Osteochondrosis, which doctor should you contact if symptoms are detected?

August 29, 2019

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Back pain is a common phenomenon that every person encounters at certain intervals. Increased physical activity, hypothermia, pregnancy, prolonged sitting at the computer, work associated with constant standing and a bunch of other reasons can provoke back discomfort.

But they are not always so harmless. Often the listed factors are only an impetus for the manifestation of symptoms of diseases of the spine, and sometimes other organs. Therefore, you should not try to deal with pain in the lower back or other area on your own. There are specialists who have thoroughly studied the causes of back pain and know how to deal with them correctly. You will find them at SL Clinic.

Who to contact for back pain

In the vast majority of cases, back discomfort is a sign of diseases of the spine and surrounding structures. Therefore, first of all you should contact:

• vertebrologist;
• spinal surgeon;
• rheumatologist;
• orthopedist-traumatologist;
• neurologist.

All these specialties overlap with each other and are partially interchangeable. Therefore, the same disease can be successfully diagnosed and treated, for example, by a rheumatologist and a vertebrologist or a vertebrologist and a neurologist.

Vertebrologist

This is a fairly broad specialist who is involved in the diagnosis and treatment of diseases of the spine and related organs and tissues, including spinal stenosis, osteochondrosis, spondylolisthesis, scoliosis, radiculitis, etc.

Consulting a doctor of this specialty will be the best option if pain occurs for the first time. It is he who will be able to thoroughly understand the situation and determine its character. You should also make an appointment with a vertebrologist if:

• regular back pain;
• limited mobility;
• discomfort while walking;
• shooting in the legs;
• feeling of pressure on the sides;
• tremors in the limbs
• weakness in arms and legs, etc.

Rheumatologist

This is a doctor whose field of activity includes the diagnosis and treatment of diseases of the joints and connective tissue. Therefore, his consultation is necessary if gout, rheumatoid arthritis, ankylosing spondylitis, rheumatism, or vasculitis are suspected or previously diagnosed.

The help of a rheumatologist is needed for:

• the occurrence of stiffness in the joints in the morning after sleep and its gradual disappearance after the start of movement;
• swelling in the projection of the joint, intervertebral disc;
• discomfort in one point, increasing after physical activity;
• weakness in the limbs.

Orthopedist-traumatologist

A specialist who treats the consequences of injuries, congenital pathologies and acquired spinal deformities. His consultation will be useful for:

• the appearance of pain after a blow or other traumatic factor;
• lack of feeling of complete recovery after injury;
• poor posture;
• fatigue;
• changes in the normal contours of the back, the appearance of previously absent bulges or depressions, etc.

Neurologist

Previously called a neurologist, this doctor specializes in the diagnosis and treatment of diseases of the nervous system. He is able to accurately determine the source of pain, detect any damage to nerve endings, ranging from inflammatory processes to compression by other structures.

By consulting a neurologist, you can begin to search for the cause of back discomfort. It’s also worth making an appointment with him if this is complemented by:

• frequent headaches;
• migraines;
• dizziness;
• loss of consciousness;
• violation of movement coordination;
• muscle weakness;
• speech disorders.

Thanks to the help of a neurologist for long-term, debilitating back pain, it is possible to prevent the formation of a painful focus in the brain and the resulting complications.

Of course, you can always consult a therapist. But this will only be a waste of time and effort. Based on the patient’s complaints, the therapist will only be able to refer him to a more specialized specialist - one of those listed above. Therefore, a visit to a therapist is only justified if it is absolutely unclear which doctor you should go to and you need to collect an anamnesis. It’s better to immediately do an MRI, and then all doubts will be dispelled, and it will become obvious which doctor’s consultation is needed.

About the vertebrologist

This is a doctor who deals with diseases of the spinal column. Such a doctor also knows how to do different types of massage, uses manual therapy, and performs plastic surgery of the spinal column. The causes of such pain are different:

• Sleeping on a very soft or hard bed.
• A person sleeps in a non-physiological position.
• If the pillowcase, duvet cover and sheets are made of non-natural fabrics.
• A person is forced to perform grueling physical work.
• Constantly sitting in one position when working on a laptop.

