What not to do with spondylosis. Nutrition and diet for spondylosis
Sciatica is a disease that damages the sciatic nerve or affects other nerve roots near the lumbosacral segment of the spine.
Sciatica is manifested by severe pain in the back of the thigh, radiating to the foot and lower leg, and sometimes felt over the entire surface innervated by the branches of the sciatic nerve.
As the disease progresses, it is often supplemented by lumbago (lumbago) - acute pain attacks that occur suddenly when irritated nerve trunks. The combination of symptoms - lumboischialgia - requires careful diagnosis, as it can be the result of various primary pathologies.
The pain may wear different character and intensity, appear as certain factors influence or be spontaneous, supplemented by other symptoms. The most difficult to tolerate are the degrees of prolonged exacerbations of lumboischialgia, alternating with short remissions or without them.
Types of lumboischialgia
There are several classifications of pathology.
There are:
- acute lumbar ischialgia (primarily occurring pain syndrome);
- chronic lumbago with sciatica (acute phases followed by remissions).
Because of its appearance, lumboischialgia is differentiated into types:
- Vertebrogenic or vertebral (associated with diseases of the spine),
including:
- discogenic (caused by a herniated disc);
- spondylogenic (due to osteochondrosis of the spine).
- Nonvertebrogenic,
including:
- angiopathic (manifests itself when the vessels of the belt are damaged lower limbs and lower back);
- myofascial (observed in diseases of muscles and fascia);
- lumboischialgia with damage to the peritoneal organs;
- lumbago with sciatica due to pathologies of the hip joint.
By degree of distribution pain syndrome lumboischialgia can be:
- unilateral - radiates to one limb, more pronounced on one side of the lower back: left or right);
- bilateral (bilateral) - appears on both sides of the spine, often radiating to both limbs.
Causes and factors provoking lumbar sciatica, what are the causes of lumbar sciatica
The pathogenesis of the pathology is as follows: pain syndrome appears when nerves are irritated as a result of their compression, injury, or inflammation.
Pain impulses may intensify when muscle in the affected area it becomes tense, its nutrition is disrupted, nodes and tubercles appear.
The most common causes of lumbago with sciatica are:
- Osteochondrosis of the spine and stages of its progression - dysfunction of individual segments, disc herniation and protrusion, formation of bone osteophytes.
- Arthrosis of the intervertebral disc.
- Osteoporosis of the spine and pelvic bones.
- Scoliosis, spinal spondylitis.
- Congenital anomalies of the vertebrae.
- Tumors, abscesses in the lumbar region.
- Diseases internal organs, more often associated with tumor processes.
- Diseases affecting large vessels, leading to poor circulation in the lumbar area.
- Damage to muscles, hip joint.
- Injuries of the lower back or hip joint, postoperative complications, unsuccessful injections into the epidural space.
- Rheumatism, systemic pathologies of connective tissue.
- Heavy infectious diseases with damage to the nerve trunks.
- Idiopathic lumboischialgia (without a specific cause).
Factors provoking the appearance of lumbar ischialgia syndrome:
- degenerative age-related processes in the spine, old age;
- obesity;
- pregnancy, especially multiple pregnancy;
- frequent stress, depression;
- posture disorders;
- doing hard work;
- hypothermia.
Symptoms of lumbago with sciatica
Most often, the first attacks occur against the background of progression of osteochondrosis. Acute syndrome lumbago with sciatica is expressed very sharply, chronic phenomena are more blurred, periodically intensifying and fading.
The main symptoms of lumboischialgia:
- severe, gradually or rapidly increasing pain in the lower back (sharp, shooting, burning, throbbing);
- spread of pain to one or both buttocks, legs up to inside knee joints or lower - to the heel through the calf muscle;
- localization of pain - inside the muscles, rarely - closer to the surface of the skin; feeling of heat followed by chills;
- sometimes - increased body temperature;
- skin itching along the nerve;
- limited lumbar mobility;
- pallor of the skin, its marbling, coldness;
- increased pain when trying to change position (often a person has to freeze in an uncomfortable position - arching his back back or forward), when stepping on his foot;
- V severe cases- loss of control over urination and defecation.
The duration of an attack of right- or left-sided lumboischialgia can vary from a couple of minutes to 24 hours or more. Often the discomfort disappears spontaneously, just as it began.
Recurrence of the attack may occur quickly (for example, on the same day) or not appear for months.
Diagnosis of lumbago with sciatica. How is lumbar sciatica diagnosed?
Methods for examining a patient with suspected lumbago with sciatica:
- X-ray of the spine.
- MRI or CT scan of the spine, hip joint, blood vessels.
- Densitometry.
- Ultrasound, MRI of the peritoneal organs.
