Dorsalgia: Causes, Symptoms, Types, Treatment, Surgery

Dorsalgia! Have you ever heard of this term? Let us learn all about Dorsalgia, its causes, symptoms, diagnosis and treatment options in this article.

Pain in the dorsal column is a frequent pathology in clinical practice. There are multiple processes that can affect the dorsal column, the most common being the degenerative ones.

Dorsalgia is technically a terminology used to describe disorders associated with pain that can be mild, moderate or even intense emerging from the joints, nerves or muscles related to the spine.

Such pain may be diffused or localised, intermittent or constant with the characteristics of burning or stinging. In case it is connected to the cervical bone, the pain may be transmitted to the extremities causing numbness feeling.

Symptoms usually increase with age and with the practice of sports activities such as gymnastics, cycling, tennis, and volleyball that produce rotation, hyperextension and waist flexion.

In the dorsal column disc prolapses, it usually does not cause any symptom unless extensive as the holes of conjunction is more extensive, so the nerve roots are further away from the intervertebral disc. Dorsal myelopathy is rare due to canal stenosis as it is usually associated with the existence of a hernia disc.

Dorsalgia meaning:

Dorsalgia means pain in the spine or back region. It is the combination of the term ‘dorsal’ meaning the back and ‘algia’ which refers to pain. Therefore, Dorsalgia means pain in the back or spine. This usually occurs because of several types of rheumatic disorders having typical pain associated with spinal joints, nerves, bones or muscles.

The definition of Dorsalgia:

It is are a generic term which can be defined as spine or back pain associated with burning or stinging sensation that usually radiates from the nerves and muscles in the spinal region, the vertebral column or other organs related to the spinal cord.

In general, it refers to any back pain in the spinal area but the origin of the pain may because of different reasons. The pain may be due to injury in the vertebral column, slip disc, sprains, lumbago, sciatica, lordosis, kyphosis or osteoporosis.

The Symptoms of Dorsalgia:

There may be variation in clinical symptoms among different patients. The symptoms will depend on the underlying causes resulting in back pain. Still, there are some common symptoms observed in patients suffering from back pain.

They are:

Burning or stinging like pain sensation,
Difficulties in bending or changing posture mainly the upper body
The problem in walking
Needing support to walk
Intense pain if nerve gets pinched, etc.

The common causes of Dorsalgia:

As already mentioned the common causes of Dorsalgia can vary from patient to patient. You can suffer from low back or neck pain because of various reasons. For adults under the age of 50 such common reasons include degenerative disc disorder or a hernia.

In case of adults over the age of 50 years search common reasons include spinal stenosis and osteoarthritis. According to some researchers, however, attention syndrome result from excessive emotional disturbance and stress, is responsible for 90% of adult back or leg pain.

Types of Dorsalgia:

According to the location of the pain, a region of spine involved or the nature of the injury, it can be divided into different types such as:

Lumbosacral Dorsalgia:

As the name suggests, this type of back pain involves two parts of the vertebral column or spine, the lumbar and the sacral region of the spinal cord. The lowest area of the spinal cord is known as the sacral region.

Lumbar Dorsalgia:

As per the name, this type of back pain concerns the lumbar region of spinal cord only. Usually, a lumbar dorsalgia is associated with lower back pain, the most active part of your spinal cord. This is why this region is more susceptible to injuries as well as muscle tears. It is the most prevalent form of Dorsalgia found in the human being.

Thoracolumbar Dorsalgia:

Two regions of the spinal cord are involved in this type of back pain, the thoracic and lumbar region. Such back pain usually happens when injuries affect the vertebral discs of these two regions resulting in moderate to intense pain. This pain can take place in both the upper and lower part of the spinal cord.

Thoracic Dorsalgia:

Thoracic Dorsalgia involves only the thoracic part of the spinal cord and is not a common region to be affected. This is because this place is the least used structure of your vertebral column as it covers the area just below the cervical region. So you can conclude that thoracic dorsalgia is rare.

Cervicothoracic Dorsalgia:

When both the cervical and the thoracic region of the spinal cord is affected by back pain, then it is called the Cervicothoracic Dorsalgia. This usually occurs due to disc dislocation or injuries in the middle portions of both or one of these two regions of the spinal cord.

