgesic effect.

Massage is an effective method for all types of diseases. Improves blood supply to affected tissues, relieves spasms and pain.

Acupressure – with it, the doctor acts specifically on pain points. Therefore, pain and muscle spasms go away. This massage increases blood flow to the paravertebral tissues and enhances regeneration.

Hirudotherapy – it is based on the use of leeches. They increase blood circulation, improve metabolism, reduce the time of inflammatory processes, strengthen the immune system, and relieve unpleasant symptoms.

Vacuum therapy – therapy is aimed at enhancing the activity of the lymphatic system, cleansing muscle, bone and cartilage tissue, removing toxins, and improving blood circulation.

Manual therapy

Recommended for pathological activity of the vertebrae, muscle tone, and inflammatory process. This method restores lymph flow and blood circulation, returning the vertebrae to their physiological place.

Read more about manual therapy.

Spinal traction

Reduces the load on intervertebral discs and forms correct posture.

Exercise therapy

The most effective method of treating all types of thoracic dorsopathies. Promotes the restoration of cartilage tissue, reduces the load on bone tissue, improves blood circulation and strengthens the muscular frame of the back. A set of exercises is developed by a doctor depending on the type of dorsopathy and the cause of the disease. The first complex, consisting of 10 classes, must be completed with a physical therapy instructor. Then you can do it at home in front of a mirror.

Once every six months it is necessary to undergo diagnostics and visit an orthopedist. As the disease progresses, the set of therapeutic exercises can be adjusted.

ON A NOTE! For dorsopathy, exercise therapy is prescribed on an ongoing basis. Even if a lasting positive result is obtained, preventative exercises are done in the morning.

Causes

Among the main root causes of the development of pathological disorders in the structure of the spinal column and/or surrounding soft tissues, doctors identify:

anomalies (congenital and acquired) of the formation of the spine and/or spinal muscles;
excessive body weight ( obesity );
back injuries (including permanent microtraumas resulting from sports);
age-related changes;
immune disorders and endocrine disorders;
increased physical stress;
sedentary (mostly sedentary) lifestyle;
violations of natural posture;
malnutrition ( vitamin / mineral ) and insufficient drinking regime;
frequent hypothermia of the body ;
infectious processes;
bad habits;
disruptions in the metabolic process;
frequent stressful situations .

Symptoms

In general, negative symptoms of all dorsopathies can manifest themselves:

constant or periodic pain (of varying intensity) in the area of the problem segment of the back;
primary soreness and muscle tension from the affected area of the back with possible secondary spread of these sensations to the limbs and/or internal organs;
increased pain during physical activity, sudden movements, prolonged monotonous body position, sneezing, coughing, etc.;
a feeling of aching and numbness that occurs in the limbs, muscle weakness (up to the development of muscle wasting and paralysis), paresis (sensitivity disorder), decreased reflexes;
spasm of the back muscles and limitation of mobility of the problem area;
disruption of the functionality of some internal organs (in severe cases).

Depending on the initial localization of a particular pathological process, the following symptoms of dorsopathies may be noted:

Cervical dorsopathy

Dorsopathies of the cervical and cervicothoracic spine are mainly manifested by limited mobility and pain in the neck area ( cervicago / cervicalgia ), in some cases radiating to the upper limbs and/or head. Due to the frequent involvement of cervical vessels in the pathological process, a disturbance in the intensity of brain nutrition is possible, which leads to dizziness , occipital headaches , and hearing and vision disorders. You may also feel overstrained muscles in the shoulder girdle, weakness in the arms, and numbness in the fingers.

Thoracic dorsopathy

For the most part, it is expressed by pain and muscle spasms in the middle part of the back, sometimes radiating to the arms. As the existing pathological process progresses, the pain syndrome can spread to the chest cavity and abdominal area. Pain such as intercostal neuralgia and thoracalgia can imitate heart and/or lung disease and even cause dysfunction of these organs.

Lumbar dorsopathy

With dorsopathy of the lumbar and lumbosacral spine, the pain is localized in the lower section of the back ( lumbago / lumbodynia ), can radiate to the sacrum and thigh ( lumboischialgia ) and further to the lower extremities along the sciatic nerve ( sciatica ). In this case, the sensitivity and performance of the leg muscles often suffer. Sometimes pain and spastic symptoms affect the organs of the abdomen and pelvis, which causes dysfunction of the corresponding organs (for example, difficulty urinating ).

Why does pathology occur?

With prolonged stress on the spine, the intervertebral discs are compressed, but then their shape is restored. Because of this feature, all people are shorter in the evening than in the morning. But with age, due to the influence of various factors, the discs lose their ability to recover. The fibrous ring loses its protection and, under the influence of prolonged stress, begins to slowly collapse. As a result, deformation of the vertebrae is observed over time.