A vertebrologist will analyze the clinical picture of spinal pain, determine its cause, and recommend therapeutic measures.

Prevention of vertebrogenic pathologies

In order not to be bothered by vertebrogenic pain, prevention should be observed. You need to sleep on a bed that has medium hardness; it is advisable to purchase an orthopedic mattress for a comfortable sleep. If the surface of the bed is very hard or the bed is very soft, then deformations of the spinal column will occur. You also need to watch your posture. If the work involves sitting in one position for a long time, then you need to do a warm-up more often, which tones well and eliminates muscle stiffness.

When working on a laptop, you need to choose the right chair and table. The back will not experience overstrain if the chair has a high back. The armrests will fix the arms, so the spine will not be overstrained. You need to get rid of excess weight. It overloads the spine, the likelihood of osteochondrosis and intervertebral hernias will increase. You need to swim and exercise more often, then your spinal muscles will be toned and your back will become flexible. If you need to lift a heavy object, your back must be straight, otherwise problems with the spine will arise.

Doctors of related fields

Back pain is not always a sign of problems occurring specifically in the spine or muscles. Sometimes the reason lies in the disruption of other organs that have nothing to do with the back. Therefore, if a rheumatologist or orthopedist does not find serious abnormalities, the patient is recommended to consult other specialists.

Due to the peculiarities of the innervation of internal organs, disturbances in their work, inflammatory processes and other factors can lead to pain not only in the lesion, but also along the nerves innervating them. Therefore, in certain cases, pathologies of the genitourinary and digestive systems lead to back discomfort.

To detect them and select the correct treatment tactics, consultations are required:

• gynecologist - a female doctor can detect endometriosis, fibroids, inflammatory and other diseases of the genital organs, in which pain often tends to radiate to the lower back;
• urologist – diagnoses and treats not only diseases of the male reproductive system, but also disorders of the kidneys and bladder in representatives of both sexes (urolithiasis is often accompanied by severe pain in the lower back);
• gastroenterologist - will be able to diagnose diseases of the gastrointestinal tract that cause back pain;
• a cardiologist - a consultation will help to accurately determine whether back discomfort is caused by heart problems, since they very often manifest themselves in this way;
• an endocrinologist - will help detect metabolic disorders and resulting osteoporosis.

When is it necessary to seek help from a specialist?

Consultation with a doctor for a spinal hernia is necessary if you have the following complaints:

• Chronic pain of varying intensity in the affected part of the ridge.
• Complete/partial absence of skin sensitivity in the problem area.
• Deterioration in work, decreased muscle tone of the upper and lower extremities with accompanying cramps and numbness.
• Malfunction of internal organs due to lumbar hernia (problems with the intestines, bladder, etc.).
• Fluctuations in blood pressure, dizziness, migraines, cognitive impairment (memory deterioration, decreased concentration) accompany cervical intervertebral hernia.

What to take with you to your appointment

In order for the consultation to be as informative as possible for the patient, the doctor must provide all available medical documents, especially those related to chronic diseases. You should also take with you (if you have):

• test results;
• x-rays;
• extracts from the medical history during surgical treatment, injuries;
• results of MRI, CT, ultrasound.

This will allow the doctor to initially understand the essence of the problem in more detail and immediately select initial therapy. Its character can be adjusted and refined in the future. Also, to get a complete picture, the doctor may recommend other diagnostic methods.

Methods for diagnosing the causes of back pain

To accurately determine the cause of discomfort, depending on the characteristics of the clinical picture, the doctor prescribes a set of diagnostic tests, which may include:

• MRI is the main method for diagnosing spinal diseases, so it is usually one of the first prescribed to patients;
• X-ray – used to assess the condition of bones;
• Ultrasound – will allow you to visualize the structure and structure of internal organs and joints;
• CT scan – provides comprehensive data on the condition of bone tissue;
• OAC – allows you to detect signs of inflammatory processes;
• biochemical blood test - shows the presence of markers typical for a particular disease.

