What are dermatomes and how do they relate to spinal nerves. How many dermatomes are there in the human body. Which areas of the body do specific dermatomes cover. Why are dermatomes important for medical diagnosis.

The Fundamentals of Dermatomes and Spinal Nerves

Dermatomes play a crucial role in our nervous system, acting as sensory highways that connect specific areas of skin to the central nervous system. But what exactly is a dermatome? A dermatome is an area of skin that receives sensory innervation from a single spinal nerve. This intricate network of nerves and skin regions forms the basis of our body’s ability to perceive and respond to various stimuli.

The human body possesses 31 pairs of spinal nerves, each forming nerve roots that branch out from the spinal cord. These spinal nerves are essential in relaying sensory, motor, and autonomic information between the body and the central nervous system (CNS). Understanding the distribution and function of these nerves is crucial for medical professionals and researchers alike.

The Spinal Nerve System: A Closer Look

Spinal nerves are a fundamental component of the peripheral nervous system (PNS), which serves as a communication network between the body and the CNS. The 31 pairs of spinal nerves are categorized into five distinct groups based on their origin along the spine:

• Cervical nerves (C1-C8): 8 pairs originating from the neck
• Thoracic nerves (T1-T12): 12 pairs emerging from the torso region
• Lumbar nerves (L1-L5): 5 pairs branching from the lower back
• Sacral nerves (S1-S5): 5 pairs associated with the sacrum in the pelvis
• Coccygeal nerves: A single pair originating from the coccyx (tailbone)

This systematic organization of spinal nerves allows for precise mapping of sensory information throughout the body, contributing to the complex network of dermatomes.

Mapping the Body: Dermatome Distribution and Patterns

The human body contains 30 dermatomes, each corresponding to a specific spinal nerve. Interestingly, this number is one less than the total count of spinal nerves. Why is this the case? The C1 spinal nerve typically lacks a sensory root, which is why dermatomes begin with the C2 spinal nerve.

Dermatomes exhibit a segmented distribution across the body, with patterns that can vary slightly from person to person. Some overlap between neighboring dermatomes is common, creating a complex tapestry of sensory regions. The distribution of dermatomes follows distinct patterns depending on the body area:

• Torso and core: Dermatomes are distributed horizontally, appearing as stacked discs when viewed on a body map
• Limbs: Dermatomes run vertically along the long axis of the arms and legs

Dermatome Mapping: From Head to Toe

Understanding the specific areas covered by each dermatome is essential for medical diagnosis and treatment. Here’s a general overview of dermatome distribution throughout the body:

Cervical Dermatomes (C2-C8)

• C2: Lower jaw and back of the head
• C3: Upper neck and back of the head
• C4: Lower neck and upper shoulders
• C5: Collarbone area and upper shoulders
• C6: Shoulders, outside of arm, and thumb
• C7: Upper back, back of arm, pointer and middle fingers
• C8: Upper back, inside of arm, ring and little fingers

Thoracic Dermatomes (T1-T12)

• T1: Upper chest, back, armpit, and front of arm
• T2-T4: Upper chest and back
• T5-T7: Mid-chest and back
• T8-T9: Upper abdomen and mid-back
• T10: Abdomen (around navel) and mid-back
• T11-T12: Lower abdomen and mid-back

Lumbar Dermatomes (L1-L5)

• L1: Lower back, hips, and groin
• L2-L3: Lower back, front and inside of thigh
• L4: Lower back, front of thigh and calf, knee area, inside of ankle
• L5: Lower back, front and outside of calf, top and bottom of foot, first four toes

Sacral Dermatomes (S1-S5)

• S1: Lower back, back of thigh, back and inside of calf, last toe
• S2-S3: Buttocks and genitals
• S4-S5: Buttocks

Coccygeal Dermatome

The single coccygeal dermatome covers the buttocks and the area around the tailbone.

The Clinical Significance of Dermatomes in Medical Diagnosis

Dermatomes serve as valuable diagnostic tools in various medical contexts. How do healthcare professionals utilize dermatome knowledge in clinical practice? By understanding the relationship between specific skin areas and their corresponding spinal nerves, medical practitioners can more accurately assess and diagnose certain conditions.

One of the primary applications of dermatome knowledge is in the diagnosis of radiculopathies. These conditions occur when a nerve root in the spine is compressed or pinched, leading to symptoms such as pain, weakness, and tingling sensations. The pattern of these symptoms often follows one or more specific dermatomes, providing crucial information about the affected nerve root.

