According to world statistics, about 80% of the adult inhabitants of our vast planet share the same health problem: periodic or even constant back pain in the lumbar region.Low 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 experience discomfort in this area, without going to the doctor and without understanding the reasons, begin to intensively use various ointments and other “homemade lotions”.With these methods you can easily achieve the opposite result than expected.
Reasons: determined, exclusive
The success of any treatment depends directly on the accuracy of the diagnosis;When symptoms are eliminated, the likelihood of relapse increases.Subsequently, such treatment can only worsen the situation.Therefore, first of all, it is necessary to 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 provoke the appearance of pain in the lumbar region.
urinary system
Very 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 a "setback" in the lower back, but also by urination disorders (frequency, discomfort, the presence of blood in the urine and its turbidity) 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 side.The nature of these pains is usually girdling without a pronounced location.
If any disease of an organ not related to the musculoskeletal system is detected, it is the one that is treated, since this 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 takes on most 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 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 located and directed to the sacrum, its character is tight (pain).During this period, the destruction processes affected the nucleus pulposus (its dehydration occurs), as well as the vertebral 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 low back pain 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 protrusion and prolapse of the disc develops.The pain at this stage becomes more intense and prolonged.Every movement brings unbearable pain.Areas of the spinal cord, blood vessels and nerve endings adjacent to the sore spot may be compressed due to the fact that the annulus fibrosus protrudes and affects 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.To maintain support and protection functions, bone tissue grows in the diseased area.This usually causes various microtraumas and, subsequently, 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 treatment prognosis is favorable;Deformation processes can be stopped completely and the consequences minimized.In 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.
Medications
To relieve pain in lumbar osteochondrosis, analgesics in tablets or injections are used;The second option is preferable, since it is more effective.To relieve the inflammatory process, anti-inflammatory (non-steroidal) drugs are prescribed.Muscle relaxants eliminate muscle spasms that occur simultaneously with pain.Chondroprotectors are used to restore damaged cartilage tissue.
All of the above remedies sometimes do not have the desired effect, since the damage prevents the drug from penetrating the site of action.
To relieve an acute attack of pain, a block is used.It should only be done 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, because 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 chondroprotector.These remedies, when used correctly and combined with massage, are quite effective.
Physiotherapeutic procedures.
In combination with drug treatment of lumbar osteochondrosis, physiotherapeutic procedures are used: balneotherapy, laser and magnetotherapy, treatment with weak currents, light and vibrations.They have practically 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 provide the long-awaited relief, but some of them have contraindications, so it is necessary to consult with your doctor.
In addition to all the above treatment methods, physiotherapy helps to overcome the disease.Correctly distributed loads of the required intensity will help restore blood circulation to damaged areas, form or strengthen the muscle corset, and thus relieve the load on the spine.
When treating osteochondrosis, it is important to correctly combine treatment methods, first of all, acute attacks of pain are relieved, then inflammatory processes, and only when the acute period of the disease ends can non-traditional physical methods and exercises be used.
Yoga and Pilates complexes have proven to be excellent rehabilitation programs for spinal diseases.
Lumbar spine hernia
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, nutrition of the disc tissue occurs, its strength decreases and, as a result, the disc ruptures.The destruction process can last for many years and go unnoticed during all this time, but with a single failed 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 lumbar spinal hernia include decreased tendon reflexes, pain of varying intensity, muscle weakness, and numbness in the extremities.Hernia pain does not always occur;Lumbago 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 involuntarily, since the body needs to find the most comfortable position in which the pain is minimal.In case of severe and rapidly progressive disease, the consequences may be paralysis of the lower extremities (partial or complete).This phenomenon is usually accompanied by alterations in the functioning of the abdominal organs, in particular the intestines and bladder.
The clinical manifestations of a hernia of the lumbosacral zone are expressed in a constant increase in pain and its intensification during specific physical activities (lifting weights, bending over, sudden strong muscle tension, cough), dull pain localized in one point that does not go away, 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 based solely on 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 nuclear radiography and radiography - thanks to these methods, the doctor will be able to clearly determine the location of the vertebra with pathological changes and see the deformed disc.
To determine the severity of the disease and its consequences, doctors use various tests: straight leg elevation, tendon reflexes, sensitivity (reaction) of the leg at all levels (from the toes to the hip joint) to various types of stimuli: pain, vibration and temperature.
Treatment methods
Depending on the severity and condition of the patient, different methods are used to treat the hernia.In case of exacerbation, first of all, it is necessary to immediately limit physical activity to bed rest and relieve pain with medication.After 5-7 days, when the acute period ends and the pain has subsided, drug treatment is complemented by other restorative procedures (massage, physiotherapy, physical education).
The pharmacological and conservative treatment of lumbar hernia is the same as that of osteochondrosis.
Surgery
In case of severe disease and presence of many serious consequences, surgical treatment is advisable.
Indications for surgical intervention:
- hernia sequestration: entry of an area of the disc 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 using MRI);
- lack of results when using medicinal and conservative treatments for three or more months;
- 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 intervention 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 performed 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 all methods used do not give any results, the deformed disc is replaced with a prosthesis.
Preventive measures
To prevent the progression of the disease, special exercises are prescribed.The exercise series must be developed by a specialist individually for each patient and must contain muscle stretching, tension and light aerobic exercise.
For a hernia of the lumbar spine, doctors recommend using 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 various degrees of rigidity.
This product is necessary to evenly distribute the load (from the diseased area to the healthy one) and relieve tension (unload).With constant use of the belt, the injured segments of the spine are corrected and returned to their anatomical position.
Lumbodynia with radicular syndrome
Against the background of osteochondrosis and hernia of the lumbar spine, lumbago develops as a consequence: 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 nearby nerve roots is observed, which is called radicular syndrome.
It is intensified by pinching of the veins, which causes swelling of the (soft) tissues and congestion.The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (sharp shooting pains radiating downwards, loss of sensitivity and impaired reflexes) and, since this is a consequence, the cause must be initially treated with an integrated approach, otherwise disability may occur.
Sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve (sciatica) and the accompanying pain, which radiates to the leg or buttocks.Despite the ability to clearly identify the "pain" point, the reason is in the spine.
Sciatica is not a stand-alone disease;This term refers to a series of symptoms that accompany certain spinal diseases.Pain sensations can be different, in some cases it is simply a slight discomfort when staying in the same not very comfortable position for a long time, and sometimes the pain causes 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, it is necessary to carry out a complete examination by different specialists and accurately identify the cause, because it is the provoking factor.By eliminating only a few symptoms, you increase the likelihood of the underlying disease progressing and many complications occurring.Paying attention to your health, early recognition of problems and timely treatment is the key to good health.