According to world statistics, about 80% of adult residents of our vast planet have 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 in the abdominal cavity. And it is completely in vain that most of those who feel 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: determine, rule out
The success of any treatment directly depends on the accuracy of the diagnosis, with the elimination of the felt symptoms, the likelihood of a relapse increases. Subsequently, such treatment can only aggravate the situation. Therefore, first of all, you need to carefully check the condition of all organs, 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 pain in the lumbar region.
Most often, kidney pain is confused with 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" in the lower back, but also by disturbances in urination (increased frequency, discomfort, the presence of blood in the urine and its cloudiness) and an increase in body temperature.
With problems with the reproductive organs in men and women in the acute stage, the pain often radiates to the lumbar region, coccyx or to the side. The nature of these pains is often belt without pronounced localization.
If a disease of an organ not related to the musculoskeletal system is detected, then it is treated, since it is the real cause of the pain syndrome. If, after a thorough examination, no problems with the above organs were found, then most likely the problem lies in the spine.
The most mobile part of the spine, which takes the lion's share of the loads, is the lumbosacral area. With a sedentary lifestyle, excessive stress and insufficient supply of nutrients to the cartilage tissue 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 pulls (aches). During this period, the processes of destruction affected the nucleus pulposus (its dehydration occurs), as well as the intervertebral discs (their standing height decreases). With heavy loads, discomfort is observed, and the pain itself is mild.
If after some time the problem is ignored and no action is taken, then thigh and buttock shootings begin. Due to the narrowing of the intervertebral spaces, 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 intervertebral discs, the spine itself is severely deformed, herniated and herniated discs develop. The 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 point because the annulus of fibers protrudes and affects the spinal canal.
The last stage of osteochondrosis of the lumbar spine "forces" the body to adapt to the changes caused by the disease in the following way. In order to maintain the support and protective functions, bone tissue grows in the diseased area. This usually leads to various microtraumas and later disability.
Comprehensive treatment approach
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 stopped completely, and the consequences are 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 the tissues of the spine, strengthen the muscular corset of the entire back, and especially its lower part.
To relieve pain in lumbar osteochondrosis, analgesics in tablets or injections are used, the second option is preferable, as it is more effective. To relieve the inflammatory process, anti-inflammatory drugs (nonsteroidal) are prescribed. Muscle spasms that occur simultaneously with pain are eliminated by muscle relaxants. Chondroprotectors are used to restore damaged cartilage tissue.
All of these funds sometimes do not have the desired effect, since damage prevents the drug from getting to the site of action.
Blockade is used to relieve an acute attack of pain. Only a professional should do it.
A suitable painkiller 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 are very effective when used correctly and in combination with massage.
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 practically no side effects and contraindications.
Increasingly, alternative (non-traditional) methods are used simultaneously with traditional treatment – hirudotherapy, acupuncture, bee stings, manual therapy. These methods bring the long-awaited relief, however, some of them have contraindications, so consultation with the attending physician is required.
In addition to all of the above treatment methods, physiotherapy will help to overcome the disease. Properly distributed loads of the required intensity will help restore blood circulation in damaged areas, shape or strengthen the muscular corset, thereby relieving the load on the spine.
In the treatment of osteochondrosis, it is important to correctly combine treatment methods, first acute attacks of pain are relieved, then inflammatory processes, and only when the acute phase of the disease is over can non-traditional methods and physical exercises be used.
As a rehabilitation program for diseases of the spine, yoga and Pilates complexes have proven to be excellent.
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 loads, the nutrition of the intervertebral disc tissue occurs, its strength decreases and, as a result, herniation of the intervertebral disc. The process of destruction can drag on for many years and all this time go unnoticed, but with a single unsuccessful movement, the mechanism kicks in and all the symptoms appear one after another.
General symptoms and course of the disease
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 appear, back pain is possible, which gradually spreads towards the pinched nerve.
Body curvature is a characteristic sign of a lumbar hernia. This phenomenon occurs involuntarily, since the body needs to find the most comfortable position in which pain is minimal. In the case of severe, rapidly progressing disease, paralysis of the lower extremities (partial or complete) can result. This phenomenon is usually accompanied by dysfunction of the abdominal organs, especially the intestines and bladder.
Clinical manifestations of a hernia of the lumbosacral zone are expressed in a constant increase in pain and its intensification with specific physical exertion (weightlifting, bending, sharp strong muscle tension, cough), dull pain with localization in a point that does not go away, the direction of painin the buttocks or leg, 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 by the patient. To more accurately determine the presence of the disease, various methods are used that help to accurately determine the location of the disease. Computed tomography, magnetic resonance imaging and radiography - thanks to these methods, the doctor can visually determine the position of the pathologically changed vertebra and see the deformed intervertebral disc.
To determine the severity of the disease and the consequences, doctors use several tests: straight leg raising, tendon reflexes, sensitivity (reaction) of the leg at all levels (from the toes to the hip joint) to various types of stimuli - pain , vibration andTemperature.
Depending on the severity and condition of the patient, different methods of hernia treatment are used. In the event of an exacerbation, motor activity should be restricted immediately to bed rest and the pain relieved with medication. After 5-7 days, when the acute phase passes and the pain subsides, drug treatment is supplemented with other restorative procedures (massage, physiotherapy, physical education).
Drug and conservative treatment of lumbar hernia is the same as for osteochondrosis.
With a severe course of the disease and the presence of many serious consequences, surgical treatment is advisable.
Indications for an operation:
- Sequestration of a hernia - a part of the intervertebral disc damaged by a hernia enters the spinal canal;
- dysfunction of all or one organ in the pelvis;
- the patency in the spinal canal is impaired (determined by MRI);
- lack of results when using a medical and conservative treatment method for three or more months;
- Inflammation of the sciatic nerve.
Today, the surgical treatment of an inguinal hernia is carried out with the help of gentle, minimally invasive endoscopic interventions.
The method of laser reconstruction consists in evaporating liquid from the protruding nucleus pulposus with a laser. As a result, 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 protrusion of the nucleus pulposus inthe channel.
To remove the damaged part of the intervertebral disc, the method of percutaneous discectomy is used. Evaporation and removal of damaged tissue is carried out using a needle inserted through the skin.
If 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 result, the deformed disc is replaced with a prosthesis.
To prevent the progression of the disease, special exercises are prescribed. Complexes of exercises should be developed by a specialist individually for each patient and must include exercises for muscle stretching, tension and light aerobic exercises.
In the case of a 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 needed to evenly distribute the load (from the diseased area to the healthy one) and relieve stress (relieve). Injured segments of the spine when wearing the belt all the time 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 spine back pain (acute paroxysmal pain). This is the "simplest" scenario. Since hernias and osteochondrosis are characterized by deformation and frequent prolapse of the damaged intervertebral disc and displacement of the spine, injury to nearby nerve roots occurs, the so-called radicular syndrome.
It is aggravated by the injury to the veins, causing tissue edema (soft) and congestion. The symptoms of lumbodynia with radicular syndrome are similar to those of a lumbar hernia (acute downward radiating pain, loss of sensitivity and impaired reflexes) and since these are sequelae, the cause must first be treated holistically or disability may result.
Another consequence of inguinal hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and the associated pain that radiates to the leg or buttocks. Despite the ability to clearly define the "sore" place, the reason is in the spine.
Sciatica is not a disease in its own right, this term refers to a set of symptoms associated with 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 comprehensive examination by various specialists and accurately identify the cause, since this is the provoking factor. With the elimination of only some symptoms, the likelihood of progression of the underlying disease and the occurrence of many complications increases. Mindful management of your health, early detection of problems and timely treatment are the keys to good health.