Common Conditions Diagnosed Using Dermatome Knowledge

• Herniated discs: Pressure on spinal nerves can cause pain along specific dermatomes
• Shingles: This viral infection often manifests as a painful rash following dermatome patterns
• Spinal cord injuries: The extent and level of injury can be assessed by examining affected dermatomes
• Peripheral neuropathy: Damage to specific nerves may result in sensory changes within corresponding dermatomes

By carefully mapping symptoms to specific dermatomes, healthcare providers can pinpoint the source of various neurological issues, leading to more accurate diagnoses and targeted treatment plans.

Advanced Dermatome Concepts: Overlap and Variation

While dermatome maps provide a general guide for understanding sensory distribution, it’s important to recognize that some degree of variation and overlap exists. How does this variability impact clinical assessments? The answer lies in the complex nature of our nervous system and individual anatomical differences.

Factors Contributing to Dermatome Variability

• Individual anatomical differences
• Developmental variations in nerve growth
• Overlap in nerve innervation between adjacent dermatomes
• Presence of communicating branches between spinal nerves

This variability underscores the importance of comprehensive clinical examinations and the use of multiple diagnostic tools when assessing neurological conditions. Healthcare professionals must consider these factors when interpreting dermatome-related symptoms and findings.

Dermatomes and Pain Management: Implications for Treatment

Understanding dermatome distribution plays a crucial role in pain management strategies. How do healthcare providers utilize this knowledge to alleviate patient discomfort? By identifying the specific dermatomes involved in a patient’s pain experience, medical professionals can tailor their treatment approaches more effectively.

Dermatome-Based Pain Management Techniques

• Targeted nerve blocks: Injecting anesthetic agents near specific spinal nerves
• Spinal cord stimulation: Placing electrodes along the spine to modulate pain signals
• Topical treatments: Applying medications to specific dermatome areas for localized relief
• Physical therapy: Designing exercises to address muscles and joints within affected dermatomes

By leveraging dermatome knowledge, pain management specialists can develop more precise and effective treatment plans, potentially reducing the need for systemic medications and their associated side effects.

The Future of Dermatome Research: Emerging Technologies and Applications

As our understanding of the nervous system continues to evolve, so too does the field of dermatome research. What new developments are on the horizon for this crucial area of study? Emerging technologies and research methodologies are opening up exciting possibilities for more accurate dermatome mapping and clinical applications.

Cutting-Edge Dermatome Research Areas

• High-resolution imaging techniques for more precise dermatome mapping
• Artificial intelligence algorithms for analyzing dermatome patterns and variations
• Gene therapy approaches targeting specific dermatome-associated nerves
• Advanced sensory testing methods for more accurate clinical assessments

These advancements promise to enhance our ability to diagnose and treat neurological conditions, potentially leading to more personalized and effective medical interventions.

Dermatomes in Everyday Life: Beyond Medical Applications

While dermatomes are primarily studied in medical contexts, their influence extends into various aspects of our daily lives. How do dermatomes impact our sensory experiences and interactions with the world around us? Understanding this connection can provide fascinating insights into human physiology and behavior.

Dermatome Influences in Daily Activities

• Touch sensitivity: Variations in dermatome innervation affect how we perceive different textures and sensations
• Temperature perception: Dermatome distribution influences how we experience hot and cold stimuli across our body
• Clothing comfort: The way fabrics interact with different dermatomes can affect overall comfort and sensitivity
• Massage therapy: Understanding dermatome patterns can enhance the effectiveness of massage techniques

By recognizing the role of dermatomes in our everyday sensory experiences, we can gain a deeper appreciation for the intricate design of our nervous system and its impact on our quality of life.

Dermatomes Diagram: Spinal Nerves and Locations

A dermatome is an area of skin supplied by a single spinal nerve. There are 31 pairs of spinal nerves, forming nerve roots that branch from your spinal cord.

Your spinal nerves help to relay sensory, motor, and autonomic information between the rest of your body and your central nervous system (CNS).

So why are dermatomes important? How many are there? And where can they be found? Continue reading as we answer these questions and more.

Each of your dermatomes is supplied by a single spinal nerve. Let’s take a closer look at both of these components of the body.

