Strong pain in lumboy wishout is caused by irritation of the spinal nerves, in particular the sedanistic nerve. This may be caused by the defeat of the spine as a result of excessive loads.
The disease occurs in 25-30% of cases with back pain in various origin and is found primarily in people of young and middle age (25-45 years old), since it is at this age that the greatest load on the spine arises in view of some professional features and peak of human activity.
What it is?
Lumboishiasia is a violation that affects the sedellastic nerve, manifested by pain in the area of \u200b\u200bthe waist, which affects the buttock, the back of the leg, the shin. With this disease, pain syndrome develops sharply and suddenly. Usually its appearance provokes a sharp movement, lifting weight, long staying in an uncomfortable posture.
Lumboy's syndrome can manifest themselves with different types of unpleasant sensations - an increasing, burning, novel pain, a feeling of heat or zyabacity in the affected area.
Causes of the development of pathology
The main reasons for lumboy walgia are an awkward movement, or raising too heavy items. However, provoking the emergence of such a violation also:
- constant stress and depression;
- the hernia of the vertebral disk;
- heavy physical work or some sports;
- age after thirty years;
- deforming osteoarthritis;
- disorders of the posture due to pregnancy or excess weight that shift the center of gravity of the body.
Depending on what exactly led to the development of such a violation, the following categories of LumboishIligia are distinguished:
- neuropathic, in which pain develops due to the squeezing of nerve roots;
- muscular-skeletal, which is formed on the basis of pathologies of the musculoskeletal system, in particular, the spinal column and the lower extremities. In addition, the same category includes discogenic lumboishiasia and hindsting syndrome;
- mixed - this includes combinations of pathologies of different anatomical structures and a combination of different anomalies of the lower limbs based on the heterogeneous process;
- angiopathic - in this case, soreness appears due to the defeat of the blood vessels of the lower extremities.
The presence of any form of lumboy-walled requires mandatory clinical, instrumental and laboratory tests. Such studies are necessary to identify the pathologies of blood vessels located in the lower limbs and the abdominal cavity.
In addition, possible causes of the disease there may be violations of the functionality of the small pelvis organs and the abdominal cavity, which can also be identified using the studies described above.
Pathogenesis
The pathogenesis of LumboishIligia is directly related to the cause that it provoked. For example, the pear muscle syndrome usually occurs during osteochondrosis, in which the area of \u200b\u200bthe damaged intervertebral disk becomes the source of pathological pulses. At the same time, the patient's nervous system perceives the pulses as pain and makes everything possible to eliminate it by increasing the tone of the muscles or immobilizing the lesion zone. The tension in the muscles is distributed beyond the source of pain, affects the pear-like muscle and the sedanized nerve. Due to the contraction of the muscles, squeezing the nerve and pain occurs.
The cause of lumboy walgia can also be intervertebral hernia, pathological processes in which lead to narrowing the lumen of the spinal column channel. This further leads to squeezing and inflammation of the sciatic nerve. As a result, motor and sensory nerve fibers are annoyed, which provokes pain syndrome. The pain also appears as a result of a severe course of hernia or its complications.
Classification
There are several pathology classifications.
Distinguish:
- acute lumboy walkers (primary pain syndrome);
- chronic Lumbago with Ishias (sharp phases are replaced by remissions).
Due to the appearance of LumboishIligia differentiate to the species:
- vertebrogenic or vertebros (associated with diseases of the spine),
including:
- discogeneous (due to the hernia of the intervertebral disk);
- spondylogenic (proceeds due to the osteochondrosis of the spine).
- never accompanied
including:
- angiopathic (manifests itself with the lesion of the vessels of the belt of the lower extremities and the lower back);
- miofascial (observed for diseases of muscles and fascia);
- lumboishialgy when defeating the organs of the peritoneum;
- lumbago with Ishias on the background of the pathologies of the hip joint.
According to the degree of distribution of pain syndrome Lumboishialia, can be:
- one-way - irradiates into one limb, is more pronounced on one side of the lower back: on the left or right);
- bilateral (bilateral) - manifests itself on both sides of the spine, often gives both limbs.
Symptoms of LumboishIligia
The following symptoms from the belt and lower extremities are characterized by lumboy-wallery:
- movements in the lumbar region are dramatically limited,
- the emergence of lower back pain, which are given in one or less in both legs,
- the patient is forced to make a special position - bent forward and leaning out,
- pains in the lower back are enhanced by changing the position of the body,
- in the course of the nerve there may be a feeling of itching, burning, heat, or vice versa, sharp coldness,
- in the leg of the pain pass on the buttock, the rear-outer surface of the thigh, knee and partly the calf muscle,
- attempts to move and full advancing on the leg cause a sharp pain, which has the character of the burning, increasing and novel,
- pains are becoming stronger in cooling, cold, exacerbation of chronic pathology, overwork, after severe physical exertion,
- the skin of the sick legs usually has a pale color, can have a marble color, cold on a mouthpiece
Lucky wishouts are usually arising on the progressive osteochondrosis. With acute lumbashishing, these phenomena are strongly pronounced and sharply, when chronic flow can manifest itself with periods - with activation and attenuation, wave-like.
