With pain almost every character. Such diseases as sciatica, lumbago, is a very common cause of temporary disability, especially in people engaged in physical labour. 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 may be the result of congenital anomalies of the spine and its ligaments, acute and chronic infections, intoxication, or even tumors.
Lower back pain is sometimes very strong and sometimes people tolerate them quite easily. The fact that the reaction of 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, the sensitivity towards pain is significantly reduced, including when sciatica.
Pain is a complex adaptive mechanism, it is sometimes referred to as the "keeper" of health. Caused by external influences or defects in the body, it signals danger. After receiving the pain signal, the body includes mechanisms for defense from the negative effects. The pain due to a number of pathological processes reveal themselves before any external symptoms. So painful feelings play a positive role: they give to know that it is time to act. If you have pain in the lower back and rump, do not delay treatment to the doctor. Remember the Eastern wisdom: "the treatment of diseases of the light, you have to treat severe."
One third of the patients with lumbar pain caused by degenerative changes of the spine, which are collectively 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 in the spine can be formed bony outgrowths - osteophytes, which irritate the nerve roots and sensory nerve endings of the spine and its ligaments, causing a dull pain pain in the back.
The intervertebral discs make up the lenticular lens, the shape corresponds to the small indentations on the surface of the vertebrae. With age, the discs lose moisture, dry up, they cracks, holes, and cracks. As a result, the vertebra becomes movable, and may slip outside of the disk, which leads to narrowing of the intervertebral foramen and compression takes place here the spinal nerve root. The lumbar vertebrae are the most mobile and yet are under pressure when weight lifting. Therefore, the discs between them are the most susceptible to deformation.
Who suffer from lumbar degenerative disc disease have severe pain, and the reason is not only a mechanical irritation of nerve roots: the rupture of the membranes and the walls of the intervertebral discs released substances, irritating pain receptors.
At a later stage of the disease of the discs protrude, the formation of ts.n. mezhpozvonkovuyu hernia, which is usually found in middle-aged and older persons. The most commonly 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 passing them in the nerve roots - most major. mezhpozvonkovaya hernia is very dangerous. And it's not just that it pinches the nerve roots, causing pain on the type of sciatica. Massive herniated disc presses on the spinal cord, which can cause loss of sensation and even paralysis of the legs and urinary disorders.
For a herniated lumbar disc, is characterized by the following symptoms: "strut" - when standing the patient is forced to lean by a knee or a chair to reduce the load on the affected disc; "cushion" - the inability to lie on the belly, not tucked under his 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 occurs as a consequence of abnormalities of the intervertebral discs, their innate inferiority. The external factors that encourage the development and aggravation of lumbar degenerative disc disease include: high humidity, extreme temperature changes, drafts (unfinished); a significant and prolonged tension of the muscles, bones and ligaments of the lumbosacral spine; mechanical injuries, and chronic infection.
The most common diagnosis for severe back pain - sciatica. For a long time it was believed that this disease is an infectious origin. However, practice shows that patients usually do not temperature of the body increases, does not increase the number of leukocytes in the blood and cerebrospinal fluid. Sciatica almost never affects children. So in most cases it is likely that the reason for sciatica can be infection.
Really, 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. It usually is unilateral, radiates to the buttock, rear thighs and the outside surface of the tibia. Pain with sciatica can worsen with the change of body position, walking, coughing, sneezing, straining. Sometimes it is connected with the sensations of numbness, prickling, pins and needles, burning, itching. Increased sensitivity of the skin, painful muscles, lower back, buttocks, shins.
Symptoms of sciatica are severe. Patient change of movement, posture, appear the characteristic movements and poses. When walking he tilts the torso 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. The body motion in the lumbar spine is limited. On the other hand back muscles tense. With sciatica often curved spine. The patient sits on the healthy cheek, throwing the trunk back with a tilt toward healthy feet. If he needs to lift the object off of the floor, he squats or bends the torso forward while bending the other leg. Lying down one leg usually bent.
Mild forms of sciatica does not limit the patient is in motion. If the disease progresses, decreased muscle tone, muscle weakness, patients are concerned about itching, feeling of "pins and needles". Lying in bed, suffer, for several hours, you can find a comfortable position. They often feel cold, dryness, or, conversely, the humidity of the feet. The skin of the feet becomes pale or bluish color and becomes thinner. But, these symptoms don't need to set myself a hasty diagnosis of "sciatica". A similar picture is given pannikulez - inflammation of the subcutaneous fat on the basis of violations of metabolism in the adipose tissue, and lesions of the joints of the feet.