At this stage, the body turns on the self-defense mode and, to support the spine, bone growths - osteophytes - begin to appear on the edges of the intervertebral discs. The development of all these changes in the vertebrae is accompanied by pain. Initial changes in intervertebral discs can occur as early as 35 years of age.

This is a natural process of the occurrence of thoracic dorsopathy due to the aging of the body. But many factors can accelerate the progression of pathological changes:

elderly age;
Excessive or improper exercise. This may include professional sports, constant heavy lifting due to professional activities, improper load distribution;
passive lifestyle, work associated with prolonged sitting or standing;
unbalanced diet, causing nutrient deficiency in intervertebral discs;
curvature of posture;
congenital developmental disorders of the musculoskeletal system;
genetic predisposition;
obesity or low weight.

Thoracic dorsopathy can occur at any age for the following reasons:

spinal injuries, including vertebral compression fracture;
muscle spasm due to myositis or prolonged tension;
frequent respiratory diseases;
neoplasms in the spine;
Bekhterev's disease.

Tests and diagnostics

As mentioned earlier, this painful condition is not an autonomous nosological entity and therefore the diagnosis of dorsopathy can only be justified as a preliminary one. In the process of further examination of the patient’s back condition, the diagnostician (vertebrologist, orthopedist, neurologist) is obliged to find out the exact root cause of the present pain and other negative syndromes and make a true diagnosis corresponding to them. Depending on this, the patient will be recommended further therapy for a specific disease of the spine or adjacent soft tissues.

During a comprehensive diagnosis of a patient with dorsopathy who seeks medical help, the following studies and procedures are carried out:

initial examination of the patient with clarification of his medical history and all existing complaints;
palpation of the structure of the spinal column and back muscles;
physical diagnostics in terms of the functionality of the spine (bending, turning, etc.) and the rest of the musculoskeletal system (mainly arms and legs);
neurological examination to determine negative symptoms of the nervous system remote from the spine;
various types of radiographic examination (functional radiography, contrast radiography, etc.);
CT or MRI diagnostics;
immunological, biochemical and other required blood tests;
electrocardiography and ultrasound of blood vessels (to exclude cardiovascular pathologies);
lumbar puncture , joint biopsy and other similar studies (if necessary).

Diagnostic features

At the initial stage of development, dorsopathy does not have pronounced symptoms. Therefore, patients most often consult a doctor already at the second stage of the disease, when osteochondrosis occurs. An experienced orthopedist can make a diagnosis of dorsopathy based on an X-ray examination of the patient. But it happens that to clarify the diagnosis, an additional diagnosis of dorsopathy is required - MRI, and clinical tests.

A feature of diagnosis is that it is necessary to accurately identify the specific type of dorsopathy and its cause. It is necessary to accurately establish the entire complex of diseases that form the diagnosis of dorsopathy. The main therapy will be aimed at eliminating the cause of the disease. The success of treatment will largely depend on the correctness of the diagnosis.

Treatment with folk remedies

In relation to the treatment of dorsopathies with alternative medicine, various rubs and compresses are most often used to help get rid of pain and other uncomfortable sensations in the back.

Sabelnik and beeswax

Take 2 tbsp. l. previously finely chopped cinquefoil grass and fill them with 200 ml of any vegetable oil (unrefined is best). Place the pan with the butter and cinquefoil over low heat and simmer for about 30 minutes, stirring occasionally. Next, strain the broth through several layers of gauze, add 50 grams of beeswax to it and mix everything thoroughly. Rub the ointment prepared in this way twice a day into the affected areas of the back until the negative symptoms disappear.

Black radish

Grate the raw black radish on a medium grater and squeeze it lightly to remove excess liquid. Lubricate the skin over the problem area of the back generously with vegetable oil and place a gauze pad on top. Spread a thick layer of grated radish on its surface, cover it with a similar piece of gauze and wrap this part of the body with a warm cloth (plaid, down scarf, etc.). Keep this compress on the skin until a strong burning sensation occurs. After this, remove the compress, wipe the application area with a dry cloth and wrap it again with a warm cloth.

Lilac

Since ancient times, common lilac has been successfully used for pain in the back area. To prepare this remedy, take about 0.5 cups of fresh flowers of this plant and pour 500 ml of vodka into them in a glass container. Infuse this mixture in a dark place for 7-10 days, then strain it through cheesecloth and use it as a rub if necessary. After rubbing painful areas of the back with lilac tincture, it is best to wrap them in a warm cloth or lie under a blanket for a while.

Fir oil

Among essential oils, fir oil has a beneficial effect on back tissue and sore joints, which exhibits a distracting, anti-inflammatory and analgesic effect. The most effective way to use this product is to use it with a relaxing massage or rubbing problem areas of the back followed by applying a warm compress to them. To do this, 5-8 drops of fir oil are diluted with 10 ml of olive oil and used for 20-30 days using the methods described above.