Diagnostics
If the patient is tormented by the pain in the lower back area, and discomfort applies to their feet, it is necessary to go on the reception to the neuropathologist. For the correct formulation of the diagnosis, as well as the exception of other pathologies, the following studies will be carried out:
- Test Lasega. The patient falls on his back. Doctor asks him to raise his leg. The doctor then pulls the feet of the patient. When breeding a sciatic nerve, the patient will significantly increase discomfort.
- General inspection and study of patient complaints. The event is aimed at eliminating disturbing signals characterizing such pathologies as spinal infections, oncology.
- Magnetic and computed tomography. A detailed and accurate study of violations that occurred in the hip joint.
- Radiography of the spine. The event makes it possible to identify various sickness sides.
- Blood tests. They define autoimmune processes and inflammatory reactions occurring in the body.
- Densitometry. This type of diagnostics determines the bone density and allows you to identify osteoporosis in the early stages.
How to treat Lumboishiyalgia?
Before starting treatment, it is necessary to seem to see a neurologist or therapist to identify the exact cause of the occurrence of this pain syndrome.
In the acute period, the patient needs peace (up to 2 weeks) and the reception of some drugs. In the treatment of the disease, such drugs are prescribed:
- Package - injections or tablets of non-steroidal anti-inflammatory drugs (Brufen, Movied), non-nucleic analgesics (Lyrics, Catadolon).
- Miorlaxants - to neutralize muscle spasms (Sirdalud, Middokalm).
- Diuretic - against the edema of nerve trunks (Laziks).
- Novocaine blockades in the spine area, with unbearable pain - blockades with glucocorticosteroids (diprospan, hydrocortisone).
- Sedable preparations (phenosipam, relaignation).
- Vitamins of group B - to activate the conductivity of nerves and muscle recovery (Milgamma, neuromulitivitis).
- Bleeding activators (Trental, Actovegin).
- Local painkillers - ointments, creams with nonsteroidal components (diclac, fast-gel).
As the condition improves, therapeutic physical culture is prescribed, the gymnastics for the spine, massage, UHF, paraffin therapy, treatment with microtoks, magnetotherapy, electrophoresis.
Gymnastics
To reduce pain and prevent possible recurrences, patients are shown to undergo a course of therapeutic gymnastics. This course of exercises is aimed at strengthening the muscles that surround the vertebral pillar, thanks to which it is possible to reduce the risk of vertebrae offsets and make them more resistant to the loads. Patients must carry out exercises in specialized agencies under the control of specialists. However, over time, after passing the course of therapeutic physical education, they will be able to continue their homes at home on their own.
The complex of medical gymnastics must include exercises that promote muscle stretching (corps turns, slopes, back deflection). Effective are also considered to be exercises aimed at restoring the mobility of the hip joints and the spine (squats, mahs with legs, lifting the case from the position lying). Patients are also recommended to engage in simulators and yoga.
Popular treatment
People's methods should be carried out at home by people's methods at home all after the recommendations of the attending physician.
It is possible to facilitate the state by the following manipulations:
- Pain in the painful zones of the batching fat, a solution of vegetable oil with ammonia alcohol (2: 1 ratio).
- Apply to the inflamed sections of Cashitz from the rubber black radish, the compresses from the alcohol tincture of birch kidney.
- Use warming plasters.
- Wear a belt from dog wool.
The forecast for LumboishIligia, as a whole, is favorable if the patient will visit the doctor in a timely manner and the treatment of the underlying disease will begin. However, you should not neglect the prevention measures that will help prevent this unpleasant phenomenon.
Treatment of homeopathy
Simultaneously with standard treatment it is possible to use homeopathic agents. They have a positive effect on the whole organism, activate the processes of self-regulation and self-describing.
The most effective drugs - "Traumel-C", "Pois-T". They consist of useful vegetable complexes, minerals, chondroprotectors that relieve inflammation that improve blood circulation, metabolic processes, restoration of cartilage and bones.
Prevention
In cases where the load on the spine cannot be avoided, there must be uncomplicated rules that minimize the risk of lumbashing syndrome.
- Avoiding the injuries of the spine and supercooling, especially in the area of \u200b\u200bthe belt.
- Timely treatment of diseases of the joints, blood vessels, spine.
- Do not wear high-heeled shoes.
- It is also desirable to avoid lifting weights, especially from tilt, it is better to sit down.
- It is necessary to monitor your own post and control the body weight.
- If you need a trip behind the wheel, you need to stop each hour, to warm up and go.
- Remember: alcohol and smoking reduce the body's resistance to various infectious diseases.
- In the presence of chronic lumboyashivalgia, it is recommended to undergo regular sanitary and resort treatment.
- Also it is necessary to regularly undergo profiles from orthopedic, neuropathologist and neurologist.
- With sedentary work, you need to make a 5-10-minute break every hour, in which to warm up the back and legs. The chair must have armrests and an adjustable back to reduce the load on the back.
The best prevention of the occurrence of re-seizures of LumboishIligia is the implementation of therapeutic gymnastics, massage courses and compliance with precautionary measures when loaded on the spine.
