Lumbodynia pain in the back and lower back. Lumbodynia: symptoms and treatment of the syndrome. Two main syndromes of chronic lumbodynia

Due to upright posture, a person’s lower back is subject to a very large load. Little of, modern look A life characterized by insufficient physical activity, excess weight, systematic stress and unhealthy diet further aggravates her condition.

These factors provoke lumbodynia syndrome. It manifests itself with severe pain in the lumbar region, affecting the quality of life.

Lumbodynia- these are lower back pains of varying intensity, which are the cause of destructive processes in the intervertebral discs.

Also, lumbargia syndrome can accompany various ailments of the spine and back muscles. It is often observed, for example, with osteochondrosis. Foci of lumbodynia, as a rule, appear in the fourth and fifth lumbar vertebrae.

Causes of the disease

A sedentary lifestyle is one of the causes of pathology

Unregulated physical activity causes severe pressure on the joints, leading to their inflammation. Accordingly, areas appear in the muscle tissue where severe pain is felt. With tension, the pain worsens. But Load is not the only factor in the occurrence of lumbodynia.

Static voltage plays an important role. That is, those at risk are those who have sedentary work, as well as those who often sleep in an uncomfortable position. It's no secret that if you stay in an uncomfortable position for a long time, you may experience back pain or spasms. Pregnancy or obesity also significantly strain the spine, increasing the risk of lumbodynia. In addition, they provoke swelling.

Physical inactivity— that is, a sedentary lifestyle and insufficient physical activity impair blood flow and the elasticity of the intervertebral discs. All this weakens the muscular system. As a result, hypertrophy is diagnosed. The vertebrae are pressed against each other, the nerve roots are compressed, which causes pain.

Posture disorders also affects the condition of the back. If the position is incorrect, the vertebrae become displaced. The tissues of the intervertebral discs gradually lose their properties. Hypothermia provokes vascular spasms, impairs blood circulation, and leads to inflammation of the joints. Excess weight puts unnecessary stress on your discs. In turn, stress is muscle contraction, which is no less harmful to blood flow.

As a person ages, the functions of many systems, including muscles, deteriorate.. Muscles become less strong, intervertebral discs are less elastic, articular cartilage is destroyed, and posture deteriorates. Most people experience back pain. Especially for those over fifty-five years old.

Various injuries very often cause the appearance of pathology

Various injuries very often cause pain. Compression fractures, disc displacements, ligament and soft tissue ruptures, and high pressure on the spinal nerve often become the main factors of the disease. Also, injuries occur due to lifting heavy objects, falls, and road accidents. In such cases, you cannot do without drug treatment and exercise therapy.

Back diseases– most common reasons lumbodynia. For example, a disease characterized by wear of intervertebral discs, swelling, and inflammatory processes. – bulging of the fibrous ring of the disc. – this is the protrusion of the nucleus pulposus, which compresses the nerve roots, causing pain. – abrasion of cartilage tissue, which is caused by increased load on the joints.

Weak muscles affected by one disease or another do not support the spine well. Again, pressure on the intervertebral discs and articular cartilage increases. Tears and sprains of the ligaments increase the spaces between the vertebrae and create discomfort. There is also such a pathology as narrowing of the spinal canal. This is a degenerative process in the vertebrae that causes pain in the buttocks and thighs.

Another factor in the appearance of lumbodynia may be spondylitis.. This is one of the inflammatory back diseases. With it, the number of bacteria in the vertebrae increases. They provoke internal destruction, affecting the intervertebral disc. Also, during illness, the spinal canal narrows and pain appears.

Osteoporosis makes the vertebra more fragile. At the same time, the distance between the vertebrae decreases. Nerve roots, arteries and veins are compressed, causing swelling and disruption of the spinal cord's nutrition. With such changes, lumbodynia occurs very quickly.

Symptoms

Pain in the lumbar region during coughing is one of the symptoms of the pathology

Diagnosis of lumbodynia usually diagnosed to the patient after the following symptoms are detected:

pain accompanied by spasm of muscle tissue in the lumbar spine;
pain that worsens during static, dynamic loads and palpation of the diseased area;
difficulty flexing and straightening the back;
pain in the lumbar region when coughing, sneezing, screaming or when exhaling deeply;
spasms of the back muscles;
shooting pain, decreased sensitivity of the lower extremities.

Diagnostics

After a person has addressed the problem to the attending physician, a number of procedures must be carried out. But first, a good specialist collects an anamnesis. By studying the medical history and listening to the patient’s complaints, the doctor determines the causes of pain and ways to eliminate them. That's why You can’t hesitate to visit the doctor.

Lumbodynia of the lumbar spine has vivid symptoms, and its treatment is not as simple as it seems at first glance. In order to diagnose the disease, you need to conduct a thorough examination. At the initial stage, the doctor makes a primary diagnosis based on symptoms. And then sends the patient to undergo the following tests:

X-ray examination in several projections.

Treatment options

When treating lumbodynia, medication, manual, physiotherapeutic, and surgical treatment are used.

It is aimed at restoring the elasticity of cartilage. During treatment, spasms are relieved, metabolic processes in muscles and cartilage are normalized. Pain syndrome is removed with the help of medications and exercise therapy.

After the main course of treatment there is a period of rehabilitation. It is carried out with the help of special exercises, massage, reflexology. It is important that only with such a well-coordinated algorithm of actions is it possible to achieve good results. This means that by following all the recommendations of specialists, you can really forget about excruciating pain.

