The acute pain in the lumbar region, on the background of osteochondrosis of the spine – is a problem faced by the absolute majority referred to the people. After having been able to we "award" for our bipedalism (due to the increase of the axial load on the spine), this disease sooner or later affects every inhabitant of the planet, the question is only in the speed with which this occurs, and the extent to which you express the symptoms. This "grim statistics obliges to include this pathology is socially significant diseases, and the struggle against it must be a task not only of an individual who suffers from manifestations of the disease, but also the system in world health in general. That is why the question of the treatment of the osteochondrosis of the spine – the theme very current.
Then, what is osteochondrosis? Let us look briefly at how the development of the disease. In the title, if translated from the latin at the foot of the letter, the identification of patterns that change to the osteochondrosis: the bone and cartilage. For the amortization and the resistance to vertical loads of the nature placed between our vertebrae species of fibrozno-cartilage, "pillow" — the discs of the spine. Their feeding is done in childhood, through the blood vessels, which are lost in approximately 25 years, and the power begins to be diffused thanks to the muscles that surround it.
When pathological of loads on the vertebral column (sedentary work, or vice versa – excessive workload, physical), violations of the processes of mineral exchange of intervertebral disc loses its elasticheskie and dampening properties, diminish in height, changes the structure of the vertebrae, appear of the pathology is of bone growth (osteophytes and zamechatelnye plates), it alters the mobility in the affected by the department of the vertebral column. In the last stages of the disease the central part of the intervertebral disc, called the nucleus gelatinous, break fibrous ring, form a kind of saccular protrusion between the bodies of vertebrae — intervertebral hernia. The herniation may cause compression of adjacent nerve roots, it produces intense pain in the area of sdavleniya, as well as in the area adjustable, the work of the nerve affected. Due to the constant irritation of the nerve plexus occurs reflector spasm of the skeletal musculature, in the medicine called protective of the defense, which on one hand protects against suffering department of the spine from unnecessary movement, and on the other hand increases the compression, swelling and pain in the affected area.
In the great majority of cases (90%) syndrome of pain at osteochondrosis (even very severe) was due to muscle spasm! In other cases, the cause of the pain – compression of the nerve root or the spinal cord directly herniated intervertebral disk.
The osteochondrosis of the lumbar spine: how to heal
Of all departments of the spine, and the humans of their five (cervical, thoracic, lumbar, kresttsoviy and coccygeal), due to the increased engine load with most often of the manifestations of the disease suffers the lumbar. The osteochondrosis of the lumbar spine has bright, well-known of all the symptoms, and the treatment of their social importance of the task, because it affects the quality of life not only of older persons, but also to active people of working age.
The pain may have been directly in the lumbar region, as well as the front of the thigh, or across the back or outer surface of the leg sometimes to the toes. Often give pain in the buttock area, the sacrum, the crotch, and sometimes can be had only in these areas, masking under diseases of the reach and the intestines and making it difficult the approach of a correct diagnosis. The intensity of the pain syndrome can be so high that the man loses the ability to perform the most basic of the movement, take awkward positions and loses the normal sleep. This is the back pain, that in wide circles it has become synonymous with the disease itself.
The limitation of motor activity. Violate normal movement and sensation in the extremities, produce muscle spasms, paraesthesia (sensation of tingling, burning, "crawling chills").
The failure of the function of the organs of the pelvis. With the intense syndrome of the root, known as the lumbago, or when the great Grajewo the protrusion of the can even be the urination, and the work of the intestines, causing severe pain to the patient.
The treatment of the osteochondrosis of the lumbar spine often becomes a difficult task both for the patient and for the physician. Each person who suffers from this disease, I wondered: "How is osteochondrosis of the back?", "That cure osteochondrosis back?", "If the treatment of degenerative disc disease lumbar of the house does not help – to what doctor to go to?", "If the contraceptive pill and ointments when the lumbar spine osteochondrosis does not help - as a cure?".
To deal with the exacerbation of osteochondrosis and assign the treatment competent will help the following clinicians: physician, neurologist, specialist in the care of massage, chiropractor, physical therapist, and the need of surgical treatment – physician neurosurgeon.