The pain attack, localized in the area of \u200b\u200bthe belt and the rear surface of the hip, developing due to lifting weights, awkward turning of the body, the protrusion of the intervertebral disk. The disease is manifested by sudden pain, forced body position and impaired movement in the lower back and affected limb. The diagnosis is established on the basis of a clinical inspection, radiographic study, CT or MRI, myelography. The treatment uses analgesics, nonsteroidal anti-inflammatory drugs; After an element of inflammation, medical gymnastics is assigned, physiotherapy procedures are applied. With unfavorable current, surgical treatment is carried out.
General
Lumboishiasia - painful sensations in the lower back of various intensities (from the sensation of discomfort to powerful intense pains), prone to irradiate in the leg, resulting from the pathological compression and irritation of the deformed vertebrae of the spinal roots of L4-S3, forming a sedanized nerve. Pain sensations arise against the background of the osteochondrosis of the spine, spondyloarthrosis, intervertebral hernia and other diseases accompanied by destructive changes and the formation of osteophytes. The disease is approximately 20-30% of cases among all pathological processes associated with spin pain. It is most often found in people of working age (young and middle age, 25-45 years old).
Causes of LumboishIlia
Lumboishialias most often has vertebrogenic origins and is caused by a reflex "reflection" of pain in the intervertebral hernia of the lumbar department, lumbar spondyltroitrosis and other degenerative changes in the spine. In part of the patients, it is a manifestation of myofascial pain syndrome involving the back muscles and pelvis. Also pain may be due to irritation of binder, bone, muscle structures; At the same time it happens two-way, with poorly determined localization; Paining reaction is deep and rarely irradiages below the level of the knee joint. In the elderly, the arthrosis of the hip joint (coxarthrosis), the pain in which can irradiating into the lower back is often the cause of lumboy-walled. The following situations can provoke the development of pain reaction: sharp turns of the body, hypothermia, staying on drafts, long-term prefitting in an uncomfortable, monotonous pose. Less often, pathology develops without any visible reasons.
The risk group on the development of Lumboy-wallege includes people with overweight, chronic diseases of the spinal column, intervertebral hernias, infectious exacerbations, as well as patients who work in production, are constantly experiencing increased loads and for a long time carried out in the same position of the body.
Pathogenesis Lumboy wishligia
The mechanisms for the development of pain syndrome with lumboy wishouts are different, depending on the causes that run the pathological process.
Lumboy wishies differentiate from the mouse muscles of the back and the pathology of the hip joint. For accurate diagnosis, the doctor carefully studies history, conducts an examination of the patient, gives an assessment of the existing objective and subjective clinical manifestation of pathology.
Treatment of LumboishIligia
In the complex therapy of LumboishIligia, as a rule, include anti-inflammatory funds, minesplates, antispasmodics, drugs for improving microcirculation. A positive effect on the well-being of a patient has a vitamins that contribute to the restoration of tissues, regeneration and nutrition of cartilage structures of the spinal column.
An excellent painkillers and a concentrating action in the subacute period of the disease has a therapeutic massage. With lumboy-walling, special attention is paid to the region of the lower back and the sacrum. In the systematic knelling of this zone, it is possible to improve the bloodstream, restore metabolism in the spinal column and slow down the progression of osteochondrosis.
If physiotherapy and drug treatment cease to act or ineffective, operational treatment is appointed. Indications to its conduct are: symptoms of spinal cord; pelvic disorders and lower paraparex; severe pain syndrome, not amenable to conservative treatment. Most often it is recommended to carry out surgical treatment of intervertebral hernia. During operation, the damaged disk can be deleted partially or completely. It is possible to carry out discectomy, microdiskectomy and endoscopic discectomy. With total interventions, plastic is used for a damaged intervertebral disc.
With frequent recurrences of lumbar pain, special gymnastic exercises are recommended. They allow you to strengthen the muscles surrounding the vertebral pole, which significantly reduces the risk of vertebrae displacement and increases their physical stress resistance. Therapeutic physical culture is recommended to be carried out in a medical facility, under the guidance of an experienced physician LFC. Without knowledge in the field of exercise, it is not necessary to experiment with unknown exercises, since with one embarrassing movement you can stretch the muscles, provoke the appearance of the inflammatory process and strengthen the signs of intervertebral hernia. Gradually, patients get used to the rhythm, in which exercises are performed, master new techniques and approaches, so that after extracting from the hospital or termination of the active period of treatment, continue to apply therapeutic physical culture, but without any assistance.
Forecast and prophylaxis of lumbarishalgia
Approximately in 95% of cases, Lumboishialgy is benign and, with a timely favorable forecast, has a fairly favorable forecast. In terms of frequent recurrences of the disease and the absence of treatment, tissue deformations may occur, the nodes in the depths of the muscles are often generated, metabolic processes are violated.
Preventive measures for lumbar pain are aimed at timely treatment of spinal diseases and prevent their progression in the future. It is recommended to avoid the long-term voltage of the muscles of the spine, which leads to stagnant phenomena and provokes the appearance of destructive changes in vertebral cartilage tissue. Motor stereotype correction is required; Avoid performing movements to unprepared muscles; The creation of a muscular corset is required, which will ensure the correct load distribution on the vertebral post. It is also necessary to make the correction of posture disorders with the formation of the correct posture, to take care of a decrease in body weight and abandon smoking. In addition, for the prevention of frequent recurrences, it is recommended to pass sanatorium-resort treatment to the prevention of frequent relapses 1-2 times a year.