- Blood tests for markers of infectious and autoimmune diseases(eg rheumatoid factor).
Treatment of lumbago with sciatica
For the treatment of vertebrogenic lumbar sciatica on the right or lumbar sciatica syndrome on the left, it is recommended to wear special corsets, as well as sleep on orthopedic mattresses. In any case, only a specialist can decide how to treat lumboischialgia.
In most cases, the pathology is successfully treated. In this case, treatment is aimed at eliminating the underlying disease and relieving pain.
Drug treatment
IN acute phase illness, the patient is prescribed bed rest (up to 14 days) and a course of treatment various groups drugs:
- Painkillers - injections or tablets of non-steroidal anti-inflammatory drugs (ketorolac, brufen, dexalgin, arcoxia, movalis, piroxicam), non-narcotic analgesics(lyrics, katadolon).
- Muscle relaxants to relieve muscle spasms (sirdalud, mydocalm, baklosan).
- Diuretics to eliminate swelling of the nerve trunks (Lasix).
- Novocaine blockades in the spinal area, for severe pain - blockades with glucocorticosteroids (diprospan, hydrocortisone).
- Sedatives (phenozipam, relanium, other tranquilizers and sleeping pills).
- B vitamins to improve nerve root conductivity and recovery muscle fibers(milgamma, neuromultivitis).
- Blood circulation activators (trental, actovegin, aminophylline).
- Local painkillers - ointments, creams with non-steroidal anti-inflammatory components (diclac, diclofenac, fastum-gel).
Physiotherapeutic treatment. How to treat lumbago with sciatica?
Among the procedures effective for the treatment of lumboischialgia:
- acupuncture;
- massage;
- electrophoresis with drugs;
- microcurrent treatment;
- magnetic therapy;
- paraffin applications;
Physiotherapy
After restrictions on movement are lifted and pain is completely eliminated, a course of exercise therapy is prescribed:
- Muscle stretching (bending, twisting the body, arching the back from a prone position).
- Exercises to restore mobility of the spine and hip joints (squats, raising the body from a lying position, swinging legs, pulling the knees to the chest).
- Stretching the spine on a special anatomical couch.
- Exercise classes.
- Yoga.
Traditional methods.
Treatment of lumboischialgia at home:
- rubbing the sore spot with badger fat;
- wearing belts made of dog hair;
- compresses from birch bud infusion;
- baths with a decoction of pine needles;
- applying warming patches;
- rubbing the composition from vegetable oil and ammonia (2:1);
- lotions made from grated horseradish, black radish.
Signs, symptoms and treatment of lumboischialgia are associated with pain in the lumbar region, which spreads along the sciatic nerve. Acute or chronic course diseases cause pathological transformations in vascular system, internal life support system organs, lower extremities of the skeletal frame, osteoarticular segments of the hip and lumbosacral region. In some cases the diagnosis neurological clinic defined as vertebrogenic lumboischialgia. This is explained by the fact that radiating right- or left-sided pain in the lower extremities is associated with a problematic condition of the spine.
According to ICD 10, international classification diseases of the 10th revision, vertebrogenic lumboischialgia belongs to the general section of diseases “Other dorsopathies”. The ICD code is M54.4 “Lumbago with sciatica.” Based on this, it can be stated that lumboischialgia syndrome has a double clinical definition:
- Lumbago is an acute shooting pain in the lumbosacral segment of the spine.
- Sciatica – lumbosacral radiculitis, secured compression lesion spinal roots.
Thus, the main signs and symptoms of lumboischialgia are associated with neurological damage osteoarticular organization spinal system. The most likely provoking factors for the formation of pain syndrome are considered to be:
- lumbar osteochondrosis – spondylogenic form;
- intervertebral hernia lumbosacral discs – discogenic form;
- fibromyalgia (inflammation of muscles and fascia) - myofascial lumboischialgia;
- atherosclerosis vertebral artery– an angiopathic type of lumboischialgia.
According to the degree of clinical distribution, vertebrogenic (vertebral) lumbar sciatica is diagnosed as unilateral, when pain symptoms in the lower extremities are more pronounced on the right or left, or bilateral lumbar sciatica, the symptoms and treatment of which are determined by bilateral severity.
Causes of lumboischialgia
The pathogenetic factors in the progression of lumbar ischialgia on the right or left of the lumbar region, as well as the bilateral development of neurological pathology, may be due to the following clinical conditions of systemic vital organs:
- excess body weight (obesity);
- protrusion of the vertebral discs of the lumbar girdle;
- scoliosis (curved spine posture);
- psychological instability to stressful situations;
- pregnancy or hormonal imbalance among women;
- hypothermia of the osteoarticular segments of the lumbar system;
- lumbar trauma;
- age-related transformations in the articular cartilage of the sacrolumbar region;
- systematic violation of physical activity (weight lifting, etc.);
- the result of infection of musculoskeletal structures and connective tissues.
