According to world statistics, about 80% of the adult inhabitants of our vast planet are united by 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 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 of the expected result.
Reasons: determine, exclude
The success of any treatment directly depends on the accuracy of the diagnosis, with the elimination of the symptoms felt, the likelihood of relapse increases. Subsequently, such treatment can only aggravate the situation. Therefore, first of all, you need to carefully check the condition of all organs, the symptoms of which may be pain in the lumbar region.
Exacerbations of diseases of the digestive system (pancreatitis, ulcers, colitis, cholecystitis, enteritis, appendicitis) often provoke the appearance of pain in the lumbar region.
Most often, kidney pain is mistaken for symptoms of diseases of the lumbar spine, since their nature is identical. Diseases of the kidneys and urinary tract of various etiologies are accompanied not only by "recoil" to the lower back, but also by urination disorders (increased frequency, discomfort, the 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 stage, pain often radiates to the lumbar region, coccyx or to the side. The nature of these pains is often girdle without pronounced localization.
If any disease of an organ that is not associated with the musculoskeletal system is detected, it is he who is treated, since it is he who is the true cause of the pain syndrome. If, after a thorough examination, problems with the above organs were not identified, then most likely the trouble is with the spine.
The most mobile part of the spine, which takes on the lion's share of the loads, is the lumbosacral. With a sedentary lifestyle, excessive stress and insufficient intake of nutrients into the cartilaginous tissues of the spine, degenerative-dystrophic changes in the intervertebral cartilage in the lumbar region occur - 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 to the sacrum, its character is pulling (aching). 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, shootings begin in 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, disc protrusion and prolapse develop. Pain at this stage becomes more intense and prolonged. Every movement brings unbearable pain. It is possible to squeeze areas of the spinal cord, vessels and nerve endings adjacent to the sore spot due to the fact that the fibrous ring protrudes and affects the spinal canal.
The last stage of osteochondrosis of the lumbar "forces" the body to adapt to the changes that have occurred due to the disease in the following way. In order for the supporting and protective functions to be preserved, bone tissue grows in the diseased area. This usually leads to various microtraumas, and later to disability.
Comprehensive approach to treatment
Treatment of lumbar osteochondrosis must necessarily be comprehensive, regardless of the stage of development of the disease. With a mild form, the treatment prognosis is favorable, the deformation processes can be completely stopped and the consequences minimized. At the last stage of the development of the disease, the task of treatment is to eliminate all symptoms and consequences, normalize the nutrition of spinal tissues, strengthen the muscular corset of the entire back and its lower part in particular.
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-steroidal) are prescribed. Muscle spasm that occurs simultaneously with pain is eliminated by muscle relaxants. Chondroprotectors are used to restore damaged cartilage tissue.
All of these remedies sometimes do not have the desired effect, since damage prevents the drug from penetrating to the site of action.
Blockade is used to relieve an acute attack of pain. Only a specialist should carry it out.
A suitable analgesic is injected into the gap between the spinous processes with a long needle. After such a procedure, the pain goes away very quickly, but for a while, because there is no therapeutic effect.
Effective use of local complex means - ointments, gels. They have an analgesic, anti-inflammatory, warming effect, many topical preparations contain a chondroprotector. These remedies, when used correctly and combined with massage, are quite effective.
In combination with drug treatment for lumbar osteochondrosis, physiotherapeutic procedures are used - balneotherapy, laser and magnetotherapy, treatment with weak currents, light and vibrations. They practically do not have side effects and contraindications.
Increasingly, alternative (non-traditional) methods are used simultaneously with traditional treatment - hirudotherapy, acupuncture, bee stings, manual therapy. These methods give long-awaited relief, but some of them have contraindications, so consultation with the attending physician is required.
In addition to all the above methods of treatment, 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 thereby unload the spine.
In the treatment of 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, non-traditional methods and physical exercises can be used.
Yoga and Pilates complexes have proven to be excellent as rehabilitation programs for diseases of the spine.
