Dorsopatiya

Description:

Dorsopatiya (Latin dorsum - a back) - the generalized name of various pathologies of a backbone, soft tissues of a back (juxtaspinal muscles, sheaves, etc.).

The generalizing sign of different types of a dorsopatiya are pain syndromes in a trunk (cervical department, a back, a waist) which is not tied with diseases of internals. Degenerative and dystrophic diseases of a backbone, and also defeat of soft tissues of a back (juxtaspinal muscles, sheaves, etc.) are the reason of pain at a dorsopatiya. The main manifestations - dorsodynias and restriction of mobility of a backbone.

The chronic current with an aggravation of a pain syndrome is characteristic of dorsopatiya.

Dorsopatiya reasons:

Are the most frequent reason of dorsopatiya:
backbone osteochondrosis - degenerative changes in intervertebral disks with the subsequent deformations of bodies of adjacent vertebrae (spondylosis), intervertebral joints (spondylarthrosis) and the copular device of a backbone;
myofascial syndromes

Emergence and development of a dorsopatiya are promoted:
hypodynamia (low physical activity);
the degenerative and dystrophic processes in a backbone and fabrics, adjacent to it, caused by external factors and age changes (osteochondrosis);
disturbance of a bearing (scoliosis, kyphoscoliosis, stoop);
frequent catarrhal diseases, obesity, digestive tract diseases, uniform or scanty food;
alcohol abuse, smoking, and also addiction to fried, smoked food, pickles, spices and to the products rich with purine bases
permanent job in adverse meteoconditions when low temperature is combined with big air humidity;
vibration;
imperceptible uneven load of a rachis because of action of the most different factors (for example, the wrong position of a backbone during the work and other daily types of activity);
long stay of a body in physiologically uncomfortable positions: having bent hours-long sitting behind a desk at school, institute, at home, at work - in the car, at the computer, behind a drawing board, standing at the machine, behind a counter etc.
heredity (genetic predisposition is implemented through features of the somatogenic, psychogenic, hormonal, immunological, biochemical constitution, including connecting (cartilaginous) fabric).

On the frequency of occurrence defeats of lumbosacral department of a backbone (60-80%), and on the second - cervical department of a backbone (about 10%) are on the first place.

Dorsopatiya symptoms:

The main symptoms of a dorsopatiya are:
- the constant aching dorsodynias, tension and morbidity on the party of defeat in muscles of a neck, a shoulder girdle, a back and extremities;
- strengthening of pains at the sharp movements, an exercise stress, a raising of weights, cough and sneezing;
- feeling of numbness and an ache in extremities, paresis (sensitivity disturbance), weakness in muscles (up to paralysis), with decrease in reflexes and hypotrophies of muscles of hands and/or legs;
- spasms of muscles, mobility restriction, reduction of volume of movements;
local changes of soft tissues: vascular, dystrophic changes, neyromio-and neuroosteofibrosis.

Depending on localization of a dorsopatiya the following symptoms are possible:
- at a dorsopatiya of cervical department of a backbone: hand, shoulders pains, headaches. Also complaints to noise in the head, dizziness, flashing of "front sights", color spots before eyes are possible. In combination with the pulsing headache it gives the grounds to assume a so-called "syndrome of a vertebral artery" (one of complications of a cervical dorsopatiya).
- at a dorsopatiya of chest department of a backbone: pain in a thorax, in heart and other internals;
- at a dorsopatiya of lumbosacral department of a backbone: the back pain irradiating in a sacrum, the lower extremities, sometimes in bodies of a small pelvis;
- at defeat of nervous roots (hernias of intervertebral disks, osteochondrosis, a spondylolisthesis, a spondylarthrosis): the shooting pain and disturbance of sensitivity, a hypotrophy, hypotonia, weakness in the innervated muscles, decrease in reflexes.

On pain origins at a dorsopatiya it is possible to allocate the following types of pains:
local pain - usually constant, with localization in the field of damage of a backbone, changes depending on position of a body;
the reflected (projective) pain - on character is close to local, but extends on the course of the affected nerve;
- neuropathic (radicular) pain - "the shooting pain", can be stupid, aching, but at the movement, and also cough, sneezing considerably amplifies and becomes acute ("lumbago"). Sensitivity disturbances, a hypotrophy, hypotonia, weakness in the innervated muscles, decrease in reflexes are possible.
- not radicular pain - pains owing to a muscular spasm, a hyper tone of muscles (psychogenic pain).

Clinical manifestations of a dorsopatiya.

Clinically the dorsopatiya is shown in a look:
- reflex syndrome (90% of cases)
- compression syndrome (5-10% of cases).

Reflex syndromes at a dorsopatiya (muscular and tonic, neurovascular and neurodystrophic) arise owing to irritation of pain receptors in back muscles as a result of action of any pathological factors (infringement, an inflammation or irritation) and are followed by a reflex muscular spasm. However the muscular spasm in itself is the reason of an additional painful impulse, the vicious circle "pain - a muscular spasm - pain" results.