All these provoking cause-and-effect manifestations contribute to the development of acute or chronic forms of lumbodynia with sciatica.
Symptoms of neurological damage
The medical history of a patient with a neurological clinic begins with identifying the symptoms of the disease. As a rule, acute lumboischialgia has more pronounced pain symptoms:
- acute piercing pain in the lower back;
- spread of painful neuralgia to the buttock, followed by radiation to the knee joint and calf muscle;
- numbness and/or tingling along the sciatic nerve;
- coldness (marbling) of the skin;
- increased pain when changing body position.
With all this, sometimes the patient experiences a loss of control over the process of defecation and/or urination. Discomfort and acute pain attacks can last from two minutes to several hours.
Chronic lumboischialgia has dull pain symptoms, when the pain reflex does not cause pronounced acute sensations, however, it affects a person’s quality of life. The patient constantly assumes a forced position, which brings him some relief. Constant tension causes a person to feel stiff when walking or standing. Even a non-specialist can identify obvious signs of chronic neuralgia. When changing position, a sick person always reflexively pulls up his affected leg with his hand. In medicine, such a pain symptom is also defined as Minor’s symptom (syndrome).
Diagnosis and treatment of lumboischialgia
Before treating a neurological clinic, it is necessary to clearly differentiate it. An effective method of laboratory and instrumental diagnostics, providing quality treatment for sciatica and lumbago is:
- general urine analysis of the patient;
- general blood analysis;
- biochemical state of blood;
- X-ray scanning of the osteoarticular segments of the lumbar and sacrum;
Having collected a complete information picture, the attending physician establishes an appropriate diagnosis and treatment program for further action. The patient should know that home treatment prophylaxis alone folk remedies will be the least effective way therapeutic effects on neurological problem. Positive dynamics the healing process will be complex therapy prescribed by the attending physician.
The systemic complex treatment scheme includes:
- medicinal drugs;
- physiotherapeutic effects - electrophoresis, acupuncture, magnetic therapy, etc.;
- therapeutic and preventive rehabilitation with gymnastics;
- massage for the back and lower back;
- preventive treatment of lumboischialgia at home with folk remedies.
Drug treatment includes various medications and drugs with analgesic, anti-inflammatory and sedative effects. In case of an acute outbreak of lumbago with sciatica, the administration of a novocaine blockade is effective, which will stop the pain attack and relieve inflammatory processes. The selection of medicinal pharmaceutical combinations is carried out on an individual basis. Sometimes a complex of therapeutic drug treatment lumbago with sciatica in men differs from women's treatment of lumbar sciatica.
How to treat a neurological exacerbation at home
After the compulsory course drug therapy, it is necessary to continue treatment of lumboischialgia in home medicine. There are many different really useful, and not so useful, tips and recipes for treating the disease. Therefore it is necessary that home procedure treatment was necessarily agreed upon with the treating neurologist or local therapist. Let's consider the most effective folk remedies therapeutic prevention for lumbago with sciatica (do not use for acute course diseases):
- Black radish compress. The vegetable product is finely grated and mixed with 50 ml of 95% alcohol. The healing mass is applied to the lower back at night.
- Take off acute inflammation An alcohol tincture of aloe leaves will help. Finely chopped young leaves are infused in alcoholic liquid for 5–6 hours. A sore lower back should be rubbed 2-3 times a day.
- We will become favorable for the prevention of disease healing ointment based on mint herb, bee honey, vegetable oil and crushed young birch shoots. In a proportional ratio of 1:1:1:1.
- For the therapeutic prevention of lumboischialgia, a decoction for internal use based herbal collection. Lingonberry leaves, nettle and angelica roots are taken in equal proportions(1 tablespoon each) and add 500 ml of boiled water. The decoction is infused for 10–12 hours. Take half a glass in the morning and evening. The course of treatment is 1–2 weeks.
- It is very effective to use pre-prepared alcohol tincture from fly agaric. A half-liter bottle is filled 1/3 with fresh mushrooms and filled to the top with vodka or diluted alcohol. The fly agaric is infused for 1–1.5 months. It is recommended to use this compress no more than once a day. The course of treatment is 5–7 days.
Besides these folk recipes The following will help dull acute inflammation and ensure healthy blood circulation in the body:
- rubbing the lower back with badger fat;
- pine baths;
- lower back massage with vegetable oil and ammonia, in a proportional ratio of 2:1;
- wearing a belt made of dog hair.
Home treatment is not only the external use of folk recipes, but also special gymnastic exercises for lumboischialgia. Therapeutic gymnastics consists of bending and turning the back, squats, swinging the legs, pulling the knees to the sternum, and so on.
