If you believe in the statistics, 70 to 80% of the population of our country at least once in their life is faced with the back pain in the lumbar region, or, in medical terms, pain in the lower back. Its prevalence in the Uk is 59%, in Denmark — 70%, in Finland — 75%. Between all of the issued "hospital" in our country, one-third represents in cases of back pain.
The causes of low back pain can be the most varied of psychogenic factors in cancer metastasis. Fortunately, a serious pathology that you do not have more than 5% of cases of pain in the lower back, the reason — overvoltage or muscle spasm, as well as other problems of the musculoskeletal system.
Types of back pain in the lumbar region
The pain in the back, as in any other organ, without equal. Often the character of the pain — the first sign that the doctor can make an assumption about the nature of the disease.
In its origin the pain in the back can be:
- primary — caused chronic functional or dystrophic changes in the tissues of the spine and of the muscles, sometimes with the participation of neighboring structures — the root of the spinal nerve nerves.
- secondary — caused by trauma, inflammation, arthritis, or arthrosis of the intervertebral joints, the defeat of the internal organs.
The duration of the pain can be:
- acute — occurs because of a new injury or newly-created pathological state, intrinsically related to it, with duration of up to 6 weeks;
- subacute — lasts 6 to 12 weeks;
- chronic — lasting more than 12 weeks.
Typical clinical manifestations will depend on the source of the pain.
Injuries muscle clonic-tonic, and other pain syndromes
Hypothermia, constant discomfort posture during work or leisure, errors, motor stereotypes, degenerative diseases of the spine, modify the height and elasticity of intervertebral disc, so that the work load of the muscle is distributed unequally. Some of them become constantly overloaded, some, on the contrary, do not receive the required load. The individual result muscle begins to spasm, causing him pain. Appear the so-called corresponding points of the activation point, the impact on the which strengthens the spasm and the pain. Characteristic features of the pain:
- clearly limited the local phase (pain);
- it is felt in the depth of the muscle layer;
- in the muscle detected tight tight phase or weight, within which are detected particularly painful point;
- when exposed to these points dramatically to the pain intensifies, forcing the patient to shiver (a symptom of jump);
- restriction of mobility;
- if it is possible to stretch the muscle pain.
Is this type of pain work well the ointment is that warm or popular fixtures. It is true, the effects are short-term, because the reason, which causes a muscle spasm, they do not resolve. The most reliable method of injection of analgesic drug directly into the trigger point, and also kinesiotherapy, physical therapy, manipulative.
Compression radiculopathy
It is caused by compression or stretching of nerve root spinal nerves due to a herniated disc or the reduction of its height and, as a consequence, the distance between the vertebrae. This type of pain felt more like a "surface" that is spreading more in the skin than in the depth of the tissues. She is dramatically increased sneezing, coughing, the load on the spine. This is the type of pain is felt as the classic "appearances", gives in the course of division of the root.
The stenosis of the spinal canal
Occurs due to a herniated disc, protrusion (protrusions) part it in the vertebral canal, or of the occurrence of sequestration — exfoliated part of the unit. One way or another squeezed education under the name of "pony tail" — the back of the lower spinal nerves, Innervate the lower limbs. The pain extends along the course of the nerve root, from the waist to the stop, appears and in peace, and walking, increases with the extension thin spine and decreases when tilted to the front.
Special syndrome
It is called the pathology of the small intervertebral (facet) joints. The pain can be local as well as radiate (give) in the groin, coccyx, back of the thigh. Is enhanced when inclinations and rotation in the lumbar region.
All of these types of starting point of the pain of the syndrome appear subtly, sometimes the patient can even say in that day, and after any intervention (who stood up, not turned, and PR.). Pains intensify at night and after physical activity, decrease after the rest. More of this type of pain is common for people middle-aged and elderly.
Pain inflammatory
It is caused by the inflammatory defeat of the joints of the vertebral column — is a different type of arthritis: rheumatoid arthritis, disease of Reuters, ankylosing spondylitis, and t. d. Inflammatory the pain more often occurs in relation to the young people, gradually develops. It is the maximum, at the beginning of the day and decreases at night or after exercise. Many times, accompanied by the morning savannastd.