Your spinal nerves

Spinal nerves are part of your peripheral nervous system (PNS). Your PNS works to connect the rest of your body with your CNS, which is made up of your brain and spinal cord.

You have 31 pairs of spinal nerves. They form nerve roots that branch from your spinal cord. Spinal nerves are named and grouped by the region of the spine that they’re associated with.

The five groups of spinal nerves are:

• Cervical nerves. There are eight pairs of these cervical nerves, numbered C1 through C8. They originate from your neck.
• Thoracic nerves. You have 12 pairs of thoracic nerves that are numbered T1 through T12. They originate in the part of your spine that makes up your torso.
• Lumbar nerves. There are five pairs of lumbar spinal nerves, designated L1 through L5. They come from the part of your spine that makes up your lower back.
• Sacral nerves. Like the lumbar spinal nerves, you also have five pairs of sacral spinal nerves. They’re associated with your sacrum, which is one of the bones found in your pelvis.
• Coccygeal nerves. You only have a single pair of coccygeal spinal nerves. This pair of nerves originates from the area of your coccyx, or tailbone.

Your dermatomes

Each of your dermatomes is associated with a single spinal nerve. These nerves transmit sensations, such as pain, from a specific area of your skin to your CNS.

Your body has 30 dermatomes. You may have noticed that this is one less than the number of spinal nerves. This is because the C1 spinal nerve typically doesn’t have a sensory root. As a result, dermatomes begin with spinal nerve C2.

Dermatomes have a segmented distribution throughout your body. The exact dermatome pattern can actually vary from person to person. Some overlap between neighboring dermatomes may also occur.

Because your spinal nerves exit your spine laterally, dermatomes associated with your torso and core are distributed horizontally. When viewed on a body map, they appear very much like stacked discs.

The dermatome pattern in the limbs is slightly different. This is due to the shape of the limbs as compared with the rest of the body. In general, dermatomes associated with your limbs run vertically along the long axis of the limbs, such as down your leg.

Your dermatomes are numbered based on which spinal nerve they correspond to. Below, we’ll outline each dermatome and the area of the body that it’s associated with.

Remember that the exact area that a dermatome may cover can vary by individual. Some overlap is also possible. As such, consider the outline below to be a general guide.

Cervical spinal nerves

• C2: lower jaw, back of the head
• C3: upper neck, back of the head
• C4: lower neck, upper shoulders
• C5: area of the collarbones, upper shoulders
• C6: shoulders, outside of arm, thumb
• C7: upper back, back of arm, pointer and middle finger
• C8: upper back, inside of arm, ring and little finger

Thoracic spinal nerves

• T1: upper chest and back, armpit, front of arm
• T2: upper chest and back
• T3: upper chest and back
• T4: upper chest (area of nipples) and back
• T5: mid-chest and back
• T6: mid-chest and back
• T7: mid-chest and back
• T8: upper abdomen and mid-back
• T9: upper abdomen and mid-back
• T10: abdomen (area of belly button) and mid-back
• T11: abdomen and mid-back
• T12: lower abdomen and mid-back

Lumbar spinal nerves

• L1: lower back, hips, groin
• L2: lower back, front and inside of thigh
• L3: lower back, front and inside of thigh
• L4: lower back, front of thigh and calf, area of knee, inside of ankle
• L5: lower back, front and outside of calf, top and bottom of foot, first four toes

Sacral spinal nerves

• S1: lower back, back of thigh, back and inside of calf, last toe
• S2: buttocks, genitals, back of thigh and calf
• S3: buttocks, genitals
• S4: buttocks
• S5: buttocks

Coccygeal spinal nerves

buttocks, area of tailbone

Dermatomes are important because they can help to assess and diagnose a variety of conditions. For instance, symptoms that occur along a specific dermatome may indicate a problem with a specific nerve root in the spine.

Examples of this include:

• Radiculopathies. This refers to conditions in which a nerve root in the spine is compressed or pinched. Symptoms can include pain, weakness, and tingling sensations. Pain from radiculopathies can follow one or more dermatomes. One form of a radiculopathy is sciatica.
• Shingles. Shingles is a reactivation of the varicella zoster (chickenpox) virus that lies dormant in the nerve roots of your body. Symptoms of shingles, such as pain and a rash, occur along dermatomes associated with the affected nerve root.

Dermatomes are areas of skin that are connected to a single spinal nerve. You have 31 spinal nerves and 30 dermatomes. The exact area that each dermatome covers can be different from person to person.

