According to world statistics, about 80% of adult inhabitants of our huge planet share the same health problem - periodically, or even constantly, back pain in the lumbar region.Lumbar pain is the main symptom of many diseases of the spine and internal organs located in the abdominal cavity.And it is completely in vain that the majority of those who experience discomfort in this area, bypassing the doctor and without understanding the reasons, begin to intensively use various ointments and other "home lotions".With these methods you can easily achieve the opposite of the expected result.
Reasons: specified, excluded
The success of any treatment directly depends on the accuracy of the diagnosis.when the symptoms are eliminated, the likelihood of recurrence increases.Subsequently, such treatment can only worsen the situation.Therefore, first of all, you need to carefully check the condition of all organs, the symptoms of which can be pain in the lumbar region.
Digestive system
Exacerbations of diseases of the digestive system (pancreatitis, ulcers, colitis, cholecystitis, enteritis, appendicitis) often cause pain in the lumbar region.
Urinary system
Most often, pain in the kidneys is mistaken for symptoms of diseases of the lumbar spine, since their nature is identical.Diseases of the kidneys and urinary system of various etiologies are accompanied not only by "backwardness" in the lower back, but also by urination disorders (frequency, discomfort, the presence of blood in the urine and its cloudiness) and an increase in body temperature.
Reproductive system
With problems with the reproductive organs in men and women in the acute stage, the pain often radiates to the lumbar region, tail or side.The nature of these pains is often zonal without sharp localization.
If any disease of an organ unrelated to the musculoskeletal system is identified, that is what is treated, as this is the real cause of the pain syndrome.If after a thorough examination no problems are detected in the above organs, then there is probably a problem in the spine.
Osteochondrosis
The most mobile part of the spine, which takes the lion's share of the load, is the lumbosacral part.With a sedentary lifestyle, excessive loads and insufficient supply of nutrients to the cartilage tissue of the spine, degenerative-dystrophic changes occur in the intervertebral cartilage in the lumbar region - osteochondrosis.
Symptoms and stages of the disease
The main alarming symptom of osteochondrosis is pain in the lumbar region.In the initial stage, it is located and directed to the sacrum, its character is pulling (it hurts).During this period, the destruction processes affected the nucleus pulposus (its dehydration occurs), as well as the vertebral discs (their standing height decreases).Discomfort is observed with heavy loads, and the pain itself is mild.
After some time, if the problem is ignored and no measures are taken, the lumbar spine begins to radiate to the thigh and buttocks.Due to the narrowing of the intervertebral spaces, the muscles and ligaments "sag" and the spine becomes unstable.This leads to loss of sensation and numbness.
The third stage is characterized by morphological changes in the discs, the spine itself is severely deformed, and protrusion and prolapse of the disc develops.The pain at this stage becomes more intense and prolonged.Every movement brings excruciating pain.It is possible that areas of the spinal cord, blood vessels, and nerve endings adjacent to the painful site may be compressed due to the fact that the annulus fibrosus protrudes and impinges on the spinal canal.
The last stage of lumbar osteochondrosis "forces" the body to adapt to the changes that have occurred due to the disease in the following way.To maintain the supporting and protective functions, bone tissue develops in the affected area.This usually leads to various minor injuries and then disability.
An integrated approach to treatment
The treatment of lumbar osteochondrosis must be comprehensive, regardless of the stage of development of the disease.In mild cases, the prognosis for treatment is favorable.Deformation processes can be stopped completely and the consequences can be minimized.In the last stage of the disease, the goal of treatment is to eliminate all symptoms and consequences, to normalize the nutrition of the spinal tissues and to strengthen the muscular corset of the entire back and especially its lower part.
Medicines
To relieve pain in lumbar osteochondrosis, analgesics are used in tablets or injections.the second option is preferable, as it is more efficient.To alleviate the inflammatory process, anti-inflammatory drugs (non-steroids) are prescribed.Muscle spasms that occur simultaneously with pain are eliminated with muscle relaxants.Chondroprotectants are used to restore damaged cartilage tissue.
All of the above treatments sometimes do not have the desired effect, as the damage prevents the drug from penetrating the site of action.
To relieve an acute pain attack, blockade is used.It should only be done by a specialist.
A suitable analgesic is injected into the space between the spinous processes using a long needle.After such a procedure, the pain subsides very quickly, but for some time, because there is no therapeutic effect.
The use of topical compound products - ointments, gels - is effective.They have an analgesic, anti-inflammatory, warming effect.many topical formulations contain a chondroprotectant.These treatments, when used properly and combined with massage, are quite effective.
Physiotherapy procedures
In combination with drug therapy for lumbar osteochondrosis, physiotherapeutic procedures are used - bath therapy, laser and magnetic therapy, therapy with weak currents, light and vibrations.They have virtually no side effects or contraindications.
Alternative Methods
More and more, alternative (non-traditional) methods are used simultaneously with traditional treatment - irudotherapy, acupuncture, bee stings, manual therapy.These methods provide the long-awaited relief, but some of them have contraindications, so consultation with your doctor is required.
In addition to all the above treatment methods, physical therapy helps to overcome the disease.Properly distributed loads of the required intensity will help restore blood circulation in the damaged areas, form or strengthen the muscular corset and thus relieve the load on the spine.
When treating osteochondrosis, it is important to correctly combine treatment methods, first of all, acute pain attacks are relieved, then inflammatory processes, and only when the acute period of the disease is over can non-traditional methods and physical exercises be used.
Yoga and pilates sets have proven to be excellent rehabilitation programs for spinal conditions.
