Have you ever felt pain on parts of your backbone and spine? Well, it may be dorsalgia. Back pain is a common ailment that can affect at least 8 out of 10 people at some point in their lives. The word “dorsalgia” is gotten from two words dorsal,” which means back, and “algia,” which means pain. If you have been having back pain or researching about spinal pain, you must have heard of this word.
Dorsalgia is a spinal pain that comes from different parts of your backbone. The pain can be felt in bones, back muscles, nerves, and joints. This include lower back pain, mid back pain, and sciatica pain. The pain can comes as a dull pain or as a sharp, sudden pain. Most back pain can go away after some days while others can last for a long time, if the pain lasts for more than 3 months, it is called a chronic pain. Note that dorsalgia do not include pain from conditions like scoliosis or lordosis.
TYPES OF DORSALGIA
The region of spine where the pain is felt determines the type it is. The human spinal column as we know has 5 sections with the total of 33 bones that are collectively called the vertebrae. The 5 sections of the vertebral column are the Cervical, Thoracic, Lumbar, Sacrum, and Coccyx. Each section that is affected describes the type of dorsalgia affecting it.
1. Thoracolumbar Dorsalgia: This type of pain occurs in the thoracic and lumbar regions of the spine which are the 2nd and 3rd sections of the vertebrae. Thoracolumbar dorsalgia is characterized by pain affecting the upper and lower back.
2. Thoracic Dorsalgia: This type is rare and occurs once in a long while because the thoracic region is part of the body that is hardly used. The pain is usually felt in the mid back.
3. Cervical Dorsalgia: This is also known as neck pain or cervicalgia. Cervical dorsalgia is felt from the upper or cervical part of the spine that is anywhere in the neck from the bottom of the head to the top of the shoulders. It can be caused by stress or injury. The pain can be mild and can make the neck to become stiff or severe resulting to inability or difficulty in moving and bending the neck.
4. Cervicothoracic Dorsalgia: From the name, this type of dorsalgia affects both the cervical and thoracic spinal regions, the cervical region being the topmost section of the vertebrae which is part of the neck region and the thoracic spine which is the second part of the spinal column located between the cervical spine and lumbar spine. This pain is felt in the neck and the mid-back.
5. Lumbar Dorsalgia: The lumbar spine is found at the end of the thoracic spine and down to the point where the sacral spine begins. This pain is common because the lumbar spine is mostly used during daily activities, it is felt in the lower back.
6. Lumbosacral Dorsalgia: This pain is experienced in the lumbar and sacral spinal cord. It is usually sharp and sudden and is triggered by irritation of the posterior spinal artery or sensitive vertebral column innervation (Premier Pain Centers).
CAUSES OF DORSALGIA SPECIFIC AND NONSPECIFIC
Dorsalgia can be specific or nonspecific. According to the Gesund.bund.de, an online health portal published by the German Federal Ministry of Health, Nonspecific back pain or dorsalgia occurs when there is no particular cause for the back pain. The pain is triggered by the following factors:
- Stress, anxiety or depression
- Lack of exercise
- Weak core muscles
- Muscle tension causes by abnormal mechanical stress
- Changes in pain perception in the central nervous system
- Sitting for long periods of time (at a desk), unilateral or strenuous manual labor resulting to abnormal biomechanical stress or unilateral stress.
Specific dorsalgia on the other hand, are those back pains that their causes can be clearly identified. Common causes are:
- Bechterew’s disease
- Narrowing of the vertebral canal
- Broken vertebral body due to osteoporosis
- Acute slipped disc
SYMPTOMS OF DORSALGIA
Some signs of having dorsalgia can be:
- Pain or difficulty when you bend down
- Burning sensation and pain in the neck and back
- Carrying out daily activities like sweeping, climbing the stairs or getting up from a chair become difficult.
- Sharp pain in the neck and back
- Pain when you change your position or posture
- Numbness in upper or lower back
- Stiff back
HOW TO DIAGNOSE DORSALGIA
If you feel pain in your neck or back, it is advised that you see a doctor or an orthopedic surgeon. There will be series of examinations and diagnosis done, some of this examinations are:
1. Physical Examination: The first diagnosis is to physically check you and you will be asked to do some physical activities and movements like sitting, standing, walking and your doctor checks your performance. To better diagnose your condition, some questions can be asked. These questions can be :
- Do you have consistent pain throughout the day or does it come and fade away ?