Spinal nerves help to relay information from other parts of your body to your central nervous system. As such, each dermatome transmits sensory details from a particular area of skin back to your brain.

Dermatomes can be helpful in evaluating and diagnosing conditions affecting the spine or nerve roots. Experiencing symptoms along a specific dermatome can help inform doctors about which area of the spine may be affected.

Dermatomes Diagram: Spinal Nerves and Locations

A dermatome is an area of skin supplied by a single spinal nerve. There are 31 pairs of spinal nerves, forming nerve roots that branch from your spinal cord.

Your spinal nerves help to relay sensory, motor, and autonomic information between the rest of your body and your central nervous system (CNS).

So why are dermatomes important? How many are there? And where can they be found? Continue reading as we answer these questions and more.

Each of your dermatomes is supplied by a single spinal nerve. Let’s take a closer look at both of these components of the body.

Your spinal nerves

Spinal nerves are part of your peripheral nervous system (PNS). Your PNS works to connect the rest of your body with your CNS, which is made up of your brain and spinal cord.

You have 31 pairs of spinal nerves. They form nerve roots that branch from your spinal cord. Spinal nerves are named and grouped by the region of the spine that they’re associated with.

The five groups of spinal nerves are:

• Cervical nerves. There are eight pairs of these cervical nerves, numbered C1 through C8. They originate from your neck.
• Thoracic nerves. You have 12 pairs of thoracic nerves that are numbered T1 through T12. They originate in the part of your spine that makes up your torso.
• Lumbar nerves. There are five pairs of lumbar spinal nerves, designated L1 through L5. They come from the part of your spine that makes up your lower back.
• Sacral nerves. Like the lumbar spinal nerves, you also have five pairs of sacral spinal nerves. They’re associated with your sacrum, which is one of the bones found in your pelvis.
• Coccygeal nerves. You only have a single pair of coccygeal spinal nerves. This pair of nerves originates from the area of your coccyx, or tailbone.

Your dermatomes

Each of your dermatomes is associated with a single spinal nerve. These nerves transmit sensations, such as pain, from a specific area of your skin to your CNS.

Your body has 30 dermatomes. You may have noticed that this is one less than the number of spinal nerves. This is because the C1 spinal nerve typically doesn’t have a sensory root. As a result, dermatomes begin with spinal nerve C2.

Dermatomes have a segmented distribution throughout your body. The exact dermatome pattern can actually vary from person to person. Some overlap between neighboring dermatomes may also occur.

Because your spinal nerves exit your spine laterally, dermatomes associated with your torso and core are distributed horizontally. When viewed on a body map, they appear very much like stacked discs.

The dermatome pattern in the limbs is slightly different. This is due to the shape of the limbs as compared with the rest of the body. In general, dermatomes associated with your limbs run vertically along the long axis of the limbs, such as down your leg.

Your dermatomes are numbered based on which spinal nerve they correspond to. Below, we’ll outline each dermatome and the area of the body that it’s associated with.

Remember that the exact area that a dermatome may cover can vary by individual. Some overlap is also possible. As such, consider the outline below to be a general guide.

Cervical spinal nerves

• C2: lower jaw, back of the head
• C3: upper neck, back of the head
• C4: lower neck, upper shoulders
• C5: area of the collarbones, upper shoulders
• C6: shoulders, outside of arm, thumb
• C7: upper back, back of arm, pointer and middle finger
• C8: upper back, inside of arm, ring and little finger

Thoracic spinal nerves

• T1: upper chest and back, armpit, front of arm
• T2: upper chest and back
• T3: upper chest and back
• T4: upper chest (area of nipples) and back
• T5: mid-chest and back
• T6: mid-chest and back
• T7: mid-chest and back
• T8: upper abdomen and mid-back
• T9: upper abdomen and mid-back
• T10: abdomen (area of belly button) and mid-back
• T11: abdomen and mid-back
• T12: lower abdomen and mid-back

Lumbar spinal nerves

• L1: lower back, hips, groin
• L2: lower back, front and inside of thigh
• L3: lower back, front and inside of thigh
• L4: lower back, front of thigh and calf, area of knee, inside of ankle
• L5: lower back, front and outside of calf, top and bottom of foot, first four toes

Sacral spinal nerves

• S1: lower back, back of thigh, back and inside of calf, last toe
• S2: buttocks, genitals, back of thigh and calf
• S3: buttocks, genitals
• S4: buttocks
• S5: buttocks

Coccygeal spinal nerves

buttocks, area of tailbone

Dermatomes are important because they can help to assess and diagnose a variety of conditions. For instance, symptoms that occur along a specific dermatome may indicate a problem with a specific nerve root in the spine.