Drug treatment

As a rule, people come to the doctor complaining of back pain. Painkiller injections and massage help in the fight against them. .

Nimesulide

Mydocalm, Baclofen, Sirdalud. Medicines, reducing muscle tension and pain;
Nimesulide– relieves inflammation, pain, swelling;
Diclofenac– an anti-inflammatory, analgesic drug that has an antipyretic effect;
Actovegin, Pentoxifylline– medications that normalize the condition of blood vessels.
Nimesulide-gel, Deep-relief gel– drugs have an anti-inflammatory effect, relieve swelling;
Dimexide, Novocaine– soothes pain in muscles and joints. They penetrate the tissue, which quickly helps with the diagnosis of lumbodynia.

Operations

The surgical method is used under general anesthesia. In this case, damaged parts of cartilage and discs are removed and replaced with artificial fixation elements. After such a procedure, a long rehabilitation period begins. The patient will have to stick to a diet and forget about physical activity.

Massage and exercise therapy

Massage and special gymnastics occupy a special place in the treatment of lumbodynia. When a vertebrogenic lumbar is diagnosed, a set of exercises is necessarily prescribed. It must be performed under the supervision of a qualified professional. After all, only he is able to create an effective individual program for each patient.

Therapeutic massage of the lower back relaxes the muscles, helps strengthen the muscle corset, improve lymph flow, reduce swelling, and eliminate pinched nerve roots. You can conduct no more than 10 sessions per course. A larger number of visits can, on the contrary, do harm. Experienced doctors advise repeating the course to prevent lumbodynia about twice a year.

Physiotherapy

In parallel with medications for lumbodynia, physiotherapy is prescribed. It eliminates discomfort and other symptoms of the disease. In addition, physiotherapeutic procedures have a relaxing, vasodilating effect.

Acupuncture

After it, stiffness decreases. Most often used:

magnetic therapy;
electrophoresis with novocaine;
ultrasound;
diadynamic therapy;
acupuncture;
manual therapy;
traction.

Preventive measures

In order to protect yourself from the disease, it is not enough just to know what lumbodynia of the lumbosacral spine is. In addition to symptoms, you need to know The following recommendations will help protect against the onset of chronic pain:

Don't forget about your posture. Try to always stand straight, and when sitting down, press your back tightly against the back of the chair.
Set aside at least 15 minutes for exercise.
Avoid injuries and colds in the lumbar area.
When lifting weights, do not move suddenly.
Change your mattress to a semi-firm one.
If you need to carry something heavy, balance the weight in both hands.
When playing sports, use a special belt.
Starting from 6-7 months of pregnancy, wear a bandage.

Conclusion

Lumbodynia of the lumbar spine is quite common. It can be the result of both injury and disease. internal organs. Ignoring back pain can even lead to disability. Therefore, if you discover symptoms of lumbodynia, you should immediately consult a doctor.

The spine is the structure of the human skeleton that is subject to enormous stress, especially during walking and lifting weights. In this regard, the spine is more susceptible to various pathological processes, among which one of the most common is lumbodynia of the lumbar spine.

In medical terminology, the term lumbodynia means a disease accompanied by painful sensations in the lumbar region of various etiologies. This pathology is not independent; it develops under a huge number of concomitant factors, most of which are separate diseases.

The pathological process can be divided into two main types:

Spondylogenic lumbodynia - the development of the disease is caused by compression of blood vessels, which leads to impaired blood circulation in the lumbar spine. The pathological process also involves intervertebral joints and the vertebrae themselves.
Discogenic lumbodynia - this term implies deformation of the joints in the mentioned area of the spine, accompanied by severe pain in the lower back. The deformity is caused by pathological changes in the intervertebral space.

The disease lumbodynia is predominantly neurological in nature and can be diagnosed in people of any age. age group. For example, in adolescents, pain is caused by active stages of growth; in middle-aged people, increased physical activity, injuries, and illnesses. But still, older people are most susceptible to lumbodynia, in whom most diseases arise in connection with age-related changes in the body, affecting nervous system, cartilage and bone tissue, muscles and ligaments.

Classification

Lumbodynia according to ICD 10 is a type of another back disease - dorsalgia, caused by tissue degradation or spinal injuries.

Lumbodynia was assigned a separate code according to ICD 10 - M 54.5. Regarding the wording, according to international classification this pathology is characterized by pain in the lower back, lumbar pain, which has a different etiology.

It is also worth understanding that the disease, in addition to the two types described earlier, has several separate types, differing in the duration of the course and the specificity of painful sensations:

Acute lumbodynia - it is characterized by sudden intense pain in the lumbar region, aggravated by the slightest movements, walking, turning the body, bending, etc. In some cases, pain in the lower back may not be associated with injuries or pathologies of the spine. A striking example would be lumbodynia with radicular syndrome, in which prolapse of the intervertebral disc occurs with subsequent pinching of the nerve roots.
Chronic lumbodynia - in this case, pain in the sacrum and lower back can also appear suddenly, but initially their intensity is extremely low. Painful sensations do not go away for a long time (systematically accompany a person for 6 months or more), and are gradually increasing in nature. The pain radiates to the buttocks, then the legs, and also up the back.
Vertebrogenic – painful sensations vary in specificity, but are almost always long-lasting. The cause of lumbago lies in various diseases of the spine, including osteochondrosis, osteoporosis, protrusions, injuries and much more.
Nonvertebrogenic – pain that occurs in the lower back is not related to lesions of the spinal column. They are provoked by other diseases of the lumbar localization, for example, kidney pathologies.

