What is Dorsalgia?
Dorsalgia is a medical term referring to back pain, specifically pain localized to the spine, which can occur in any region of the vertebral column including the cervical (neck), thoracic (mid-back), or lumbar (lower back) areas. 1
Clinical Definition and Scope
- Dorsalgia represents one of the most common skeletal muscle syndromes encountered in clinical practice 1
- The term encompasses both axial spine pain (pain localized to the midline of the spine) and radicular pain (pain that radiates distally, typically due to nerve root irritation) 2
- When pain persists for three months or longer and occurs on at least half of the days in the past six months, it is classified as chronic spine pain 2
Types of Back Pain Within Dorsalgia
The condition can manifest as several distinct pain patterns:
- Non-specific (musculoskeletal) pain: Approximately 85% of patients present with non-specific pain that cannot be attributed to a specific identifiable cause 2
- Radiculopathy: Pain caused by nerve root compression or irritation, such as sciatica (pain radiating down the leg below the knee in the sciatic nerve distribution) 2, 3
- Pain associated with potentially dangerous diseases: Including cancer, infection, or inflammatory arthropathy 2
Pain Mechanisms
Dorsalgia involves multiple pathophysiological components:
- Nociceptive pain: Arising from stimulation of pain receptors in spinal structures such as the intervertebral disc, facet joints, ligaments, and muscles 4, 5
- Neuropathic pain: Resulting from nerve damage or dysfunction, often due to disc herniation affecting nerve roots or the dorsal root ganglion 4
- Psychogenic components: Psychological factors that can modulate pain perception and contribute to chronicity 4, 5
Epidemiological Impact
- The global prevalence of chronic low back pain ranges from 4% in adults aged 24-39 years to 20% in adults aged 20-59 years, with higher rates in older populations 2
- Chronic low back pain is the leading cause of disability worldwide 2
- Neck pain (another form of dorsalgia) ranks as the third leading cause of years lived with disability 2
Clinical Considerations
- Dorsalgia frequently develops in older patients with multiple comorbidities (polymorbidity), which complicates treatment selection due to polypharmacy concerns 1
- Advanced imaging often reveals incidental findings with low correlation between radiological pathology and clinical symptoms 2
- The condition requires careful differential diagnosis to exclude serious underlying pathology such as vertebral osteochondrosis (Scheuermann's disease), spondylodiscitis, spinal tumors, or vertebral fractures 6