- Do you feel pain on your back when sitting, standing, lying down, or some combination?
- What time of day do you feel your back pain the most?
- Does your pain limit your ability to perform normal tasks? If so, which tasks?
- Do over-the-counter medications or at-home remedies relieve your pain?
- Do you have other health conditions?
- Does your family have any history of back problems or spinal conditions?
- Have you suffered any injuries, even in childhood, that could affect your back? If so, what are they?
It is advised that you share every details and information with your doctor, it will help with your diagnosis.
2. Imaging Tests: These tests are carried out to take a closer look at what may be the cause of your pain. Tests like MRI are used to diagnose dorsalgia while tests like x-rays or CT scans are used to diagnose and find treatment methods.
3. Neurological Testing: Neurological testing are done to check the nerves if they are suspected to be the cause of your dorsalgia. These tests include :
i. Stork Test: You stand on your feet and your lower back is examined. When you are starting to feel comfortable, your doctor will have you lift your knee toward the ceiling.
ii. Straight Leg Test: You lay on your back on the exam table for this test while relaxing your outstretched, affected leg. Your leg is lifted at 30-60 degrees gently by the doctor. If you feel pain in the back or pain that radiates in the leg, your condition may have a nerve-related origin.
iii. Adam’s Forward Bend Test: You will be asked to stand with both feet on the floor then bend forward at the waist. Your doctor will watch for abnormalities or signs of larger conditions.
HOW TO TREAT DORSALGIA
Dorsalgia treatment depends on how mild or severe the pain is. Some treatment options are:
1. Physical Therapy: This is used or recommended when the pain is not too serious or severe. You will be asked to come for different sessions and your physiotherapist or chiropractor will monitor your progress and body’s reaction to the therapies and exercises. You should also be asked to take enough rest to accelerate your healing.
2. Medications: Most over-the-counter and non-steroidal anti-inflammatory drugs are commonly used to relieve most back and joint pains. NSAIDs include Naproxen (Aleve), aspirin, ibuprofen (Motrin, Advil), Diclofenac and indomethacin (Indocin).If you do not want anti-inflammatory drugs, you can get drugs with acetaminophen. Acetaminophen or paracetamol can be found in drugs like Benadryl, Tylenol, Dayquil and Excedrin.
3. Muscle Relaxants: Muscle relaxants are mostly recommended if medications do not treat acute back pain especially nonspecific dorsalgia. Cyclobenzaprine is a muscle relaxant that effectively treats neck pain and related muscle spasms
4. Dry Needling: Dry needling is done by inserting a small needle into a muscle point to trigger it, thereby improving blood flow and relaxing the muscles around the area. This is usually used in treating pain in the thoracic spine (the spine in the upper back and abdomen).
5. Transcutaneous Electrical Nerve Stimulation (TENS): Transcutaneous electrical nerve stimulation units are small, handheld, battery-operated devices that are used to block nerve impulses. They are commonly used for treating middle back pain. You should ask a doctor which type of TENS unit is good for the type of pain you feel.
6. Facet Injections of Lidocaine or Steroids: When the pain is an acute lumbar back pain, steroids like Cortisone can be used to relieve pain for months, although you may not feel pain relief until several days after the injection. Lidocaine which is another steroid acts quickly but will only relieve pain for a couple of hours.
7. Surgery: When your back pain is severe or other treatment methods did not provide relief, surgeries can be recommended. Surgeries like:
- Spinal fusion: Eliminating or removing movements between vertebrates in the spine by fusing them together.
- Discectomy: Damaged discs are removed to remove pain. This surgery rate is 80-90%.
- Disc arthroplasty: The damaged discs are replaced with artificial discs.
Dorsalgia is a common health condition, it means spinal or back pain. There are many factors that can cause this; ranging from lack of exercise, injury, stress or overusing the spines. Treating this pain can be done using drugs, physical therapy, muscle relaxants or even surgeries in severe cases.