When pain occurs in the lumbar back, it is always customary to talk about lumbodynia. However, this concept is general; it requires further study of the nature and causes of pain in order to make an accurate diagnosis and further treatment.

Causes of pathology

The cause of pain, called the generalized concept of lumbodynia, can be many various factors. In this case we're talking about about diseases of the spine, internal abdominal organs, and various external factors.

First, let's look at the list of the most likely causes of lumbodynia that are not related to diseases:

In addition to injuries and other factors mentioned, you can also add hypothermia of the back to this list, excess weight, constant exposure to stress and age-related changes.

As for the more dangerous causes of the development of the pathological process, that is, diseases, these include:

– wear of the intervertebral discs occurs with subsequent damage to the roots of the spinal nerves with subsequent swelling.
Arthrosis is accompanied by thinning of the intervertebral discs, which leads to the abrasion of cartilage tissue.
, as well as protrusions affecting these joints.
Pathological narrowing of the spinal canal caused by the proliferation of bone tissue and compression of the spinal cord.
Spondylitis is an inflammatory process affecting the spine. Pathology can develop under the influence of diseases such as tuberculosis, syphilis, gonorrhea or due to damage to the body by fungi.
Osteoporosis is a violation of microcirculation within bone tissue leading to its destruction. The result is not only lower back pain, but also various complications.

This list contains the most likely causes of the development of lumbodynia due to progression various diseases. However, this can also include pathologies accompanied by damage to nerve tissue and much more.

We must also not forget about non-vertrebrogenic lumbodynia, in which a person suffers from pain associated with pathologies of the kidneys, organs of the reproductive system and parts of the body. gastrointestinal tract, oncology of the corresponding localization.

Symptoms

Of course, with lumbodynia, the main symptom is pain in the lumbar region, because it is this clinical sign that determines the existence of the medical term under discussion.

But, firstly, the pathology also has other manifestations, and secondly, the pain symptom has its own specificity, which may indicate the reasons for the development of the pathological process.

So, the clinical picture of lumbodynia is as follows:

The first symptom is painful sensations that different character. In some cases there is a sharp pain, in others it is dull and aching.
The pain can be paroxysmal (in this case it is cyclical) or constant.
Depending on the specific nature of the damage to the vertebral joints or other causes, the pain is localized on one side or covers the entire lumbar region.
In the case of lumbodynia, pain intensifies with movement, exertion, coughing, palpation, and often radiates to the pelvic region and legs.
In addition to painful sensations, if we are talking about damage to the spinal nerves, the skin in the lumbar region may become numb, goosebumps, and tingling.
Stiffness of the lower back muscles and spinal ligaments, their rigidity.

In some cases, there are disorders of stool and urination, and men have problems with potency.

Diagnostics

To make an accurate diagnosis, certain diagnostic methods are required. In addition to the initial examination of the patient and collection of anamnesis, the doctor may refer the patient for the following examinations:

back to identify spinal deformities.
- a procedure that can establish in detail the nature of the pathology.
– is required to determine how the development of the identified pathological process affects nearby tissues and nerve branches.

Treatment of the disease

Treatment of lumbodynia requires mandatory consultation with a doctor. At the same time, for a full-fledged struggle it is necessary not only systematic, but also A complex approach, which involves the use of the following techniques:

Drug therapy.
Massages.
Physiotherapy.
Pharmacopuncture.
Reflexology.
Ethnoscience.
Surgical exposure.

To fully understand the principles of treatment of lumbodynia, let’s consider each point separately.

Drug therapy

The doctor prescribes certain medications, sets dosage and duration of administration of each, followed by adjustment of treatment. Let's consider the main groups of drugs aimed at combating symptoms and treating pathology:

In order to improve the patient's condition and relieve pain, antispasmodics and analgesics are prescribed.
Non-steroidal anti-inflammatory drugs are often prescribed in the form.
If swelling occurs, resort to the use of diuretics.
In some cases, vasodilators are required.

Much depends on the causes of lumbodynia, because, say, the methods of treating a pinched nerve and usually a bruise will be radically different.

Massage

A massage performed by a specially trained health worker (physiotherapist), provided the massages are carried out over a long course, gives excellent results. Therapeutic massages are aimed at:

Strengthening ligaments and muscles, increasing their elasticity;
Restoring spinal mobility and flexibility;
Relieving muscle spasms;
Normalization of blood circulation;
Elimination of pain;
Acceleration of regeneration processes.

Physiotherapy

Physiotherapy treatments are also prescribed by a doctor. In this area, you may need a course of the following procedures:

Exposure to ultrasound;

Operative surgery

Surgical intervention is resorted to only in extreme cases, when pathological processes in the vertebrae threaten a person’s life or, for example, create a threat of paralysis.

Depending on the nature of the pathology, discectomy and other implantation methods may be required.

Pharmacopuncture

A relatively new trend in medicine, which involves treatment through subcutaneous injections of drugs. Injections in the lumbar region quickly relieve pain, normalize the patient's condition and promote recovery.

Reflexology and acupuncture

Reflexology and acupuncture involve influencing biologically active points through acupuncture and acupressure. This is an auxiliary treatment method, however, it allows you to speed up regeneration and metabolic processes, speeding up recovery. The pain disappears after 1-2 sessions.