The methods of control of the osteochondrosis of the lumbar spine
What is important in the treatment of degenerative disease of the disc is the correct way of life! The people, actively and successfully engaged in the physical culture and the tracking of the spine, the back never hurts! Unfortunately, few people meet these simple truths.
The review of this issue, we highlight:
- pharmacological;
- the not-drug.
Non-drug based techniques of treatment of the condition is of the lumbar spine
The distraction of the procedures. Its effect lies in the title - the application of various applicators, massage carpets and rollers, wool time, "lotions" and "rastirok" because of the impact on surface waters of the nerve endings and the blood vessels of the several reduces muscle spasm and pain. These methods can be used as auxiliaries, but isolated from your application at the time of aggravation of the degenerative disc disease lumbar without systemic treatment special medicines is very effective for.
The tool of immobilization. Under these tools include tyres of different designs, the use that helps protect the spinal column of the sudden "dangerous" movements and to redistribute the load static work. The tool of immobilization can be purchased in the stores of medical technology and pharmacy, however, before purchasing advisable to consult with your doctor, who will help you define the best in your situation, the design, the stiffness and the completion of the bandage. Apply recommended only in the time of the influence of adverse factors (travel at the wheel, sedentary work, etc.), as prolonged use leads to malnutrition of the muscles.
Therapeutic exercise (physical therapy) is an integral component of the comprehensive treatment of the osteochondrosis. The realization of exercises intended to keep the tone of these muscles of the back and removing pathological muscle spasm help the regeneration and maintenance of the motor activity, the reduction of the intensity of the pain syndrome. An important advantage physiotherapy in the fact that after the training the instructor person can every day to perform the exercises at home, as well as the existence of a complex of exercises applicable even when the sharpening process. The most effective way to physical therapy is the mecanoterapia – training in simulators individually developed the methodology, as that for the formation of a corset muscle requires a resistance work.
Massage – known since ancient times, the most common and, perhaps, the most beloved of the patients method of prevention and treatment, however, in the phase of exacerbation of the degenerative disc disease, lumbar division may not apply. In addition, to perform massage to the osteochondrosis must be a specialist to the health and the education, well-versed in the anatomy and physiology and trained in techniques is provider of therapeutic massage.
Chiropractic and recruit popularity in the past years, osteopathy in the performance of competent professional can have a significant therapeutic effect, and even in the long term to get rid of the acute episodes of the disease. It is also important to remember that when you put your chiropractor before you start the procedures necessary to conduct a survey of the spine (x-ray, computer, or magnetic resonance imaging, bone densitometry), to give a chance to your doctor to assess the prevalence and the intensity of the process and eliminate any possible contraindications to manipulation. As massage, chiropractic and osteopathy has a number of contraindications, for example, expressed in terms of the ratio of compression of the nerve root herniation, subluxation of the vertebrae. In the period of acute degenerative disc disease, lumbar of usually used gentle the therapy technique of manipulation (the relaxation of muscles, etc).
Iglorefleksoterapija. According to the results of recent studies of the application of this popular in the circles of the methodology considers the evidence in medicine book foundations of osteochondrosis of the lumbar spine, not pad of the symptoms of the disease, and refers to the non-traditional methods of treatment.
Physical therapy, including clinical guidelines and national standards of provision of medical assistance to the osteochondrosis, a long time ago that has proved its effectiveness in the treatment of this disease. The osteochondrosis of the lumbar spine is applied electromyostimulation, amplipuls-therapy shock wave wave therapy, interstitial biostimulate, lazeroterapija. A popular method in the combined treatment remains the magnetic therapy. Its advantages are a good tolerability and a small list of contraindications, the possibility to apply in the period of acute disease. Influencing at all levels of the injury process, because through a few procedures that significantly reduces the pain and allows a person to extend the motor activity. In addition, thanks to the improvement of trophic tissue slows the progression of the disease. A clear advantage of this method is the possibility of their independent use patient outside the walls of the health facility.
But if all this non-drug based methods of treating osteoporosis - then treat lumbar osteochondrosis?
The pharmacological treatment
The disease involves the appointment of the following groups of drugs:
Non-steroidal anti-inflammatory drugs (nsaids) are produced in the ways as local (gels, ointments, creams), and for systemic use (tablets, candles, solutions for intramuscular and intravenous). Its operation is based on blocking the inflammatory process in enzymatic level, by eliminating the swelling in the injured area and greatly reduces the pain.