Other possible causes of lower back pain — pathology of internal organs, for example kidney disease, or inflammation supportive than women. Since many diseases can manifest themselves in a similar way, at least with regard to the starting point of the pain of the syndrome, it is best not to get involved with the diagnosis itself, and contact your doctor.
Immediate expert advice is required in the case of:
- the pain appeared after a trauma, especially in aged women;
- the story has the disease;
- the pain is accompanied by temperature rise;
- abruptly and for no apparent reason diminishes the weight;
- changes of gait and / or taken away from the foot;
- appear difficulties to urinate and defecate.
These signals may be the manifestation of a office of diseases that require immediate treatment.
The diagnosis of the pathology
Pain in the back and lumbar region your doctor first of all, it is necessary to eliminate the risk of life in the state — fortunately, they are very rare.
General and biochemical analysis of blood, they allow to identify inflammatory changes, detect a high level of calcium, which is characteristic for metastases of malignant neoplasms in bone structures, changes in the number of cells in the blood, in the multiple myeloma disease and so on. Men in age you can assign an analysis PROStandtspecific antigen to the exclusion of a possible prostate cancer.
X-ray examination detects the change of the height of the intervertebral disc, the possible OSteofits — proliferation, and bone, caused properly distributed, the load on the vertebrae, variation of shapes own vertebrae.
The computed tomography and magnetic resonance imaging will show bulging intervertebral disc, кandльцификandts (areas of calcification), stenosis of the spinal canal.
Today, to replace these two studies, gradually, comes from the ultra-sound of the spinal column, which allows to detect similar changes, not to subject the patient to excessive radiation load.
Mandatory consultation with a neurologist, for reading — chiropractor.
After a full examination, it becomes understandable the strategy of treatment. As a rule, to deal with pain in the lumbar region, can therapeutic methods, the operation is shown to be relatively rare.
The drug treatment of pain in the lumbar region of the back
In 95% of cases the patient, there is no reason to worry — usually, the back pain is not a threat to health and can be curable. Myofascial syndrome adjusted more quickly to the solution of radicular pain can take a few months. One way or another, in most cases, it is necessary medical therapy. Use non-steroidal anti-inflammatory drugs (NSAIDS) to relieve pain and decrease swelling, medications to maintain the intervertebral cartilage. Sometimes, to reduce the pain and swelling are prescribed and hormonal treatments — they are faster anti-inflammatory non-steroids, its administered in the form of blocks and drippers under the supervision of a doctor.
Medicines can be in the form of ointments and gels — this method of treatment of low back pain popular advertising rollers. But as the method of introduction in the body of an active substance outdoor use means more мandлоэффекtepnoe, that can predict, after all, the largest part of the same does not penetrate through the skin.
Another popular technique — the oral intake of medicines, or, more simply, pills and capsules. Drink the pill is not difficult, the effect comes very quickly — usually within half an hour-an hour, but the prolonged intake of drugs can affect the state of the gastrointestinal tract.
Therefore, the quickest and most efficient way to alleviate the pain of the injection directly into the muscle, or the area of the victim root, the so-called lock. Its only flaw is the rigid requirement of high qualification for the doctor that will perform this manipulation.
NEMAdикandIUнtознandя therapy
Usually, the medication treatment is complemented NEMAdикandIUнtознsми methods. Which physioPRthodурs need, solve your doctor. This can be a classic and a massage or therapy manipulative, and OStеопandt- diffraction procedures, and acupuncture. Gaining popularity and Chinesetерandпия special fitness-special activities dECOMPRессионнsх simulators that help relieve tense muscles, to train new motor stereotypes, thus eliminating the cause of pain in the back.
So, the best treatment option for back pain — the combination of IUdикandIUнtознsх methods and approach to drugs. This integrated work in several senses more quickly cope with the disease, to completely get rid of the pain or to obtain a lasting effect.