Folk remedies

Treatment folk remedies- this is also an auxiliary method and yet it is an excellent help to the methods already described. Let's consider the most effective recipes traditional medicine:

Ointment with the addition of pine resin - to prepare, take 20 grams of resin and 200 milliliters of any vegetable oil. Mix both ingredients thoroughly and rub into areas of pain. Repeat the procedure daily for 14 days.
Infusion for rubbing - soak 4 tablespoons of chopped walnuts in 500 milliliters of alcohol. The tincture is “prepared” for 14 days, all this time it stands in a dark, cool place, it needs to be shaken daily. After 2 weeks, the patient rubs a small amount of tincture daily into the lumbar area.

Many people do not even suspect that periodic subacute or moderate lumbar pain is called lumbodynia, and they immediately rush to complain about radiculitis, myositis or osteochondrosis. So what is lumbodynia of the lumbosacral spine?

This term does not denote a pathology with a specific cause, but serves as a collective name for the clinical pain symptom in the lower back or sacrum, caused by spasm of the back muscles. Lumbodynia can be caused by a variety of reasons, including those not related to pathologies of the spinal column.

Lumbodynia of the lumbar spine differs from other back pain in the following characteristic symptoms:

the nature of the pain syndrome is moderate;
the pain that arises intensifies gradually over 1-2 days;
pain is most pronounced in the morning, and may spread to the buttocks and/or upper back of the thighs;
intensification of the pain symptom occurs after physical exertion or remaining immobile for a long time - sitting, standing;
pain discomfort decreases or goes away after slight physical activity;
The pain has been recurring for more than 3 months.

The main symptom of lumbodynia is the occurrence of a pronounced fixation symptom complex - a decrease in the severity of lordosis in the lower back and a slight curvature of the body in the direction of the lesion, a clear limitation of mobility in the lower back.

If a person is forced to constantly change position or puts pressure on the lower back with his hands too often, this is a typical patient with lumbodynia who needs treatment. Otherwise, the pain syndrome will not only worsen, but also its periods of attenuation will disappear.

Both adults and children who are in a period of active growth are susceptible to lumbodynia - girls 10-12 and boys 13-16 years old. But the largest contingent suffering from lumbodynia is represented by women over 50 years of age.

Causes

One of the types of systematization of the etiology of pain in the lower back and sacrum divides the causes of lumbodynia into 2 large groups.

The first includes those that are directly related to the pathology of the spine itself: osteochondrosis, injuries to the vertebra or intervertebral disc, tears of ligaments or muscle fibers, the emergence of persistent trigger points, pinched nerve roots and nerves, destruction of facet joints, inflammatory-tumor injuries of the spine, other dystrophic or degenerative pathologies of the lower back and sacrum.

The second group includes causes not related to the spinal column, but, one way or another, influencing it: obesity, hypothermia, working with constant static tension of the back muscles; illnesses genitourinary system, infectious or inflammatory diseases of internal organs or systems, chronic kidney pathologies, pregnancy, natural aging of the body.

Initial examination and diagnosis

Primary diagnosis is an examination by a neurologist of the lumbosacral region of the spine, during which lumbodynia manifests itself with the following symptoms:

increased pain when bending forward, sneezing, coughing, laughing;
the pain subsides if you bend back or lie on your healthy side;
acute pain is noted if you press on the affected vertebra, or rather on its spinous process or paravertebral points;
disturbance of sensitivity – goosebumps, tingling, numbness;
in adolescents - transverse stretch marks on the lower back, caused by the rapid growth of bones over muscles.

But in order to establish the true cause of lumbodynia and prescribe adequate treatment, a neurologist needs to conduct hardware diagnostics - see X-ray images in 2 projections, as well as CT, MRI or NMR images.

Treatment of lumbodynia of the lumbar and lumbosacral spine

In the arsenal of modern neuropathologists there is wide range techniques and medications to help patients diagnosed with lumbodynia of the lumbar spine. The treatment will definitely be complex. If necessary, to maintain bed rest until the pain subsides, a sick leave certificate will be issued. The neurologist will also remind you of the need to sleep on a “board” and wear a brace.

For general medicinal effects, modern drugs belonging to the group of centrally acting muscle relaxants, NSAIDs, anticonvulsants and vasodilators are used. During treatment, most patients are prescribed antidepressants. Ointments, gels or compresses are used for local anesthesia. When treating severe cases of lumbodynia, temporary prescription of an opiate-containing medication is possible.

In cases of ineffective treatment of lumbodynia and progressive symptoms, minimally invasive endoscopic intervention may be used.

If you have lumbodynia, you should not engage in non-drug self-treatment. Only the treating neurologist will be able to correctly select the appropriate procedure from the numerous physiotherapeutic techniques.

Not a single sane chiropractor will begin his treatment, perform manipulations for lumbodynia, without appropriate photographs and explanations from a neurologist, but only on the basis of visible symptoms. If the “chiropractor” did without them, then your lower back is in danger.

Since the root cause of lumbodynia is a weakened muscular corset of the spine, without a competent instructor physical therapy not enough. In case of its absence, the neuropathologist himself will give necessary recommendations and printed complexes physical exercise with lumbodynia.

