Damage and subsequent pain of the vertebrae and spine, along with other related problems, are collectively referred to as vertebrogenic algic syndrome. The common denominator is pain, which can radiate throughout the back from the neck, through the chest, torso, all the way to the lower back and sacrum.
Pain can also be accompanied by shooting sensations in other parts of the body.
Headaches, pain in the upper and lower limbs, or even in the front of the chest, may also occur, and it can even appear to be cardiac distress. This condition can affect 80 to 90 percent of the population, and everyone will encounter it at least once in their lifetime.
Cause of origin
The vertebrogenic algic syndrome (VAS) is a back pain caused by pathological processes in the spine. The main cause of VAS is the degeneration of intervertebral discs in the spine, which can lead to a narrowing of the space for the spinal cord and nerve roots in the spine. This narrowing can cause pain that is characterized as sharp and stabbing.
In addition to degenerative changes in the spine, VAS can also be caused by spinal injuries, infections, inflammations, tumors, or disorders of blood supply to the spine. Risk factors that may contribute to the development of VAS include a sedentary lifestyle, smoking, obesity, stress, as well as age and genetic factors.
VAS can occur in both younger and older individuals. Among the functional causes of VAS are faulty posture, unilateral overload of the spine, which occurs during work or even sleep in one position. Similarly, sedentary work is also mentioned, where we can sit incorrectly and overload the spine by sitting for long periods.
On the other hand, heavy physical work, lifting heavy loads, can also be a cause. Another cause is cooling of the back, when we are exposed to drafts at work, get caught in a gust of wind, or are constantly exposed to air conditioning.
Degenerative diseases
The causes are degenerative diseases caused by various circumstances. They can occur as a result of aging or genetics. Chronic negative impact results in pathological conditions such as osteochondrosis, i.e. degenerative changes of intervertebral discs, spondyloarthrosis, which primarily affects intervertebral joints, spondylosis, where there is a degenerative process affecting the entire segment, or spinal stenosis, which is a narrowing of the spinal canal.
The problem also involves the protrusion of intervertebral disc or herniated disc. It is a pathological process in which the disc protrudes out of its normal position. It can take several forms, such as bulging, protrusion, extrusion, and sequestration. Similarly, root syndrome, which is caused by a different disease than a herniated disc, the formation of osteophytes in spondylosis, or spinal stenosis can also be involved.
Congenital defects
Among congenital defects are scoliosis, spondylolisthesis, varying numbers of vertebrae (lumbarization of S1 – where S1 is then the last lumbar vertebra, sacralization of L5 – when L5 is part of the sacrum). An example is also spina bifida, a cleft spine. Osteomyelitis or spondylodiscitis also belongs here. It is an inflammatory condition affecting the vertebra and the disc.
Patients with osteoporosis also experience vertebral algic syndrome, which is characterized by pain originating from the spine. It is caused by the thinning of bone tissue, which is known as osteoporosis. Menopause and hormonal changes that occur during this period can cause it in women.
It can also be caused by kidney disease, digestive or endocrine system disorders, as well as rheumatic diseases. In these cases, bones, joints, cartilage, and other soft tissues are damaged. Arthritis is a joint disease, so it also affects the spine. Joint inflammation has various forms, including rheumatoid arthritis.
By duration
The vertebralgenic pain syndrome is also recognized by patients with osteoporosis, which is known for the thinning of bone tissue. It can be caused by menopause and hormonal changes that occur during this period in women.
The cause can also be kidney, digestive or endocrine system diseases, as well as rheumatic diseases, which affect the bones, joints, cartilage and other soft tissues. Arthritis is a joint disease that can also affect the spine. Joint inflammation has various forms, one of which is rheumatoid arthritis.
It can occur as an acute or chronic form and can have a significant impact on a person’s psyche. In most cases, the acute form subsides within four weeks, but in 10 to 40 percent of cases, it progresses to chronic difficulties.
According to the duration of the pain, we distinguish between acute, subacute, and chronic pain. Acute pain persists for about one month, subacute pain lasts about three months, and chronic pain lasts more than three months and in some cases, even a lifetime.
Spine and its devision
The spine can also be divided based on its localization. Pain can concentrate only in the cervical spine in 30 percent of cases, in the thoracic spine in 10 percent, and in the lumbar spine in 60 percent of cases. In some cases, a polytopic form appears when the pain affects several sections of the spine.
The spine – columna vertebralis – consists of vertebrae, intervertebral joints, ligaments, intervertebral discs, and spinal muscles. The vertebrae are designated by sections:
- cervical – 7 vertebrae, vertebrae Cervicales C1 to C7,
- thoracic – 12 vertebrae, vertebrae Thoracicae Th1 to Th12,
- lumbar – 5 vertebrae, vertebrae Lumbales L1 to L5,
- sacral – 5 or 6 vertebrae, vertebrae Sacrales S1 to S5 (S6),
- together they form the os sacrum – the sacrum,
- coccyx – 4 or 5 vertebrae vertebrae Coccygeae Co1 – Co4 (Co5).
Intervertebral discs, which serve as shock absorbers and enable movement of the spine, are located between individual vertebrae. Muscles around the vertebrae provide stability and movement of the spine.
Effects of aging
The spine is a support system for the body, carrying its weight, enduring static and dynamic loads, participating in movement, balance, and stabilization, as well as protecting the spinal cord and spinal nerves. The spine must withstand everyday activities, and in addition, is affected by the aging process.
Degenerative changes in vertebrae, joints, discs, muscle loss, loss of ligament elasticity, and bone demineralization, as in osteoporosis, are examples of this.
With age, the number of blood vessels decreases and disappears, resulting in worsened nourishment of the intervertebral discs. A significant negative factor in reduced disc nourishment is also a lack of movement or inactivity, resulting in a decrease in water content in the disc.
After birth, the core contains up to 90 percent water, but by the age of 50, it decreases to approximately 70 percent, leading to disc fibrosis and disruption of the annulus. A complication of this condition is the protrusion of the nucleus from the disc, which can cause compression of the spinal cord or nerve roots.
Can it be prevented?
It cannot be clearly stated. Likewise, the impact of height or weight on this problem cannot be discussed. Of course, obesity has been confirmed to be associated with radicular pain. However, it can be stated that some sports have a positive effect on the spine, such as endurance running. Conversely, elite swimming or cross-country skiing is not suitable and is, in fact, risky for spinal degeneration.
Regular exercise, at least walking or stretching every hour while sitting in a sedentary job, can certainly help. On the other hand, in heavy physical work, taking breaks and regularly visiting a physiotherapist can help correct deviations.
In both cases, it helps to use quality work tools adapted to our comfort and correct posture. It is also necessary to maintain hydration, consume quality food, and minimize unhealthy habits such as smoking and alcohol consumption.
Diagnosis and examinations
A very important step in the occurrence of VAS is diagnosis. The doctor needs to know the location, spread, character, intensity, and time horizon of the pain. The spine can be evaluated visually and by touch. The use of imaging methods such as X-ray, CT, MRI, PMG perimyelography, contrast examination of the spine, spinal cord, or EMG – electromyography – which evaluates muscles, is not uncommon. Laboratory blood and cerebrospinal fluid testing can also be used.
Simple functional blocks can also be detected by a general practitioner. More serious conditions require more complex neurological examinations, which can be supplemented as needed.
Doctors from multiple disciplines may be involved in diagnosis, such as general practitioners for adults or children, neurologists, orthopedists, rheumatologists, neurosurgeons, radiologists, physiotherapists, and potentially psychologists and psychiatrists. Differential diagnosis is important, and specialists from internal medicine, cardiology, and surgery may also be involved.
