According to world statistics, about 80% of the adult population of our vast planet share the same health problem - periodic, or even constant, back pain in the lumbar region.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, bypassing the doctor and without understanding the reasons, begin to intensively use various ointments and other "homemade lotions".With this method you can easily achieve the opposite of the expected result.
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The success of any treatment directly depends on the accuracy of the diagnosis;when symptoms are eliminated, the likelihood of relapse increases.After that, such treatment can only worsen 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.
Digestive system
Severity of diseases of the digestive system (pancreatitis, ulcers, colitis, cholecystitis, enteritis, appendicitis) often cause pain in the lumbar region.
Urinary system
Often, kidney pain is mistaken for a symptom of lumbar spine disease, as its nature is the same.Diseases of the kidneys and urinary tract of various etiologies are accompanied not only by "recoil" to the lower back, but also by urinary disturbances (frequency, discomfort, the presence of blood in the urine and its turbidity), and an increase in body temperature.
Reproductive system
With problems with reproductive organs in men and women in the acute stage, pain often radiates to the lumbar region, tailbone or to the side.The nature of this pain is often circular without clear localization.
If any organ disease not related to the musculoskeletal system is detected, it is the one that is treated, because it is the real cause of the pain syndrome.If, after a thorough examination, no problems with the above organs are identified, then most likely there is a problem with the spine.
Osteochondrosis
The most mobile part of the spine, which takes the largest part of the load, is the lumbosacral part.With an inactive lifestyle, excessive load 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 worrying symptom of osteochondrosis is pain in the lumbar region.At the initial stage, it is localized and directed to the sacrum, its character is attractive (painful).During this period, the destruction process affects the nucleus pulposus (dehydration occurs), as well as the vertebral disc (its 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, lumbago begins to radiate to the thighs and buttocks.Due to the narrowing of the intervertebral space, 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 disc, the spine itself is severely deformed, and disc protrusion and prolapse develop.The pain at this stage becomes more intense and prolonged.Every movement brought unbearable pain.It is possible that the area of the spinal cord, blood vessels and nerve endings adjacent to the pain point may be compressed 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 as a result of the disease in the following way.In order for support and protection functions to be preserved, bone tissue grows in diseased areas.This usually leads to various microtraumas, and subsequently to disability.
An integrated approach to treatment
Treatment of lumbar osteochondrosis must be comprehensive, regardless of the stage of development of the disease.In mild cases, the prognosis for treatment is favorable;the deformation process can be stopped completely and the consequences can be 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 tissue, and strengthen the muscular corset of the entire back and its lower part in particular.
Medicines
To relieve pain in lumbar osteochondrosis, analgesics are used in tablets or injections;the second option is better, because it is more effective.To relieve the inflammatory process, anti-inflammatory drugs (non-steroidal) are prescribed.Muscle spasms that occur simultaneously with pain are eliminated by muscle relaxants.Chondroprotectors are used to restore damaged cartilage tissue.
All of the above drugs sometimes do not have the desired effect, because damage prevents the drug from penetrating to the site of action.
To relieve acute attacks of pain, restraints are used.It should only be carried out by experts.
An appropriate analgesic is injected into the space located between the spinous processes using a long needle.After such a procedure, the pain disappears quickly, but for some time, because there is no therapeutic effect.
The use of local complex products - ointments, gels - is effective.They have an analgesic, anti-inflammatory, warming effect;many preparations for topical use contain chondroprotectors.These drugs, when used correctly and combined with massage, are quite effective.
Physiotherapy procedures
In combination with drug treatment for lumbar osteochondrosis, physiotherapeutic procedures are used - balneotherapy, laser and magnetic therapy, treatment with weak current, light and vibration.They have almost no side effects or 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 long-awaited relief, but some of them have contraindications, so consultation with your doctor is necessary.
In addition to all the above treatment methods, physical therapy helps to overcome this disease.Properly distributed load with the required intensity will help restore blood circulation in the damaged area, form or strengthen the muscle corset, and thus relieve the load on the spine.
When treating osteochondrosis, it is important to combine treatment methods correctly, first of all, acute pain attacks are relieved, then the inflammatory process, and only when the acute period of the disease ends, non-traditional methods and physical exercises can be used.
Yoga and Pilates complexes have proven themselves as excellent rehabilitation programs for spinal diseases.
