According to world statistics, about 80% of the adult inhabitants of our vast planet share the same health problem - periodically, or even constantly, back pain in the lumbar region.Lower back pain is the main symptom of many diseases of the spine and internal organs located in the abdominal cavity.And it is completely useless that most of those who experience discomfort in this area, bypassing the doctor and not 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: defined, excluding
The success of any treatment directly depends on the accuracy of the diagnosis;when symptoms are eliminated, the likelihood of relapse increases.Then, such treatment can only worsen the situation.Therefore, first of all, you should 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 provoke the appearance of pain in the lumbar region.
Urinary system
Most often, kidney pain is confused with symptoms of spine diseases, as their nature is identical.Diseases of the kidneys and urinary tract of various etiologies are associated not only with "pulling" in the lower back, but also with urination disorders (frequency, restlessness, the presence of blood in the urine and its turbidity) and an increase in body temperature.
Reproductive system
With problems with the reproductive organs in men and women in the acute phase, the pain often radiates to the waist, tail or sides.The nature of these pains is often circumscribed without a pronounced localization.
If any disease of an organ that is not related to the musculoskeletal system is detected, it is the one that is treated, since this is precisely the real cause of the pain syndrome.If, after a thorough examination, no problems are identified with the above organs, then there is most likely a problem with 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 localized and directed to the sacrum, its character is pulling (pain).During this period, the destruction processes affect the nucleus pulposus (its dehydration occurs), as well as the vertebral discs (the height of their posture 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, lumbago begins to radiate to the thighs 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 sensitivity and numbness.
The third stage is characterized by morphological changes in the discs, the spine itself is severely deformed, and disc protrusion and prolapse develop.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 injured site are 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.In order to preserve the supporting and protective functions, bone tissue grows in the diseased area.This usually leads to various microtraumas, and then to disability.
An integrated approach to treatment
Treatment of lumbar osteochondrosis should be comprehensive, regardless of the stage of development of the disease.In mild cases, the prognosis for treatment is favorable;the 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 in particular of 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 effective.To relieve the inflammatory process, anti-inflammatory drugs (non-steroids) are prescribed.Muscle spasms that occur simultaneously with pain are eliminated by muscle relaxants.Chondroprotectors are used to restore damaged cartilage tissue.
All the above remedies sometimes do not have the desired effect, as the damage prevents the medicine from penetrating into the site of action.
To relieve an acute attack of pain, a blockade is used.It should only be performed 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 goes away very quickly, but for some time, because it has no therapeutic effect.
The use of complex local products - ointments, gels - is effective.They have an analgesic, anti-inflammatory, warming effect;many preparations for local use contain a chondroprotector.These tools, when used properly and combined with massage, are quite effective.
Physiotherapy procedures
In combination with drug treatment for lumbar osteochondrosis, physiotherapeutic procedures are used - balneotherapy, laser and magnetic therapy, treatment with weak currents, light and vibration.They practically have no side effects or contraindications.
Alternative Methods
More and more, alternative (non-traditional) methods are used simultaneously with traditional treatment - hirudotherapy, acupuncture, bee stings, manual therapy.These methods provide long-awaited relief, but some of them have contraindications, so consultation with the doctor is required.
In addition to all the above treatment methods, physiotherapy helps to overcome the disease.Properly distributed loads of the required intensity will help to restore blood circulation in the damaged areas, form or strengthen the muscle corset and thus relieve the load on the back.
During the treatment of osteochondrosis, it is important to correctly combine treatment methods, first of all, relieve acute pain attacks, then inflammatory processes, and only when the acute period of the disease is over, non-traditional physical methods and exercises can be used.
Yoga and Pilates complexes have proven to be excellent rehabilitation programs for spinal diseases.
Hernia of the lumbar spine
Against the background of untreated or neglected osteochondrosis of the lumbar region, a hernia develops very often - 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, the disc ruptures.The process of destruction can drag on for many years and go unnoticed all this time, but with a single unsuccessful movement 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 limb numbness.Pain from a hernia does not always occur;lumbago is possible, which gradually spreads in the direction of the pinched nerve.
