Back pain can affect your life and movement to a great extent. It is the number one cause of disability if you do not seek medical help timely and have it accurately diagnosed. Dorsalgia can range from constant dull pain in the back to intense, shooting pain that may result from bulging or herniated discs, injury or accident, and even some medical problems. Schedule an appointment with experienced physicians and therapists at Physical Therapists NYC to have your symptoms properly diagnosed with physical examination and tests. The award-winning therapists help you understand this condition and come up with personalized treatment plans to provide quick relief.
The list of conditions that can be called dorsalgia is long. It can be anything from an annoying irritant that is bothersome to something that becomes intolerant and leaves you unable to do even the basic tasks. Learning about dorsalgia may help understand what it is and how to treat it.
What Is Dorsalgia?
Dorsalgia is a collective name given to a group of conditions that produce moderate to intense pain in the muscles, nerves, bones, joints, or other structures associated with the spinal column of the body. The word dorsalgia comes from two words, dorsal which means back, and algia, which means pain.
It is more than just simple back pain. The pain can be sporadic or persistent, depending on the type of injury or medical condition, restricted to the particular area of the back or spine, or spread to other areas.
Generally, dorsalgia includes spinal-related pain such as lower back pain, mid back pain, and sciatica pain. It does not include pain related to scoliosis, lordosis, or other specifically classified conditions. Its signs and symptoms vary depending on the intensity of the pain and your unique physical characteristics.
Types of Dorsalgia
There are six known types of dorsalgia. They are:
Cervical dorsalgia is also medically known as cervicalgia. It involves the cervical spine. You feel pain in the neck region that occurs due to some injury or as a result of degeneration of the cervical spine.
This type of dorsalgia involves cervical and thoracic regions of the spine. The cervical spine is the uppermost part of the vertebral column located in the neck region while the thoracic spine is the second portion of the vertebral column. It is placed between the cervical spine and the lumbar spine. The pain in cervicothoracic dorsalgia comes from both of these portions.
This type of back pain results from only the thoracic vertebral segments. It is a rare type of dorsalgia.
It involves both the thoracic and lumbar spine. This type of pain comes from both the upper and lower back.
The lumbar spine is located where the thoracic spine ends and it continues down to where the sacral spine starts. Lumbar dorsalgia is more common among people as this part of the spine is most used of all for daily movements.
It involves back pain that roots from both the lumbar and sacral spine.
Symptoms of Dorsalgia
Symptoms of dorsalgia can vary from person to person, depending on the underlying causes. Some common signs that indicate you may be suffering from dorsalgia include:
- Numbness or tingling in upper or lower extremities;
- Muscle ache;
- Sharp and shooting pain in the back or neck;
- Burning sensation;
- Pain that radiates down the leg;
- Limited flexibility of the back when trying to bend;
- Difficulty in changing posture;
- Inability to perform simple activities like getting up from a sitting position.
Symptoms of dorsalgia are determined based on an evaluation of things like how you move, including sitting, standing, walking, and lifting your legs.
What Causes Dorsalgia?
There may be thousands of potential causes of back pain or dorsalgia. Some common causes include:
- A bulging or herniated disc;
- An injury such as a car accident, gunshot wound, sports-related incident, slip, and fall, or physical altercation;
- Extensive manual labor or physical exertion;
- Stress-related disorders;
- Degenerative disc disease;
- Certain medical conditions such as osteoporosis in women.
Any of these situations can lead to severe backache. Your healthcare provider or best physical therapist can determine the causes or trigger factors behind your pain and help you avoid them in the future.
How Is Dorsalgia Diagnosed?
Back pain is not enough to be diagnosed as dorsalgia, and you cannot determine what may be causing this condition. It is necessary to visit a doctor or a physical therapist who evaluates your symptoms and diagnoses the problem.
Your healthcare provider will begin the diagnosis process with a physical examination. He will ask you to sit, stand, walk and pick your legs up off the floor. You must describe your pain in detail so that the doctor can make an accurate diagnosis. The doctor will ask you about the type of pain you experience and if it is a dull ache, sharp or stabbing pain, or pulsing pain that leaves you unable to move.
The doctor will confirm the diagnosis by asking the following questions:
- When does your back hurt most?
- Does it hurt more when you are standing, sitting, lying down, or bending?