Based on the results obtained, one can not only judge the nature of the pain that occurs, but also the need for emergency surgical care for the patient. After all, some diseases have a poor clinical picture, but at the same time pose a serious threat to human life, for example, cancer.

Diagnostics

Diagnostic procedures will help determine the specialist who will treat the patient. Held:

• Examination of urine with blood will help identify inflammatory processes.
• X-ray examination from various projections.
• A CT scan will help detect the effects of injury.
• MRI will most accurately determine the spread of the pathological process. Do not use more than once every 30 days.
• An ultrasound will reveal problems with cartilage, tendons, and oncological processes.
• An electromyogram records the electrical signals produced by muscle contractions. This method will determine how well muscle tissue functions.

If you are worried about back pain, then it is better not to endure the pain, not to self-medicate, but to immediately seek help from a therapist, who will refer you to other specialists. Then complications will not arise in the body, which are not always successfully treated, so it is better not to risk your health.

When a doctor's consultation is needed urgently

In some cases, if you have back pain, you should not hesitate to seek medical help. This is about:

• chronic pain;
• lumbago;
• regular occurrence of pain after physical activity;
• persistence of discomfort without improvement for 3–5 days;
• lack of relief at rest;
• a feeling of numbness in the arms, legs or face;
• irradiation of pain in the legs, buttocks, thighs, perineum;
• the presence of pressing pain inside;
• fever;
• breathing problems;
• chest pain;
• limited mobility.

These symptoms may be signs of serious problems that require immediate attention.

Why is it important not to self-medicate?

Since in the vast majority of cases the causes of discomfort lie in diseases of the spine, the use of topical agents with an analgesic effect temporarily muffles their symptoms and gives the patient a false sense of normalization of the condition. This approach is fraught with the development of complications, because discomfort is most often a consequence of:

• Osteochondrosis is a dystrophic-degenerative disease in which intervertebral discs are gradually destroyed. This leads to the formation of protrusions and hernias, as well as a number of other complications.
• Intervertebral herniation - pathological protrusion of the intervertebral disc can pose a serious threat, especially if it is sequestered. Since the neoplasm puts pressure on surrounding tissues, which may include nerve roots, blood vessels, and the spinal canal, severe pain occurs. With prolonged non-intervention, a stroke may develop as a result of severe disruption of the blood supply to the brain.
• Scoliosis is a disease most often diagnosed in childhood. Over the years, it can progress and provoke displacement of internal organs and disruption of their functioning. The heart and lungs are most often affected. In advanced cases, the patient can only be helped by surgery.

Spondylosis, spondyloarthrosis and other pathologies that can lead to disability manifest themselves in a similar way.

The only case when moderate, aching back pain can be considered physiological is pregnancy. But even in this case, after giving birth you should play it safe and visit a specialist. After all, a strong increase in the load on the spine and its prolonged persistence can give rise to the development of pathological changes in its cartilage, that is, provoke the development of osteochondrosis, protrusions and hernias.

If these abnormalities are diagnosed in the early stages, they can be quickly managed through conservative therapy. If you start the disease and suppress its manifestations with painkillers, irreversible changes or the development of conditions are possible in which only surgical intervention can improve and eliminate the threat to health or even life.

Kinds

There are 3 main types of scoliosis:

• functional;
• structural;
• idiopathic.

Functional

With functional curvature, there is no torsion or other changes in the structure of the vertebrae. The spine is fully straightened when the torso is tilted and in a lying position. This condition is reversible and can be corrected by performing therapeutic exercises aimed at strengthening the back muscles.

Structural

The structural type is characterized by the presence of typical changes and is often a congenital pathology. A scoliotic arch is formed by vertebrae with a wedge-shaped deformity or twisted bodies. Structural changes can also be a consequence of injuries, neurological and endocrine diseases. Their appearance is promoted by various metabolic disorders, muscular dystrophy, myopathy, poliomyelitis, neurofibromatosis, etc.

Idiopathic

This is the most common form, diagnosed mainly in 10-12 year old children, mostly girls. There are many different theories regarding its occurrence, but they all agree on one thing - the curvature is caused by a violation of the development of vertebral tissues during the period of active growth.

