Spine

The spine supports the whole body and consists of 33–34 vertebrae (segments), divided into 7 neck (cervical), 12 chest (thoracic), 5 lower back (lumbar), 5 sacral and 4–5 tailbone (coccygeal) vertebrae. The number of vertebrae can sometimes vary because of developmental anomalies.

The structures that make up the spine, as well as all the surrounding structures, can cause complaints, so a careful examination by a specialist physiatrist is always needed. We also recommend bringing all your previous test results, so that the correct diagnosis can be made and successful treatment started as quickly as possible. Complaints can be vertebral (localised to the spine) and/or vertebrogenic (a problem with the spine causes pain and/or tingling in distant parts of the body). Besides pain, other phenomena – such as weakness and altered sensation, and changes in reflexes and in diagnostic provocation tests – help the physiatrist to assess the level of the lesion, i.e. the source of the complaints.

What the examination reveals is confirmed with diagnostic tests: X-rays, magnetic resonance imaging (MRI), computed tomography (CT), isotope bone scintigraphy, electrophysiological methods (electromyography with nerve conduction studies) and somatosensory evoked potentials, as well as laboratory tests with which we detect or monitor bone metabolism, inflammation, infections, malignant changes and more. The diagnostic work-up can also include genetic tests and histocompatibility antigen tests (HLA typing). We also monitor changes in other organs and organ systems that can have repercussions for the spine, such as the skin (psoriasis), the digestive system (inflammatory bowel disease – ulcerative colitis and Crohn's disease), the urinary system (chlamydia, mycoplasma and ureaplasma infections) and the respiratory system (infections and inflammation – COPD, asthma).

Our advice is to be patient and not to try various unproven treatments, which can only harm you, before you have been examined by a doctor. Regular exercise is essential. Most people have some kind of pain or discomfort, but if your pain has lasted for a long time, wakes you up at night, or causes weakness or changes in sensation, or if you have problems with other organs and organ systems, it is high time to see your doctor.

All segments of the spine, as well as the surrounding structures, can be a source of pain – from bones, joints (facet syndrome), ligaments (ligamenta flava), discs, nerve structures (the spinal cord, nerves and plexuses) and blood vessels to fasciae and muscles. Remember that changes in the pancreas or stomach, as well as diseases of other organs such as infections, tumours, aneurysms and many others, can cause pain, or a subjective feeling of pain, in the spine.