Lumbalgia syndrome: what is it? Painful ailments in the lumbar region, which are second only to headaches in prevalence. It is erroneous to consider that lumbalgia ("lumbus" - lower back, "algos" - pain) is a disease. This is a signal of hidden ailments that need to be identified and treated. Discomfort in the back can cause disability.
What is lumbalgia
The musculoskeletal system consists of many "segments" - these are vertebrae, discs between them, muscles, tendons, ligaments, and nerve roots. If pathological changes occur in any of these structures of the spine or pelvic organs, back pain appears. The malaise can be accompanied by sensations unbearably sharp or dull, prolonged, more than 3 months. Lumbalgia is a pain syndrome characterized by muscle cramps and stiffness of movements. The disease has practically no age restrictions, but mostly elderly people suffer from it.
What is lumbargia of the lumbosacral spine, according to the international classification of diseases? In the ICD-10, this syndrome is listed under the number 54.5. Additional numbers indicate the type and stage of development of the pathology. Often, the lumbalgia code follows the designation of the disease that caused it. Knowing these codes, you can check the compliance of the treatment with the approved medical standards.
Lumbalgia should not be identified with lumbago. Although these pathologies are similar, they are manifested and treated in different ways. Compare: lumbalgia is a pain that intensifies gradually, and with lumbago it fights instantly, like a cross. In the first case, it often radiates (gives) to the buttocks and thighs, and in the second, it is concentrated in the lower back. With lumbago, a maximum after a week passes by itself, with lumbalgia without treatment, the condition only worsens.
Varieties of pathology and their classification
Lumbargia of the lumbar spine is manifested in one of two forms:
- acute: severe pain appears unexpectedly and is often not associated with the spine itself - with the exception of protrusion (protrusion) of the intervertebral discs;
- chronic: pathology develops slowly and is associated with damage to the structures of the spine.
Depending on the nature of its origin, the syndrome is divided into two main types:
- vertebrogenic lumbalgia, the causes of which are disorders in the spine;
- non-vertebrogenic, caused by diseases that occur in the lumbar region, but outside the spinal column.
Acute form of pathology
Acute lumbargia of the lumbar spine is often the result of awkward movement, improper lifting of a heavy load, injury or hypothermia. Serious pathological changes are not observed in the vertebrae. However, if degenerative processes occur in the lumbar or sacral regions, severe pain sooner or later becomes the peak of their development. Sometimes acute lumbalgia goes away on its own, but more often it becomes chronic.
You can talk about the presence of this form of lumbargia of the lumbar spine if the pain, which often extends to the buttocks and legs, is relatively weak and does not go away within six months. Sensations are repeated with obvious periodicity or under the influence of negative factors (increased physical activity, hypothermia). When probing the location of the pathology, the patient confirms the pain.
Common pathologies of the spine that cause vertebrogenic pain syndrome, that is, pain in the lumbar region, include:
- protrusions, disc herniation;
- spondylosis (proliferation of bone tissue on the periphery of the vertebrae);
- arthritis, arthrosis of the intervertebral joints;
- injuries of the lumbar spine;
- narrowing of the spinal canal;
- tumors of the vertebrae.
Such diseases of the internal organs can cause lumbargia of the lumbar spine:
- chronic pyelonephritis, stones, cysts, prolapse of the kidneys;
- chronic pancreatitis, stomach ulcer;
- inflammation or polycystic ovaries, endometriosis or uterine tumors;
- neoplasms near the spine.
The causes of the disease
Pain pathology of the lumbar spine is caused by:
- excessive load on the vertebrae of the back;
- lack of exercise, sedentary work;
- violation of posture;
- severe stress;
- age-related degradation of the spine (after 60 years, 70% of people suffer from lower back pain).
The main signs and symptoms
Typical manifestations of the pathology of the lumbosacral spine:
- pain aggravated by leaning forward, coughing, sneezing, radiating to the pelvis, perineum, limbs;
- muscle hypertonicity;
- "goosebumps", numbness of the skin of the lower back, buttocks, legs;
- intermittent claudication;
- problems with urination, stool;
- disruptions in the menstrual cycle;
- weakening male potency.
Lumbargia of the lumbar spine is detected during examination and instrumental examination of the patient. X-ray images help to establish whether there is a deformation of the spine, whether the spinal canal is narrowed. Computed tomography refines information to the smallest detail. MRI gives a complete picture that allows us to judge the mechanism of the impact of negative factors not only on the spine, but also on neighboring soft tissues, blood vessels, and nerve roots.
Treatment of lumbargia of the lumbar spine
Since the disease is benign in nature, it is very successfully amenable to therapy. Particularly successful intervention in the early stages, when there are no irreversible complications. How to treat lumbalgia so that getting rid of it is effective? It is necessary not only to provide analgesic medication, but also to eliminate the cause of acute pain. If the pain is chronic, it is important that the treatment of the lumbosacral spine be comprehensive, using:
- manual therapy;
- therapeutic massage;
- acupuncture, including pharmacopuncture;
- vacuum therapy;
- dry or underwater traction (traction) of the spine;
- medical gymnastics;
Wearing the lumbosacral corset
Orthopedic products, fixing the area of the patient's lumbar spine, reduce its physical activity. Vertebral discs, blood vessels, and nerve endings experience less pressure. Due to this, the patient gets rid of pain and experiences significant relief in the spine. Medical corsets protect the patient from sudden movements and protect against additional injuries.
Carrying out complex treatment, doctors use the following medicines:
- Midokalm, Sirdalud, Baclofen, which reduce muscle hypertonicity and relieve pain;
- drugs Nimesulide (Nise), Diclofenac; gels Nimesulide, Deep Relief; Novocaine or lidocaine for analgesic blockade;
- Diprospan, hydrocortisone, dexamethasone, hormonal anti-inflammatory drugs;
- Actovegin, Pentoxifylline, vasodilator, reducing blood viscosity;
- Alflutop, Dona-3, contributing to the restoration of cartilage.
Widely practiced procedures:
- magnetic and magnetic laser therapy;
- ultrasound treatment;
LFK and massage of the lumbosacral
Gentle manual therapy techniques and months-long courses of therapeutic exercises contribute to:
- spinal stretching;
- strengthening adjacent muscles and ligaments;
- greater flexibility of the intervertebral joints.
Lumbar massage helps:
- relieve muscle corset of the back from spasms and strengthen it;
- improve blood circulation;
- activate lymph outflow and reduce swelling around the nerve roots;
- accelerate tissue regeneration;
- eliminate pain.
Surgical intervention is necessary for serious circulatory disorders and innervation of the spinal cord, abscesses, neoplasms. If during instability of the vertebrae the movements cause unbearable pain to the patient, spinal fusion is performed - the operation of fusion of the degenerative segment using an implant. With intervertebral hernias, a discectomy is performed - removal of the affected disc, which is replaced with an artificial one. Such operations should be resorted to in extreme cases, since then relapses are frequent.
Possible complications and consequences
Among the unpleasant consequences are serious conditions and ailments, which in the absence of adequate therapy can lead to disability:
- pain that can not be cured;
- protrusions, disc herniation;
- problems with urination, defecation;
- paralysis of limbs;
- lumbosacral radiculitis;
- paralytic sciatica similar to stroke.
Measures to prevent the development of lumbargia of the spine are extremely simple. It follows:
- sleep on a mattress of medium hardness;
- fight overweight;
- when sedentary work periodically knead the lower back;
- avoid overcooling;
- to lift weights correctly: to strain the muscles not of the back, but of the legs, squatting slightly;
- avoid back injuries.