According to world statistics, about 80% of adult inhabitants of our huge planet share the same health problem - periodic, or even constant, 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 most of those who experience discomfort in this area, bypassing the doctor and not understanding the reasons, begin to intensively apply various ointments and other "home lotions". With these methods, you can easily achieve the opposite result than expected.
Reasons: determine, exclude
The success of any treatment directly depends on the accuracy of the diagnosis, with the removal of felt symptoms, the likelihood of recurrence increases. After that, such treatment can only make the situation worse. Therefore, first of all, you must carefully check the condition of all organs, the symptoms of which can be pain in the lumbar region.
Exacerbations of diseases of the digestive system (pancreatitis, ulcers, colitis, cholecystitis, enteritis, appendicitis) often cause pain in the lumbar region.
Most often, pain in the kidneys is mistaken for symptoms of lumbar spine disease, because their nature is identical. Diseases of the kidneys and urinary tract of various etiologies are accompanied not only by "distraction" in the lower back, but also by urination disorders (increased frequency, discomfort, presence of blood in the urine and its turbidity), and an increase in body temperature.
With problems with the reproductive organs in men and women in the acute phase, the pain often radiates to the lumbar region, the coccyx, or to the side. The nature of these pains is often explained without a pronounced localization.
If any disease of an organ that is not related to the musculoskeletal system is detected, it is treated, because it is the real cause of the pain syndrome. If no problems with the above-mentioned organs are found after a detailed examination, then it is most likely a problem with the spine.
The most mobile part of the spine, which takes the lion's share of the load, is the lumbosacral. With a sedentary lifestyle, excessive stress and insufficient intake of nutrients in the cartilaginous tissues 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 phase, it is localized and directed to the sacrum, its character is pulling (pain). In that period, destructive processes affected the nucleus pulposus (its dehydration occurs), as well as the vertebrae (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, cracking in the thigh and buttocks begins. 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 stiffness.
The third stage is characterized by morphological changes of the discs, the spine itself is severely deformed, disc protrusion and prolapse develop. The pain in this phase becomes more intense and long-lasting. Every movement brings excruciating pain. It is possible to compress the area of the spinal cord, blood vessels and nerve endings near the painful site due to the fact that the fibrous ring protrudes and affects the spinal canal.
The last stage of lumbar osteochondrosis "forces" the body to adapt to the changes caused by 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 later to disability.
A comprehensive approach to treatment
Treatment of lumbar osteochondrosis must necessarily be comprehensive, regardless of the stage of disease development. With a milder form, the treatment prognosis is favorable, the deformation processes can be completely stopped, and the consequences can be reduced to a minimum. In the last stage of disease development, the task of treatment is to eliminate all symptoms and consequences, normalize the nutrition of the spinal tissue, strengthen the muscular corset of the entire back, and especially its lower part.
To relieve pain in lumbar osteochondrosis, analgesics are used in tablets or injections, the second option is preferable, because it is more effective. Anti-inflammatory drugs (non-steroidal) are prescribed to alleviate the inflammatory process. Muscle spasm that occurs simultaneously with pain is eliminated by muscle relaxants. Chondroprotectors are used to restore damaged cartilage tissue.
All these drugs sometimes do not have the desired effect, because damage prevents the penetration of the drug to the site of action.
The block is used to relieve an acute attack of pain. Only a specialist should perform it.
A suitable analgesic is injected with a long needle into the space between the spinous processes. After such a procedure, the pain disappears very quickly, but for some time, because there is no therapeutic effect.
Effective use of local complex agents - ointments, gels. They have an analgesic, anti-inflammatory, warming effect, many local preparations contain a chondroprotector. These remedies, when used properly and in combination with massage, are quite effective.
Physiotherapy procedures are used in combination with medical treatment of lumbar osteochondrosis - balneotherapy, laser and magnetotherapy, treatment with weak currents, light and vibrations. They practically have no side effects and contraindications.
Increasingly, alternative (non-traditional) methods are used simultaneously with traditional treatment - hirudotherapy, acupuncture, bee stings, manual therapy. These methods provide the long-awaited relief, but some of them have contraindications, so a consultation with a doctor is required.
Along with all the mentioned treatment methods, physical therapy helps to overcome the disease. Properly distributed loads of the required intensity will help restore blood circulation in damaged areas, form or strengthen the muscle corset and thus relieve the spine.
In the treatment of osteochondrosis, it is important to properly combine treatment methods, first of all, acute pain attacks are alleviated, then inflammatory processes, and only when the acute period of the disease ends, non-traditional methods and physical exercises can be used. used.
