If you believe the statistics, 70-80% of our population of pain at least once in your life, in front of the back in the lumbar region, or, in medical language, pain in the lower back. The prevalence in the UK is 59%, Denmark 70%, in Finland 75%. Under all issued "hospital" in our country, a third of the cases are attributable to back pain.
The reasons for back pain can be very diverse — from psychogenic factors to metastasis of cancer. Fortunately, on a more serious pathology is necessary, not more than 5% of the cases, pain in the lower back, the cause — and- surge, or spasm of the muscles, but also other problems of the musculoskeletal system.
Types of back pain in the lumbar area
Pain in the back, as in any other Organ, is varied. Most of the time it is the character of the pain — the first feature, according to the doctor to make an assumption about the nature of the disease.
According to the origin of the pain in the back can:
- primary — triggered chronic functional disturbances or degenerative changes in the tissues of the spine and of the muscles, sometimes with involvement of adjacent structures — the spinal nerve roots.
- Secondary — caused by injury, inflammation, Arthritis or osteoarthritis of all joints, the defeat of the internal organs.
For the duration of the pain can be:
- acute — occurs because of the new damage or the newly created pathological condition, inseparably connected with it is, it will take up to 6 weeks;
- subacute — lasts 6-12 weeks;
- chronic — longer than 12 weeks.
Typical clinical manifestations are dependent on the source of the pain.
Muscle-Tonic and other pain syndromes
Hypothermia, long-lasting poor body posture at work or in leisure time, or the wrong motor stereotypes, degenerative diseases of the spine, the height and elasticity of intervertebral discs, lead to the fact that the load is distributed to the muscles unevenly. Some of them are not constantly overloaded, some, on the contrary, get the required work load. As a result of the starts in the individual muscles spasm, causing pain. There are so-called trigger points, the impact on the intensifies the spasm, and tenderness. The characteristic features of the pain:
- clearly limited area (local pain);
- to feel in the depth of the muscle layer;
- in the muscle undetectable narrow narrow plot of land, or radial load, within which is found particularly painful points;
- when exposed to these points of pain increases sharply, forcing the patient's tremors (Symptom jump);
- Restriction of mobility;
- if it is possible to stretch the muscle pain is reduced.
It is ointments are effective in such pain well, the warm or popular devices. The truth is, the effect of them temporarily, but the reason, the spasm of the muscles, they do not eliminate it. A more reliable method of injection of anesthetic directly into the Trigger point, as well as physiotherapy, physiotherapy, manual therapy.
Compression Well Radiculopathy
By compression or stretching of the nerve, the distance between the vertebrae roots due to disc herniation or reduction of its height and, as a result of that. Such pain spreads, often out of the "superficial", rather in the skin than in the depth of the tissue. It increases greatly when sneezing, coughing, strain on the spine. Such pain felt as the classic "witch's shot", presented in the course of the nerve root.
Spinal canal stenosis
Occurs because of a herniated disc, a protrusion (bulging) into the spinal canal or the occurrence of sequestration — the exfoliating parts of the plate. Somehow, the education act, under the title of "horse's tail" — nerves of the lower spinal nerve roots, the lower extremities Innervate. The pain extends it along the vector of the nerve root, from the waist to the feet, will go alone and when reinforced with the straightening of the spine, and reduce bending.
A special syndrome
Called pathology of the small intervertebral (facet) joints. The pain may be a local, but also emit () in the lower abdomen, coccyx, on the back of the thigh. Increases when bending and twisting in the lower back.
All of these types of pain appear sharp, and sometimes the Patient can even say what day and what effects (something lifted up, spinning like a top, etc.). The pain intensified in the evening and after exertion, reduced to silence. Often this kind of pain is typical for people in middle and advanced age.
Inflammatory Pain
By inflammatory joint of the spine various types of Arthritis: rheumatoid, Reiter's disease, ankylosing Spondylitis, etc., Inflammatory pain disease often occurs in relatively young people, develops gradually. You can have a maximum in the early afternoon and decreases in the evening or after physical exertion. Often accompanied by morning stiffness.
Other possible causes of pain in the lower back pathology of the internal organs, e.g., kidney stone disease or inflammation of the appendages in women. Since many diseases can manifest in a similar way, at least in terms of pain, it is better, not with the diagnosis itself, but see a doctor.
Immediate consultation of a specialist is required, if:
- the pain came after an injury, especially in women over the age;
- in the story, there is an oncological disease;
- Pain accompanied by fever;
- suddenly and for no apparent reason, falls into the weight;
- the gangue deducted, or feet, changes;
- there are difficulties in urination and defecation.
These symptoms may be a Manifestation of serious diseases that require immediate treatment.
The diagnosis of the pathology
The pain in the back and lumbar area, the doctor first of all-threatening conditions of life exclude, fortunately they are rather rare.
To identify General and biochemical analysis of blood inflammatory changes, increased calcium levels, which is characteristic for the metastasis of malignant tumors in the bony structures, changes in the number of blood cells in multiple myeloma and so on. Men in the age group, you can specify that the analysis on prostate-specific Antigen, for a possible exclusion of prostate cancer.
The radiological examination revealed that a change in the height of the intervertebral disc, possible osteophytes — bony growths of tissue, the by the wrong load is distributed to the vertebrae, the change in the shape of the vertebrae.
Computed tomography and MRI shows the bulging of the intervertebral disc, calcification (calcification), spinal canal stenosis.
Today on the exchange of these two studies, ultrasound of the spine gradually, allowing to detect similar changes, without the patient an excessive radial load.
Mandatory consultation of the neurologist, according to the testimony — chiropractor.
After a complete investigation clearly, the strategy of the treatment. In General, dealing with pain in the lumbar spine, therapeutic methods, surgery is relatively rare.
Drug treatment of pain in the lumbar spine of the back
In 95% of cases when the patient is not a reason for concern — usually not a threat to the health of pain in the back and can be curable. Myofascial syndrome faster corrected, for the elimination of radicular pain can last a few months. One way or the other, in most cases, this requires a drug therapy. You use non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief and reduction in swelling, drugs Band for the maintenance of the cartilage. Sometimes, to reduce pain and swelling, and hormonal preparations prescribed — you non-steroidal anti-inflammatory faster, you will be in the Form of blockades and additions under the supervision of a physician
The formulations may be in the Form of ointments and gels, the procedure for the treatment of back pain is popular for advertising movies. But as the method of administration of the active substance, the use of external resources — the invalid, that it is possible to predict, because the largest part of the funds itself does not penetrate through the skin.
Another popular method is the oral intake of medications, or, better to say, pills and capsules. Do not drink the tablet difficult, the effect occurs quite quickly, usually within a half hour-hour, but the long-term taking of drugs effects on the condition of the gastrointestinal tract-intestinal.
Therefore, the fastest and most effective way to alleviate the pain of injection directly into the muscle or affected area of the spine, the so-called blockages. Its only drawback — the hard requirement of high qualification of the doctor, for the implementation of this Manipulation.
Non-drug therapy
In General, drug treatment is complemented by patients with non-drug methods. Which physiotherapy need to be decided by the attending physician. This is a classic Massage or manual therapy, and osteopathic treatments as well as acupuncture can. Gaining popularity and kinesio therapy — special exercise in the Form of training to your specific decompression simulators, which will help relieve tight muscles, the formation of new motor stereotypes, thus the cause of the pain in the back.
So, the best Option of the therapy of back the combination of drugs not pain-drug methods and approaches. Such a comprehensive work in several directions allows you to be faster to cope with the disease, completely to get rid of pain or a lasting effect.