Classification
Spinal diseases primarily affect the nervous system. Neurological pathologies are divided based on the reasons that provoked them:
- congenital anomalies affecting the number and relative position of the vertebrae;
- dystrophy, metabolic type lesions (osteochondrosis, spondylosis);
- damage resulting from trauma;
- oncology (malignant and benign neoplasms);
- inflammation caused by viruses, bacteria and parasites (syphilitic and tuberculous spondylitis, mycosis, ankylosing spondylitis).
There is a classification of diseases according to the area affected.
The following syndromes are characteristic of the cervical and thoracic spine:
- reflex;
- muscular-tonic;
- neurodystrophic;
- radicular.
Among the diseases of the lumbar region are:
- lumbago;
- coccydynia;
- osteoporosis;
- fibromyalgia;
- spinal cord canal stenosis.
Who diagnoses lumbar pain?
If your lower back hurts, which doctor will help? Lower back pain can be due to problems with the spine or dysfunction of some internal organs. Therefore, the therapist first evaluates the symptoms and then refers them to the right expert. If a person stays in an uncomfortable position for a long time, then over time his lower back hurts. But if he rests, warms up, and receives a massage procedure in the absence of contraindications, then such discomfort will go away on its own and no medical help will be required.
If your lower back hurts, it is often caused by injuries that cause fractures of the spinal column. Acute pain syndrome in the lumbar region occurs due to a herniated disc located between the vertebrae, protrusion. The sciatic nerve is irritated and sciatica appears. Pain sensations stretch from the gluteal area to the sole. In severe cases, one or two legs may become numb and paralysis may occur. In this case, the help of a neurologist or neurosurgeon is relevant.
In 93%, the cause of pain is osteochondrosis, spondylosis, osteoarthritis, and ankylosing spondylitis. Such pathologies will affect the back, lower back, and the person will suffer from pain
Lumbar sciatica can occur when a person bends awkwardly. The pain will radiate to the gluteal area or thigh. The patient stands and moves with difficulty. The treating neurologist will help you cure radiculitis. Oncological processes also provoke pain in the lumbar region. The patient then needs to consult an oncologist.
Pain in the lumbar segment may occur due to pathologies of the urinary organs. In addition to pain, a person will have difficulty urinating, feel nauseous, vomit, and develop edematous changes with hyperthermia and other symptoms. A urologist or nephrologist will help the patient. If a man has an inflamed prostate, the pain varies depending on the location; the lumbar area is also painful. The pain syndrome has varying intensity; the scrotum and perineum are painful. You need to consult a urologist.
Symptoms
The clinical picture for diseases of the spine is of two types:
- Vertebral. Pathological processes develop in the tissues and components of the spine itself.
- Extravertebral. Processes develop in nearby tissues.
The most common signs of back and spinal column diseases:
- pain (focused at the site of the lesion, varies in intensity);
- inability to fully move;
- curvature of posture;
- ruptures in bone tissue;
- numbness of the skin of the back and limbs.
Indirect signs:
- dysfunction of the pelvic organs, respiratory and cardiovascular systems;
- dizziness and weakness;
- digestive system dysfunction;
- sleep disturbances;
- loss of consciousness.
Traumatologist-orthopedist
Unlike a vertebrologist, an orthopedic traumatologist does not specialize exclusively in diseases of the spine. He deals with dysfunctions of the musculoskeletal system as a whole.
When your back hurts, an orthopedic doctor can help, but you can also consult a doctor for club feet, abnormalities in the development of fingers, congenital dislocation of the hip, and diseases that are the result of infections, metabolic disorders, or injuries.
An orthopedic traumatologist treats patients with fractures, severe dislocations, sprains, ligament tears, bruises and injuries. It will help with osteochondrosis, kyphosis and lordosis.
Instead of making an appointment for a massage in Serpukhov, make an appointment at the Doctor Pozvonkov center for progressive medicine, where qualified doctors of all the above specializations work.
Who treats
Back pain is a symptom that accompanies a wide variety of diseases affecting not only the spine, so patients usually seek an initial consultation with a therapist. The doctor will conduct an examination, listen to the patient’s complaints and, if there is a suspicion of spinal diseases, refer to one of the following highly specialized specialists:
- vertebrologist;
- neurologist;
- orthopedist.
A vertebrologist often sees patients only in large medical centers. He specializes in manual therapy and massages, helps eliminate inflammation, stretches the spine, relieves pain, and prescribes medication.
The neurologist eliminates back pain and relieves intense pain, restores motor ability, and normalizes blood supply.
The help of an orthopedist will be needed for spinal curvatures of varying severity. He corrects scoliosis and kyphosis, performs operations to remove hernias and eliminate bone growths.
Which doctor should you go to for back pain?