Hernia of the lumbar spine
Against the background of untreated or neglected osteochondrosis in the lumbar region, hernias very often develop - 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 years and go unnoticed all this time, but with one unsuccessful movement the mechanism starts, and all the symptoms start 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 limbs.Pain from a hernia does not always occur;lumbago is possible, which gradually spreads towards the pinched nerve.
Distortion of the body is a characteristic sign of a lumbar hernia.This phenomenon happens involuntarily, because the body needs to find the most comfortable position where the pain is minimal.In severe and rapidly developing disease, the result may be paralysis of the lower leg (partial or complete).This phenomenon is usually accompanied by disturbances in the function of the abdominal organs, especially the intestines and bladder.
The clinical manifestation of lumbosacral zone hernia is expressed in a constant increase in pain and its intensity during certain physical activities (lifting heavy, bending, sudden strong muscle tension, coughing), local dull aching pain at one point that does not disappear, direction of pain in the back or legs, or numbness of this area.
Diagnosis of lumbar disc herniation
It is difficult to diagnose a hernia visually or only based on the symptoms described by the patient.In order to more accurately determine the presence of the disease, several methods are used to 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 clearly determine the location of the pathologically changed vertebrae and see the deformed disc.
To determine the severity of the disease and its consequences, the doctor uses a number of tests: the height of the straight leg, tendon reflexes, the sensitivity (response) of the leg at all levels (from the toes to the hip joint) to several types of stimuli - pain, vibration and temperature.
Treatment methods
Depending on the severity and condition of the patient, different hernia treatment methods are used.In case of exacerbation, first of all, you should immediately limit physical activity until bed rest and relieve pain with medicines.After 5-7 days, when the acute period ends and the pain has subsided, drug treatment is supplemented with other rehabilitation procedures (massage, physiotherapy, physical education).
Drug and conservative treatment of lumbar hernia is the same as osteochondrosis.
Surgery
In cases of severe disease and the presence of many serious consequences, surgical treatment is advised.
Indications for surgical intervention:
- hernia resorption - insertion of the disc area damaged by the hernia into the spinal canal;
- dysfunction of all or one organ in the pelvis;
- patency in the spinal canal is impaired (determined using MRI);
- lack of results when using medical and conservative treatment for three months or more;
- inflammation of the sciatic nerve.
Surgical treatment of hernias is now carried out using a gentle and minimally invasive endoscopic operation.
The laser reconstruction method involves the evaporation of 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 several 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, a percutaneous discectomy method is used.Vaporization and removal of damaged tissue is done with a needle inserted through the skin.
In cases where it is impossible to restore a damaged disc by any method, starting with drugs and ending with minimally invasive surgery, or all methods used do not bring any results, the defective disc is replaced with a prosthesis.
Preventive measures
To prevent the development of the disease, special exercises are prescribed.The exercise set must be developed by a specialist individually for each patient and must contain exercises for muscle stretching, tension and light aerobic exercise.
For a herniated lumbar spine, doctors recommend wearing a special fixation belt.Externally, 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 distribute the load evenly (from the diseased area to the healthy one) and relieve tension (unloading).With continued wearing of the belt, the injured spinal segment is corrected and returned to its 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 hernia and osteochondrosis are characterized by frequent deformation and prolapse of damaged discs and displacement of the spinal column, pinching of nearby nerve roots, the so-called radicular syndrome, is observed.
It is intensified by pinching the vein, which causes swelling of the (soft) tissue and congestion.The symptoms of lumbodynia with radicular syndrome are similar to the symptoms of lumbar hernia (sharp shooting pain radiating down, loss of sensitivity and impaired reflexes), and since this is the consequence, the cause must initially be treated with an integrated approach, otherwise deformity may occur.
Sciatica
Another consequence of hernia and osteochondrosis is inflammation of the sciatic nerve - sciatica and accompanying pain radiating to the legs or back.Despite the ability to clearly identify the place of "pain", the reason lies in the spine.
Sciatica is not an independent disease;this term refers to some symptoms that accompany certain diseases of the spine.The sensation of pain can be different, in some cases it is only mild discomfort when staying in the same position is not very comfortable for a long time, and sometimes the pain leads to loss of consciousness and analgesics do not help in this case.
For effective treatment, it is not enough to diagnose sciatica or lumbago;in any case, you need to conduct a full comprehensive examination from different specialists and accurately identify the cause, because it is a provoking factor.By eliminating only a few symptoms, the likelihood of the underlying disease developing and the appearance of many complications increases.Paying attention to your health, early detection of problems and prompt treatment are the keys to good health.