Garlic

To prepare a garlic lotion, take 300 grams of completely peeled garlic cloves, chop them using a meat grinder or garlic grinder and place in a dark glass container. Next, pour 100 ml of vodka and 500 ml of apple cider vinegar into the resulting slurry, tightly close the container with a lid and leave it all together for 3 weeks (shake periodically). After this time, strain the tincture and use it to apply compresses, which should be kept on the skin until a strong burning sensation is felt.

Honey and mustard plasters

Apply fresh natural honey of a liquid consistency to the diseased area of the back with a middle layer, cover it with several layers of gauze and place a slightly moistened mustard plaster on top (depending on the area affected by the disease, there may be several of them). Wrap this area of the back with a woolen scarf or other warm cloth and keep the compress on the skin for a maximum of an hour (until there is a strong burning sensation). After removing the compress, clean the skin with a damp cloth and spend some more time under the blanket.

Dandelion

Place freshly picked dandelion flowers (about a glass) in a liter glass container and pour in 500 ml of vodka. Seal the container tightly with a lid and place it in a dark place to infuse for 10 days (shake occasionally). In the future, use the tincture to rub problem areas of the back 3-4 times a day.

Prevention

Separately, primary (prevention of the occurrence of back pathologies) and secondary (prevention of exacerbations and relapses of an existing disease) prevention of dorsopathies are divided.

Primary prevention:

limiting excessive physical stress on the spinal column and back muscles;
regular amateur sports;
general active and healthy lifestyle;
regulation of own weight ( obesity );
good nutrition in terms of supplying the body with all the elements it needs;
wearing comfortable or orthopedic shoes;
giving up all bad habits;
proper organization of study/working and sleeping space;
prevention of spinal trauma and body hypothermia ;
effective and timely treatment of all developing painful conditions.

Secondary prevention:

at least an annual examination by a doctor;
regular exercises appropriate to the state of health (including swimming);
normalization of body weight (in case of existing obesity );
dietary adjustments;
exclusion of excessive physical activity;
vitaminization and mineralization of the body.

In children

Recently, dorsopathies are increasingly plaguing adolescents and even children of a younger age group, which is a consequence of their changed lifestyle, which consists of decreased physical activity and prolonged sitting (study, computer games, etc.). As a result, it is the children's spinal column and back muscles, which are in the stage of active growth in this age period, that are primarily affected.

Unlike spinal pathologies in adult patients, which often require long-term and comprehensive therapy, most back problems in childhood are solved through regular exercise and proper organization of leisure and study. In this case, the main thing is not to miss the right moment to start treatment and seek medical help as early as possible.

During pregnancy

It would also be useful for pregnant women to find out what dorsopathy of the lumbar spine is, since during pregnancy it is this that most often worries expectant mothers. In particular, this occurs due to rapid weight gain, redistribution of the center of gravity and a sharp change in hormonal levels. Treatment of dorsopathies of the lumbosacral spine during pregnancy is complicated, since most medications used in such therapy are prohibited in this period of a woman’s life. In such a situation, back pain will mainly have to be dealt with with the help of special gymnastics and non-aggressive external remedies.

Osteochondrosis of the lumbar region

Determination of the subclass occurs after diagnosis of the disease. The doctor studies the results of the patient’s studies, considers the existing syndromes (radicular, cardiac, reflex). If lumbar osteochondrosis is suspected, the patient is referred for additional studies of the kidneys and gastrointestinal tract. MRI, CT and X-ray studies are carried out. A neurologist treats osteochondrosis. According to the ICD, lumbar osteochondrosis is classified in the international classification system under code M42.16.

Consequences and complications

Possible complications of dorsopathies will primarily depend on the patient’s specific back disease. In general, the most significant negative consequences of spinal pathologies occur due to infringement of vertebral blood vessels, nerve roots and the spinal cord itself. Such exacerbations in the near future can cause the development of many serious pathological conditions ( muscular atrophy , hypertension , paralysis of the limbs , digestive disorders , urinary incontinence ) and even lead to a stroke .

List of sources

Fedin A.I. Dorsopathies (classification and diagnosis). Atmosphere. Nervous diseases, 2002, No. 2, 2-8.
Borenstein D. "Epidemiology, etiology, diagnostic evaluation and treatment of low back pain." Intl. Medical Journal, 2000, No. 35, p. 36-42.
Alekseev V.V., Podchufarova E.V., Yakhno N.N. Algorithms for diagnosis and treatment of patients with pain syndromes in the lumbosacral region // Pain. – 2006. – No. 2. – P. 29–37.
Bogacheva L.A. Back pain: clinical picture, pathogenesis, organization of primary medical care: dis. ... Doctor of Medical Sciences. M., 1998.
Wayne AM Pain syndromes in neurological practice. / AM Wayne, T.G. Voznesenskaya, A.B. Danilov et al. - M.: MED press-inform, 2001. - 368 p.