Examples of this include:

• Radiculopathies. This refers to conditions in which a nerve root in the spine is compressed or pinched. Symptoms can include pain, weakness, and tingling sensations. Pain from radiculopathies can follow one or more dermatomes. One form of a radiculopathy is sciatica.
• Shingles. Shingles is a reactivation of the varicella zoster (chickenpox) virus that lies dormant in the nerve roots of your body. Symptoms of shingles, such as pain and a rash, occur along dermatomes associated with the affected nerve root.

Dermatomes are areas of skin that are connected to a single spinal nerve. You have 31 spinal nerves and 30 dermatomes. The exact area that each dermatome covers can be different from person to person.

Spinal nerves help to relay information from other parts of your body to your central nervous system. As such, each dermatome transmits sensory details from a particular area of skin back to your brain.

Dermatomes can be helpful in evaluating and diagnosing conditions affecting the spine or nerve roots. Experiencing symptoms along a specific dermatome can help inform doctors about which area of the spine may be affected.

Inflammation of the sciatic nerve » Polyclinic No. 2 Cherepovets

What could be more painful than a sudden, piercing back pain? Especially if it concerns pain along the nerve. Of all the nerves and nerve bundles, the sciatic is the largest in the body. The pain that occurs with inflammation of the sciatic nerve can not only deprive a person of working capacity, but also completely immobilize him. Therefore, one can imagine that all the attention of a person will be reduced to only one thing – to relieve this terrible pain.

Inflammation of the sciatic nerve is called sciatica. Often, sciatica is confused with sciatica, but these are different pathologies, since sciatica includes, in addition to pain, the causes of the disease and factors that lead to the development of inflammation. In addition, it is rather problematic to determine sciatica, due to the fact that pain attacks can appear only a couple of times a year.

The age category for this disease can be different, but is more common in people over thirty years of age.

The most common cause of the disease is the so-called “piriformis syndrome”, when, due to excessive physical exertion, the muscle tissue of the nerve, which is located just in the very middle of this muscle, is squeezed.

Pregnancy, or rather the third trimester of pregnancy, can also be probable causes of inflammation. This is due to an increase in the load on the lower back, which can cause displacement of the vertebrae with subsequent infringement of the sciatic nerve. Also, inflammation can be caused by various infections that affect both the sciatic nerve itself and inflammation along the nerve. In rare cases, colds and viral illnesses can cause sciatica. Infections and inflammation, in turn, lead to diseases such as neuritis, osteomyelitis, and abscesses of the soft tissues adjacent to the nerve.

Even ordinary hypothermia can provoke sciatica, especially if you sit down on cold or frozen surfaces during frost.

Exhausting physical activity, all kinds of injuries and consequences after injuries, in turn, can also lead to inflammation of the sciatic nerve. Pain is the main and most striking symptom of sciatica. The nature of the pain ranges from aching, with tingling and numbness, to acute, in which a person loses the ability to move. Usually the pain occurs in the leg and is localized in one half of the body, while there may be numbness of the affected limb. Pain in this case arises from any slightest movement, not only the affected area, but the whole organism. Even coughing and sneezing can cause severe pain. Pain tends to intensify at night and often deprive a person of sleep.

In addition, sciatica may be indicated :

• hyperemia in the back and pelvis;
• edema formation;
• disturbed sleep;
• temperature;
• blood and burning when urinating;
• swelling in the area of ​​the sciatic nerve.

If you have these symptoms, you should consult a specialist in time to avoid further complications. Timely measures not taken can aggravate the situation and more serious methods of treatment will be required to solve it.

Pinched sciatic nerve – symptoms and treatment

Pinched sciatic nerve – discomfort in the lower body associated with squeezing or irritation of the nerve itself. Most often, the disease affects people over 30 years old.

The sciatic nerve is the largest in our body. It covers most of the body – from the lumbosacral spine, then passes into the buttock, along the back of the thigh and to the lower leg. Therefore, it is important to monitor his condition. The slightest irritation in one part of the nerve will lead to pain throughout its area. In the absence of timely treatment, sensitivity and mobility of the lower extremities are gradually lost.