Attention! In case of acute pain, therapeutic gymnastic procedures are strictly prohibited.
In addition, during the acute period of lumbago with sciatica it is prohibited:
- Use warming ointments (Finolgon, Capsicum, etc.), which act on nerve receptors and play a distracting role. By increasing blood flow to the pinched nerve after the action ends medicinal product the pain doubles.
- If the disease is caused by a hernia intervertebral discs, then hanging on a horizontal bar or crossbar can play a role bad joke, and aggravate the pain process for some more time.
- You should not diligently warm your lower back with a hot bath, mustard plasters or vacuum jars, since by dilating the blood vessels, the pain not only will not go away, but, on the contrary, will intensify.
It is equally important when treating lumboischialgia to observe certain rules healthy eating. Spicy, salty and fatty foods retain water in the body, which further increases swelling and intensive development of acute symptoms. inflammatory process. It is recommended to completely abstain during periods of exacerbation. sweet food, coffee, strong tea, carbonated drinks and any type of alcohol.
Disease prevention
A diagnosis of lumbago with sciatica is not a death sentence, but an opportunity to reconsider your attitude towards your own health. Having felt it once acute attack neurological clinic, a person tries in every possible way to get rid of repeated pain symptoms. In order not to provoke neuralgia of the lumbosacral region, it is necessary to perform certain therapeutic and preventive actions daily:
- Do not provoke a painful attack due to physical actions.
Vertebrogenic lumboischialgia is a syndrome based on fairly strong pain. The main cause of the disease is a violation of the lumbosacral part of the back. Special symptomatic manifestation: pain radiates to the legs, and it can be either one limb or both.
Characteristics of the disease
Vertebrogenic lumboischialgia is a disease in which quite severe pain occurs in the lumbosacral spine. A person has the feeling that pain is clearly present in the legs or in one of them. The pain syndrome occurs quickly, and there was no hint of its occurrence previously. In most patients, pain is present only on the right or only on the left. It is very rare that the pain effect persists on both sides at the same time.
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The pain is clearly felt in the buttocks or hip area. However, symptoms of this nature are not present in all people suffering from the disease in question. Within a week, the pain clearly moves to the area of one leg. In this regard, it is quite problematic to straighten the leg normally; some patients are unable to perform this action in full.
Discomfort in the leg leads to constant control of the movements of the affected limb. Full pressure on the foot during walking is not realized, so the leg is usually in unusual conditions (in a half-bent state). All of these factors ultimately influence the occurrence of lameness, which over time becomes more serious.
Sciatica syndrome leads to curvature of the leg, as a person constantly tries to remove additional load from it, which causes severe pain. Usually the leg is either pointed forward or pointed to the side, which interferes with normal walking.
What causes the disease?
Despite the many possible places localization, forms of pain that appear during the syndrome, the causes of the disease are few. The main factor is lumbosacral radiculitis or herniated discs. Pain in the lumbar region occurs due to compression nerve ending, which appears when an intervertebral hernia forms (one of the discs falls out). In the diseased spinal region, negative changes associated with poor circulation are observed, swelling appears, and an inflammatory process begins.
The main signs of the syndrome are various pain sensations (cutting, dull, shooting, tearing, aching, drilling). This is due to the response nerve root to the process of compression due to a hernia. Pain makes itself felt through certain irritating factors. Previously, when a person was healthy, they went unnoticed. For example, to similar reasons include:
- lumbar bruises;
- inaccurate, sudden movement;
- lifting heavy weights with a jerk;
- sharp bends and turns of the body when a person is holding an impressive load;
- prolonged stay in a bent, uncomfortable position, etc.
Vertebrogenic lumboischialgia is often observed in combination with sensory disturbances in the lower extremity. There is a possibility of numbness, burning, a feeling of coolness, and the sensation of goosebumps running across the skin. Level pain sensitivity may decrease or increase.
Manifestation of pain
Lumboischialgia symptoms are quite characteristic, which are most clearly expressed in various pain sensations. Determining their exact location in most cases is problematic. The pain itself has ambiguous manifestations. In this regard, it is impossible to say exactly what kind of pain accompanies the disease. In some patients it is aching, in others it is burning. In addition, pain sensations differ in the degree of manifestation, but weak pain impulses are observed much less frequently than strong ones. It is also necessary to pay attention to the fact that the pain, in addition to the legs, is noticeably expressed in the lumbar region.
The disease in question has various shapes, therefore, for each of them they allocate their own clinical manifestations. One of the most common forms of the disease is the muscular-tonic form. It is inherent special features which are accompanied by fairly pronounced spasms. This leads to movement becoming constrained, which limits the capabilities of the lumbar region. This factor is negative manifestation, which is observed as various kinds curvatures characteristic of the spine. In this case, the patient may additionally develop diseases such as scoliosis and other similar lesions.
