When back pain is not just the spine
Back pain can be the first sign of an infection, a malignant disease, a fracture, an inflammatory disease or a disease of the internal organs. That is why, before rehabilitation, the doctor looks for warning signs:
problems passing urine or stool and numbness in the perineum, groin and inner thighs, which point to cauda equina syndrome
progressive weakness in the legs or arms
fever, night sweats or unexplained weight loss
night pain that does not ease with rest
a history of malignant disease, immunosuppression or long-term corticosteroid treatment
onset of pain before the age of 20 or after 55 without a clear cause
Depending on the findings, the doctor refers you for urgent investigation, imaging or to another specialist if needed. The causes ruled out include spondylodiscitis, epidural abscess, tuberculous and brucellar spondylitis, metastases, multiple myeloma, osteoid osteoma and spinal cord tumours.
Herpes zoster
Reactivation of the varicella-zoster virus in the dorsal root ganglia, most often in the thoracic dermatomes. Dermatomal pain may precede the rash by several days, so it is mistaken for radiculopathy, a fracture or visceral pain. Antiviral treatment should be started within 72 hours of the rash appearing, and postherpetic neuralgia is treated with medication for neuropathic pain and blocks.
Vertebral haemangioma
The most common benign tumour of the spine, present in a significant proportion of adults, usually as an incidental finding on MRI. Based on its imaging features, the doctor distinguishes it from metastasis and multiple myeloma. A typical haemangioma is not a contraindication to rehabilitation, while the aggressive form is referred for vertebroplasty, radiotherapy or surgery.
Appointments
An examination by a physiatrist does not require a referral. Please bring all your test results, scans and discharge letters to your first appointment.
Phone: 01 3737 333 · Mobile: 099 3737 333 · Email: info@faktorzdravlje.com
Faktor Zdravlje Polyclinic, Domobranska 25, Zagreb. We are open Monday to Friday from 8 am to 8 pm and on Saturdays from 9 am to 1 pm.