Lumboy wishlogia call the occurrence of painful sensations, heat or coldness in the zone of the waist and legs.
With lumboy-walled pains spread over the region of the buttock and the rear surface of the limb to the knee zone. Unpleasant symptoms arise due to the distribution of the process on the zone of the seeded nerve and the spinal nerves.
The reasons
Usually, with lumboy-walled, pain attacks occur sharply, as a result:
- raising heavy items,
- long stay in uncomfortable or forced poses,
- awkward and sharp movements.
The main reasons for the development of LumboishIlias are:
- hernia or protrusions of intervertebral disks.
- deforming osteoarthritis
- age changes of the spine after thirty years,
- chronic stress
- excess weight,
- pregnancy,
- heavy physical or sports loads,
- spinal injuries
- supercooling of the spine region,
- infectious diseases
- arthritis, fibromyalgia.
Views
Depending on the causal factors, such forms of lumboy walkers are distinguished:
- muscular and skeletal, which will be formed as a result of problems with various departments of the musculoskeletal system in the spinal zone and lower extremities.
- neuropathic, with the formation of pain syndrome due to the compression or reliance of nervous trunks, which are responsible for the innervation of the region of the lower limbs,
- angiopathic, in which pain syndrome occurs due to the defeat of the veins or the arteries that feed the lower back and the lower limbs, the formation of their ischemia and the deficiency of oxygen in the tissues.
- mixed - this form of lumboy walkers is due to the pathology of several structures in the field of lower extremities (nerves and vessels, nerves and the musculoskeletal system, etc.).
Mechanisms of formation
The causes of LumboishIligia are irritation of nerve roots by various impacts - inflammation, injury, squeezing with muscles or deformed bone structures.
This leads to irritation of the nerve and the occurrence of pain impulses. At the same time, the muscles can strain, their bugness is formed, the skin can be disturbed and the nodules in the thickness of the muscles may even form.
In the process of the development of lumbashingalgia, due to the nerve impairment, there is an unpleasant feeling of heat or chills of limbs, the color disorders of the limb or a sharp pallor of the skin.
All of these tissue changes lead to even more violations and the emergence of even more pronounced pain.
Symptoms of LumboishIligia
With lumboy-walling, the following manifestations from the lower back and lower extremities are characteristic:
- the emergence of lower back pain, which are given in one or less in both legs,
- movements in the lumbar region are dramatically limited,
- pains in the lower back are enhanced by changing the position of the body,
- the patient is forced to make a special position - bent forward and leaning out,
- in the leg of the pain pass on the buttock, the rear-outer surface of the thigh, knee and partly the calf muscle,
- in the course of the nerve there may be a feeling of itching, burning, heat, or vice versa, sharp coldness,
- sick leg skin usually has a pale color, can have a marble color, cold to the touch,
- attempts to move and fully advancing on the leg cause a sharp pain, which has the character of the burning, increasing and new.
- pains become stronger when cooled, cold, exacerbation of chronic pathology, overwork, after severe physical exertion.
Lucky wishouts are usually arising on the progressive osteochondrosis.
With acute lumbashishing, these phenomena are strongly pronounced and sharply, when chronic flow can manifest itself with periods - with activation and attenuation, wave-like.
Diagnostics
The basis of diagnostics is a manifestation of typical complaints of pain in the back and leg, and the doctor's inspection and laboratory diagnostics are necessary. Instrumental research is required:
- x-ray study of the lumbar and pelvic region,
- CT or MRI of the lumbosacral spine.
Treatment of LumboishIligia
Therapists, neurologists and orthopedists are diagnosed with the diagnosis and treatment of LumboishIligia. Comprehensive treatment and rehabilitation methods are used.
In the sharp period:
- bed regime with restriction of physical exertion and body movements,
- reducing the consumed fluid for removing the swelling,
- putting pain in analgesic effect with anti-inflammatory effect (ketorol, nurofen, diclofenac), the use of them inside and place - in gels, creams, ointments.
- with pronounced pain syndromes Novocaine blockades,
- in severe muscular spasms, antispasmodics and muscatics are used.
As acute manifestations are used:
- medical gymnastics
- osteopathic practices
- massotherapy,
- igloreflexotherapy,
- physiotherapy
- we carry special orthopedic designs - corsets, belts-proofreaders.
The forecast in the case of acute lumbashingalgia is favorable, the process can be quickly stopped. In the chronic process, the forecast is more complex - it all depends on the cause and severity of the disease.
Prevention
In order not to form complications and not cause the exacerbations of LumboishIligia, it is necessary:
- not be long in a vertical position
- for relaxation of the legs, periodically rely on chairs or support,
- do not wear high heels,
- with sedentary work, it is more common to change the position and sit on the chair straight, laying a roller under the lower back,
- with a long ride in the car to make frequent stops, getting to warm up,
- do not smoke,
- follow your weight
- at the very first signs of pain to contact the doctor.
Under Ishias, the disease is understood by the disease leading to the damage to the sciatic nerve or covering other nerve roots near the lumbosacral segment of the spine.
Ishiygia is manifested by a strong pain in the back of the back of the thigh, irradiating in a foot and a shin, and sometimes felt throughout the surface, innervated by the branches of the sedellastic nerve.