In the early stages of the disease is sufficient local application of nsaids in complex with the non-drug methods (medicinal gymnastics, magnet). When expressed patalgico the process of intensive and syndrome painful that resorting to preformed, and sometimes under forms of medication.
Unfortunately, they possess a good anti-inflammatory and analgesic effect of nsaids, maintaining the unity of the system that could be called the development and intensification of ulcerative-erosive processes of the gastrointestinal tract, as well as the failure of renal and hepatic function. Therefore, the patients, during a long time of taking nsaids is also required of drugs, protect the stomach mucosa and a laboratory of control of performance indicators in the liver and the kidneys.
The System of muscle relaxants, i.e., medications, rent a muscle spasm. The principle of its action lies in the title: relax spasm of the muscles that contribute to the reduction of the compression of nerves and blood vessels, edema in the area of the defeat, enhances blood circulation and of the innervation – decreases the pain; by the reduction of the défense of the muscles, decreases tension ligamentous apparatus is reduced protrusion (bulging) intervertebral disc relieves pain, increases the amount of movements.
Muscle relaxants for the treatment of osteochondrosis of the spinal column are available in the form of tablets and solutions for injection for intramuscular, to achieve therapeutic effect it is necessary to take continuous, gradually increasing the dose. Also as nsaids, muscle relaxants have a number of contraindications and may cause unwanted side effects, therefore, despite the counter in the pharmaceutical networks, prior to their acquisition, you should consult with your doctor.
Local anesthetics or medications for local anesthesia are used for the pharmacological treatment of degenerative disc disease in the form of the so-called paravertebral blocks, when the solution of the medication is injected first subcutaneously, then in the area of appendices of the affected vertebra in the projection of the alleged sdavleniya nervous.
Accumulating in the membranes of nerve fibers in the product actually blocks the pain signal. The physical therapist, without a doubt, you perform this type of lock, you may not, to carry it out, you should consult nevrologu or the neurosurgeon.
Also for paravertebral introduction are sometimes used solutions of corticosteroids (csg) - hormonal drugs, have a marked anti-inflammatory action. Local its use allows to achieve maximum effect and to reduce to a minimum the risk of the unwanted side of the drug action. As the lock is made are courses of 2 to 3 times a year, to make the must the doctor a neurologist or doctor to a neurosurgeon.
The vitamins of group "A". In any pharmacy you can find a great variety of drugs of this group, as in the forms of oral administration, such as for intramuscular administration. Is believed to have neurotrophic and easy analgetic action, however, the report of the justification of its application to the osteochondrosis of the spine of the evidence-based medicine has not been received.
Physical therapy is the osteochondrosis lumbar
Unfortunately, sometimes a comprehensive treatment with the use of modern drugs, physical therapy, massage, and physical therapy is ineffective – the man continues to experience the pain, it keeps the limitation of the physical activity, suffers considerably the quality of life. So it is in the late stages of the disease, when they form large, often multiple gryzenia protrusions of the intervertebral discs. In this situation, it is indicated the surgical treatment. In addition, the surgical intervention is shown when the so-called "tire hernia", when considerable compression spinnomozgovogo of the channel causes nekupirutayasa pain, static-dynamic of the violation and the blocking of the functions of the bladder and the bowel. In such cases, the operation is carried out in an emergency order. The aim of the surgical intervention to the osteochondrosis of the lumbar spine is the mechanics of decompression spinnomozgovogo of the canal and the nerve roots.
Today in the surgical treatment of osteochondrosis is applied as the already well-known bulky operational methodology and the proposal of modern medicine minimally invasive endoscopic intervention with the application of laser and rf exposure, part of which can be carried out even under local anesthesia.
Having examined the main methods of treatment of osteochondrosis of the lumbar spine, I want to point out once more that the patient, sets the question of "how to cure lumbar osteochondrosis?", you should rely not only on medical care, but also in the own forces, aware of the importance of a healthy lifestyle, which is welcome, the good food, applies to competent dosed physical load, and most important, it is this faith in the victory over the disease.