- Is your pain consistent throughout the day, or do you feel it growing at a particular time?
- Do you suffer from any other health conditions?
- Do you have a family history of back problems or spinal issues?
- Did you suffer any injuries, even in childhood, that could affect your back?
- Have you used any home remedies or over-the-counter medications to relieve your pain?
Neurological testing such as EMG is required, especially if your physician suspects a nerve-related cause. The following neurological tests can help to detect dorsalgia:
- Straight leg test – for this test, your doctor will ask you to lie down on your back on an examination table. You will be asked to relax your affected leg. The doctor will then gently lift your leg 30 to 60 degrees. If this causes pain in the back or pain that radiates in the leg, it means your condition has a nerve-related origin.
- Stork test – for this test, you will have to stand on the floor while the doctor examines your lower back. When you are comfortable and ready to balance, the doctor will ask you to lift your knee towards the ceiling.
- Adam’s Forward Bend test – during this test, you will be asked to stand with both feet on the floor then bend forward at the waist. The physician will check for abnormalities or signs of other conditions.
- Imaging: Imaging tests become necessary for diagnosing complex causes of dorsalgia. X-rays, CT scans, and MRIs can help the doctor identify your condition successfully and come up with the best treatment plan.
Combined, physical examinations, neurological tests, and imaging can help in accurately determining the factors behind your pain.
How Is Dorsalgia Treated?
Your healthcare provider will recommend the best treatment for dorsalgia depending on the intensity and severity of your pain. Mild cases of dorsalgia can be treated with conservative therapy that includes physical therapy, home remedies, and medication. If your symptoms are detected in the early stages, it can help to alleviate the pain and prevent further complications with preventative care.
If conservative therapy fails to provide relief, the doctor may recommend slightly more invasive treatments like dry needling or injections to help you. Surgery may become necessary in severe cases.
Physical therapy is the first-line treatment for relieving backache associated with dorsalgia. If your primary care doctor believes your condition is not serious and no underlying medical problem is causing pain, physical therapy will help you get back to your normal activities. It has been observed that in some cases of chronic back pain, physical therapy is more effective than surgery.
Physical therapists see their patients anywhere from once to a few times a week for several weeks or months and recommend the best ways and means to provide relief from pain.
It is essential to select the best physical therapist who is highly trained as well as experienced and offers the best treatment plan to target your specific condition. Supervised exercise therapy can accelerate the recovery process and prevent further injuries and pain.
Over-the-counter medications work well for back pain associated with dorsalgia. The most commonly used over the counter medications include:
- NSAIDs – Non-steroidal anti-inflammatory drugs are usually recommended for backache and acute back pain. They are available over-the-counter and through prescription, and can be taken as pills, capsules, topical creams, and gels. Popular NSAIDs are aspirin, ibuprofen (Motrin, Advil), Naproxen (Aleve), and indomethacin (Indocin). Diclofenac, a prescription NSAID, is often applied in topical form for effectively relieving joint pain.
- Acetaminophen – also called paracetamol, acetaminophen is a pain reliever and fever reducer that can help with dorsalgia. It can keep intense pain at bay and help you remain active. It is important to note that acetaminophen does not have anti-inflammatory properties, and if you suspect your pain is accompanied by inflammation, it may not be the best choice for you. Acetaminophen is present in over-the-counter medications like Tylenol, Excedrin, Benadryl, and Dayquil.
- Muscle relaxants – if over the counter medications like NSAIDs and acetaminophen are unable to control the pain, your doctor may prescribe stronger medications, including muscle relaxants to help you feel better. Cyclobenzaprine is a muscle relaxant that treats neck pain and related muscle spasms effectively. Muscle relaxants have also been shown to provide relief for non-specific back pain, especially acute pain.
You can get the best treatment for dorsalgia, depending on the causes of your pain and its severity. Physical therapy and medications can provide desired relief and manage your condition in case your pain is not resulting from an underlying medical issue.
Alternative treatments for dorsalgia include:
Dry needling can treat pain in the thoracic spine, the spine in the upper back and abdomen. It is often used in sports medicine, and physical therapists perform dry needling to alleviate muscle pain. During this procedure, a small needle is inserted into the trigger point of the muscle which relaxes the muscles and enhances the blood flow in the affected area.