As the disease progressing, it is often supplemented with races (lumbago) - sharp pain, arising suddenly when irritating the nervous trunks. The combination of symptoms - Lumboishialgy - requires careful diagnosis, as it can be a consequence of various primary pathologies.
Pain can wear different character and intensity, appearing as the effect of some factors or be spontaneous, is supplemented by other symptoms. The degree of protracted exacerbations of LumboishIligia, alternating with short remissions or without any, is most difficult.
Types of Lumboishhalgia
There are several pathology classifications.
Distinguish:
- acute lumboy walkers (primary pain syndrome);
- chronic Lumbago with Ishias (sharp phases are replaced by remissions).
Due to the appearance of LumboishIligia differentiate to the species:
- Vertebrogenic or vertebros (associated with diseases of the spine),
including:
- discogeneous (due to the hernia of the intervertebral disk);
- spondylogenic (proceeds due to the osteochondrosis of the spine).
- Never accompanied
including:
- angiopathic (manifests itself with the lesion of the vessels of the belt of the lower extremities and the lower back);
- miofascial (observed for diseases of muscles and fascia);
- lumboishialgy when defeating the organs of the peritoneum;
- lumbago with Ishias on the background of the pathologies of the hip joint.
According to the degree of distribution of pain syndrome Lumboishialia, can be:
- one-way - irradiates into one limb, is more pronounced on one side of the lower back: on the left or right);
- bilateral (bilateral) - manifests itself on both sides of the spine, often gives both limbs.
Causes and factors provoking LumboishIligia What are the causes of lumboy walgia
The pathogenesis of pathology is as follows: pain syndrome appears when irritating the nerves as a result of their squeezing, injury, inflammation.
Pain impulses can enhance when the muscle tissue in the damage zone becomes tense, its nutrition is disturbed, nodes and tuberculk appear.
The most common cause of Lyumbago with Ishias becomes:
- Osteochondrosis of the spine and the stage of its progression - dysfunction of individual segments, hernia and disk protrusions, the formation of bone osteophytes.
- Arthrosis of the intervertebral disk.
- Osteoporosis of the spine and pelvic bones.
- Scoliosis, spondylitis of the spine.
- Congenital vertebral abnormalities.
- Tumors, abscesses in the lower back area.
- Diseases of internal organs, more often - associated with tumor processes.
- Diseases affecting large vessels leading to circulatory disorders in the zone of the waist.
- Muscle defeat, hip joint.
- Ranger injuries or hip joint, postoperative complications, unsuccessful injections in epidural space.
- Rheumatism, systemic pathology of connective tissue.
- Heavy infectious diseases with damage to nerve trunks.
- Idiopathic Lumboishialgy (without a certain reason).
Factors provoking the appearance of Lumbish Halgia syndrome:
- degenerative age processes in the spine, elderly age;
- obesity;
- pregnancy, especially multiple;
- frequent stress, depression;
- posture disorders;
- severe labor;
- supercooling.
Symptoms of Lumbago with Ishiam
Most often, the first attacks arise against the background of the progression of osteochondrosis. The acute syndrome of Lumbago with Ishias is expressed very sharply, chronic phenomena - more lubricated, periodically activating and plumbing.
The main symptoms of Lumboishhalgia:
- strong, gradually or quickly increasing lower back pain (acute, rigging, burning, pulsating);
- the spread of pain on one or both buttocks, legs to the inside of the knee joints or lower - to the heel through the ionic muscle;
- localization of pain - inside the muscles, rarely - closer to the surface of the skin; Sensation of the heat that replaced by the church;
- sometimes - an increase in body temperature;
- skin itch during the nerve;
- limiting the mobility of the lower back;
- pallor skin, their "marble", coldness;
- strengthening pain when trying to change the situation (often a person has to be sipped in an uncomfortable posture - by moving back or forward), when on foot;
- in severe cases, the loss of control over urination, defecation.
The duration of the attack of right-hand or left-sided lumbishligia can vary from the pair of minutes to 24 or more hours. Often discomfort disappears spontaneously, as it starts.
The repetition of the attack may occur quickly (for example, on the same day) or not to appear for months.
Diagnosis of Lumbago with Ishias. How is Lumboy's diagnostic?
Methods of examination of the patient with suspicion of Lumbago with Ishias:
- Radiography of the spine.
- MRI or CT spine, hip joint, vessels.
- Densitometry.
- Ultrasound, MRI organs of the peritoneum.
- Blood tests for markers of infectious and autoimmune diseases (for example, rheumatoid factor).
Treatment of Lumbago with Ishias
For the treatment of vertebrogenic lumbashingalgia to the right or syndrome of LumboishIligia, we recommend wearing special corsets, as well as sleep on orthopedic mattresses. In any case, how to treat Lumboishchiya only specialist solves.
In most cases, pathology is successfully exposed to therapy. At the same time, treatment is aimed at eliminating the main disease and the removal of pain syndrome.
Medicia treatment
In the acute phase of the disease, the patient is appointed bed regime (up to 14 days) and coursework of various groups of drugs:
- Anesthetics - injections or tablets of non-steroidal anti-inflammatory drugs (ketorolac, bruphen, dexalgin, arcocus, mowed, pyroxics), non-nancotic analgesics (lyrics, catadolone).
- Miorosanta for removing muscle spajamy (Sirdalud, Middokalm, Naclaosan).