Important! The diagnosis of idiopathic scoliosis is made only after excluding other causes.

Scoliosis is classified according to location into the following types:

• cervicothoracic with the apex of curvature in the region of the 3rd–4th thoracic vertebrae;
• thoracic (apex – 8–9 vertebra);
• thoracolumbar (11–12 vertebrae – peak of the arc);
• lumbar.

Treatment of back pain

After accurately determining the cause that provokes discomfort, the doctor initially prescribes conservative therapy. Usually it is complex in nature and includes taking a number of individually selected medications from the following:

• NSAIDs;
• corticosteroids;
• muscle relaxants;
• antidepressants;
• products for topical use.

In case of severe pain, a blockade can be performed in a clinical setting. The essence of the procedure is the introduction of anesthetic solutions at certain points. This allows you to block the transmission of pain impulses and leads to normalization of the condition in 2–5 minutes.

In order to increase the effectiveness of drug therapy, patients are additionally prescribed a course of physiotherapeutic procedures, manual therapy, exercise therapy and wearing orthopedic bandages. They help reduce the load on the spine, improve blood circulation, speed up regeneration processes and reduce pain.

In most cases, exercise therapy plays a significant role in treatment, so you should not neglect daily exercise. But only a specialist who knows the exact diagnosis can develop a set of exercises that will bring benefits and not harm. In some situations, exercise therapy is contraindicated. Therefore, you should not try to improve your condition with physical exercise on your own.

If severe pathologies are detected, in some cases, patients are urgently hospitalized for the purpose of careful medical monitoring of their condition or surgical intervention.

Treatment of scoliosis

If a patient with scoliosis is obese, experts first recommend losing excess weight. Excess weight only aggravates the situation and any treatment in case of inaction in relation to restoring a person’s normal body weight will not bring the desired result.

As a rule, in the initial stage, scoliosis is treated with therapeutic massage and exercise therapy. In the early stages of scoliosis development, patients are prescribed regular visits to a chiropractor . Also, the patient must constantly be in a specially designed rigid corset. Rigid fixation of the spinal column and regular exercise will help return the spine to the correct position. Usually, patients with scoliosis are prescribed calcium supplements.

For scoliosis, therapeutic massage procedures and electrical stimulation of the spinal muscle corset may be prescribed . Regular visits to the pool are also recommended, as swimming has a positive effect on getting rid of bone deformities. Swimming can even completely cure stage I scoliosis, but in more complex forms it only contributes to treatment.

In some cases, surgery cannot be avoided. In such cases, scoliosis is treated by fastening the vertebrae together using special surgical wires and pins . Recovery after such an operation is a very long process. After such an operation, the mobility of the spine will be limited.

Surgical treatment for back pain

If conservative therapy is ineffective or a number of abnormalities are detected, patients may be recommended surgery. Surgical treatment is indicated for:

• increasing herniation of intervertebral discs and compression of the spinal canal, nerve roots, etc.;
• sequestered hernias;
• spinal fractures;
• spinal canal stenosis;
• hemangiomas;
• instability of the spinal motion segment of the spine;
• severe forms of spondyloarthrosis;
• cauda equina syndrome;
• scoliosis grade 3–4;
• neoplasms;
• disruption of the pelvic organs and other cases.

Performing the operation is the task of the spinal surgeon. This specialist knows methods of surgical treatment of a wide variety of diseases of the spine and brain. It can eliminate deformations, compression of nerve roots, blood vessels, eliminate congenital anomalies and neoplasms of any nature.

Surgery for back pain

In the arsenal of spinal surgeons there is a huge variety of different techniques, the use of which can eliminate almost any disorder. Operations can be performed via a posterior approach (from the back), lateral (used for neck operations) and anterior (access to the spine is provided by entering it through the abdominal cavity).