Facet injections of lidocaine or steroid
Facet injections of lidocaine and steroids have shown remarkable therapeutic effects, particularly in the case of acute lumbar back pain. A steroid can relieve pain for months, but you may not feel relief from the pain until several days after the infection. As compared to this, lidocaine acts quickly but only provides respite for a couple of hours.
Talk to your healthcare provider about facet injections of steroids or lidocaine and how they may help you seek relief from the sharp, stabbing pain. Ask about the facet infections they want to use and how would they help. Knowing how many injections you may need and their possible side effects can make the process easy and prepare you for the experience.
Transcutaneous electrical nerve stimulation
TENS is a possible therapy for middle back pain resulting from dorsalgia. TENS units are small, handheld, battery-operated devices that block nerve impulses. They are available over-the-counter, but you must consult your healthcare provider or therapist to get the right type of TENS that is effective for the type of pain you are going through.
Other options include:
- Chiropractic care to alleviate the back pain;
- Acupuncture to relieve low back pain symptoms;
- Massage to ease the back pain;
- Yoga to strengthen muscles and improve posture;
- Heat therapy to reduce the symptoms of acute and subacute low-back pain.
These alternate therapies can help in the treatment or management of dorsalgia without going through invasive procedures.
If no other treatment option works, surgery may be the only way to seek lasting relief from back pain. Your doctor may recommend the following surgical procedures to treat dorsalgia:
- Discectomy – in literal terms, discectomy means cutting out the disc. During this procedure, the surgeon will remove one or more damaged discs to alleviate the pain. The success rate for this surgery is 80 to 90%.
- Disc arthroplasty – it is a relatively new form of spinal surgery that enables surgeons to replace damaged discs with artificial disc implants. Despite its newness, this surgery has delivered positive results so far.
- Spinal fusion – medical and technological developments help surgeons perform spinal fusion surgeries by making small incisions. A spinal fusion removes movement between two or more vertebrae in the spine and fuses them to alleviate the pain.
Surgeries always carry significant risks of complications, and you should discuss their long-term benefits and side effects with your physician and therapist before making a decision.
Risks and Side Effects of Dorsalgia Treatments
Dorsalgia treatment carries the following risks and side effects:
- Long term use of NSAIDs increases the risk of gastrointestinal and cardiovascular problems Acetaminophen has been linked to nausea and potentially liver damage if high doses are taken for an extended period
- Using muscle relaxants for a long time can lead to fatigue and lethargy, as well as blurred vision and dry mouth
- Side effects of dry needling are minor and include bleeding at the site of needle insertion, bruising and fainting
- Facet injections have a low risk of side effects, and the most commonly experienced adverse effects are temporary pain, infection, or negative response to cortisone-like weight gain or water retention
- TENS units are considered safe if they are used according to the provided instructions. Turning the impulse up too high or placing the electrodes on sensitive skin can result in burning or irritation. People with heart problems and implanted devices and pregnant women should not use TENS units without a doctor’s supervision.
- All surgical procedures carry risks of infection and reaction to anesthesia. Discuss the risk of excessive bleeding, blood clotting, bone failing to fuse, and spinal cord injury before going ahead with the surgery.
Knowing the risk factors and side effects of each form of treatment helps you make a wise decision and choose the best option for treating dorsalgia.
Self-Care Tips for Dorsalgia
Self-care and lifestyle changes can help in managing dorsalgia pain. Self-care tips include:
- Light exercise and physical activity to increase strength and endurance in the back and spine;
- Maintaining a healthy weight to keep away back pain;
- Adopting correct posture for sitting to maintain the normal back curve;
- Standing straight to reduce stress on back muscles and nerves;
- Avoid lifting heavy objects that damage the back muscles and nerves.
The main aim of treatment is to achieve optimal relief and get back to normal activities in the least possible time and prevent further pain. You will have to work with your physician and physical therapist to learn about effective pain management.
The back and spinal pain associated with dorsalgia is usually severe and affects your daily life and habits. Treatment varies almost as much as the causes and pain level, and you must seek medical attention to have your symptoms evaluated to detect the underlying reason behind the discomfort. The highly skilled and experienced therapists at the Physical Therapists NYC use state-of-the-art equipment and proven techniques that reduce pain quickly and enable you to return to normal function. They come up with recovery plans after determining the exact causes behind your condition and ensure the best physical therapy outcomes.