- Diuretic products in order to eliminate edema of nerve trunks (Laziks).
- Novocaine blockades in the spine area, with severe pain - blockade with glucocorticosteroids (diprosun, hydrocortisone).
- Sedatives (phenosipam, relaignation, other tranquilizers and sleeping pills).
- Vitamins of group B to improving the conductivity of nerve roots and muscle recovery (Milgamma, neuromulititis).
- Blood Circulation Activities (Trental, Actovegin, Eufillin).
- Local painkillers - ointment, creams with nonsteroidal anti-inflammatory components (diclac, diclofenac, fast-gel).
Physiotherapeutic treatment. How to treat Lumbago with Ishias?
Among effective procedures for the treatment of lumboy
- acupuncture;
- massage;
- medicinal electrophoresis;
- treatment with microcurrents;
- magnetotherapy;
- paraffin applications;
Physiotherapy
After removing the restrictions on the movement and the complete elimination of pain syndrome is assigned to the course of exercise of the exercise:
- Tensile muscles (slopes, corps turns, bending the back from the position lying on the stomach).
- Exercises for restoring the mobility of the spine and the hip joints (squats, lifting the housing from the position of lying, mahi legs, pulling the knees to the chest).
- Stretching the spine on a special anatomical couch.
- Classes on simulators.
- Yoga.
Folk methods.
Treatment of LumboishIligia at home:
- rubbing a sore place with fat badger;
- wearing bones of dog wool;
- compresses from the infusion of birch kidneys;
- baths with decoction of pine needles;
- applying warming patches;
- rubbing the composition of vegetable oil and amusing (2: 1);
- silver from grated horseradish, black radish.
Which irrades (gives) to one or both legs. It mainly applies to the buttock, as well as on the posterior surface of the foot, without reaching the toes.
In this disease, the process amusement roots, in particular the sedanized nerve, are involved in the process.
The pain may have a different character, but most often it is a burning, noving, increasing pain. It spreads mainly in the course of a sedlication nerve. In this case, the patient appears a feeling of heat or zyabacity.
Usually the occurrence of pain occurs suddenly, when lifting gravity, during injury or due to a sharp awkward movement. But there are factors predisposing to lumboy-walled. The main of them are: age for over 30 years, stress, depression, low pain threshold, pregnancy, improper posture, deforming osteoarthritis, severe physical work, overweight. One of the most frequent causes of lumboy walgia - hernia or, as some authors write, loss of the intervertebral disc in the lumbar spine. It should be noted that the term "disk loss" is erroneous, so they say the hernia of the disk or protrusion.
Lumboishialgy is a heterogeneous clinical phenomenon (from the point of view of pathobiomechanical and pathophysiological mechanisms underlying LumboishIlia). It is a topically localized pain or other unpleasant sensations arising in the area of \u200b\u200bthe lower back (LUMBUS), a pelvis, hips (in Greek. Ischion), legs, feet and having a different "pain pattern" depending on the reason that lies At the heart of LumboishIlia.
Lumboishialgy as a clinical phenomenon does not have specificity. It is "clinically orienting", "analytically guide" manifestation of "pathology", its specific attribute importance acquires during the "clinical analysis", which is encouraged by the fact of the presence of lumboy-walled.
Symptoms of LumboishIligia
Symptoms of Lumboishalgia include:
- limited movements in the lumbar department,
- increase pain when changing body position,
- "Return" pain along the nerve, arising from the moves,
- fixing the back in a position slightly bent forward
- in connection with the circulating disorder, the change in the color and temperature of the skin of the lower extremities,
- pain when trying to step on the leg.
The disease Lumboishialgy has a benign character, and therefore is treated sufficiently successfully. It is mainly manifested with a long physical activity that occurs most often against the background of the degenerative spine damage (osteochondrosis).
Therefore, it is very important to begin treatment as soon as possible, preventing the progression of the process.
In the first days, the occurrence of lumboy-wallege should be limited to the physical activity, as well as the amount of fluid from the drink to reduce the edema in the area of \u200b\u200bintervertebral disks. At the same time, the reception of anti-inflammatory non-steroidal drugs is shown.
With the following symptoms, it is necessary to immediately apply to the hospital: back pain after injury, fever, swelling or redness in the spine, deterioration of the sensitivity of organs of the small pelvis and lower extremities, spontaneous urination or defecation.
Diagnosis of LumboishIligia
If the back pain occurs, you must consult a doctor. The doctor will examine the patient and, if necessary, appoint additional methods of examination, such as radiographic research, computer or magnetic resonance imaging, capable of determining the exact cause of pain syndrome.
Treatment of LumboishIligia
The treatment of lumboy-wallege is carried out according to the treatment algorithm, which is associated with the instability of the spine, squeezing (compression) of the nerve roots of the lumbosacral spine. This disease is not considered as a local manifestation of pain, treatment is aimed not only for the removal of pain syndrome, but also to eliminate the cause of the cause of the disease.