Distortion of the body is a characteristic sign of lumbar hernia.This phenomenon occurs involuntarily, as the body must find the most comfortable position in which the pain is minimal.In severe disease, with rapid progression, the consequences can be paralysis of the lower extremities (partial or complete).This phenomenon is usually associated with disturbances in the functioning of the abdominal organs, especially the intestines and bladder.
The clinical manifestations of a hernia of the lumbosacral area are expressed in a continuous increase in pain and its intensification during specific physical activities (lifting weights, bending, sudden strong muscle tension, coughing), dull pain localized in a point that does not go away, the direction of pain in the buttocks or legs, or numbness of this area.
Diagnosis of lumbar disc herniation
It is difficult to diagnose a hernia visually or based only on the symptoms described by the patient.To more accurately determine the presence of the disease, several methods are used to help determine the exact location of the disease.Computed tomography, nuclear magnetic resonance and radiography - 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 several tests: straight leg elevation, tendon reflexes, sensitivity (reaction) of the leg at all levels (from the toes to the hip joint) to several 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 worsening, first of all, you should immediately limit physical activity until bed rest and relieve pain with medication.After 5-7 days, when the acute period is over and the pain has subsided, drug treatment is supplemented with other restorative procedures (massage, physiotherapy, physical education).
Medical 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 advised.
Indications for surgical intervention:
- sequestration of a hernia - the entry of an area of the disc damaged by a hernia into the spinal canal;
- dysfunction of all or an organ in the pelvis;
- patency in the spinal canal is impaired (determined using MRI);
- lack of results when medicinal and conservative treatment is used for three or more months;
- inflammation of the sciatic nerve.
Surgical treatment of hernia is now performed using gentle, minimally invasive endoscopic operations.
The laser reconstruction method involves vaporizing the 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 type of intervention has a number of contraindications, such as early spine surgery, spondylolisthesis, spondyloarthritis, blockage of the spinal canal (stenosis) and extension of the nucleus pulposus into the canal.
To remove the damaged part of the intervertebral disc, the percutaneous discectomy method is used.Steaming and removal of damaged tissue is performed 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 do not bring any results, the deformed disc is replaced with a prosthesis.
Preventive measures
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 exercises.
For a hernia of the lumbar spine, doctors recommend placing a special fixation belt.Outwardly, it resembles a capsule, its width is about 30 cm, it is attached to the body with Velcro and has several degrees of stiffness.
This product is necessary to evenly distribute the load (from the diseased area to the healthy one) and to relieve tension (discharge).With continuous wearing of the belt, the damaged segments of the spine are corrected and returned to their anatomical position.
Lumbodynia with radicular syndrome
Against the background of osteochondrosis and spinal hernia, lumbago develops as a consequence - lumbar lumbago (acute paroxysmal pain).This is the "simplest" scenario.Since hernias and osteochondrosis are characterized by frequent deformation and prolapse of the damaged disc and displacement of the spine, compression of nearby nerve roots, called radicular syndrome, is observed.
It is intensified by constriction of the veins, which provokes (soft) tissue swelling and congestion.The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (sharp shooting pains radiating down, loss of sensitivity and impaired reflexes), and since this is a consequence, the cause must first be treated with an integrated approach, otherwise disability may result.
Sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatic nerve pain and accompanying pain radiating to the leg or buttocks.Despite the ability to clearly identify the "injured" place, 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 only mild discomfort when you stay in the same not very comfortable position for a long time, and sometimes the pain leads to loss of consciousness and analgesics do not help in this case.
For effective treatment, it is not enough to diagnose sciatica or lumbago;in any case, you should do a full comprehensive examination by various specialists and accurately identify the cause, because it is the provoking factor.Eliminating only a few symptoms increases the likelihood that the underlying disease will progress and many complications will appear.Taking care of your health, early recognition of problems and prompt treatment is the key to good health.