For today’s conversation, I chose the problem that we, neurologists, most often encounter in everyday practice. The relevance of back pain is high - it is registered annually in 15-25% of the country's adult population. Between the ages of 30 and 45, back pain is one of the most common causes of disability. However, only 40% of patients seek medical help. It is also known that in a third of patients, acute pain subsequently becomes chronic, which persists for more than 12 weeks.
Types of dorsopathy
Based on the nature of the damage to the spine, diseases are divided into deforming diseases, spondylopathies and others.
Deforming pathologies lead to degradation of intervertebral discs - up to their complete destruction, displacement of the vertebrae. This group includes scoliosis, kyphosis, lordosis. Spondylopathies include inflammatory and infectious lesions of the spine, arthritis, osteochondrosis, and spondylosis. The remaining diseases, including vertebrogenic dorsopathy (pathological changes in the disc with subsequent entrapment of the spinal cord) and back pain caused by other causes, are combined into a separate group. Spinal diseases are localized in different parts - cervical, thoracic or sacrolumbar. Dorsopathy of the cerebral palsy is accompanied by muscle spasms and sometimes cerebral circulatory disorders. The patient may experience dizziness and weakness in the arms. The pain may spread to the forearms and shoulders. The thoracic region suffers much less frequently than others due to its lack of mobility. This is the longest section of the spinal column, and diseases here manifest themselves in the most unexpected ways: in the form of heart pain, chest pain, coughing, weakness in the upper limbs.
The most common case of dorsopathy is damage to the sacrolumbar region. This pathology can be found in any adult. It is asymptomatic, or its signs are so weak that the patient does not pay attention to them. During exacerbations, the patient experiences pain in the lower back (lumbodynia) and lower extremities, and a malfunction of the pelvic organs occurs.
There are cases when the pathology is limited to damage to one vertebra, but polysegmental and widespread dorsopathy are more common. In the first case, the disease affects the entire spine, in the second - several vertebrae in different areas.
MRI
- MRI remains the imaging modality of choice for the cervical spine due to its complete imaging safety for the evaluation of the cervical spine.
- Advantages of MRI include: assessment of soft tissue morphology (eg, discs, muscle nerves, spinal cord), visualization of cerebrospinal fluid, non-invasiveness, and no radiation exposure to the patient.
- Modern MRI machines with high magnetic fields and new software products provide faster and more detailed visualization.
- Unfortunately, some MRI sequences depict larger-than-actual pathology and do not detect some abnormalities. Other disadvantages of MRI include high cost, the inability of claustrophobic patients to tolerate the procedure, the need for long periods of patient immobilization, and poorer visualization of bone structures compared to CT (MSCT).
- In addition, MRI is worse at differentiating compression of the root by disc herniation from the effect on the root by spondylous osteophyte.
EMG (ENMG).
Electrodiagnostic studies continue to be the standard methods for assessing neurological function of the cervical spine. The advantages of these methods are the low cost and safety of these tests.
Nerve conduction studies (NCG) and electromyography (EMG) provide the ability to assess the extent of root and peripheral nerve damage.
Needle EMG can detect acute, subacute and chronic radicular signs of motor nerve fiber pathology.
Laboratory diagnostics
. Necessary for differential diagnosis of inflammatory infectious or systemic conditions.
Causes of pathology
Most often, back pain occurs against the background of arthrosis and arthritis, with abnormal development of the spine, which leads to degenerative processes in the discs and vertebrae. Other causes of dorsopathy are known:
- overweight;
- bad habits: smoking, taking drugs, drinking alcohol, etc.;
- violation of the diet, errors in compiling the daily diet, poor quality of products;
- diabetes;
- heredity;
- spinal cord infection, etc.
All of these factors cause irreversible changes in the shape of the vertebrae and the height of the intervertebral discs. The paravertebral tissues become inflamed, pinched nerve fibers of the spinal cord and muscle spasms are observed.
Why does my back hurt?