There is also a vegetative-vascular form of the disease. It is inherent in her following features: the presence of burning pain, numbness that covers the sore leg, while many patients note that it is the foot that is numb.
A sore leg differs from a healthy limb: a pale tint appears, the leg may not be warm enough, since the blood circulation processes in it are disrupted. This form may also be characterized by a disturbance in vascular tone. Usually it becomes high, which leads to either intense heat in the limb, or, conversely, cold. The pain intensifies when changing body position. Especially if a person tries to get to his feet from a lying position.
Therapeutic effect
Treatment at home involves using a painkiller when you feel acute pain. medicine. It is necessary to lie on the sofa on your side (on the side that is not affected), the sore lower limb is pressed against abdominal cavity, you can grab it with your hands. Those. the person will be in the fetal position, and after a short period of time the pain will go away.
It will not be possible to use this method if the person is on the street or in public place. This measure helps for a while, the pain will remind itself again, so you should definitely contact medical institution.
Diagnosis of the disease that provokes lumbar ischialgia is carried out by a doctor using a general clinical examination. It is necessary to do a magnetic resonance imaging of the spine and radiography. If indicated, myelography is performed, CT scan. Carrying out these manipulations will allow you to set accurate diagnosis and prescribe the correct course of therapeutic effects on the body.
The primary goal of therapy in the acute course of the disease is to relieve pain and eliminate the inflammatory process. To do this, in almost all cases, patients are shown to be in bed. Nonsteroidal anti-inflammatory drugs and muscle relaxants are prescribed. Drugs with an analgesic effect are used.
The doctor can prescribe therapeutic blockades, procedures with physiotherapeutic effects, sedatives. Sometimes, as part of complex treatment, reflexology is used.
After finishing acute period diseases, purpose therapeutic effects on the body - improving the tone of the corset of muscle tissue on the back and the ligament apparatus. Because of this, the basis conservative therapy Therapeutic gymnastics and massage procedures are performed.
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Sometimes manual treatment is used, but there are a number of contraindications to it. Main - acute course diseases (cases when discomfort is caused by compression of the nerve roots). It should be taken into account that lumboischialgia is not a disease, but only a pain syndrome provoked by diseases. If the patient does not have a radicular type of syndrome, then after therapeutic effects on the body it is eliminated in 3-6 weeks. The radicular type can be overcome only after 1.5-2 months.
However, if the pain disappears, this is not a guarantee of absolute recovery. The disease that provoked the onset of the syndrome requires further treatment, the duration of which is determined by the attending physician based on the indications of periodic examinations. During therapy chronic forms diseases require an individual approach.
In diseases of the musculoskeletal system, dorsalgia (back pain) is a common symptom of various pathologies. Already in middle age, a similar symptom is observed in large group patients, especially often in men 30-40 years old. Often, diagnostic errors do not allow timely identification and “neutralization” of a combined disease - lumbago with sciatica - masked under the symptoms of lumbosacral radiculitis.
What is lumbago with sciatica (lumboischialgia)
Causes and factors provoking lumboischialgia
The pathogenesis of the pathology is as follows: pain syndrome appears when nerves are irritated as a result of their compression, injury, or inflammation.
Pain impulses can intensify when the muscle tissue in the affected area becomes tense, its nutrition is disrupted, and nodes and tubercles appear.
The most common causes of lumbago with sciatica are:
- Osteochondrosis of the spine and the stages of its progression - dysfunction of individual segments, hernia and protrusion of discs, the formation of bone osteophytes.
- Arthrosis of the intervertebral disc.
- Osteoporosis of the spine and pelvic bones.
- Scoliosis, spinal spondylitis.
- Congenital anomalies of the vertebrae.
- Tumors, abscesses in the lumbar region.
- Diseases of internal organs, most often associated with tumor processes.
- Diseases affecting large vessels, leading to poor circulation in the lumbar area.
- Damage to muscles, hip joint.
- Injuries of the lower back or hip joint, postoperative complications, unsuccessful injections into the epidural space.
- Rheumatism, systemic pathologies of connective tissue.
- Severe with damage to nerve trunks.
- Idiopathic lumboischialgia (without a specific cause).
Factors provoking the appearance of lumbar ischialgia syndrome:
- degenerative age-related processes in the spine, old age;
- obesity;
- pregnancy, especially multiple pregnancy;
- frequent stress, depression;
- posture disorders;
- doing hard work;
- hypothermia.
Symptoms of lumbago with sciatica
Most often, the first attacks occur against the background of progression of osteochondrosis. Acute lumbago syndrome with sciatica is expressed very sharply, chronic phenomena are more blurred, periodically intensifying and fading.