Cervical Dorsalgia:

This is the rarest region of the vertebral column to be affected by back pain, as the cervical area is the uppermost section of the spinal cord. However, degenerative diseases or injuries to the cervical spine or discs may result in Cervical Dorsalgia.

The condition may be associated with intense pain in case the nerves in this region get involved in the injury, or cervical spine gets generated due to the degenerative diseases. Such pain usually radiates towards the shoulder and finally to the arms or even hands. It is also known as Cervicalgia.

Dorsalgia or back pain needs to be understood correctly for proper treatment. All the types of back pain discussed above have different and specific therapies based on its nature. It is observed that the lower vertical column area is more susceptible to accidents and injuries compared to the other regions.

The pain experienced by the patients also differs according to different categories of back pain. If it is not possible to identify the type of back pain you are suffering from, then healthcare professionals usually treat the case as dorsalgia unspecified.

Diagnosis of dorsalgia:

The physicians or the healthcare professionals follow a specific diagnostic algorithm to diagnose and treat patients with back pain or lower back pain.

Clinical history is necessary and essential guidance to diagnose back pain, which includes:

Family and personal history
Age and sex
The practice of sports that may trigger injury
Other disorders
Characteristics of the pain
General and local symptoms

After examination of clinical history, the healthcare professionals perform the physical examination to detect the extent and type of the disease, which is followed by the additional tests.

The physical examinations include:

Comprehensive general exploration
Inspection
Palpation
Percussion
Mobilization of the dorsal column
Neurological exploration

The additional tests include:

Simple radiography of the dorsal column
Analytical Examinations
Gamma Ray Analysis (Gammagraphy)
Magnetic resonance analysis

Treatment procedures for different types of Dorsalgia:

The primary aims of back pain treatment are to manage the pain and then look for a permanent solution.

The key goals are:

To reduce the intensity of the pain as quickly and as far as possible
Restoring the normal activities of the patient
Aiding in lowering the residual pain
Assisting in evaluating and eliminating the possible side effects of treatment

Different types of treatment procedures available for various types of back pain described above. As already mentioned, it is essential to understand the cause and nature of back pain you are suffering from to initiate a proper course of treatment.

So the first step should be to diagnose the type of back pain you are affected with and then go through the available treatment courses.

Available Therapeutic Treatment options:

In treatment options, different medications are used to relieve you from the nerve pains. These medications include the anticonvulsants, painkillers (relievers) and muscle relaxants. Never try to do self-medication.

Always use these medications upon suggestions from a health care provider. For the success of treatment, it is imperative to make a proper diagnosis before starting the medication.

Surgical mode of treatment:

Apart from treatments, there are several surgical treatment options available as well. In general, these treatments involve spinal surgery for treatment of various back disorders. The common forms of operations used in dorsalgia are:

Artificial disc replacement:

Artificial disc replacement has evolved recently as a surgical option to treat low spine pain due to spinal disc damage. It is becoming more and more common mode of treatment for back pain.

Microdiscectomy or discectomy:

Microdiscectomy or discectomy is used in general for the treatment of back pain mainly when the pain radiates to legs or arms of the patients. Such pain usually happens if you have a herniated disc. The success rate of such surgeries is quite high.

Vertebroplasty or Quifoplasty:

This is another surgical option available to manage back pain that originates from compression fractures resulting from osteoporosis.

Other modes of treatment:

Spinal column stimulation:

This treatment involves the use of an electrical instrument to block the signals of pain generating from the area to reach your brain. Therefore, you will not feel any pain sensation from the Dorsalgia affected region.

Spinal fusion:

This is another useful way of treating acute as well as back pain resulting from scoliosis induced deformities, spondylolisthesis and degenerative.

Lifestyle management, massage therapies, physiotherapy, spinal cord exercises, hot or cold pack and bath, etc. can help.

References:

Manual SER de las enfermedades reumáticas. 5.ª ed. Madrid: Editorial Panamericana
MRI Findings of Dorsalgia, The neuroradiology journal, 2011
Semiología de lasenfermedades reumáticas. Madrid: Editorial Panamericana
https://www.ncbi.nlm.nih.gov/pubmed/22337573
www.dorsalgia.org