Some indicators of the state of the autonomic nervous system in neurological manifestations of lumbar spine osteochondrosis

Abstract

Introduction. Back pain is a major health problem worldwide, as 84% of the adult population of any country experience it during their lifetime. Some studies have shown the presence of autonomic nervous system dysfunction in chronic back pain. However, research on this topic is still limited.The purpose of the study: to investigate the functional state of the autonomic nervous system in patients with neurological manifestations of lumbar spine osteochondrosis using clinical methods of assessing the autonomic sphere available to the doctor, which may have practical significance for further optimization of back pain treatment.Methodology/Methods. 104 male patients with neurological manifestations of lumbar spine osteochondrosis (mean age 34.05±5.7) without signs of obesity and somatic and vascular pathology and 25 practically healthy individuals (mean age 35.04±3.6) were examined.Among the examined patients, there were 50 patients with radiculopathies against the background of intervertebral disc hernias, verified by neuroimaging, and 54 patients with reflex manifestations of lumbar spine osteochondrosis.Standard clinical methods of examining the state of the autonomic nervous system were used to determine autonomic tone, autonomic reactivity, and autonomic support of activity.Results and Discussion. Clinically, 100% of the examined patients had myofascial disorders against the background of classic reflex muscle-tone syndromes. A statistically significant predominance of sympathotonic-directed baseline tone was found in the group of patients with root disorders compared to patients with reflex syndromes of lumbar osteochondrosis, which correlated with a significantly higher pain index according to VAS in this group of patients.Autonomic reactivity indicators during the cold test in the patient group were significantly higher compared to the control group and higher when cold irritation was applied on the side of the pain syndrome (sciatica).Conclusions. The conducted study shows the presence of the influence of lower back pain on the state of the autonomic nervous system depending on the type of neurological manifestations – radicular dysfunction or reflex changes. There is a need for further high-quality studies using instrumental methods to examine various links of the autonomic nervous system. After all, the effectiveness of treatment and the likelihood of complications, both in the course of the disease and possible side effects when using medicinal and non-medicinal methods of treatment, depend on the state of the autonomic nervous system.