If pain syndrome is strongly pronounced, the doctor prescribes medication therapy, which is aimed at reducing the muscular spasm of the near-color muscles and on the relief (removal) of pain. The most efficient ways of treating chronic pains in the lumbosacral spine are:
- special massage
- physiotherapy
Prevention of LumboishIligia
- Try not to stand for a long time, and if for any reason it is impossible, periodically for alternating relaxation legs, rely on the chair
- Do not wear high heels, the optimal height of the heel must be 4-7 cm
- If you work continuously sitting (for example, at a computer), take care that you have a comfortable chair with armrests. The chair should be adjusted: the back - at the optimal corner of the tilt, the seat is height. Under the flange put the roller. Knees should be above the pelvis
- Making trips to long distances, every hour of the path is recommended to make stops to be
- Do not lift gravity
- Do not smoke
- Watch your weight
- Learn to relax, pass the periodic preventive inspections from your attending physician
Types of LumboishIligia
Types of LumboishIligia depending on the etiopathogenetic mechanisms:
- Muscular-skeletal: pain syndrome (myofascial, arthropathic, muscular-tonic, periodropathic - tendopathy, ligatics, bursitis) is formed due to the pathology of the various structures of the musculoskeletal system of the spinal column and the belt of the lower extremities. Separately considered gamstring syndrome and discogenic lumboy
- Neuropathic: pain syndrome (neuralgic, neuralistial, neurodistrophic) is formed due to compression (irritation) of nervous structures that innervate any anatomical structure of the lower limb belt. As a result, indicated neuropathic syndromes appear
- Angiopathic: the formation of pain syndrome occurs due to the immediate damage to the vessels (veins and arteries) of the lower limb - the iliac, femoral, tibial and surround of their sympathetic plexus, as well as as a result of symptomic (pain) ischemia anatomical structures of the lower limb belt, which is due to functional and / or organic damage vessels, which leads to a deficit of blood flow
- Mixed, which is divided into combined (due to the pathology of various anatomical structures of the belt of the lower extremities, the disease is based on the pathology and the combined (due to the pathology of various anatomical structures of the lower limbs belt, the heterogeneous process is based on pathology). As part of the "mixed" category, it should be separately indicated by the possibility of appearance, due to the pathology of the small pelvis organs and organs of the abdominal cavity, combined or combined lumboy-walled
Forms LumboishIligia
Most often there is a Lumboishialgy having four forms:
- muscular and skeletal (including myofascial, muscular tonic, arthrogenic);
- neurosistrial;
- neurodistrophic;
- neuropathic (usually arises due to radiculopathy).
Muscular and skeletal lumbish
Muscular and skeletal lumbashialgia may occur due to isolated reflex muscular-tonic syndromes of vertebrogenic character. As sources of pain impulsation, a fibrous ring receptor, intervertebral joints capsules, a vertebral-motor segment, muscular-ligament apparatus.
In recent times, it is becoming increasingly attached to pathological changes arising in phasean (intervertebral) joints with the formation of a facet syndrome. At about a quarter of cases, the cause of the pain in the back is the pathology of the facet joints. At the same time, pain imitates the damage to the root and irrades her leg. In response to painful impulsation, muscle spasm appears. Thus, the formation of a vicious circle is: "Pain is muscular spasm - pain." Almost all muscles can be involved in the process. Muscles are in a state of spasm: they can determine painful muscle seals with palpation. At the same time, the irradiation of pain occurs not by dermatomas, but on sclerotomas. The pain does not reach the foot. In character, it differs significantly from radicular. It has a deep enough character, is very variable intensity - from a small sensation of discomfort to sufficient intensity pain. Sensitive motor disorders are not characteristic. Save tendon reflexes. Not determined muscle hypotrophy.
One of the most frequent causes of the pain in the back with its irradiation in the leg is the myofascial pain syndrome, in which the muscles of the legs and the pelvic belt are involved in the process. The main reasons for its development include: overloading of the untrained muscles, a long antiphysiological posture, diseases of the visceral organs (most often a small pelvis and gastrointestinal tract), articular pathology, developmental abnormalities. The criteria for the installation of the diagnosis of myofascial pain syndrome are: painful muscle seals, painful spashed muscles, active trigger points with the formation of a zone of reflected pain. It is essential that to set the diagnosis of myofascial pain syndrome, it is necessary to press on an active trigger point and reproduce exactly the pain to which the patient complains. Thus, one of the necessary conditions for the diagnosis of myofascial syndromes is the reproducibility of pain.
In addition to the variants of LumboishIligia, which are described above, the following reasons are relevant: the pathology of the hip joints, the sacrum and iliac articulation, the pear muscle syndrome.
Neurodistrophic form of lumboy walgia
The neurodistrophic form of lumboy walgia occurs on the basis of the muscular-tonic reflex. In this case, simultaneously with the foci of neurosteofibrosis (trigger points), an uneven bug art structure appears, which occurs most often in the area of \u200b\u200bthe knee or hip joints. Most often occurs periartrosis of the knee joint. At first, in all patients, pain is localized in the lumbar spine, and then moves to the knee joint and into the popliteal fossa.
The hip per daytrosis is manifested by the painfulness of movements and the limitation in the hip joint. From patients come with complaints of increased fatigue in the legs, the impossibility of climbing the steps, run, breed legs. If you hold the palpation under the groin bale and the harness in a large sterling of the femoral bone, there is a sharp pain.
