Lumbago: Symptoms and Treatment
Lumbago is an acute pain that can otherwise be defined by the patient as a «lumbago», this pain arises in the lower back (ie, in the lower back). Lumbago, the symptoms of which are manifested primarily due to overvoltage arising in this area when lifting the gravity or slanting sharply, deprives the person of the opportunity to straighten up for a certain time.
Predominantly, the causes of lumbago are overexertion in the lumbar region, as well as the presence of lumbar hernias, the urgency of vertebral dislocation or congenital vertebral anomalies. Among the reasons for the appearance of a sharp lumbago that occurs when lifting the gravity or when tilted, isolate or prolapse of the intervertebral disc, or significant muscle tension and tension of the ligament of the back.
Localization of back pain is possible only in the lumbosacral region, which is defined as lumbulgia, but it can also radiate (spread) to the legs, which defines it already as a lumboschialgia. Intensive acute pain in the lumbar region, as we have already determined, is, in fact, lumbago.
Acute lumbulgia, as a rule, is formed against the background of a degenerative process, which is actual for the patient, occurring in the region of the spine (that is, with its osteochondrosis). Gradually, the intervertebral disc loses its water and sinks, which in turn leads to a loss of its inherent damping function with the acquisition of greater sensitivity in relation to the mechanical stress exerted on it.
The fibrous ring located along the periphery of the disc is thinned, then cracks form in it, and already along them the pulpous nucleus (the central part of the disc) begins to shift toward the periphery, thereby forming a protrusion. As a result of trauma or the impact of intensive loads, this protrusion can increase at an abrupt rate, which provokes protrusion into the vertebral canal of both the pulpous nucleus and part of the fibrous disc.
Subsequently, a similar course is defined as a herniated disc. The pain localized only in the back completely excludes the possibility of damage to the spine, and it can also be associated with the damage of the vertebral column itself (in view of the fact that it is the primary manifestation indicating the protrusion of the disc), and with soft tissues (i.e., Or muscles or with their spasm).
As a rule, there is a pronounced muscular tension in the lumbar region when straightening lordosis and antalgic scoliosis. Adopting a lying position leads to a reduction in pain, but any, even the slightest movement, again, leads to its strengthening. Acute lumbulgia takes place spontaneously enough, within a few days (in rare cases, several weeks). In some cases, its transformation into lumboschialgia manifests itself.
Often, the causes of acute pain in the lumbar region are the relevance of kidney disease, as well as diseases of the adrenal gland (pyelitis, renal colic, kidney infarction, paranephritis). So, sharp and sudden pain arising in the lumbar region and giving to the genitals, groin, thigh and simultaneous accompaniment of painful and frequent urination, indicates acute colic. Acute pyelitis is also characterized by the appearance of pain in the lower back, but the pain is more blunt, the intensity characteristic of renal colic in this case is not characteristic of it.
With regard to lumbosciagia, it can represent a pain reflected (reflex), in the emergence of which an important role is given to pain receptors of ligaments, capsules in the intervertebral joints and other types of tissues of the spine. In addition, lumboscialgia can also represent radicular pain that occurs when the spine is involved. In this case, not only its mechanical compression is noted, but also swelling, inflammation and demyelination.
As a rule, radicular pain is characterized by its own intensity, different from reflex pain, often it has a shooting or piercing nature of manifestation. Irradiation occurs in the distal region of the innervated rootlet region, which occurs in combination with paresthesias, numbness, muscle atrophy, and weakness of the area.
At the age of 30-50 years, lumboschialgia is provoked by a disc hernia, and at the age of more elderly, changes in the degenerative character (formation of osteophytes, hypertrophy of ligaments, etc.) become important factors in this matter. In the presence of a herniated disc, pain often occurs when the movement is abruptly perfect or when it is tilted, falling, or when lifting gravity.
Inspection of the back, as a rule, determines the fixity of its position in a slightly bent position. Often, a scoliosis is determined, which is strengthened when trying to tilt forward, but is lost when lying down. The forward slope is given with a sharp limitation, at the same time it is realized only by the hip joint. To a lesser extent, extension is limited, and a sharp increase in the painful manifestations is most often characteristic of the prolapse of the disc.
Thus, it can be summed up that the pain in the lumbago can have a different character, that is, be pulsating, piercing, tearing, piercing. Subjective localization of pain sensations focuses on muscles, ligaments and bones, with or without irradiation. The appearance of painful phenomena in lumbago is explained by the irritation of the receptor disc located in the region of the fibrous ring or in the area of ligaments adjacent to it. As a response, in turn, there is a tonic muscular tension.
When the patient becomes helpless, the characteristics of his flow lead to hardening in one or another forced posture, the attempt to change which leads to increased pain and to the development of muscle spasm in the lumbar region. The pain can last as several minutes, and several hours or days. The state of rest, as well as the adoption of a recumbent position, leads to a loss of pain. As a rule, aching pain in the lumbar region persists for the next days, and intensification of it is noted during coughing, tilting, sneezing and tension in general.
In the treatment of lumbago, specialists apply therapy that corresponds to the pain algorithm that caused instability in the spine or the compression of the nerve roots (i.e., compression) in the lumbosacral vertebral column. The disease is considered not as a local manifestation of pain, but as specific causes, this pain provoked, proceeding from them, respectively, and the treatment is selected.
A pronounced pain syndrome requires the appointment of drug therapy, which will allow to stop the pain (eliminate it), and also contribute to the reduction of muscle spasm. With chronic pain of the vertebral part under consideration, effective treatment is indicated using such techniques as spinal traction, therapeutic exercises, acupuncture, massage, etc.
If there is a characteristic for lumbago symptoms, it is necessary to consult a neurologist.