What is Dorsalgia? How Should I Treat My Back Pain?

WHAT IS DORSALGIA? 

Chances are, you or someone you know has had lower back pain. Each year 15% of the population has their first episode of low back pain, and over the course of our lives, 80% of us will have lower back pain. Even though back pain is common, the medical community does a poor job managing it. Stories of chronic pain, poor posture, arthritis, opioid use, multiple surgeries, severe pain, and a lifetime of disability are far too common.

Let’s look at some of the common treatments for low back pain and see how they stack up against physical therapy:

MEDICATION

Low back pain is the #1 reason for opioid prescription in the US, however, in 2106 the CDC recommended against the use of opioids for pain relief in favor of “non-drug treatment like physical therapy.”

IMAGING

Having an X-ray or MRI for back pain is common, however, it’s rarely needed or helpful. Research has NEVER demonstrated a link between imaging and symptoms. As we age, degenerative changes in imaging are common.

• 90% of people aged 50 to 55 have disc degeneration when imaged, whether they have symptoms or not
• In 2015 a study that looked at 1,211 MRI scans of people with no pain found that 87.6% had a disc bulge.
• Just getting an image increases the chances that you’ll have surgical treatment by 34%.

SURGERY

The US has sky-high rates for dorsalgia surgeries – 40% higher than any other country and 5x higher than the UK. You’d think that with all the back surgeries we do, we’d be pretty good at it but the outcomes are terrible! A patient (worker’s comp) study looked at 725 people who had spinal fusions VS 725 people who didn’t. The surgical group had:

• A 1 in 4 chance of a repeat surgery
• A 1 in 3 chance of a major complication
• A 1 in 3 chance of never returning to work again

Physical Therapy

• Current clinical practice guidelines support manual therapy and exercise.
• Research proves that early PT leads to better outcomes with lower costs, and decreases the risk of surgery, unnecessary imaging, and use of opioids.
• A study of 122,723 people with low back pain who started PT within 14 days found that it decreased the cost to treat back pain by 60%
• Unfortunately, only 2% of people with back pain signals start with PT, and only 7% get to PT within 90 days.

Despite the data showing that conservative therapy, PT is the most effective, safest, and lowest cost option to treat low back pain, most people take far too long to get there. Almost every state has direct access, meaning that you can go directly to a physical therapist without a doctor’s referral. If you see your doctor for neck or back pain, and PT isn’t one of the first treatment options, ask for it! A Physical Therapist is a specialist trained to be able to assess your lower back and neck pain and refer out to an MD or request imaging if appropriate, so often you may save time and money by seeing your PT first!

The different types of Dorsalgia:

Simply termed, dorsalgia is severe pain in the back. It takes root from two words: “Dorsal” which means back, and “algia” which means pain. However, dorsalgia is more than just simple back pain. If we talk in specific terms, the pain involved in dorsalgia comes from the spine. Accordingly, the section of the spine that is responsible for the pain makes for a particular type of dorsalgia.

In all, there are six known types of dorsalgia. These are listed here:

1. Cervical dorsalgia

Sometimes, cervical dorsalgia is also medically termed as cervicalgia. In this type, the cervical spine is involved. The pain you feel is in the neck region and occurs due to some injury or otherwise as a result of degeneration of the cervical spine.

2. Cervicothoracic dorsalgia

As is evident in the term, this type of dorsalgia involves cervical and thoracic regions of the spine. The cervical spine is the uppermost part of the vertebral column that exists in the neck region. Whereas the thoracic spine is the second portion of the vertebral column. It is located between the cervical spine and lumbar spine. Hence, the pain in cervicothoracic dorsalgia comes from both of these portions.

3. Thoracic dorsalgia

As compared to cervicothoracic dorsalgia, this type of back pain comes from only the thoracic vertebral segments. Typically, this type of dorsalgia is a rare occurrence.

4. Thoracolumbar dorsalgia

Thoracolumbar dorsalgia involves both the thoracic and lumbar spine. Usually, this type involves both upper and lower back pain.

5. Lumbar dorsalgia

The lumbar spine is located where the thoracic spine ends and continues down to where the sacral spine starts. As this part of the back is the most used of all in our daily movements, lumbar dorsalgia is more common among patients with this disease.

6. Lumbosacral dorsalgia

This type involves back pain that roots from both the lumbar and sacral spine.

Symptoms of Dorsalgia

Varying between the six types, the symptoms of this disease are usually common across patients. You may feel a sharp or stinging pain in your back or only your neck. This pain also carries a burning sensation. You may have difficulty changing your position like climbing the stairs or rising from a chair or bed. In addition to that, there will also be pain or difficulty while bending down.

Overall, a change of posture is painful for patients with dorsalgia. In some cases where nerves are compromised due to a bulge of spinal discs, the symptoms usually also include numbness in the upper and lower extremities. Sometimes, a stinging sensation is also experienced. Both of these problems make it difficult for the patient to carry out everyday activities with ease.

Treatment for Dorsalgia

Nonsurgical Treatments

When surgery is not involved, treatment of dorsalgia is mainly relied on with pain relief medications along with physical therapy.