With pain almost every character. Such ailments, such as sciatica, lumbago, is very common causes of temporary incapacity for work, particularly in people who perform physical work. Most often back pain is associated with changes in the lumbosacral spine, which should be treated very seriously. Although painful sensations in the lumbar region can be the result of congenital anomalies of the spine and its ligaments, acute and chronic infections, poisoning, or even tumors.
Lower back pain sometimes very strong and sometimes people tolerate them quite easily. The fact that the response to pain is individual, affected by mental and age-related factors. In the elderly pain with sciatica is very strong, although usually the perception of pain in the elderly weakened. And patients with mental illness sensitivity to pain is significantly reduced, even when sciatica.
Pain is a complex adaptive mechanism, it is sometimes called the "guardian" of health. Caused by external influences, or malfunction in the body's danger signals. After receiving the pain signal, the body includes defense mechanisms against the adverse effects. Pain due to a number of disease processes reveal themselves before any external symptoms. So painful feelings play a positive role: they give to know that it's time for action. If you have pain in the lower back and t.j. the remainder, do not delay treatment to the doctor. Remember the Eastern wisdom: "the treatment of a disease of the light, who have for the treatment of heavy."
One third of patients with lumbar pain due to degenerative changes in the spine, which are together called "osteochondrosis". Osteochondrosis is a complex of changes in the bones and ligaments of the spine, caused by degeneration of the intervertebral discs. In addition, osteochondrosis of the spine can be formed bony outgrowths - osteophytes irritating the nerve roots and sensory nerve endings, the spinal column and its ligaments, which cause dull pain pain in the back.
The intervertebral discs have a lenticular lens shape, corresponding to the small indentations on the surface of the vertebrae. With age, the discs lose moisture, dry up, have cracks, gaps, and cracks. As a result, the bobbin becomes movable and can slide off the disk, leading to a narrowing of the intervertebral foramen and compression takes place here of the spine nerve roots. In the lumbar vertebrae are the most mobile and yet are under pressure, when lifting weights. Therefore, the discs between them are the most sensitive to deformation.
Suffering from lumbar degenerative disc disease are severe pain, and the reason is not only a mechanical irritation of nerve roots: rupture of the membranes and the walls of the intervertebral disc releasing substance, irritant receptors to pain.
In a later stage of the disease the drives protrude, which form the so-called mezhpozvonkovuyu hernia, which is usually found in middle-aged and elderly people. Most often affects the discs of the lumbar spine, as the intervertebral foramina between the fourth and fifth lumbar vertebrae and between the fifth lumbar vertebra and the sacrum is very narrow, and pass them in the nerve roots - most massive. mezhpozvonkovaya hernia is very dangerous. And it's not just that it pinches the nerve roots, causing pain on the type of sciatica. A massive herniated disc affects the spinal cord, which can cause loss of sensation or even paralysis of the legs and urinary dysfunction.
For a herniated lumbar disk, characterized by the following symptoms: "strut" - when standing the patient is forced to lean a hand on the knee or a chair to reduce the load on the affected disc; "cushion" - the inability to lie on the belly, not tucked under her pillow; "landing" - the patient, trying to pick up something from the floor, not tilted, and squats.
One of the main causes of osteochondrosis - a violation of lipid and mineral metabolism. Sometimes osteochondrosis arises as a result of abnormalities of the intervertebral discs, their innate inferiority. External factors that promote the development and aggravation of lumbar degenerative disc disease include: high humidity, extreme temperature changes, drafts; important and long-lasting tension of the muscles, bones and ligaments in the lumbosacral spine; mechanical damage and chronic infections.
The most common diagnosis for severe back pain - sciatica. For a long time it was believed that this disease is of infectious origin. However, practice shows that patients do not usually the body temperature rises, it does not increase the number of leukocytes in the blood and cerebrospinal fluid. Sciatica almost never affects children. So in most cases it is unlikely that the cause for sciatica can be infection.
True sciatica is one of the most common manifestations of degenerative disc disease. Pain in the lumbar-sacral region in this disease can be both acute and obtuse. This is usually one-sided, radiates to the buttocks, thighs, rear and outer surface of the tibia. Pain with sciatica can be aggravated due to changes in body position, walking, coughing, sneezing, straining. Sometimes it is combined with sensations of numbness, tingling, pins and needles, burning sensation, itching. The increased sensitivity of the skin, sore muscles, lower back, buttocks, shins.
Symptoms of sciatica are severe. The patient changes walking, posture, appear the characteristic movements and poses. When walking is the torso tilts forward and to the side of the healthy leg. In a standing position one leg is bent, which reduces the tension on the nerve trunks. Body motion in the lumbar spine is not limited. On the sick side of the back muscles tense. With sciatica often curved spine. The patient lies on the healthy cheek, throwing the trunk back with pivots in the direction of the healthy leg. If you must for lifting objects from the floor, squats or bends the torso forward while bending the affected leg. Lying down one leg usually bent.