As soon as the first man got up from all fours and raised his head proudly, he doomed all his descendants to suffering associated with the spine. The spine in four-legged animals is located horizontally and serves to balance all parts of the body. Such a spine remains in ideal condition for a long time and can withstand any stress, tension and exposure to adverse factors. In humans, the spine began to play the role of a rod, or column, and turned into that part of the body that is very easy to disable. Numerous modern studies have shown that pathological changes in the spine are not inherent to individual people or groups of people, but to all of humanity as a biological species. These changes lead to the fact that by the age of fifty, approximately 80% of men and 60% of women suffer from spinal diseases, and the onset of clinical manifestations of the disease falls on the most working period of life, on average 35 years. The most common cause of back pain is dorsopathies.
Symptoms of dorsopathy
Signs of dorsopathy depend on its location. If the cervical spine is affected, the patient experiences pain in the neck and shoulders. He complains of dizziness, flashing colored spots before his eyes, tinnitus, and headache. The muscles of the neck and shoulder girdle are tense, and there is numbness in the arms.
Thoracic dorsopathy is accompanied by back pain radiating to the heart and internal organs. Pain may increase during deep breaths. All this misleads the patient, and he may waste time doing, for example, self-medication of the stomach. As thoracic dorsopathy syndrome develops, it leads to disruption of respiratory function and the functioning of the heart muscle.
The lumbar region of the spine differs from the thoracic region in greater mobility, and therefore is exposed to various lesions more often. Dorsopathy of this zone is accompanied by:
- lower back pain radiating to the buttocks, thighs, legs and feet;
- decreased sensitivity in the lower extremities - up to complete immobility;
- disruption of the functioning of organs located in the pelvic cavity. In advanced cases, the patient cannot control the rectum and bladder.
Other symptoms of spinal dorsopathy include muscle weakness, body aches, dry skin, loss of muscle mass in the arms and legs, and a feeling of fatigue that does not go away after a long period of rest.
Diagnosis of spinal dorsopathy
The initial examination of the patient is carried out by a neurologist. First, he interviews the patient and performs a neurological examination. The doctor checks the muscle strength of the limbs, evaluates the reactivity of the skin, and palpates the spine to detect pain points.
After this, the neurologist refers the patient to radiation diagnostics: radiography, MRI or CT. Depending on the results obtained, the neurologist may additionally prescribe:
- biopsy;
- lumbar puncture;
- spinal scintigraphy (study of metabolism in bone tissue), etc.
The listed studies are carried out only after studying the results of previous examinations and for special indications: with their help, the diagnosis of secondary dorsopathy is confirmed or excluded. If the cause of the pain cannot be established, it is generally accepted that it is deforming unspecified dorsopathy.
If the pathology of the spine and internal organs is not confirmed, and the patient’s back hurts, it is possible that this is muscular dorsopathy resulting from overload or hypothermia.
Treatment of dorsopathy with therapeutic anti-inflammatory patch DORSAPLAST
The therapeutic pain-relieving anti-inflammatory patch DORSAPLAST has shown high effectiveness in the treatment of many types of dorsopathy.
Thanks to the simultaneous influence of two physiotherapeutic factors - deep soft warming heat of infrared radiation and the influence of a magnetic field with specially selected characteristics - this innovative drug allows you to relieve pain and inflammation, improve blood circulation in the affected area, and reduce the dose of painkillers and anti-inflammatory drugs.
Therapeutic pain-relieving anti-inflammatory patch DORSAPLAST can be used both in the complex treatment of dorsopathy and in monotherapy of many types of dorsopathy . The patch is applied to the cervical, thoracic or lumbar spine, depending on the type of disease and location of pain.
To relieve acute symptoms in the treatment of dorsopathy, a therapeutic patch is used for 3 to 5 days. The duration of the course of treatment is from 9 days. It is usually recommended to use the treatment patch in the morning for 12 hours, but it can also be used at night.
High efficiency, unique composition, long-term (up to 12 hours!) therapeutic effects, ease of use and affordable price make DORSAPLAST the drug of choice in the treatment of most types of dorsopathy of various etiologies.
Read more about DORSAPLAST
Treatment options
In general, spinal dorsopathy and its complications can be treated with medication. Surgical intervention is rarely used: in cases of severe pain, severe limitations in functionality and the absence of positive results from conservative treatment.
