How to determine that a person has neuralgia of the back: distinctive signs and differential diagnosis


What is neuralgia of the back?

Neuralgia (from the Latin. Neur – nerve and -algia – pain) – painful sensations in one or another area of ​​the body, associated with nerve damage by the pathological process. At the same time, the lesion may be inflammatory, mechanical or other. Neuralgia of the back can develop in a number of diseases of various etiologies.

It is important not to confuse the term “neuralgia” with “dorsalgia”. The first applies only to the pathology of the peripheral , while the second includes a wider range of diseases.

Thus, spinal neuralgia is most often associated with disorders in the musculoskeletal system, whereas the intercostal nerves are more often affected by various infectious and inflammatory processes. In all cases, pain syndrome is accompanied by a decrease in range of motion, which allows us to distinguish neuralgia from radiating pain, for example, in urolithiasis.

The causes of the development of pathology in the back area

The back area is divided into the thoracic and lumbar regions. Depending on the location of the diseased site, the causes of the development of neuralgia can be quite diverse. The very nature of pain, their duration, associated symptoms, circumstances of occurrence also help differentiate the causes of the development of pathology.

Diseases of internal organs

The cause of pain in the thoracic back quite often can be:

  • Pleurisy. of the pleura is almost always accompanied by pain along the intercostal spaces. In this case, the discomfort is aggravated during inhalation or exhalation.
  • Coronary heart disease. An attack of angina pectoris, myocardial infarction, especially with an atypical course, can often manifest themselves as painful sensations in the area of ​​the shoulder blades, between them. Such a course of pathology can serve as a reason for referring to a neuropathologist, a traumatologist, while the heart will remain without attention. In this situation, the pain is irradiating in nature – the proximity of the pathways in the central nervous system leads to a distorted perception of the localization of pain.
  • Diseases of the esophagus. Damage to the esophagus, the development of tumors quite often manifests itself by the appearance of pain in the back just below the shoulder blades. Sensations dramatically increased after swallowing.

Symptoms of neuralgia of the lumbar spine can occur against the background of pains radiating to the nature of pancreatitis or pathology of the kidneys.

Diseases of the musculoskeletal system

In almost half of the cases, intervertebral neuralgia is associated with the development of a herniated disc, osteochondrosis, or scoliosis. Her most famous example is radiculitis, a pathology in which the roots of the spinal nerves are compressed, which leads to the development of a pronounced pain syndrome. This disorder can develop as a result of the formation of intervertebral hernias, disc protrusion, various injuries, and impaired posture.

The consequences of injuries very often lead to the development of neuralgia of the lumbosacral spine. This is due to the fact that the spinal nerves in the lower spine are more prone to strangulation.

How to determine that a person has neuralgia of the back: distinctive signs and differential diagnosis

Diseases of the nervous system

Shingles caused by the varicella zoster virus is always accompanied by severe burning and pain in the torso, on the back. A feature of its symptoms is the predominant lesion of the intercostal nerves and the development of inflammatory processes on the skin, accompanied by a small blistering rash. This disease directly affects the ganglia, where the virus settles for a very long period of time. Herpes zoster is prone to relapses due to reduced immunity.

Sometimes idiopathic, not specifically associated neuralgia of the back occurs. Often it is the result of trauma or neuritis suffered in the past.

Main symptoms

The main symptoms of neuralgia include:

  • Pain along the nerve or in a separate part of the back.
  • Disturbance of the normal functioning of the muscles of the back.
  • The absence of significant changes in sensations when changing the position of the body.

The presence of serious pathology may indicate:

  • The progression of symptoms.
  • The development of fever.
  • The lack of effect of ongoing analgesic therapy.

Diagnostic methods

By itself, neuralgia of the back is almost never a definitive diagnosis. It is established temporarily, until the root cause of its development is identified. To clarify the causes of the disease can resort to the following methods:

  • General blood analysis. Allows you to find out the nature of the pathological process (infectious, non-infectious).
  • Radiography of the chest, lumbar spine. Allows you to identify as a pathology of the spine itself, and all sorts of lung diseases.
  • MRI Conducted for accurate and targeted diagnosis of diseases of the spine. Shows highly informative in tumors and their metastases.
  • ECG and ultrasound are used exclusively to detect abnormalities in the heart or abdominal organs, respectively.

Principles of treatment

The treatment of neuralgia of the back is based on the effect on the underlying cause of the disease. Because of this, the tactics of actions taken can be extremely diverse.

If an intervertebral hernia is detected, surgical intervention with its removal or even complete replacement of the disc is indicated. All kinds of injuries that led to the emergence of long-term neuralgia require orthopedic correction in the form of surgery or conservative therapy, including a complex of physical therapy, the use of corsets. For symptomatic treatment, Analgin or can be taken. It should be remembered that the latter can lead to the development of gastric ulcer.

Treatment of neuralgia of the back with shingles is the appointment of antiviral drugs, conducting anti-inflammatory therapy. Antiherpetic drugs that are applied to the affected area as an ointment are quite good. Removal of the inflammatory process occurs due to the intake of Paracetamol, Nimesulide or .

You can also topically apply anesthetics and anti-inflammatory ointments containing Ketorolac, Diclofenac, Nimesulide, menthol, bee venom.


Completely eliminate the risk of neuralgia is impossible. However, if you avoid injury, excessive physical exertion, hypothermia, back pain may never bother. This is especially important for people who have already suffered at least once from neuralgia in the back.

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