Exacerbation of the disease can be caused by hypothermia, carrying heavy objects, or sudden movement.
The main symptoms of lumboischialgia:
- severe, gradually or rapidly increasing pain in the lower back (sharp, shooting, burning, throbbing);
- spread of pain to one or both buttocks, legs to the inside of the knee joints or lower - to the heel through the calf muscle;
- localization of pain - inside the muscles, rarely - closer to the surface of the skin;
- feeling of heat followed by chills;
- sometimes - increased body temperature;
- skin itching along the nerve;
- limited lumbar mobility;
- pallor of the skin, its marbling, coldness;
- increased pain when trying to change position (often a person has to freeze in an uncomfortable position - arching his back back or forward), when stepping on his foot;
- in severe cases - loss of control over urination and bowel movements.
The duration of an attack of right- or left-sided lumboischialgia can vary from a couple of minutes to 24 hours or more. Often the discomfort disappears spontaneously, just as it began.
Recurrence of the attack may occur quickly (for example, on the same day) or not appear for months.
Diagnosis of lumbago with sciatica
Methods for examining a patient with suspected lumbago with sciatica:
- X-ray of the spine.
- or CT scan of the spine, hip joint, blood vessels.
- Densitometry.
- Ultrasound, MRI of the peritoneal organs.
- Blood tests for markers of infectious and autoimmune diseases (for example, rheumatoid factor).
– damage to the structure nerve fibers, which can develop at any age. IN in rare cases The disease occurs as an independent illness, but most often it is a complication of various diseases.
You can find out how secondary purulent meningitis occurs and how it differs from the newly developed disease.
Treatment of lumbago with sciatica
For the treatment of vertebrogenic lumbar sciatica on the right or lumbar sciatica syndrome on the left, it is recommended to wear special corsets, as well as sleep on orthopedic mattresses. In any case, only a specialist can decide how to treat lumboischialgia.
In most cases, the pathology is successfully treated. In this case, treatment is aimed at eliminating the underlying disease and relieving pain.
Drug treatment
In the acute phase of the disease, the patient is prescribed bed rest (up to 14 days) and a course of various groups of drugs:
- Painkillers - injections or tablets of non-steroidal anti-inflammatory drugs (ketorolac, brufen, dexalgin, arcoxia, movalis, piroxicam), non-narcotic analgesics (lyrica, catadolone).
- Muscle relaxants to relieve muscle spasms (sirdalud, mydocalm, baklosan).
- Diuretics to eliminate swelling of the nerve trunks (Lasix).
- Novocaine blockades in the spinal area; for severe pain, blockades with glucocorticosteroids (diprospan, hydrocortisone).
- Sedatives (phenozipam, relanium, other tranquilizers and sleeping pills).
- B vitamins to improve the conductivity of nerve roots and restore muscle fibers (milgamma, neuromultivitis).
- Blood circulation activators (trental, actovegin, aminophylline).
- Local painkillers - ointments, creams with non-steroidal anti-inflammatory components (diclac, diclofenac, fastum-gel).
Physiotherapeutic treatment
Among the procedures effective for the treatment of lumboischialgia:
- acupuncture;
- massage;
- electrophoresis with drugs;
- microcurrent treatment;
- magnetic therapy;
- paraffin applications;
All procedures are prescribed only by the attending physician, taking into account existing contraindications and the nature of the underlying pathology. For osteochondrosis, manual therapy and spinal traction may be indicated.
Physiotherapy
After restrictions on movement are lifted and pain is completely eliminated, a course of exercise therapy is prescribed:
- Muscle stretching (bending, twisting the body, arching the back from a prone position).
- Exercises to restore mobility of the spine and hip joints (squats, raising the body from a lying position, swinging legs, pulling the knees to the chest).
- Stretching the spine on a special anatomical couch.
- Exercise classes.
- Yoga.
The photo shows the main types of exercises that are used in the treatment of lumbago with sciatica:
Homeopathy treatment
In parallel with traditional treatment possible use homeopathic remedies. They have a beneficial effect on the entire body, stimulate the mechanisms of self-regulation and self-healing. The most effective drugs for lumboischialgia are Traumeel-S and Tsel-T.
Traditional recipes against lumboischialgia
From traditional methods therapy, the following remedies relieve pain and optimize blood circulation in the spinal area:
- Rubbing the lower back with badger fat.
- Wearing belts made of dog hair.
- Compresses made from infusion of birch buds.
- Baths with a decoction of pine needles.
- Applying warming patches.
- Rubbing in ointment from vegetable oil and ammonia (2:1).
- Applications from grated horseradish, black radish, mumiyo infusion, dead bees.