Pinching may occur due to:

• Lumbar hypothermia
• Excessive load on the pelvic muscles
• Scoliosis and other spinal disorders
• Spinal injuries
• Arthrosis and other diseases of the hip joint
• Pregnancy
• Complications during childbirth
• Sedentary
• Injuries of the sciatic nerve during intramuscular injections
• Infectious diseases
• Neoplasms (benign and malignant)
• Pain when bruised or falling
• Intervertebral hernia
• Osteochondrosis
• Piriformis syndrome

Therefore, experts divide the disease into two types – primary and secondary. The primary is associated with compression of the nerve trunk by a damaged muscle, and the secondary is caused by the pathology of the spinal column, hip joints, and occurs against the background of pregnancy or diseases of the pelvic organs.

A pinched nerve can develop faster if you are overweight. It is also important to monitor the intake of essential vitamins and minerals in the body, since their absence or deficiency leads to the risk of accelerated development of the disease.

Symptoms and treatment of pinched sciatic nerve

This disease is quite painful and will not pass without a trace. Therefore, when the first symptoms appear, you should see a specialist – a neurologist, neuropathologist or therapist. He will prescribe the necessary treatment and medications.

Symptoms of pinched sciatic nerve

• Pain in the lower back, hamstrings, buttocks or lower leg
• Discomfort while walking, when bringing the legs together and bending the knee
• Feeling of heat in the toes
• Feeling of chilliness in the affected area of ​​the nerve
• Excessive sweating
• Impaired joint mobility – usually patients complain that they cannot straighten their leg
• Numbness of limbs
• Goosebumps on the leg
• Discoloration of the skin in the affected area
• General malaise, lethargy and weakness
• Increased body temperature

It is in the presence of these symptoms that neuropathologists, neurologists and therapists diagnose a pinched sciatic nerve. If the specialist has doubts, then to fully clarify the situation, the patient is sent for CT or MRI. Based on the results of the procedures, the diagnosis and treatment will be determined.

Symptoms in women with pinched sciatic nerve

The disease can occur during pregnancy. In the second or third trimester, the enlarged uterus puts pressure on the pelvic muscles, thereby causing a spasm. In the expectant mother, the center of gravity is redistributed and the lumbar vertebrae are displaced. Also in the pelvic area, the growing head of the fetus compresses the sciatic nerve.

From 40 to 80% of pregnant women complain of back pain. However, pinching of the sciatic nerve is not always the cause, it is observed only in 5% of cases.

Doctors say that the disease can go away after childbirth. However, you should not endure pain until this moment, it is better to see a specialist in order to avoid serious consequences and increase pain.

Treatment of pinched sciatic nerve

Most of the time, the pain comes on suddenly. Therefore, before contacting a specialist, you need to take a few simple steps:

1. Sit in a comfortable and pain-free position. The best option is to lie on your back or on your healthy side with a straight leg in which pain is felt

2. Avoid activity as much as possible, as each extra movement can provoke additional pain

3. Give up old-fashioned methods of treatment – it is better to put the heating pad aside, and do not rub the diseased area. These actions may aggravate the situation

4. Take painkillers. They will help dull the sharp aching pain. Usually such drugs are in the form of capsules or ointments

Emergency medical attention should be called for unbearable pain that is not dulled or suppressed by analgesics. In more favorable cases, medical assistance is also needed. It is best to contact a neurologist, neurologist or therapist. As soon as the pain is relieved, see a doctor at a local clinic.

How is a pinched sciatic nerve treated?

After asking about symptoms and examining, the doctor refers the patient to an X-ray, ultrasound, CT, MRI, or a general and biochemical blood test. Procedures are necessary in order to determine the extent of the problem. Also, based on their results, the doctor determines the cause of the pinched sciatic nerve and detects inflammation.

After that, experts prescribe anti-inflammatory drugs, a complex of B vitamins and muscle relaxants. Also, the patient can receive a referral to physiotherapy and exercise therapy. Usually, procedures are prescribed for unbearable pain that does not go away even after complex treatment. In special cases, the doctor may prescribe additional vitamin complexes, antioxidants and painkillers. Thus, not only the symptoms of the disease will be removed, but the fight against the disease-causative agent will also begin.