For each patient, the type of access and surgical technique are selected individually. It can be:

• Discectomy is a surgical intervention on the intervertebral disc, which involves removing the hernia or the entire disc in an open manner, through a small incision (microdiscectomy) or endoscopically. Thanks to it, the pressure of pathologically altered cartilage on the nerves is eliminated, which leads to the elimination of pain and impaired mobility.
• Percutaneous methods for treating intervertebral protrusions - surgeons are able to reduce the size of pathological protrusion only by inserting a thin needle into the affected intervertebral disc. Through it, a light guide or a special electrode is immersed into the thickness of the nucleus pulposus. They create thermal energy or a cloud of cold plasma, which leads to sclerosis of part of the nucleus pulposus and a decrease in the size of the disc. These methods include cold plasma, laser and radiofrequency nucleoplasty.
• Laminectomy - removal of part of the vertebra and its arch above the spinal root. The method allows you to increase the free space around the nerve, which will lead to an improvement in its blood supply, elimination of swelling of the perineural membrane and, as a consequence, a decrease in compression.
• Spondylodesis is a method that involves removing the intervertebral disc and connecting the vertebrae of the affected segment to each other, as a result of which they are completely fused. This leads to stabilization of the spinal motion segment, eliminates pathological mobility of the vertebrae and prevents injuries.
• Vertebroplasty is a minimally invasive method of treating compression fractures, hemangiomas and some other tumors, osteoporosis of the spine, which involves filling the defect with bone cement. It is injected into the desired area using a thin needle. The procedure can be performed under local anesthesia and has a short recovery period.
• Endoprosthetics of the intervertebral disc - in case of severe destruction of cartilage tissue, it is possible to replace the discs with artificial implants. They have good biomechanical properties and can withstand heavy loads.
• Operations to correct curvatures (deformations) of the spine - in case of scoliosis, metal structures are used to straighten the spinal column. They come in different types and require different installation methods. Metal structures are installed along the entire scoliotic arch and allow significant alignment of the spine to be achieved.

The cost of such operations varies widely. The highest prices are for microsurgical interventions and operations involving the installation of implants or expensive fixation structures.

“SL Clinic” is your chance to get rid of back pain

Back pain can be a sign of serious diseases that require complex treatment to avoid complications, disability, and death. Therefore, when they appear, you should immediately contact a vertebrologist, neurologist, rheumatologist or orthopedist-traumatologist. The best specialists in these specialties accept patients at the SL Clinic.

Our clinic specializes in the treatment of spinal diseases, neurological disorders and a number of other pathologies. With us you can not only get advice from highly qualified doctors, but also quickly undergo all the diagnostic measures necessary in a particular case using the latest generation equipment. We will be able to accurately determine the cause of pain and select the optimal treatment tactics, which will ensure the onset of improvement and the achievement of stable remission.

If indicated, you can get help from professional spinal surgeons in the best clinics in the capital. Our surgeons have extensive practical experience, regularly improve their skills and master advanced techniques for providing surgical care to patients with various diagnoses.

The SL Clinic performs all types of percutaneous and endoscopic spine surgeries. If necessary, surgeons can perform open surgical interventions, correct spinal deformities, and perform operations of any complexity using modern implants.

We will provide you with the most comfortable treatment conditions at affordable prices. Contact the SL Clinic, follow the recommendations of specialists, and you will forget about back pain and limited mobility.

Kinesitherapy for hernia

Specialists from our Kinesitherapy Centers in Klin, Dubna, Tver and Zelenograd will help identify the cause, eliminate symptoms and prevent complications and recurrence of a spinal hernia without surgical intervention.
The methodology is based on special exercises on anti-gravity and decompression simulators, an individually developed training program, recommendations regarding lifestyle correction, nutrition for the fastest possible recovery of muscles, spine, and nervous system function.

A unique set of training that has no analogues allows you to:

• Engage the deep muscles of the spine that are located around the hernia.
• Restore lost mobility/functionality to the spine.
• Reduce the risk of re-development of the disease by forming a correct idea of ​​why an intervertebral hernia occurs.

An individual, comprehensive approach to solving the problem, taking into account the characteristics of the body, the psychology of the individual patient, modern equipment, a comfortable atmosphere, and experienced qualified staff are the main reasons why you should contact one of our kinesitherapy centers for the treatment of spinal hernia.