Mild forms of sciatica does not restrict patient movement. If the disease progresses, reduced muscle tone, muscle weakness, patients care, itching, feeling of "pins and needles". Lying in bed, suffering for hours can't find a comfortable position. Often I feel cold, dryness, or, on the contrary, the humidity of the feet. The skin on the feet becomes pale or bluish color and become thinner. But these symptoms should not set itself a hasty diagnosis of "sciatica". A similar picture give pannikulez - inflammation of subcutaneous fat on the basis of infringement of metabolism in the adipose tissue, and damage to the joints of the legs.
In addition to the recurrent sciatica is very common that the acute form of the disease the lumbar spine, lumbago, or cross. In lumbago irritate the nerve roots and sharp pain. This often occurs in people who perform heavy physical work, as a result of the overstrain of lumbar muscles, and often with colds. But sometimes an attack of lumbago may cause acute and chronic infections, it can also be one of the symptoms of sciatica. The pain usually stops after a few days, sometimes it takes two or three weeks. While the attack did not let go, the patient is better to stay in bed.
A special form of lumbago develops when, after the heavy physical exertion is a strain of the muscle bundles, tendons, or bleeding in the muscles. This type of pain in the low back, manifested as a pain in the back along the entire length of the spine and a feeling of General muscle fatigue.
It should be specially noted: if you have a sick lower back, this does not mean that affects the spine. The cause of lumbar pain can myositis (inflammation) of the lumbar muscles. The disease lasts a long time. Muscle pain is not as strong as in lumbago, and dull, aching. When the muscles are compressed, painful on palpation and tension. In patients with chronic infections and metabolic disorders myositis of the lumbar muscles may be combined with pain in the joints.
Pain in the lower back: what to do?
Back pain can be so strong that without treatment will not do. Whatever the cause for the attack in the first days you must stay in bed. In the following days, as the pain subsides, the patient is allowed to walk, first on crutches, it is desirable to remove the spine. Bed must be hard thin mattress laid on a wooden Board.
For the local heating in the area of maximum pain is used irritating ointments, mustard and capsicum or of the plaster. Bring relief for a warm wool scarf, a heating pad, a pouch filled with heated sand, leeches. Well helps rubbing also anti-inflammatory and painkillers. With myositis help hot packs.
Analgesic effect of elektroprotsedury: percutaneous elektroanal'geziya, sinusoidal modulated currents, diadynamic currents, electrophoresis with novocaine and other. With the same aim, reflexology (acupuncture, moxibustion, electroacupuncture, laser therapy) and novocaine blockade. With sciatica cause intervertebral disc displacement, subject to the traktsionnuyu therapy - traction of the trunk on the bed or under the water. These procedures should be performed in the hospital. Effective treatment, sodium chloride, radon, sulfide, turpentine, iodine-bromine baths, Naftalan, mud, low temperatures.
One of the emerging types of therapeutic effects for back pain became a way of "biological feedback". Its principle is justified by the prominent Russian physiologist P. K. Anokhin in the 30-ies of the last century. The method, which includes training for management functions of the organism. Here is its use for the treatment of back pain. Before the patients goal is to maximally relax the back muscles. The patient sees his own elektromiogrammu reflects the muscle tension on the screen, and when they are tense, hard, and heard a beep. Between the release of the amplitude of the electromyogram is reduced, the sound disappears. As a result, the patient formed the motivation for reducing pathological tension in the muscles. Typically, the results are immediately. For the patient to learn to relax and control muscle tone, you need to spend five or six sessions. In the future, patients are able to manage the relaxation of the back muscles themselves.
It is equally important to manage your pain and prevent the attacks is wearing external supports - orthoses: corset corrector posture; reklinatora (especially the corset, which eliminates the tilt), shoulder straps and belt: elastic belt lifter or the installer. They prevent the deformation of the spine, improves venous and lymphatic flow, which gives the figure slim. Well, if the composition of the material from which the belt is wool.
You should only consider that if you do not follow medical advice, then the regular wearing of orthoses can cause damage. First, they need to wear over the underwear to prevent chafing. Too tight tightening of the braces difficult breathing, digestion and blood circulation in the lower half of the body. If you do not leave them, day or night, may be muscle atrophy of the lumbar spine. Orthoses may be useful in long periods of sitting at the table, intense physical activity, riding on public transportation. The rest of the time is better off without them, on the muscles that have to work. An excellent drug for back pain are exercise therapy. Their muscle "corset" artificial "props" for the spine unnecessary.
Sometimes, in order to relieve the pain attack, patients resort to taking anti-inflammatory and analgesic agents. With a very strong pain, are more efficient in the form of intramuscular injections. Usually prescribe analgesics and nonsteroidal anti-inflammatory drugs . Anti-inflammatory nonsteroidal means that the abuse is not worth it. Contra-indications for their use, peptic ulcer and 12 duodenal ulcer in acute phase, expressed by the human liver. To avoid complications, you need to take only one medicine shorter than 5-7 days, pre-arranging with the individual characteristics of the organism.
In the elderly (over 65 years), hypertension, heart failure, or peptic ulcer disease nonsteroidal preparations it is better to replace the so-called cyclooxygenase-2 inhibitors. These medicines practically do not irritate the gastrointestinal tract and do not have any other side effects. Nice to have a course of injections of vitamins, especially group B.