Prevention of disease

After success in the treatment of lumbodynia, you should not relax, otherwise the pain symptom will definitely return. You should avoid any sudden movements in the lower back, and when lifting heavy objects, follow the “straight back rule” and do not strain your back by carrying things in one hand. To prevent lumbodynia, while working while sitting, you need to monitor your posture and positioning of your legs, and also do 10-minute warm-ups every hour. To sleep, you need to choose a semi-rigid mattress.

You should not travel in vehicles that may experience strong shaking. In order to prevent lumbodynia, you should maintain a comfortable temperature regime– do not expose the body to hypothermia or severe overheating. It is forbidden to visit the sauna for some time, otherwise lumbodynia of the lumbosacral region will resume with renewed vigor.

To prevent lumbodynia in expectant mothers in the third trimester of pregnancy, it is recommended to wear a support bandage for the spine and not to forget about special sets of physical exercises for pregnant women.

And, of course, you shouldn’t be lazy! Lumbodynia does not tolerate regular visits to the pool and daily special sets of physical exercises, which can be performed at home. Exercise should become a habit because it combats the main cause of lumbodynia. The main thing is that the exercises are correctly alternated, and are aimed not only at maintaining the tone of the back (lower back) muscles, but also at stretching them.

Special physical exercise is considered the main prevention of the return of lumbodynia, a pain symptom in the lumbosacral spine.

When lumbodynia of the lumbar spine appears, treatment is not always started. According to experts World Organization healthcare, 90% of people have experienced lower back pain at least once in their lives. However, many of them ignore the symptom and do not consult a doctor. Especially in cases where the pain is random and goes away quickly. In some cases, lumbodynia occurs as a result of physical overload, and then disappears without a trace. But if the pain appears with enviable regularity and intensifies, you should not postpone a visit to a specialist.

What is lumbodynia

Having repeatedly encountered lumbar pain, people do not know what lumbodynia of the lumbosacral spine is. Lumbodynia is the name given to acute or chronic pain in the lower back. Its variety is lumbago. - this is a sudden, severe pain of a shooting nature (lumbago) in the lumbosacral spine. Lumbodynia refers to dorsalgia (back pain). She was assigned the ICD 10 code M54.5.

The term lumbodynia was introduced into medical practice to identify pain syndrome of vertebral etiology. After all, other diseases can cause lower back pain. They can be caused by muscle inflammation, diseases of the pelvic and abdominal organs (including cancer). Such pains are called referred pains.

Pain syndrome usually develops after:

hypothermia;
bruise;
injuries;
excessive physical activity;
overwork.

Lumbodynia can occur after a long stay in a forced uncomfortable position, against the background of psychological experiences and stress. People who have sedentary jobs suffer from lower back pain. Prolonged stay in a bent position causes. Vibration negatively affects the condition of the spine.

Sometimes sharp pain appears after coughing, sneezing, yawning or sudden movement. Pain syndrome can be a consequence of long walking with flat feet or in uncomfortable shoes. It doesn't always appear right away. In some cases, discomfort in the lower back is detected only after 1 or 2 days.

Types of lumbodynia

Acute lumbodynia can be triggered by:

injury;
lifting a heavy load;
displacement of the intervertebral disc with sprain of the posterior longitudinal ligament.

In this case, the pain is often so severe that the person cannot move. Even in a lying position, any movement causes him suffering.

Acute discogenic lumbodynia occurs as a result of protrusion of the intervertebral disc. It puts pressure on neighboring tissues and compresses nearby spinal nerve roots. The defect provokes muscle spasm, which puts additional pressure on the nerve endings, aggravating the patient’s condition. Pain that occurs as a result of compression of the spinal nerves in the L1–L5 segments, at the level of their exit from the spinal cord, is called lumbodynia with radicular syndrome.

The spondylogenic form of the disease is accompanied by mild to moderate pain. Exacerbation of pain syndrome can occur only after intense physical exertion. This form of the disease is diagnosed in children and adolescents. It provokes osteochondrosis.

Chronic lumbodynia is diagnosed when lower back pain persists for more than 12 weeks. They are often moderate and tolerant. Increased intensity of pain occurs after infectious diseases, stress and overwork.

Lumbodynia syndrome can manifest itself in 2 main forms, namely Levingston and Sol-Williams syndromes:

Levingston syndrome is characterized by stiffness in the triangle of the multifidus muscle. There is a feeling of tightness in this area and a constant dull pain is felt.
With Sol-Williams syndrome, the pain intensifies with a strong sigh, during coughing and sneezing.

How does lumbodynia manifest?

The painful sensation can be localized strictly in the center of the lumbosacral region. But more often it occurs to the right or left of the spine. The pain intensifies after prolonged standing or sitting. It grows gradually, acquiring painful intensity over time.

A semi-sitting position has a negative effect on the patient's condition. Being in it, a person feels quite comfortable. However, attempts to sit down or stand up cause a sharp dagger of pain that does not allow straightening up. To straighten up, patients are forced to press on the lower back with their hands.

Lumbodynia of the lumbar spine increases with muscle tension. It is difficult for the patient to wash himself while leaning over the sink. The ironing process, which requires keeping the body tilted for a long time, quickly causes fatigue and pain. Leaning forward becomes more and more difficult every day. The pain intensifies if heavy objects are held in the hands. It is very painful to pick up fallen things from the floor.

While in a sitting position, the patient tries to transfer his weight to the support in front or lean against the back of a chair, pressing his back tightly against it. This allows him to reduce pain. While walking, a person takes an unnatural position, trying to minimize discomfort.