As mentioned above, pain itself does not allow us to accurately determine the cause of the pain syndrome. Therefore, in case of acute or chronic back pain, without signs of injury, it is more correct to consult a doctor not according to his specialty, but according to his qualifications and experience. Problems begin when a doctor undertakes to treat a disease outside of his specialty. For example, for the same intervertebral disc herniation, most traumatologists will most likely offer surgical treatment, despite the fact that, according to statistics, only a small number of patients need surgery. Or vice versa, if a neurologist tries to treat the same severe scoliosis, this will only lead to a waste of time and money - the curvature can only be eliminated surgically.
Related specialists for the treatment of back pain
What other doctor is needed for back pain? Modern medicine is always teamwork. Successful and effective treatment almost always requires the collective efforts of doctors from several specialties. Therefore, if necessary, doctors of other professions are involved in treating back pain, depending on the cause.
General practitioner
A therapist is a specialist in the treatment of diseases of internal organs. Pathologies of the lungs, heart, liver and biliary tract, kidneys, and gastrointestinal tract can also manifest as back pain. A patient with a disease of the spine or spinal cord may for the first time turn not to a neurologist or traumatologist, but to a therapist. The latter’s task in any case is to establish a preliminary diagnosis, prescribe appropriate treatment if back pain is caused by therapeutic reasons, or redirect the patient to a specialist in another field of medicine for consultation and treatment.
It has been noted that diseases of internal organs, such as the gastrointestinal tract, often provoke pathologies of the spine, being a predisposing factor for the same osteochondrosis. Metabolic disorders due to intestinal disease will certainly affect the processes of regeneration of cartilage and bone tissue. Therefore, even if a patient has been accurately diagnosed with a spinal disease, this does not mean that he does not need to see a therapist. It is necessary to treat not individual parts of a person, but the entire body as a whole.
Surgeon
General surgery deals with the surgical treatment of abdominal organs and soft tissues. Back pain can be a symptom of appendicitis, diaphragmatic abscess, pancreatitis, and other gastrointestinal diseases that require surgical treatment. Therefore, if such diseases are suspected, the patient may be referred for a consultation with a surgeon.
Neurosurgeon
A neurosurgeon is a specialist in the field of surgical treatment of diseases of the nervous system. This is a specialty related to neurology - if a neurologist prefers a scalpel rather than a pen and a hammer, he becomes a neurosurgeon. Surgical treatment of neurological complications of osteochondrosis and hernia, spinal cord tumors, spinal cord injuries is a direct indication for consultation with a neurosurgeon.
Rehabilitologist, exercise therapy doctor
A rehabilitologist is the second, and perhaps the first, most important doctor, whose help with diseases of the spine and musculoskeletal system is difficult to underestimate. Unfortunately, in practice, the efforts of a rehabilitation physician are usually ignored, although only proper rehabilitation can consolidate the results of successful treatment prescribed by a neurologist, an operation perfectly performed by a neurosurgeon or traumatologist. Without proper rehabilitation, the symptoms will return again, and the pain will begin to occur with renewed vigor.
The main task of a rehabilitation therapist is to show and teach the patient to fight the disease on their own. For this purpose, exercises and physical therapy complexes are given to help strengthen the spine, create a muscular frame that helps compensate for the load on the back, preventing relapse and complications. You can and should contact a rehabilitation specialist or exercise therapy doctor at the same time as a neurologist or traumatologist - often gymnastics, yoga, and physical exercise alone are enough to significantly improve the quality of life and cure a sore back.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Chiropractor, osteopath, chiropractor, reflexologist
There are many specialists in the field of treating spinal diseases using non-drug means. The effectiveness of these techniques varies depending on the qualifications and experience of the doctor. However, in practice, if an experienced doctor can suspect a serious illness and immediately redirect the patient to a neurologist or traumatologist, then many specialists with insufficient qualifications or even without medical education can cause late treatment, a waste of time and money. Thus, attempts to treat pain caused by a spinal cord tumor using manual therapy will lead to complications, disability or even death.
Abroad, all these specialists belong to the representatives of the so-called alternative medicine, which has only auxiliary value in the established diagnosis and does not deny official medicine and modern methods of treatment. In Russian realities, such “specialists” without medical education often oppose themselves to “medicine with pills and operations,” maiming patients and causing late treatment. Remember, you can turn to alternative medicine only if the specialist has a medical education, has an accurately established diagnosis, after consultation and with the permission of a neurologist, orthopedist-traumatologist or other specialist.
When to see a doctor
Any pain in itself is a reason to see a doctor. Therefore, instead of enduring it for months, thinking about what kind of doctor you need if your back hurts, it is better and more correct to turn to an experienced specialist - a neurologist, orthopedic traumatologist, therapist or surgeon. Yes, in 50% of cases the cause of pain can be banal osteochondrosis or myositis, without any risk to health, but this does not mean that you should neglect consulting a doctor.
In some cases, back pain may have warning signs that indicate that the patient requires urgent medical attention:
- Back pain due to high temperature, fever, weight loss and exhaustion;
- Back pain in combination with impaired sensitivity, weakness of the muscles of the arms and legs, burning sensation, tingling, crawling on the skin, dysfunction of the pelvic organs (urinary and fecal incontinence, urinary and fecal retention), paralysis and other neurological disorders;
- Back pain combined with nausea, vomiting, confusion or loss of consciousness, convulsions;
- Back pain accompanied by abdominal pain, lower back pain, headache;
- Sudden unbearable sharp and severe pain in the back, radiating to other parts of the body;
- Back pain after injury, accident, fall.