Drug treatment of dorsopathy involves taking NSAIDs: they suppress inflammatory processes in the area of the affected vertebrae and help reduce pain. To relax the back muscles, the patient is prescribed muscle relaxants. When treating nonspecific dorsopathy the following is used:
- Manual therapy and massage. With their help, blocking of the lumbosacral joints is eliminated.
- Transcutaneous electrical neurostimulation on the paravertebral area of the back.
During the period of remission, physical therapy is permitted. Classes (group or individual) are conducted under the guidance of a doctor or instructor. The task of exercise therapy is to teach the patient a rational motor regimen and return him to his usual professional and everyday motor activities. Patients with chronic pain learn to overcome their fear of movement. Special exercises strengthen the muscles of the lower back.
When dorsopathy is accompanied by psychoemotional disorders, psychological correction is carried out.
If conservative treatment does not have an effect, neurological complications of dorsopathy progress, compression myelopathy occurs, defecation and urination functions are impaired, and surgery is prescribed.
Prices for services
Spinal traction
Clinical studies have shown the high effectiveness of spinal traction treatment. During the procedure, the height of the intervertebral discs increases. Negative pressure is created in the intervertebral space, retracting the protruding part of the disc. The pressure on the nerve roots decreases or disappears completely.
During traction, conditions are created that are favorable for the regeneration of the torn area of the annulus fibrosus, and blood flow improves. The shock-absorbing properties of the vertebrae are restored, the load is removed from the muscles and spine.
Traction is carried out after examining the patient on MRI or CT on a multifunctional traction-massage, inversion tables and Professor Velikanov’s device. The patient is placed on the simulator, the limbs are secured with belts, and the spine is stretched using a sliding table or belt traction. All parameters of the procedure are determined by the doctor, taking into account the characteristics of the patient’s body.
You can stretch the spine yourself - using a horizontal bar. The exercise is useful, but it practically does not affect the cervical and first thoracic vertebrae.
Classification of dorsopathies
Dorsopathy can be caused by degenerative and inflammatory processes of various structures of the spine: intervertebral disc, intervertebral joints, spinal ligaments, paravertebral muscles. Involvement of the spinal roots or spinal cord in the process produces focal neurological symptoms.
According to international standards, all types of dorsopathy can be divided into three large groups:
- deforming dorsopathies - pathological deformations of the spinal column caused by dystrophic changes in the intervertebral discs (without violating the integrity of the fibrous ring, without protrusions and hernias of the nucleus pulposus). This group includes lordosis, kyphosis, scoliosis, spondylolisthesis (displacement of one of the vertebrae relative to another), osteochondrosis and subluxations;
- spondylopathies - include all types of inflammatory, degenerative and traumatic spondylopathies;
- other dorsopathies are discogenic dorsopathies with progressive degenerative-dystrophic changes in the intervertebral discs (fibrous ring and nucleus pulposus) with protrusion, intervertebral hernias, as well as various types of dorsalgia, i.e. pain syndromes in the neck, trunk and limbs without displacement of the intervertebral discs, without dysfunction of the spinal roots or spinal cord.
Prevention of dorsopathy
To protect the spine from diseases, you need to move more - but without overload, dress for the weather and eat right. If acute pain occurs in the spine, it is necessary to give the body a rest. You can only lie on a hard, flat bed. Duration of rest - from one to several days.
If you already have a spinal disease, you should not lift or carry heavy objects. A healthy person needs to learn how to work with a load correctly: when lifting, you need to bend not your back, but your legs and not allow your torso to turn.
The doctors of our clinic have modern equipment for diagnosing dorsopathy and are proficient in all methods of its treatment. They are ready to give recommendations on how to prevent dorsopathy. You can make an appointment on the website or by phone.
Ways and methods of disease prevention
Preventive measures will allow you to stop the development of the disease before you have to treat cervical dorsopathy. A simple set of measures will help you avoid pain, expensive treatment and dangerous complications in the future. Therefore, the prevention of dorsopathy of the cervical spine should be taken with all possible seriousness. The rules of prevention are simple. Need to:
- Healthy food;
- control body weight;
- move more;
- avoid hypothermia.