According to world statistics, about 80% of the adult inhabitants of our vast planet are united by 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 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 felt symptoms, the likelihood of relapse increases. Subsequently, such treatment can only worsen the situation. Therefore, first of all, you should carefully check the condition of all organs, the symptoms of which can be pain in the lumbar region.
Digestive system
Exacerbations of diseases of the digestive system (pancreatitis, ulcer, colitis, cholecystitis, enteritis, appendicitis) often provoke the appearance of pain in the lumbar region.
urinary system
Most often, pain in the kidneys is confused with symptoms of diseases of the lumbar spine, since their nature is identical. Diseases of the kidneys and urinary tract of different etiology are accompanied not only by "pulling back" to the lower back, but also by urination disorders (frequent urination, discomfort, the presence of blood in the urine and its turbidity) and an increase in body temperature.
reproductive system
With problems of the reproductive organs in men and women in an acute stage, the pain often radiates to the lumbar region, the tailbone or the side. The nature of these pains is often a girdle without pronounced localization.
If any disease of an organ that is not related to the musculoskeletal system is found, it is treated, since it is the real cause of the pain syndrome. If no problems with the upper organs are found after a thorough examination, then most likely the problem is in the spine.
Osteochondrosis
The most mobile part of the spine, which takes the lion's share of the loads, 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 (painful). During this period, the destruction processes affect the nucleus pulposus (its dehydration occurs), as well as the vertebral discs (reduces their height in a standing position). Discomfort is observed with heavy loads, and the pain itself is mild.
After a while, if the problem is ignored and no measures are taken, shootings in the thigh and buttocks begin. 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, disc protrusion and prolapse develop. 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 inflamed area 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 that have occurred due to the disease in the following way. In order to maintain 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 development of the disease. In a mild form, the prognosis for treatment is favorable, the deformation processes can be completely stopped and the consequences can be minimized. In the last stage of the development of the disease, the task of treatment is to eliminate all symptoms and consequences, to normalize the nutrition of the spinal tissues, to strengthen the muscular corset of the entire back, and especially of its lower part.
Medicines
Analgesics in tablets or injections are used to relieve pain in lumbar osteochondrosis, the second option is preferable, as it is more effective. To alleviate the inflammatory process, anti-inflammatory drugs (non-steroidal) are prescribed. Muscle spasm that occurs simultaneously with pain is eliminated with muscle relaxants. Chondroprotectors are used to restore damaged cartilage tissue.
All these means sometimes do not have the desired effect, because damage prevents the drug from penetrating to the site of action.
The block is used to relieve an acute attack of pain. It should only be performed by a specialist.
An appropriate analgesic is injected with a long needle into the gap between the spinous processes. After such a procedure, the pain disappears very quickly, but for some time, since 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.
Physiotherapy procedures
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.
Alternative methods
Increasingly, alternative (non-traditional) methods are used alongside 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 necessary.
In addition to all the above methods of treatment, physical therapy helps to overcome the disease. Properly distributed loads with the necessary intensity will help to restore blood circulation in the damaged areas, shape or strengthen the muscle corset and thus relieve 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 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 go on for many years and remain unnoticed all this time, but with one failed movement, the mechanism is triggered 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 in 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 where pain is minimal. With a severe, rapidly progressing course of the disease, the consequences can be paralysis of the lower limbs (partial or complete). This phenomenon is usually accompanied by disorders 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 exertion (lifting weights, bending over, sharp strong muscle tension, coughing), dull pain with localization in one point that does not disappear, the direction of the pain in the buttock or leg, or numbness in this area.
Diagnosis of hernia of the lumbar spine
It is difficult to diagnose a hernia visually or only by the symptoms described by the patient. 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 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 a straight 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 are used to treat hernia. In case of exacerbation, first of all, it is necessary to immediately limit motor activity to bed rest and relieve pain with drugs. After 5-7 days, when the acute period ends and the pain subsides, drug treatment is supplemented with other restorative procedures (massage, physiotherapy, physical education).
Medicinal and conservative treatment of lumbar hernia is the same as for osteochondrosis.
surgery
In the case of a severe course of the disease and the presence of very serious consequences, surgical treatment is recommended.
Indications for surgery:
- hernia sequestration - part of the herniated disc enters the spinal canal;
- dysfunction of all or one organ in the small pelvis;
- impaired patency in the spinal canal (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 hernia is now performed using gentle, minimally invasive endoscopic operations.
The laser reconstruction method consists in vaporizing liquid from the bulging nucleus pulposus using a laser. Thanks to this, the nerve root is "released", i. e. 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 in the canal.
To remove the damaged part of the intervertebral disc, the percutaneous discectomy method is used. Vaporization and removal of damaged tissue is done with a needle inserted through the skin.
In the event that 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 give results, the deformed disc is replaced with a prosthesis.
Precautions
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 should include exercises for muscle stretching, tension and light aerobic exercises.
Doctors recommend wearing a special fixation belt for herniated lumbar spine. Outwardly, it looks like a capsule, its width is about 30 cm, it is attached to the body with Velcro and has several degrees of hardness.
This product is needed 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 herniation of the lumbar spine, as a result, lumbago develops - lumbar back pain (acute paroxysmal pain). This is the "simplest" scenario. Since hernia and osteochondrosis are characterized by deformation and frequent prolapse of the damaged disc and displacement of the spine, there is a disorder of the nearby nerve roots, called radicular syndrome.
It is aggravated by a violation of the veins, which provokes swelling of the tissues (soft) and congestion. The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of a lumbar hernia (sharp shooting pain that radiates downward, loss of sensitivity and impaired reflexes) and since this is a consequence, the cause must initially be treated with an integrated approach, otherwise it threatensimpairment.
sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and the accompanying pain that radiates to the leg or buttock. Despite the ability to clearly determine the "sick" place, the cause 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 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 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 accurately identify the cause, since it is the provoking factor. With the elimination of only some of the symptoms, the probability of the progression of the main disease and the appearance of many complications increases. Careful attitude to your health, early recognition of problems and timely treatment are the keys to good health.