A person feels comfortable only in a supine position. If pathological changes have occurred in the presacral disc, the patient prefers to lie on the healthy side. If the root is compressed near the fourth lumbar disc, he tries to lie on his sore side.

During an exacerbation, the pain increases for several days in a row, reaching its peak on the 4th or 5th day. After this, lumbodynia syndrome decreases and disappears if the patient remains calm and avoids any stress. In cases where a person does not change the rhythm of life and refuses treatment, the pain syndrome does not disappear. It may remain intense or become less pronounced.

In some cases, lumbodynia torments people for weeks or even months. Pathology develops and spreads to neighboring areas. Over time, pain appears in the buttock, leg or tailbone area, transforming into and. Its symptoms and treatment depend on the stage of development of the pathology.

How to cure lumbodynia

When pain occurs, the patient is prescribed rest. It is necessary to lie in bed more and avoid sitting. Until the pain disappears, you need to wear a special orthopedic belt that will support the vertebrae in the correct position.

If the pain is very severe, then strict bed rest is prescribed for 7-10 days. The patient is recommended to lie on his stomach more often. When a person lies on his back, a special circle or a terry towel rolled into a ring is placed under his lumbar region.

The pad allows the affected area of the spine to be supported. Place a pillow or rolled blanket under your feet. Elevated legs reduce the load on the spine and help return the vertebrae to their normal position.

To eliminate severe pain and reduce inflammation, non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Ketoprofen, Meloxicam) are prescribed. It is recommended to give injections on the first day. The drugs are then taken orally. The tablets should be taken during or immediately after meals, with plenty of water. If the patient has diseases of the digestive system, therapy is carried out in the form of injections. Ointment (Diclofenac, Ibuprofen) is applied to the lumbar region 2-3 times a day.

The duration of treatment with non-steroidal anti-inflammatory drugs depends on the duration of lumbodynia. For severe radicular pain, you need to take 1 type of drug for at least 3-4 weeks.

Excruciating pain is relieved using paravertebral blockades with anesthetics (Lidocaine, Procaine) in combination with hormonal drugs (Dexamethasone, Hydrocortisone).

He is prescribed:

gentle manual therapy techniques;
massage;
acupuncture;
spinal traction;
physical therapy.

Physical therapy for lumbodynia

For the first exercise, you need to lie on your back. Legs are bent at the knees and pressed to the chest, holding them with your hands. You need to stay in this position for several minutes. At this time, the spine is unloaded and slightly stretched in the lumbar region.

For the next exercise, arms are spread to the sides (lying on your back). One leg is bent at the knee and placed on the floor. In this case, the foot of the bent leg should touch the knee of the straight leg. The head is turned in the direction opposite to the side on which the bent knee is located. The exercise is repeated 5–10 times, changing legs.

The third exercise is done by bending both legs at the knees and placing them on the floor. The head is turned in the opposite direction. Then the legs are placed on the other side, changing the position of the head. The exercise is repeated 5-10 times. When performing crunches, you should try not to lift your pelvis from the floor.

For the fourth exercise, you need to get on all fours. The back is arched, lowering the head down, then arched, raising the head up. The exercise is repeated 5–10 times.

All movements must be performed slowly and smoothly. Therapeutic exercises can be repeated 2 or 3 times a day. If sharp pain occurs during exercise, you should consult your doctor.

Lumbodynia is a collective concept denoting pain and inflammation in the lumbar region. In this case, the intervertebral discs, the spinal column itself, as well as the area around the spinal column are exposed to the inflammatory process. At the same time, nearby tissues and muscle fibers are also involved in the inflammatory process.

Is lumbodynia dangerous?

At proper treatment, the changes that occur with lumbodynia are quite easy to treat and do not pose a serious danger, leaving no traces behind. However, in the absence of treatment, or with improperly selected treatment, lumbodynia can be dangerous due to constant and intense progression, in which more and more tissues are involved in the inflammatory process. It is also worth noting that the disease progresses very quickly.

Its danger also lies in the fact that there is a serious danger of involvement of the cerebrospinal fluid in the inflammatory-infectious process, which can result in its contamination and spread of infection throughout the spinal canal, including into the brain area. This may result in an inflammatory-infectious process in the brain area. A common consequence of lumbodynia is myelitis (inflammation of the meninges), stroke (bleeding in the brain).

A generalized inflammatory and rheumatic process may also occur, which is accompanied by damage to connective and muscle tissue. At the same time, the heart muscle is often involved in the rheumatic process, which is fraught with heart defects, the development of severe damage to the heart muscle, up to heart disease and heart failure.

ICD-10 code

M54.4 Lumbago with sciatica

Epidemiology

According to statistics, lumbodynia occurs in every 10 people in a severe, quite pronounced form. Most often it appears in winter, since during this period the body is as weakened as possible, and cases of frequent hypothermia are also observed. This entails pain in the lumbar region. In first place in terms of the incidence of lumbodynia are patients who lead a sedentary, sedentary lifestyle, as well as those who have a history of musculoskeletal diseases. In second place, strangely enough, are athletes who, on the contrary, experience excessive stress on the skeletal and muscular system, feel overload and overtraining, as well as frequent injuries and damage. In third place are elderly people, especially those who suffer from acute and chronic arthritis, osteochondrosis, and radiculitis. The fourth place is occupied by people who have had infectious diseases and are undergoing chemotherapy and radiation. In fifth place are children under one year old and newborns with genetic abnormalities in the motor system.