The main features of the neurodistrophic syndrome:
- primary pronounced pains in the lower back for several years;
- the presence on one leg of the isolated lesion of the large joint, and not many joints and on the upper, and on the lower limbs, as it happens during rheumatic diseases;
- refractoriness to pharmacological methods of treatment;
- gomolateralness of the lesion of the joint from Lambalgia.
Thus, the peculiarities of the flow of the neurodistrophic form of the lumboy-walled syndrome are to:
- the occurrence of changes in the joints and pain on the background of lumbar pains or immediately after them;
- distrophic changes are most often subjected to large joints in this order: knee, ankle, hip;
- there is a clear link between the exacerbations of the lower back pain and in the joints.
Neurosistal lumboy worshiology
Neurosudal Lumboishialia is divided into the following types: Vasodilator, Vazospadic and mixed. The development of this disease in most patients usually occurs after hypothermia, overwork the legs in a forced position.
Patients having a vasospatic form of lumboy walkers feel angry, cooling, numbness in the right or left lower limb, a feeling of gravity, the appearance of pain. When examining a doctor, vegetative disorders are detected, manifesting the color of the skin and nails, dry skin, hyperacratosis of stop, swelling in the field of shin and ankle joint.
Patients having a vasodilator version of LumboishIlia feel fever and cutting in the lower limbs. When inspecting the doctor notes the marble of the skin, pale the leg and foot, cyanosis, as well as increased pain in the process of changing the position of the body.
The mixed type of such a type of lumboy-walled is determined by the combination of described signs.
Sometimes may be diagnosed with pseudo-adandardic syndrome, determined by pale of fingers and a decrease in pulsation on the rear of one of the feet with a long pain in the lower back. When conducting differential diagnosis in patients with refroring atherosclerosis of the lower limbs vessels, the absence of symmetric lesions preceding long-term pains in the lower back and a significant decrease in the pulsation of the vessels of the lower extremities should be taken into account.
In the presence of LumboishIligia, clinical analyzes must be carried out, and if necessary, laboratory and instrumental tests necessary to determine the pathology of the belt of the lower extremities, the vessels of the abdominal cavity, the organs of the small pelvis, the abdominal organs, as its possible causes.
Neuropathic (radiculopathic) Lumboy wish
Clinical symptoms of radiculopathy (as one of the possible options for the appearance of back pain with irradiation in the leg) are:
- radicular shooting pains that apply to the buttock, thigh, caviar, foot and amplified in the lumbar spine when driving;
- mandatory presence in various combinations of symptoms of the loss of the affected root in the innervation zone (hyptestesy, reduction or loss of tendon reflexes, hypotrophy or muscle atrophy with the formation of peripheral paresis).
It should be emphasized that the symptoms of the loss of the affected root accurately correspond to the zone of its innervation (taking into account the individual variants of the "root" innervation). To form a diagnosis of radiculopathy, there is not enough insulated pain even in the zone of a separate root. The doctor can make a diagnosis of radiculopathy only if the symptoms of the loss of the affected root are observed. When taking into account all clinical symptoms, which are characteristic of radiculopathy, it is possible to overcome the hyperdiagnosis of the root lesions observed in the practice of polyclinic doctors.
It must be remembered that among other complications of osteochondrosis of the spine of radiculopathy only 5%.
The greatest clinical significance on the lumbosacral level of the spine has a radiculopathy arising from the hernia of an intervertebral disc. Most often squeezed roots L5 and S1. This is explained by the fact that the discs L4-L5 and L5-S1 earlier wear out, as well as the fact that the rear longitudinal bunch, protecting discs from falling out, weak and narrow - its width is not more than 1-4 mm and it takes only 3 / transverse 4 diameters of the front wall of the spindomy channel. From microtraumamization, the root of L4 suffers from microtraumaticism. Upper-friendly roots are amazed even more rarely, mainly with severe injury.
L5 root lesion (L4-L5 disk). There is a localization of pain and parests from the loin to the buttock (along the outside of the hip), as well as in the rear of the feet and the thumb on the lateral surface of the lower leg. Location of hyptestesia: on the front of the head of the shin, on the rear of the foot and the first, second, third fingers. Basically, parires can be detected in a long extensor of the thumb. In hypotension and hypotrophy, the front tibial muscles are disturbed by re-flexion and / or extension of the thumb. The patient is hard to stand on the heel, there is no loss of reflexes. The formation of gomolateral scoliosis - the tilt of the body into a healthy side. In this case, the intervertebral hole increases, and the compression of the root decreases.
The damage of the root S1 (disk L5-S1). The area of \u200b\u200bthe pain is located in the buttock, the rear surface of the leg and hips, the lateral edge of the foot, the lateral ankle. It is possible to define hypsheat in the field of lateral ankle, the outer surface of the leg, the fourth and fifth of the foot. Hypotrophy and atrophy with the formation of the peripheral pack can be observed in the ionic muscles and less often in the foot of the foot. There is a breakdown of the plantar flexion of the foot and fingers, the stop of the foot. The patient is hard to stand on socks, Achilles reflex falls out or decreases. Often the formation of heterolateral scoliosis is the inclination of the body in the sore side. This reduces the tension of the root. The appearance and inverse situation is possible - the formation of a homolateral scoliosis.
As a rule, the clinical picture of radiculopathy is combined with muscle-tonic reflex syndromes, which can modify and strengthen the painting of pain.
