With pain almost every sign. Such ailments as sciatica, lumbago, is a very common causes of temporary disability, especially in people engaged in physical labor. 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, intoxication, or even tumors.
Lower back pain sometimes very strong and sometimes people tolerate them quite easily. The fact that the reaction 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, including when sciatica.
Pain is a complex adaptive mechanism, it is sometimes called the "watchdog" of health. Caused by external impacts or malfunctions in the body, it signals danger. After receiving a pain signal, the body includes defense mechanisms against adverse effects. 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: "treat the disease light, having to treat heavy."
A third of patients with lumbar pain caused by degenerative changes in 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 intervertebral disks. In addition, osteochondrosis in the spine can be formed bony outgrowths - osteophytes, which irritate nerve roots and sensory nerve endings of the spine and its ligaments, causing a dull aching pain in the back.
The intervertebral discs constitute the lenticular lens, the shape corresponding to the small indentations on the surface of the vertebrae. With age, the discs lose moisture, dry up, they are cracks, gaps and crevices. As a result, the vertebra becomes movable and can slide off of the disk, leading to narrowing of the intervertebral foramen and compression taking place here spinal nerve root. The lumbar vertebrae are the most mobile and yet are under pressure when weight lifting. Therefore, the discs between them are most susceptible to deformation.
Suffering from lumbar degenerative disc disease have severe pain, and the cause is not only a mechanical irritation of the nerve roots: the rupture of the membranes and walls of the intervertebral disc released substances, irritating pain receptors.
At a later stage of the disease the drives protrude, forming the so-called mezhpozvonkovuyu hernia, which is usually found in middle-aged and elderly. 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 passing 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. Massive herniated disc presses on the spinal cord that can cause loss of sensation or even paralysis of the legs and urinary disorders.
For herniated lumbar disc, 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 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 arises 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; a significant and prolonged tension of muscles, bone and ligaments of the lumbosacral spine; mechanical injury and chronic infection.
The most common diagnosis for severe back pain - sciatica. For a long time it was believed that this disease has an infectious origin. However, practice shows that patients do not usually the body temperature rises, does not increase the number of leukocytes in the blood and cerebrospinal fluid. Sciatica almost never affects children. So in most cases unlikely to cause of sciatica can be infection.
Indeed, the 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 is usually unilateral, radiates to the buttock, rear thighs and the outer surface of the tibia. Pain with sciatica can be aggravated by change of body position, walking, coughing, sneezing, straining. Sometimes it is combined with sensations of numbness, tingling, pins and needles, burning, itching. Increased sensitivity of the skin, painful muscles, lower back, buttocks, shins.
Symptoms of sciatica are severe. Patient change gait, posture, appear characteristic movements and poses. When walking he tilts the torso forward and to the side of the healthy leg. In the standing position one leg is bent, which reduces the tension on the nerve trunks. Body motion in the lumbar spine is limited. On the sick side back muscles tense. With sciatica often curved spine. The patient sits on a healthy cheek, throwing the trunk back with a tilt toward healthy legs. If he needs to lift the object off the floor, he squats or bends the torso forward while bending the affected leg. Lying down one leg usually bent.
Mild forms of sciatica does not limit the patient in motion. If the disease progresses, reduced muscle tone, muscle weakness, patients concerned about the itching, sensation of "pins and needles". Lying in bed, sufferers for hours can't find a comfortable position. They often feel cold, dryness, or, conversely, the humidity of the feet. Skin on the feet becomes pale or bluish color and becomes thinner. But these symptoms should not set itself a hasty diagnosis of "sciatica". A similar picture give pannikulez - inflammation of the subcutaneous fat on the basis of violations of metabolism in adipose tissue, and lesions of the joints of the feet.
In addition to the recurrent sciatica is very common this acute form of the disease 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 the result of the overstrain of lumbar muscles, and often with colds. 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 did not let go, the patient is better to stay in bed.
A special form of lumbago develops when after heavy physical exertion is strain muscle bundles, tendons or bleeding in the muscles. This kind of backache manifests itself as soreness of the back along the entire length of the spine and a feeling of General muscle fatigue.
It should be particularly emphasized: if you have a sick lower back, this does not mean that the affected spine. Cause of lumbar pain can be a myositis (inflammation) of lumbar muscles. The disease lasts a long time. Muscle pain is not as strong as in lumbago, and dull, aching. When the muscles are compacted, painful at palpation and tension. Patients with chronic infections and metabolic disorders myositis of the lumbar muscles may be combined with pain in the joints.
Sore lower back: what to do?
Back pain can be so strong that without treatment will not do. Regardless of the cause of 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 unload the spine. The bed should be hard - a thin mattress laid on a wooden Board.
For local heating in the area of greatest pain used irritating ointments, and mustard or capsicum plaster. Bring relief to warm wool scarf, electric heating pad, a pouch filled with heated sand, leeches. Well helps rubbing including anti-inflammatory and painkillers. With myositis help hot packs.
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, apply traktsionnuyu therapy - traction of the trunk on the bed or under water. These procedures should be carried out in a 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 pain in the back became a method of "biological feedback". Its principle is substantiated by the eminent Russian physiologist P. K. Anokhin in the 30-ies of the last century. The method involves training for management functions of the organism. Here is its use for the treatment of back pain. Before patients the aim is to maximally relax the back muscles. The patient sees his own elektromiogrammu reflecting the muscle tension on the screen and when they tense, hard, and hears a beep. During relaxation the amplitude of the electromyogram is reduced, the sound disappears. As a result, the patient formed the motivation to reduce pathological tension in the muscles. Typically, results are achieved immediately. For the patient to learn to relax and control the 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.
Equally important to manage pain and prevent attacks is wearing external supports - orthoses: corset corrector posture; reklinatora (special corset that eliminates tilt), brace and belt: elastic belt lifter or the installer. They prevent deformation of the spine, improve venous and lymphatic flow, giving 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 may cause harm. First, they need to wear 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 prolonged sitting at the table, intense physical exertion, riding on public transport. The rest of the time it's better without them - the muscles have to work. The perfect remedy for back pain are exercise therapy. Their muscle "corset" artificial "props" for the spine unnecessary.
Sometimes, in order to relieve pain attack, patients have to resort to taking anti-inflammatory and analgesic agents. With very strong pain they are more effective 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 to 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, pre-arranging it 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 the so-called cyclooxygenase-2 inhibitors. These medicines practically do not irritate the gastrointestinal tract and have no other side effects. Nice to have a course of injections of vitamins, especially group B.