In addition to the recurrent sciatica is a very common this acute form of the disease of the lumbar spine, lumbago, or cross. In lumbago irritated nerve roots and appears sharp pain. It often occurs in people engaged in heavy physical labor, as a result of the overstrain of lumbar muscles, and often with the common cold. But, sometimes an attack of lumbago, can cause acute and chronic infection, it can also be one of the symptoms of sciatica. Pain usually stops after a few days, but sometimes lasts two or three weeks. While the attack does not let go, the patient is better to stay in bed.
A special form of lumbago develops when after heavy physical exertion is a virus muscle bundles, tendons or bleeding in the muscles. This kind of backache manifests itself as pain on the back the whole length of the spine, and the feeling of General muscular fatigue.
It needs to be emphasized: if you have painful lower back, this does not mean that affects the spine. The reason for the lumbar pain can be a myositis (inflammation) of the lumbar muscles. The disease lasts a long time. Muscle pain is not as strong as in the lumbago, and dull, aching. When the muscles are compacted, painful in palpation and tension. 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 no treatment will not be made. Regardless of the reason for the attack in the first days you will have to stay in bed. In the following days, as the pain subsides, the patient is allowed to walk, first on crutches, it is desirable to unload the spine. The bed should be hard - a thin mattress placed on a wooden Board.
For the local heating in the area of the greatest pain used irritating ointments, and mustard or capsicum plaster. Bring relief of a warm wool scarf, electric pad, a pouch filled with heated sand, leeches. Well helps of friction including anti-inflammatory and pain medicine. With myositis using hot compresses.
Analgesic effect elektroprotsedury: percutaneous elektroanal'geziya, sinusoidal modulated currents, diadynamic currents, electrophoresis with novocaine and other. With the same purpose, reflexology (acupuncture, moxibustion, electroacupuncture, laser therapy) and novocaine blockade. With sciatica caused by intervertebral disk displacement, are applied traktsionnuyu therapy - traction of the trunk on the bed or under the water. These procedures should be performed in the hospital. Effective therapy - sodium chloride, radon, sulfide, turpentine, iodine-bromine baths, Naftalan, mud, low temperatures.
One of the rapidly developing types of therapeutic effects for the pain in the back has become a method of "biological feedback". Its principle is supported by the prominent Russian physiologist P. K. Anokhin in the 30-ies of the last century. The method includes training for management functions of the organism. Here is its use for the treatment of back pain. Before patients the goal is to maximally relax the back muscles. The patient sees its own elektromiogrammu reflection of the tension in the muscles of the screen and when they are tense, difficult, and hears a beep. During relaxation, the amplitude of the electromyogram is reduced, the sound disappears. As a result, the patient create incentives to reduce pathological tension in the muscles. Typically, results are achieved immediately. For the patient to learn to relax and control of muscle tone, need to spend five or six sessions. In the future, users are able to cope with the relaxation of the back muscles themselves.
Equally important is to manage the pain and prevention of the attacks is wearing external supports - orthoses: corset corrector posture; reklinatora (special corset that eliminates tilt), are prepared and belt: elastic belt lifter or the installer. They prevent deformation of the spine, to improve venous and lymphatic flow, giving the image a thin. So, if the composition of the material from which the belt is wool.
You just need to take into account that if you do not follow medical advice, then the regular wearing of orthoses can cause damage. First, they need to be worn over the underwear to avoid 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, can muscles to atrophy of the lumbar spine. Orthoses useful in the prolonged sitting on the table, intense physical exertion, like riding on public transport. The rest of the time it's better without them - the muscles need to work. The perfect remedy for back pain is exercise therapy. Their muscle "corset" man-made "props" for the spine are unnecessary.
Sometimes, in order to relieve the pain attack, patients need to resort to the taking of anti-inflammatory and analgesic agents. With a very strong pain that they are more efficient in the form of intramuscular injections. Usually prescribe analgesics and nonsteroidal anti-inflammatory drugs . Anti-inflammatory nonsteroidal means to abuse is not worth it. Contraindications for their use are peptic ulcer and 12 duodenal ulcer in acute phase, expressed by the human liver. To avoid complications, you need to take only one medicine short courses of 5-7 days, prior arrangement with the individual characteristics of the organism.
In the elderly (over 65 years) with hypertension, heart failure, or peptic ulcer disease nonsteroidal preparations it is better to replace t.n. cyclooxygenase-2 inhibitors. These drugs practically does not irritate the gastrointestinal tract and have no other side effects. It is nice to have during the procedure of vitamins, especially group B.