Lumbar hernia of the spine
In the context of untreated or neglected osteochondrosis of the lumbar region, a hernia often develops - a disease in which, due to insufficient physical activity or excessive stress, nutrition of the disc tissue occurs, its strength decreases and, as a result, a disc rupture.The process of destruction can last for many years and go unnoticed all this time, but with a single unsuccessful move the mechanism starts and all the symptoms begin to appear one after another.
General symptoms and course of the disease
Symptoms of a herniated lumbar spine include decreased tendon reflexes, pain of varying intensity, muscle weakness and numbness of the extremities.Pain from a hernia does not always occur.Back pain is strong, which gradually spreads in the direction of the pinched nerve.
Distortion of the body is a characteristic sign of hernia.This phenomenon happens involuntarily, since the body needs to find the most comfortable position in which the pain is minimal.In severe, rapidly progressing disease, the consequences may be paralysis of the lower limbs (partial or complete).This phenomenon is usually accompanied by disorders in the functioning of the abdominal organs, especially the intestines and bladder.
The clinical manifestations of a hernia of the lumbosacral zone are expressed in a constant increase in pain and its intensification during certain physical activities (lifting weights, bending, sudden strong muscle tension, coughing), dull pain localized in a point that does not subside, direction of pain in the buttock or leg, or numbness of this area.
Diagnosis of lumbar disc herniation
It is difficult to diagnose a hernia visually or based solely on the symptoms described by the patient.To more accurately determine the presence of the disease, various methods are used that help to accurately determine the location of the disease.Computed tomography, nuclear magnetic resonance and X-ray - thanks to these methods, the doctor will be able to clearly determine the location of the pathologically changed vertebra and see the deformed disc.
To determine the severity of the disease and the consequences, doctors use various tests: straight leg raising, tendon reflexes, sensitivity (reaction) of the leg at all levels (from the toes to the hip joint) to various types of stimuli - pain, vibration and temperature.
Treatment methods
Depending on the severity and condition of the patient, different methods of hernia treatment are used.In case of an exacerbation, first of all, you should immediately limit physical activity until bed rest and relieve pain with drugs.After 5-7 days, when the acute period has passed and the pain has subsided, the medication is supplemented with other rehabilitation interventions (massage, physical therapy, physical therapy).
Medicinal and conservative treatment of lumbar hernia is the same as for osteochondrosis.
Surgery
In case of severe disease and the presence of many serious consequences, surgical treatment is recommended.
Indications for surgery:
- herniation - entry of a herniated disc area into the spinal canal.
- dysfunction of all or one organ in the pelvis.
- patency in the spinal canal is impaired (determined using MRI).
- lack of results when using medicinal and conservative treatment for three or more months.
- inflammation of the sciatic nerve.
Surgical treatment of hernia is now performed with gentle, minimally invasive endoscopic procedures.
The laser reconstruction method involves vaporizing fluid from the protruding nucleus pulposus using a laser.Thanks to this, the nerve root is "released", that is, its compression is eliminated.But this kind of intervention has a number of contraindications, such as early spinal surgery, spondylolisthesis, spondyloarthritis, obstruction of the spinal canal (stenosis) and protrusion of the nucleus pulposus into the canal.
The percutaneous discectomy method is used to remove the damaged part of the intervertebral disc.Vaporization and removal of damaged tissue is done with a needle inserted through the skin.
In cases where it is impossible to restore a damaged disc by any method, starting with medication and ending with minimally invasive surgery, or all the methods used have no effect, the deformed disc is replaced with a prosthesis.
Precautionary measures
In order to prevent the progression of the disease, special exercises are prescribed.Exercise sets should be developed by a specialist individually for each patient and should contain exercises for muscle stretching, tension and light aerobic exercise.
For a herniated lumbar spine, doctors recommend the use of a special fixation belt.Outwardly it looks like a capsule, its width is about 30 cm, it is attached to the body with Velcro and has several degrees of rigidity.
This product is necessary for the uniform distribution of the load (from the diseased area to the healthy) and the relief of tension (unloading).With continuous use of the belt, the injured parts of the spine are corrected and returned to their anatomical position.
Lumbodynia with radicular syndrome
In the context of osteochondrosis and herniation of the lumbar spine, the lumbar spine develops as a consequence - lumbar lumbago (acute paroxysmal pain).This is the most "simple" scenario.Since hernias and osteochondrosis are characterized by deformation and frequent prolapse of the damaged disc and displacement of the spine, pinching of nearby nerve roots is observed, called root syndrome.
It is aggravated by pinching the veins, which causes tissue swelling (tissue) and congestion.The symptoms of sciatica with radicular syndrome are similar to the symptoms of a lumbar hernia (severe pain radiating downwards, loss of sensation and decreased reflexes) and since this is a consequence, the cause must first be treated with a comprehensive approach, otherwise disability may result.
Sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and accompanying pain radiating to the leg or buttocks.Despite the ability to clearly identify the "painful" point, the reason lies in the spine.
Sciatica is not an independent disease.this term refers to a number of symptoms that accompany certain diseases of the spine.Pain sensations can be different, in some cases it is just mild discomfort when you stay in the same not very comfortable position for a long time, and sometimes pain leads to loss of consciousness, and pain relievers do not help in this case.
For effective treatment, it is not enough to diagnose sciatica or low back pain.In any case, you need to carry out a complete comprehensive examination by different specialists and precisely determine the cause, because it is the causative factor.By eliminating only a few symptoms, the likelihood of progression of the underlying disease and the occurrence of many complications increases.Paying attention to your health, early recognition of problems and timely treatment are the keys to good health.