Shpidonov Gennady Stanislavovich
Neurologist
Rostov State Medical University (neurology)
10 years of experience
Diagnostics
To determine an accurate diagnosis, you may need to undergo the following tests:
- radiography – obtaining an overview image;
- pneumomyelography is a radiology method based on the injection of a coloring liquid into the spinal canal after a spinal puncture;
- angiography is a study involving the introduction of contrast into an artery: carotid or vertebral;
- myelography - fluid is injected into the subarachnoid spinal canal;
- discography – study of a specific disc using contrast fluid;
- spiral CT;
- MRI;
- Doppler ultrasound – a study to determine the degree of patency of a large artery located in the spine;
- Electromyography – study of peripheral nerves.
Why is manual therapy needed?
This method of treatment has many advantages. One of which is effective assistance in cases where drug therapy remains powerless. The course of treatment gives quick results and an increase in overall tone. Due to the impact on active points of the body, the motor activity of internal systems and organs is resumed, blood circulation improves, muscles become toned, tissue nutrition improves and normal metabolism is restored.
A chiropractor can be helpful for a variety of patient diagnoses:
- kyphosis;
- intervertebral hernia;
- flat feet;
- osteochondrosis;
- torticollis;
- vegetative-visceral disorders;
- knee periarthritis;
- pseudoangina;
- thoracalgia;
- protrusion of spinal discs;
- injuries of various types.
Treatment methods
Therapy for spinal diseases is conservative and includes:
- Drug treatment. The effect of prescribed drugs can be aimed at relieving attacks of acute pain, eliminating inflammatory processes, protecting and restoring cartilage and bone tissue.
- Physiotherapeutic procedures;
- Physical therapy;
- Traction therapy aimed at increasing the distance between the vertebrae using special devices;
- Massage;
- Treatment in specialized sanatoriums;
- A therapeutic diet.
If the prescribed course of treatment does not produce results, surgery may be necessary, during which the following will be performed:
- restoration of connective ligaments;
- replacement of destroyed or deformed vertebrae, joints and discs with implants;
- stem cell therapy;
- cartilage tissue transplantation;
- removal of intervertebral hernia;
- restoration of fractures, connection of fragments.
The sooner you consult a specialist, the greater the chances of restoring your spine and returning to a full life.
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Vertebrologist
When your back hurts, a vertebrologist is the first person you should make an appointment with. Diagnosis and treatment of pathologies of the musculoskeletal system is his specialization, so in particularly difficult cases one cannot do without consulting a vertebrologist.
The doctor's competence includes treatment:
- neuralgia;
- scoliosis;
- kyphosis;
- lordosis;
- osteochondrosis;
- spinal injuries;
- dorsopathies;
- intervertebral disc herniation.
The spine is directly connected to the nervous system, so a vertebrologist deals with the elimination of neurological disorders. For this reason, patients are sometimes referred to him with symptoms that are not externally related to the spine: hearing, vision, circulatory, digestive or breathing problems.
Vertebrology is a fairly young field in medicine, so you need to take into account that it is difficult to get an appointment with such a specialist.
Neurologist
When a therapist suspects a spinal hernia, pinched nerve roots or blood vessels, he prescribes one of the instrumental methods of analysis. After which he looks at the received images of a detailed image of the vascular system, checks the presumptive diagnosis and refers him to a neurologist. Almost every district hospital or medical center has a neurologist who deals with back diseases caused by pinched nerve endings, vascular bundles or inflammation of the spinal roots.
Therefore, if a patient complains of back pain, stiffness in movements and other accompanying symptoms of neurological diseases, then the therapist can refer him to a neurologist. The main task of this doctor is to eliminate the inflammatory process and pain in the problem area of the back, facilitate the patient’s movement and eliminate pinching. After the therapeutic course, the patient's sensitivity should improve and normal blood flow should be restored.
A neurologist treats pathologies of the nervous system: nerve fibers, peripheral and central nervous systems.
Causes of spinal hernia
The disease can be caused by:
- spinal injury;
- benign or malignant neoplasm;
- lordosis, osteochondrosis, scoliosis;
- infectious disease;
- hereditary predisposition, age-related changes;
- overweight;
- low physical activity;
- pregnancy;
- heavy physical work;
- excessive sports activities.
Lack of treatment leads to paralysis due to cartilage prolapse and spinal cord damage, disruption of the abdominal organs, dysfunction of the intestines, bladder, genitals, hemorrhoids, varicose veins, and curvature of the tibia. This is why a hernia of the lumbar spine is dangerous.
Infringement of the cervical spine can provoke a stroke, cause pain in the joints of the hands, and impair the functioning of the lungs and thyroid gland.