Compression syndromes at a dorsopatiya are caused by mechanical impact of hernial protrusion, bone growths or other pathological structure on roots, a spinal cord or vessels. Respectively, compression syndromes divide on radicular (radiculopathies - infringement of a root of a back nerve), spinal (myelipathies - a compression of a spinal cord) and neurovascular (a compression of a vertebral artery).

As for a myelipathy, it are more often observed in cervical, is more rare in lumbosacral department of a backbone.
Myofascial pains at a dorsopatiya

In diagnosis of a dorsopatiya the role of myofascial pain syndromes is often underestimated (a miositis or a mialgiya, suffer from 35 to 85% of the population). The essence of a myofascial pain syndrome is that the muscle suffers initially, but not after morphological or functional disturbances in a backbone. Any muscle or groups of muscles can be involved in pathological process.

One of the most frequent reasons of myofascial pains - an acute remuscle strain. Usually the patient precisely remembers what movement or action caused emergence of pain. The miositis can develop also against the background of a constant overstrain of group of muscles, or overcooling.

For diagnosis of a myofascial pain syndrome it is necessary to reveal the following clinical signs:
at a palpation muscle spazmirovanny;
within a spazmirovanny muscle zones of a bigger muscular consolidation - the trigger points differing in special morbidity accurately are defined.

Classification:

Dorsopatiya can be called by degenerative and inflammatory processes of various structures of a backbone: intervertebral disk, intervertebral joints, ligaments of a backbone, juxtaspinal muscles. Involvement in process of spinal roots or a spinal cord gives focal neurologic symptomatology.

According to the international standards, all types of a dorsopatiya can be divided into three big groups:
the pathological deformations of a rachis deforming dorsopatii-caused by dystrophic changes in intervertebral disks (without disturbance of integrity of a fibrous ring, without protrusions and hernias of a pulpozny kernel). This group joins a lordosis, a kyphosis, scoliosis, a spondylolisthesis (shift of one of vertebrae concerning another), osteochondrosis and incomplete dislocations;
spondylopathies - include all types of inflammatory, degenerative and traumatic spondylopathies;
other dorsopatiya are discogenic dorsopatiya with the progressing degenerative and dystrophic changes in intervertebral disks (a fibrous ring and a pulpozny kernel) with a protrusion, intervertebral hernias, and also different types of dorsalgiya, i.e. pain syndromes in a neck, a trunk and extremities without the shift of intervertebral disks, without disturbance of functions of spinal roots or a spinal cord.
Localization of a dorsopatiya

Depending on localization allocate:
dorsopatiya of cervical department of a backbone,
dorsopatiya of lumbar department of a backbone,
dorsopatiya of chest department of a backbone

Many clinical physicians use such local and syndromal characteristics as a radiculopathy, a tservikalgiya, a lyumbalgiya, a thoracalgia, a sciatica.

Treatment of a dorsopatiya:

Operational treatment of a dorsopatiya is required rather seldom. Treatment of a dorsopatiya and its complications carry out usually by means of the conservative methods directed to elimination of a pain syndrome, dysfunctions of spinal roots and the prevention of progressing of dystrophic changes in structures of a backbone.

The technique of treatment of a dorsopatiya in each case depends on the reason and degree of manifestation of pain syndromes. The integrated approach based on a combination of various methods of treatment is optimum. The right choice of techniques allows to achieve the most resistant results.

At treatment of a dorsopatiya the following medicines and methods of treatment are applied:
- non-steroidal anti-inflammatory drugs (NPVS) - are applied in an aggravation stage to reduction of pain and suppression of inflammatory processes in a zone of the affected vertebras;
- muscle relaxants - are applied at strong muscular spasms, rasslablyayanapryazhenny muscles of a back, significantly reduce pain;
traction treatment of a dorsopatiya (treatment by extension). At use of this method of treatment of a dorsopatiya there is an extension of paravertebral fabrics, sheaves, muscles therefore the distance between separate vertebrae increases by 1-4 mm (on average on 1,5 mm). In case of a compression of a nervous root or blood vessels in the vertebral channel hernia of a disk or an osteophyte extension promotes reduction of squeezing or its full elimination;
- calmatives are also recommended at treatment of a dorsopatiya since constant pain results in overexcitement and exhaustion of a nervous system. Besides, the calming drugs allow to lower psychogenic muscular spasms;
- for treatment of a dorsopatiya different types of physiotherapeutic procedures are appointed (ultra-violet radiation, darsonvalization, an electrophoresis, фонофорез, influence of magnetic field, ultrasound, diadynamic currents, an underwater shower, massage, mud applications, etc.);
- manual therapy, acupuncture find application in treatment of a dorsopatiya;
after removal of pain at treatment of a dorsopatiya drugs for acceleration of recovery processes - biogenic stimulators, group B vitamins, anabolic drugs, vascular drugs are recommended (improve food of nervous roots and blood supply of a backbone). At this stage also the physiotherapy exercises are very useful.

It is important to remember that NPVS dorsopatiya applied at therapeutic treatment, analgetics, spasmolysants are effective, but at prolonged use can do harm to an organism. And at some gastrointestinal diseases many of these drugs in general are contraindicated.