Hernia of the lumbar spine
Against the background of undertreated or neglected osteochondrosis of the lumbar region, a hernia very often develops - a disease in which, due to insufficient physical activity or excessive load, the nutrition of the disc tissue occurs, its strength decreases and, as a result, disc rupture. The process of destruction can drag on for many years and go unnoticed all this time, but with one single unsuccessful movement, the mechanism starts, and all the symptoms begin to appear one after another.
General symptoms and course of the disease
The symptoms of a hernia of the lumbar spine include a decrease in tendon reflexes, pain of varying intensity, muscle weakness, and numbness of the extremities. Pain with a hernia does not always occur, backache is possible, which gradually spread in the direction of the pinched nerve.
Body distortion is a characteristic sign of a lumbar hernia. This phenomenon occurs involuntarily, as the body needs to find the most comfortable position in which pain is minimal. In severe, rapidly progressive course of the disease, the consequences may be paralysis of the lower extremities (partial or complete). This phenomenon is usually accompanied by disturbances in the functioning of the abdominal organs, in particular the intestines and bladder.
Clinical manifestations of a hernia of the lumbosacral zone are expressed in a constant increase in pain and their intensification during specific physical exertion (weight lifting, bending over, sharp strong muscle tension, coughing), dull aching pain with localization at one point that does not go away, the direction of painin the buttock or leg, or numbness in this area.
Diagnosis of a hernia of the lumbar spine
It is difficult to diagnose a hernia visually or by the symptoms described by the patient alone. 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 altered vertebra and see the deformed disc.
To determine the severity of the disease and the consequences, doctors use several tests: lifting 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 up to bed rest and relieve pain with medication. After 5-7 days, when the acute period is over and the pain has subsided, the 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 advisable.
Indications for surgery:
- sequestration of a hernia - a part of the disc damaged by a hernia enters the spinal canal;
- dysfunction of all or one organ in the pelvis;
- patency in the spinal canal is impaired (determined by MRI);
- lack of results when using a medical and conservative method of treatment for three or more months;
- inflammation of the sciatic nerve.
Surgical treatment of a hernia is now carried out with the help of sparing, minimally invasive endoscopic operations.
The method of laser reconstruction consists in the evaporation of fluid from the protruding nucleus pulposus using a laser. Thanks to this, the nerve root is "liberated", that is, its compression is eliminated. But this type of intervention has a number of contraindications, these are early operations on the spine, spondylolisthesis, spondyloarthritis, impaired patency of the spinal canal (stenosis) and protrusion of the nucleus pulposus into the canal.
To remove the damaged part of the intervertebral disc, the method of percutaneous discectomy is used. Evaporation and removal of damaged tissues is carried out with a needle inserted through the skin.
In the case when it is impossible to restore the damaged disc in any way, starting with medication and ending with a minimally invasive operation, or all the methods used do not bring any result, the deformed disc is replaced with a prosthesis.
In order to prevent the progression of the disease, special exercises are prescribed. Exercise complexes should be developed by a specialist individually for each patient and must contain exercises for muscle stretching, tension and light aerobic exercise.
With a hernia of the lumbar spine, doctors recommend wearing a special fixing 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 needed in order to evenly distribute the load (from the diseased area to the healthy one) and relieve stress (unload). Injured segments of the spine with constant wearing of the belt are corrected and returned to their anatomical position.
Lumbodynia with radicular syndrome
Against the background of osteochondrosis and hernia of the lumbar spine, as a result, lumbago develops - lumbar backache (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 spinal column, there is an infringement of nearby nerve roots, called radicular syndrome.
It is amplified by the infringement of the veins, which provokes tissue edema (soft) and congestion. The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (acute shooting pains that radiate down, loss of sensitivity and impaired reflexes), and since this is a consequence, the cause must initially be treated with an integrated approach, otherwise disability threatens.
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and the pain that radiates to the leg or buttock that accompanies it. Despite the ability to clearly define the "sore" 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 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 in this case do not help.
For effective treatment, it is not enough to diagnose sciatica or lumbago; in any case, it is necessary to conduct a full comprehensive examination by various specialists and accurately identify the cause, because it is it that is the provoking factor. With the elimination of just some of the symptoms, the likelihood of the progress of the underlying disease and the appearance of many complications increases. Attentive attitude to your health, early recognition of problems and prompt treatment is the key to good health.