According to world statistics, about 80% of adult inhabitants of our vast planet share the same health problem: periodic or even constant 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 in vain that the majority of those who feel 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 result of the expected result.
Reasons: determined, excluding
The success of any treatment directly depends on the accuracy of the diagnosis;when symptoms disappear, the risk of relapse increases.Subsequently, such treatment can only make the situation worse.Therefore, first of all, you should carefully check the condition of all organs, the symptoms of which may be pain in the lumbar region.
Digestive system
Exacerbations of diseases of the digestive system (pancreatitis, ulcers, colitis, cholecystitis, enteritis, appendicitis) often cause the appearance of pain in the lumbar region.
Urinary system
Most often, kidney pain is confused with symptoms of lumbar spine diseases, because their nature is identical.Diseases of the kidneys and urinary tract of various etiologies are accompanied not only by a "setback" 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
In case of problems with the reproductive organs in men and women in the acute stage, the pain often radiates to the lumbar region, tailbone or to the side.The nature of these pains is often girdling without pronounced localization.
If a disease of an organ not related to the musculoskeletal system is detected, it is she who is treated, since it is she who is the true cause of the pain syndrome.If, after a thorough examination, no problems with the above organs are identified, most likely there is a problem with the spine.
Osteochondrosis
The most mobile part of the spine, which bears the lion's share of the load, is the lumbosacral part.With a sedentary lifestyle, excessive loads and insufficient supply of nutrients to the cartilaginous tissue of the spine, degenerative-dystrophic changes occur in the intervertebral cartilage of the lumbar region - osteochondrosis.
Symptoms and stages of the disease
The main alarming symptom of osteochondrosis is pain in the lumbar region.At the initial stage, it is localized and directed towards the sacrum, its character is pulling (painful).During this period, destructive processes affected the nucleus pulposus (its dehydration occurs), as well as the spinal discs (the height of their position decreases).Discomfort is observed with heavy loads, and the pain itself is mild.
After a while, if the problem is ignored and no action is taken, the lumbago 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 causes loss of sensation 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.At this stage, the pain becomes more intense and prolonged.Every movement brings unbearable pain.It is possible that areas of the spinal cord, blood vessels and nerve endings adjacent to the tender point are compressed due to the annulus fibrosus protruding and affecting the spinal canal.
The last stage of lumbar osteochondrosis “forces” the body to adapt to the changes occurring due to the disease in the following way.So that the supporting and protective functions are preserved, bone tissue develops 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;deformation processes can be completely stopped and the consequences can be minimized.At the last stage of the disease, the goal of treatment is to eliminate all symptoms and consequences, normalize the nutrition of the spinal tissues and strengthen the muscular corset of the entire back and its lower part in particular.
Drugs
To relieve pain associated with lumbar osteochondrosis, analgesics are used in the form of tablets or injections;the second option is preferable because it is more efficient.To relieve the inflammatory process, anti-inflammatory drugs (non-steroidal) are prescribed.Muscle spasms that occur simultaneously with pain are eliminated by muscle relaxants.Chondroprotectors are used to restore damaged cartilage tissue.
All of the above remedies sometimes do not have the desired effect, since damage prevents the drug from penetrating to the site of action.
To relieve an acute attack of pain, a blockade is used.It should only be carried out by a specialist.
A suitable pain reliever is injected into the space between the spinous processes using a long needle.After such a procedure, the pain disappears very quickly, but for some time, since there is no therapeutic effect.
The use of complex local products - ointments, gels - is effective.They have an analgesic, anti-inflammatory and warming effect;many preparations for topical use contain a chondroprotectant.These remedies, when used correctly and combined with massage, are very effective.
Physiotherapeutic procedures
In combination with drug treatment of lumbar osteochondrosis, physiotherapeutic procedures are used - balneotherapy, laser and magnetic therapy, treatment with weak currents, light and vibration.They have virtually no side effects or contraindications.
Alternative methods
Increasingly, alternative (non-traditional) methods are used simultaneously with traditional treatment - hirudotherapy, acupuncture, bee stings, manual therapy.These methods bring long-awaited relief, but some of them have contraindications, so consultation with your doctor is necessary.
