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. 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 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 felt symptoms, 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 may be pain in the lumbar region.
The 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 the symptoms of spinal 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 (increased frequency, restlessness, the presence of blood in the urine and its turbidity) and increasedand body temperature.
reproductive system
With problems with the reproductive organs in men and women in the acute phase, the pain often radiates to the lumbar, coccyx, or side region. The nature of these pains is often non-localized.
If any disease of an organ that is not related to the musculoskeletal system is detected, it is the one that is treated, since it is the one that is the real cause of the pain syndrome. If, after a thorough examination, problems with the above organs were not identified, then the trouble is most likely with the spine.
Osteochondrosis
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 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 (their height in the leg decreases). Discomfort is observed with heavy loads, and the pain itself is mild.
After some time, if the problem is ignored and no action is taken, the hip and butt shots start. 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, 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 to compress areas of the spinal cord, vessels and nerve endings adjacent to the injured site due to the fact that the fibrous ring extends and touches 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 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, deformation processes can be completely stopped and the consequences minimized. In the final stage of the disease, the task of treatment is to eliminate all symptoms and consequences, normalize the nutrition of the spinal tissues, strengthen the muscular corset of the entire back and in particular of its lower part.
medicaments
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 spasm that occurs simultaneously with pain is eliminated by muscle relaxants. Chondroprotectors are used to restore damaged cartilage tissue.
All these means sometimes do not have the desired effect, since the damage prevents the drug from penetrating into 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 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 it has no therapeutic effect.
Effective use of complex local means - ointments, gels. They have an analgesic, anti-inflammatory, warming effect, many local preparations contain a chondroprotector. These remedies, 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 magnetotherapy, treatment with weak currents, light and vibration. They practically have no side effects and 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 the long-awaited relief, but some of them have contraindications, so consultation with the attending physician is required.
In addition to all the above treatment methods, physical therapy helps to overcome the disease. Properly distributed loads with the required intensity will help to restore blood circulation in the damaged areas, form or strengthen the muscle corset and thus unload the spine.
In 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 methods and physical exercises can be done. used.
Yoga and Pilates complexes have been proven to be excellent rehabilitation programs for spinal diseases.
Hernia of the lumbar spine
Against the background of undertreated 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, disc rupture. 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 a decrease in tendon reflexes, pain of varying intensity, muscle weakness and numbness of the extremities. Pain with a 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 a lumbar hernia. This phenomenon occurs involuntarily, as the body must find the most comfortable position in which the pain is minimal. In the severe, rapidly progressive course of the disease, 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 constant increase in pain and their intensification during specific physical exercises (weight lifting, bending, strong muscle tension, coughing), dull aching pain with localization in a point thatdo not go away, the direction of pain in the buttocks or legs, or numbness in that area.
Diagnosis of a hernia of the lumbar spine
It is difficult to diagnose a hernia visually or from the symptoms described only by the patient. In order to more accurately determine the presence of the disease, several methods are used that will 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 visually 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: 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.
Methods of Treatment
Depending on the severity and condition of the patient, different methods of hernia treatment are used. In case of deterioration, first of all, it is necessary to immediately limit motor activity until bed rest and relieve pain with medicines. 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 a severe course of the disease and the presence of many serious consequences, surgical treatment is advised.
Indications for surgery:
- sequestration of a hernia - 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 laser reconstruction method consists in 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, these are early operations on the spine, spondylolisthesis, spondyloarthritis, impaired patency 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 the damaged disc in any way, 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 complexes should be developed by a specialist individually for each patient and should contain exercises for muscle stretching, tension and light aerobic exercises.
With a spinal hernia, doctors recommend putting on 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 needed to evenly distribute the load (from the diseased area to the healthy one) and to relieve stress (discharge). Damaged segments of the spine with continuous wear 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 pain (acute paroxysmal pain). This is the most "simple" scenario. Since hernias and osteochondrosis are characterized by frequent deformation and prolapse of the damaged disc and displacement of the spine, there is a violation of the nearby nerve roots, called radicular syndrome.
It is exacerbated by vein encroachment, which provokes (soft) tissue edema and congestion. The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (acute shooting pain 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 there is a risk of disability.
Sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatica – sciatica and accompanying pain radiating to the leg or buttocks. Despite the ability to clearly determine 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 several diseases of the spine. Pain sensations can be different, in some cases it is only a slight 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 in this case do not help.
For an effective treatment, it is not enough to diagnose sciatica or lumbago, in any case it is necessary to carry out a comprehensive comprehensive examination by various specialists and to accurately identify the cause, because it is precisely that provocative factor. With the elimination of only some of the symptoms, the likelihood of the progression of the underlying disease and the appearance of many complications increases. Paying attention to your health, early recognition of problems and prompt treatment is the key to good health.