Causes of lumbodynia

There can be many reasons, and in almost every case they are strictly individual. For example, lumbodynia can be a consequence of frequent stress, neuropsychic stress, as well as a consequence of the development of allergic, infectious, infectious-allergic diseases. Often, pain in the lumbar region develops against the background of general hypothermia of the body, the development of inflammation of muscles and tissues with the involvement of other tissues in the inflammatory process.

Often the disease is chronic, at some point manifesting itself in the form of acute attacks of pain. In this case, it is often a concomitant factor against the background of inflammatory diseases of the upper and lower respiratory tract, nervous diseases and heart failure. It often appears during pregnancy and breastfeeding. Other tissues and organs may also be involved in the inflammatory process.

Often pain in the lumbar region is caused by hard work (physical), improperly distributed load, or excessive overload of the lower back. Often the cause is a bacterial or viral infection that accompanies the inflammatory process. Plays an important role in maintaining inflammation cytomegalovirus infection, herpes, from a bacterial infection - streptococcal. Less commonly, staphylococcal infection. Often, lumbodynia is caused by a recent history of infectious disease, including sore throat.

Sometimes congenital, genetically determined lumbodynia develops, which develops during the period of intrauterine development, and is subsequently a consequence of various diseases of the musculoskeletal system, its underdevelopment, and increased physical activity. The cause can even be intrauterine and postpartum infection of the fetus, with further progression of the infection along the spinal column and body.

Osteochondrosis

Is an inflammatory disease cervical spine spine, in which not only the vertebrae themselves, but also the intervertebral region are involved in the inflammatory process. Also, a feature of this disease is that it causes intensive deposition of moles in the intervertebral discs, which causes pain and stiffness. It occurs mainly against the background of a sedentary lifestyle, with improper gait, improper sitting, and prolonged stay in one position.

Lumbodynia against the background of dorsopathy

It is a pain syndrome of inflammatory origin, the main etiological factor of which is considered to be insufficient mobility, poor hygiene and daily routine, which entails an inflammatory and infectious process. Bone and muscle structures are involved in this process, including the vertebrae and intervertebral discs. The danger is that nerve fibers can also be involved in the inflammatory process, which increases pain, which intensively spreads along the nerve fiber. The process can be manifested by severe attacks of pain, which alternate with a feeling of burning and heat in the affected area.

Post-traumatic lumbodynia

As the name suggests, this is lumbodynia, which develops in response to injury. That is, it is a severe pain syndrome in the lumbar region, which develops after an injury affecting the lower back. Any factor of high intensity and strength can be traumatic. This may be a mechanical factor of a damaging nature (fall, strong push, pressure, mechanical friction). Often such pain occurs as a result of rapid-acting violence in relation to the lumbar spine.

According to statistics, this is most often a consequence of a fall, blow, or damage. vehicle. It can occur from bending the bone and spine beyond the limit of its elasticity, with strong compression and rupture, twisting and crushing. Special place occupied by lumbodynia, caused by the traumatic effect of the disease process of the bone, in particular, caused by congenital fragility, purulent inflammation, rickets, syphilis, tuberculosis.

Risk factors

The risk group includes people who often suffer from colds and infections, as well as those who take antibiotics and chemotherapy. Special group consists of people who are often exposed to traumatic influences and subject their lower back to heavy physical stress. People with dysbacteriosis, as well as with the presence of foci of infection (bacterial, viral), also have a significant risk of getting lumbodynia. The risk also increases in the presence of acute or chronic diseases musculoskeletal system, including osteochondrosis, arthritis, bursitis. There is also a high risk if you have diseases of the nerves and nervous system.

Pathogenesis

The pathogenesis is based on the development of pathological processes in the lumbar spine. In this case, disruption of normal blood circulation, disruption of innervation, disruption of metabolic processes in the lumbar region. There may also be deposition of salts, stones between the vertebrae, and release of intervertebral substance into the space between two vertebrae. Gradually, the inflammatory process develops, the infection progresses, which entails the progression of the disease, its spread and the formation of new foci of infection.

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Symptoms of lumbodynia

Acute lumbodynia

The acute phase implies the presence of an inflammatory process in the lumbar region and coccyx. Nerves are involved in the inflammatory process and are mechanically damaged. The pain is usually sharp, acute, more pronounced during the daytime, and also after a person has been in one position for a long time. Acute pain is practically not eliminated with the help of physical exercises, but requires special treatment, for example, injections or the use of local remedies. The most commonly used are ointments, gels, creams and other medications.

Subacute lumbodynia

The subacute form of the disease is characterized by a relatively mild form of the course, in which pain bothers a person only in the presence of appropriate conditions. For example, if a person sits or lies for a long time without moving, he will experience pain. The pain is less piercing, rather aching, pulling, which easily spreads to neighboring areas. It goes away quite quickly under the influence of physical exercises aimed at the lumbar region.

Chronic lumbodynia

The pain, which spreads to neighboring areas, causes severe tingling and burning. As a rule, exacerbation occurs under the influence of various factors that trigger the development of the disease. For example, this could be severe hypothermia, excessive nervous and mental stress, heavy physical activity, and even improper distribution of the load with its predominant localization in the lumbar region.