Complexes of yoga and pilates have proven to be excellent rehabilitation programs for spinal disorders.
Hernia of the lumbar spine
Against the background of insufficiently treated or neglected osteochondrosis of the lumbar region, a hernia often develops - a disease in which, due to insufficient physical activity or excessive load, nutrition of the disc tissue occurs, its strength decreases and, as a result, the disc ruptures. The process of destruction can drag on for years and remain unnoticed all this time, but with one unsuccessful movement, the mechanism is set in motion and all the symptoms begin to appear one after another.
General symptoms and course of the disease
Symptoms of a herniated lumbar spine include a decrease in tendon reflexes, pain of varying intensity, muscle weakness and numbness of the extremities. Pain in hernia does not always occur, back pain 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 unintentionally, because the body needs to find the most comfortable position in which the pain is minimal. In a severe, rapidly progressive course of the disease, the consequences can be paralysis of the lower extremities (partial or complete). This phenomenon is usually accompanied by disorders in the work of the abdominal organs, especially the intestines and bladder.
The clinical manifestations of a hernia of the lumbosacral zone are expressed in the constant increase in pain and their intensification during specific physical efforts (lifting weights, bending, sharp strong muscle tension, coughing), dull aching pain with localization in one point that does not occur. disappear, direction of pain in the buttock or leg, or numbness in the area.
Diagnosis of lumbar spine hernia
It is difficult to diagnose a hernia visually or according to the symptoms described by the patient himself. In order to more accurately determine the presence of the disease, several methods are used that will help to accurately determine the location of the disease. Computed tomography, nuclear magnetic and radiography - thanks to these methods, the doctor will be able to visually 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: raising the straightened leg, 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.
Depending on the severity and condition of the patient, different methods of hernia treatment are used. In case of exacerbation, first of all, it is necessary to immediately limit motor activity to rest in bed and alleviate the pain with medication. After 5-7 days, when the acute period has passed 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.
In the case of a severe course of the disease and the presence of many serious consequences, surgical treatment is advised.
Indications for surgery:
- hernia sequestration - part of the herniated disc enters the spinal canal;
- dysfunction of all or one organ in the pelvis;
- the patency of the spinal canal is disturbed (determined by MRI);
- lack of results when using medical and conservative treatment methods for three or more months;
- inflammation of the sciatic nerve.
Surgical treatment of hernia is now carried out with the help of sparing, minimally invasive endoscopic operations.
The laser reconstruction method consists in vaporizing the liquid from the protruding nucleus pulposus with 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, namely early spine surgery, spondylolisthesis, spondyloarthritis, disturbed patency 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. Evaporation and removal of damaged tissue is performed with a needle inserted through the skin.
In the case when it is impossible to restore the damaged disc in any way, starting with drugs and ending with minimally invasive surgery, or all the methods used do not give any result, the deformed disc is replaced with a prosthesis.
In order to prevent the progression of the disease, special exercises are prescribed. The complex of exercises should be created by a specialist individually for each patient and must include exercises for muscle stretching, tension and light aerobic exercises.
In the case of herniated lumbar spine, doctors recommend wearing a special belt for fixation. From the outside, 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 needed to evenly distribute the load (from the sick to the healthy) and relieve stress (relief). Injured segments of the spine are corrected and returned to their anatomical position with constant wearing of the belt.
Lumbodynia with radicular syndrome
Against the background of osteochondrosis and hernia of the lumbar spine, as a result, lumbago develops - lumbar back pain (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 spinal column, there is an injury to the nearby nerve roots, which is called radicular syndrome.
It is exacerbated by vein damage, which causes tissue edema (soft) and congestion. The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (acute shooting pains radiating downward, loss of sensitivity and impaired reflexes), and since it is a consequence, the cause must be treated initially with an integrated approach, otherwise disability threatens.
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and the accompanying pain radiating to the leg or buttocks. Despite the ability to clearly define the "painful" place, the reason lies in the spine.
Sciatica is not an independent disease, this term refers to a series of symptoms that accompany certain diseases of the spine. Feelings of pain 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 analgesics do not help in this case.
For effective treatment, it is not enough to diagnose sciatica or lumbago, in any case, it is necessary to carry out a complete comprehensive examination by various specialists and precisely identify the cause, because it is a provoking factor. By removing only some of the symptoms, the probability of progression of the underlying disease and the appearance of many complications increases. A careful attitude towards your health, early recognition of problems and timely treatment are the keys to good health.