In addition to all of the above treatment methods, physiotherapy helps to overcome the disease.Correctly distributed loads of the required intensity will help restore blood circulation in damaged areas, form or strengthen the muscle corset and thereby 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 complexes have proven themselves 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 very often develops - a disease in which, due to insufficient physical activity or excessive stress, the disc tissue becomes nourished, its strength decreases and, as a result, a disc rupture occurs.The process of destruction can last for many years and go unnoticed all this time, but with one 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 lumbar spine herniation include decreased tendon reflexes, pain of varying intensity, muscle weakness, and numbness of the limbs.Pain from a hernia does not always occur;lumbago is possible, which gradually spreads in the direction of the pinched nerve.
Body distortion is a characteristic sign of lumbar hernia.This phenomenon occurs involuntarily, because the body needs to find the most comfortable position in which pain is minimal.In the event of a serious, rapidly progressing illness, 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.
Clinical manifestations of a hernia of the lumbosacral area are expressed by a constant increase in pain and its intensification during specific physical activities (lifting weights, bending, sudden strong muscle tension, cough), dull aching pain localized in one point that does not disappear, 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 solely based on the symptoms described by the patient.To more accurately determine the presence of the disease, several methods are used to accurately determine the location of the disease.Computed tomography, nuclear magnetic 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 its consequences, doctors use several tests: straight leg elevation, tendon reflexes, sensitivity (reaction) of the leg at all levels (from toes to hip joint) to several types of stimuli - pain, vibration and temperature.
Treatment methods
Depending on the severity and condition of the patient, different hernia treatment methods are used.In case of exacerbation, 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).
Drug and conservative treatment of lumbar hernia is the same as that of osteochondrosis.
Surgery
In case of serious illness and the presence of many serious consequences, surgical treatment is recommended.
Indications for surgical intervention:
- herniated sequestration - entry of a disc area damaged by a herniation into the spinal canal;
- dysfunction of all or one organ of the pelvis;
- the patency of the spinal canal is impaired (determined by MRI);
- lack of results when using drug and conservative treatment for three months or more;
- inflammation of the sciatic nerve.
Surgical treatment of hernia is now carried out using gentle and minimally invasive endoscopic operations.
The laser reconstruction method involves evaporating 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 procedure 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.
To remove the damaged part of the intervertebral disc, the percutaneous discectomy method is used.Vaporization and removal of damaged tissue is carried out using a needle inserted through the skin.
In cases where it is impossible to restore a damaged disc by any method, starting with medications and ending with minimally invasive surgery, or if all methods used do not bring any results, the deformed disc is replaced with a prosthesis.
Preventive measures
In order to prevent the progression of the disease, special exercises are prescribed.Sets of exercises should be developed by a specialist individually for each patient and should contain exercises for muscle stretching, tension and light aerobic exercises.
In case of a lumbar hernia, doctors recommend wearing 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 rigidity.
This product is necessary to evenly distribute the load (from the diseased area to the healthy area) and relieve tension (discharge).With constant wearing of the belt, injured segments of the spine are corrected and returned to their anatomical position.
Lumbodynia with radicular syndrome
Against the background of osteochondrosis and herniation of the lumbar spine, lumbago develops as a result - lumbar lumbago (acute paroxysmal pain).This is the “simplest” scenario.Since hernias and osteochondrosis are characterized by deformation and frequent prolapse of the damaged disc and displacement of the spine, pinching of neighboring nerve roots is observed, which is called radicular syndrome.
It is intensified by pinching of the veins, which causes (soft) tissue swelling and congestion.The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (sharp pain radiating downward, loss of sensitivity and impaired reflexes), and since it 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 - sciatica and the accompanying pain radiating to the leg or buttock.Despite the ability to clearly identify the "tender" point, the reason lies in the spine.
Sciatica is not an independent disease;This term refers to a number of symptoms that accompany certain spinal diseases.Painful sensations can be different, in some cases it is just a slight discomfort when staying in the same not very comfortable position for a long time, and sometimes the pain leads to loss of consciousness and painkillers do not help in this case.
For effective treatment, it is not enough to diagnose sciatica or lumbago;in any case, you need to conduct a full and comprehensive examination by different specialists and accurately identify the cause, since it is the provoking factor.By eliminating only a few symptoms, the likelihood of progression of the underlying disease and the appearance of many complications increases.Paying attention to your health, recognizing problems early, and treating them promptly is the key to good health.