Surgical treatment of lumbago with sciatica
In case of poorly controlled attacks or frequent exacerbations, it is possible to carry out surgical treatment diseases.
Most often it is required for a herniated disc, compression of the nerve roots causing partial paralysis, cauda equina syndrome, tumor process etc.
After the operation, the patient requires long-term rehabilitation, including massage, reflexology, exercise therapy, and taking vitamins.
Psychotherapy
An important point in treatment is the introduction of psychotherapeutic techniques that can influence the patient’s behavior in a difficult situation.
A specialist will explain the procedure for changing a person’s behavior and help get rid of bad habits, will conduct auto-trainings to refuse negative thoughts, to relieve depressive symptoms.
The patient also needs to train useful skills and opportunities for relaxation, muscle relaxation, and detachment from painful sensations.
Treatment at home
If attacks of lumboischialgia occur, you should consult a doctor: the syndrome can become a manifestation of a clinical picture of serious pathologies.
During the period of remission, you need to properly organize physical activity, wear bandages, sleep on orthopedic mattresses.
- this is extremely serious damage, which entails many dangerous consequences for good health. Therefore, the symptoms of this pathology cannot be ignored; after any head injury, you should consult a doctor.
Fracture of the base of the skull, an even more serious injury. Depending on the location, its consequences may be irreversible for humans. will help you understand why a skull fracture is so dangerous.
Lumboischialgia and the army
In the presence of lumbago with sciatica, which are classified as peripheral diseases nervous system, possible exemption from military service.
To do this, the patient must exhibit repeated exacerbations of lumboischialgia of any severity or residual effects that developed against the background of past episodes of pathology (for example, dysfunction of the limbs, etc.).
Forecast and prevention of lumbago with sciatica
If the underlying disease does not lead to disability of a person, and also after successful surgical treatment, the prognosis for the disease is favorable.
The diagnosis of lumboischialgia is not a death sentence.
Usually the pain is well controlled by a complex of medications and physiotherapeutic measures.
Timely treatment will minimize the risk of exacerbations.
Prevention measures include:
- Do not occupy an uncomfortable position for a long time.
- Do not wear shoes with high heels.
- Sit only on comfortable chairs.
- At work, do muscle-relaxing exercises.
- Don't carry heavy things.
- Don't get too cold.
- Stop smoking.
- Lose weight.
- Treat diseases of the joints, spine, and blood vessels in a timely manner.
Lumboischialgia is an unpleasant but not life-threatening disease that can be treated. If you follow all the doctor’s recommendations and pay close attention to your own health, stable remission or complete cessation lower back pain.
TV show “Live Healthy!” Lumboischialgia - what causes back pain:
Many people who have reached middle age are familiar with excruciating back pain that lasts for several days in a row. However, most of them do not seek help from specialized institutions, preferring to treat themselves.
If the pain goes away after a couple of injections, then you don’t have to think about the reason for its occurrence. But this attitude towards one’s health only aggravates the disease, and the pain syndrome appears more and more often. IN in this case The main cause of back pain radiating to one or both legs is the so-called lumbar sciatica.
Lumboischialgia is a disorder affecting sciatic nerve manifested by pain in the lumbar region, which affects the buttock, back legs, lower leg. With this disease, the pain syndrome develops sharply and suddenly. Usually its appearance is provoked by sudden movement, lifting weights, or staying in an uncomfortable position for a long time.
Lumboischialgia syndrome may manifest itself different types discomfort– increasing, burning, aching pain, a feeling of heat or chilliness in the affected area.
The most common forms of the disease
In medical practice, the most common forms of lumbar ischialgia are:
- Muscular-tonic form - occurs when the nerve root is irritated by the structures that surround it.
Is the cause of pain in this case too high a load on untrained muscles, pathology of the development of the hip joints? or organ diseases gastrointestinal tract and small pelvis.
- Neurodystrophic lumboischialgia on the left or right is a kind of continuation of the muscular-tonic form of the disease.
With this form of violations are often detected trophic changes skin, and in some cases even ulcers. When palpating the affected area, you can detect a lumpy muscle structure in the area of the knee and hip joints - nodules.
Severe burning pain, worse at night, is localized in the lumbar area and popliteal fossa. The patient often experiences convulsions at night calf muscles, and during the day he may notice limited mobility of the hip joint. This form of lumboischialgia can be distinguished from others by the following characteristics:
- severe pain in lumbar region, lasting for a long time - up to several years;
- a clear connection between pain in the lower back and leg joints;
- defeat large joints one or both legs - hip, knee, ankle.
- Vegetative-vascular left-sided or right-sided lumboischialgia is characterized by a combination of unpleasant sensations: burning or aching pain, increasing when the position of the leg changes; numbness of the foot, heat or cold in the affected area.