Moderate lumbodynia

An indicator of moderation is controlled pain, which can easily be relieved with various medications, as well as with proper physical activity. There is a special set of exercises aimed at unloading the lower back. It is regular exercise that is the key to control the condition of the lower back and allows you to eliminate any pain in a relatively short time.

Complications and consequences

First of all, the main adverse consequence is pain, which bothers a person quite intensely and for a fairly long period of time. It is also worth noting that there is another unpleasant consequence - irradiation of pain, inflammation or mechanical damage to the nerve. Gradually, aseptic inflammation may spread around the affected area, but sometimes a regular inflammatory process may develop, accompanied by infection.

You should also be wary of the possibility of degenerative processes, which are accompanied by conduction disturbances, inflammation of the nerves, and inflammation of the myelin sheaths.

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Exacerbation

Occurs mainly in spring and autumn, since it is during this period that most inflammation occurs. This is due to the fact that this period is accompanied by maximum weakening of the body, defense mechanisms, resistance.

It happens under the influence of various unfavorable factors on the body: excessive stress, overexertion, increased load on the body. Quite often, exacerbation occurs in the summer, when a person performs various physical activities, swims in the river, bathes, sunbathes. cold ground, freezes, there is a sharp change in temperature - after tanning in the sun, a person plunges into cold water in a river. Failure to adhere to the daily routine, poor diet, abuse of non-dietary foods, alcohol - all these can be factors that trigger an exacerbation.

It should also be noted that in winter, exacerbations also occur quite often, especially in severe frost (due to hypothermia, draft, cold, piercing wind). Also often exacerbation occurs from stress, neuropsychic overstrain.

Remission

Characterized by a state of relative calm and improvement. Almost always occurs in any chronic pathology. A fairly long remission can occur after an acute attack of lumbodynia has been cured. Treatment with special medications, as well as after injections of painkillers, usually results in a state of remission.

If this condition is not maintained with special supportive therapy, preventive medicines and physiotherapeutic procedures, remission can quickly develop into a state of new exacerbation. But if you maintain this regime, remission can last quite a long time - from several months to several years. There are cases when, after the onset of remission, no more exacerbations occurred, and a person lives for decades without new attacks, although due to various circumstances, the diagnosis was not finally removed.

Persistent lumbodynia

This condition can also be quite long-lasting. The pain is usually not relieved by any medications or ointments. But in order to prevent persistent lumbodynia from becoming chronic, mandatory treatment is required. In most cases, mandatory hospitalization is required, since inpatient treatment is ineffective.

Recurrent lumbodynia

It often happens that lumbodynia is completely cured, and after a few weeks it returns again. This return of the disease after improvement is called relapse. At the same time, in a repeated case, treatment is also required. If possible, comprehensive treatment should be carried out, and hospitalization may even be required (since this is the most effective, complex form treatment). It is worth noting that the treatment of relapse must be approached with the utmost seriousness, since if not cured immediately, the disease can become chronic.

Diagnosis of lumbodynia

As soon as you feel acute pain, contact a neurologist or surgeon. A neurologist will conduct an examination and check basic reflexes. It is also important to consult a surgeon, who in most cases palpates the pathology and determines its cause and pathogenesis. If these specialists are not available, help can be provided by a traumatologist, or an orthopedist, or an orthopedic surgeon.

First of all, high-quality diagnostics are important, which will help make the correct diagnosis and select the optimal treatment. Without a diagnosis, it is impossible to select treatment, and it is also impossible to cure a person. Therefore, it is ideal to visit a good diagnostician. But in our country the practice of visiting diagnosticians is still not widespread enough. This scheme is practiced mainly in the USA and Europe: when a person goes to one person who conducts a comprehensive examination and makes a single diagnosis based on data from various tests, examinations, as well as an analysis of all the results obtained and available information.

As a last resort, if the clinic does not have specialists in such areas, you should contact a therapist, who will refer you to the necessary specialists. In such cases, almost always, a consultation with a surgeon and a neurologist is prescribed.

Usually the diagnosis is made based on the results of the examination: severe pain. There is a decrease in basic reflexes. First of all, it is possible to diagnose a violation of the knee reflex, a violation of the normal functioning of the Achilles tendon, and the absence of appropriate reflexes. Lasègue symptoms are observed.

Instrumental diagnostics

It is impossible to do without the use of instrumental research methods. The main methods are such methods as X-ray examination, as well as computed tomography and magnetic resonance imaging. These are methods that make it possible to determine the cause and exact localization of the pathology as accurately as possible and in a relatively short time.

The main goals of such a study are to determine at what level (part of the spine) the pinching occurred. An X-ray examination is carried out. CT and MRI are used in relation to the affected area.

Sometimes electroneuromyography may be required to determine not so much the cause as the violation of muscle contractility. It records how and at what speed/intensity nerve impulses travel.

Analyzes

Laboratory methods are ineffective and are rarely used in the diagnosis of lumbodynia. At the very least, standard methods, such as clinical and biochemical blood tests, will not show an accurate picture of the pathology. But sometimes these research methods may be required. For example, if an X-ray or tomography shows pinched and compressed nerves, tests can be used to determine what exactly caused the compression. For example, you can use a biochemical blood test to identify a tumor and determine its location. A routine clinical blood test is often used to determine the presence of an inflammatory process. Also, with the help of these tests, it is possible to determine what type of inflammation is taking place - septic or aseptic.