Most often, the development of pain syndrome is provoked by hypothermia or an uncomfortable position of the legs for a long time.
Externally, the lesion can be recognized as discoloration and dryness skin, swelling in the ankle joint area. With prolonged pain in the lower back, the skin of the toes becomes pale and the pulsation on the back of the foot decreases.
Often, signs of all the types of lumboischialgia described above occur simultaneously - in this case, the patient is diagnosed mixed form diseases. In addition, the lesion can affect both lower extremities - bilateral lumbar sciatica, or one of them - left or right lumbar sciatica.
Reasons for the development of pathology
As mentioned above, the main causes of lumboischialgia are awkward movement or lifting objects that are too heavy. However, the following can also provoke the occurrence of such a violation:
- constant stress and depression;
- poor posture due to pregnancy or excess weight, which shift the center of gravity of the body;
- deforming osteoarthritis;
- spinal disc herniation;
- heavy physical labor or certain sports;
- age after thirty years.
Depending on what exactly led to the development of such a disorder, the following categories of lumboischialgia are distinguished:
- musculoskeletal, which is formed on the basis of pathologies of the musculoskeletal system, in particular the spinal column and lower extremities. In addition, discogenic lumboischialgia and Hamstring syndrome also fall into this category;
- neuropathic, in which pain develops due to compression of the nerve roots;
- angiopathic - in this case, pain appears due to damage to the blood vessels of the lower extremities;
- mixed - this includes combinations of pathologies of different anatomical structures and a combination of different lower limb anomalies based on a heterogeneous process.
The presence of any form of lumboischialgia requires mandatory clinical, instrumental and laboratory tests. Such studies are necessary to identify pathologies of blood vessels located in the lower extremities and abdominal cavity.
Besides, possible reasons diseases may impair the functionality of the pelvic and abdominal organs, which can also be detected using the studies described above.
Main clinical signs of lumboischialgia
Typically, symptoms of lumboischialgia appear immediately after the appearance of such a disorder. The following signs indicate that a person has developed this disease for some reason:
- limited motor ability in the lumbar spine;
- increased intensity of pain when changing body position;
- spread of pain along the entire length of the nerve - from the lower back to the ankle joint;
- fixing the back in a slightly bent forward position;
- changes in the color and temperature of the skin of the lower extremities associated with circulatory disorders;
- strong pain when trying to step with the affected leg.
Basically, this disorder manifests itself during prolonged physical activity, which most often develops on the basis degenerative lesion spine – osteochondrosis. Patients with this diagnosis need to be very attentive to all unpleasant sensations.
Different Treatment Approaches
It is very important to begin therapy for the disease as early as possible, since in the absence of the necessary timely treatment the patient may develop chronic lumboischialgia, which is much more difficult to cure.
In the first days after the symptoms of the disease appear, the patient should limit as much as possible. physical exercise, and also reduce the amount of fluid consumed to reduce swelling of the intervertebral discs. In addition, treatment of lumboischialgia at home involves taking non-steroidal anti-inflammatory drugs.
Immediate contact with a medical facility is necessary if the patient experiences the following symptoms:
- lower back pain after injury;
- redness and/or swelling in the spine area;
- fever;
- deterioration in the sensitivity of the legs and organs located in the lower part of the body;
- spontaneous urination and/or defecation.
As you know, the treatment of any disease largely depends on the cause of its occurrence, stage of development and severity clinical signs, and general condition patient's health. Treatment of vertebrogenic lumboischialgia in acute condition– this is, first of all, complete rest for the patient.
It is recommended to lie on a hard surface, choosing a position in which painful sensations minimal. The duration of such bed rest may vary - from a couple of days to 2 weeks. Doctors recommend starting to move after 3-4 days of complete rest, if movement is supine position do not increase pain.
If a person is experiencing very severe pain, a specialist may prescribe various medications that should relieve muscle spasm and reduce pain. Typically, drugs for the treatment of lumboischialgia are non-steroidal anti-inflammatory drugs, the course of which is selected individually.
Medicines may also be prescribed to improve blood circulation and venous drainage, medications with B vitamins. When sharp pain stops and only pain when moving remains, the patient continues the course of B vitamins and NSAIDs.
Treatment of lumbar ischialgia with folk remedies, as well as non-drug therapy options, are used only after acute pain has been relieved.
Thus, a technique called “pharmacopuncture” is quite effective - insertion with a sharp needle into pain point a certain medicine that restores blood circulation, reducing swelling and congestion. This technique allows you to relieve muscle spasms and irritation of the nerve roots, giving lasting positive results.
In parallel with this, the patient also needs to engage in therapeutic exercises- Your doctor will tell you what exercises to do for lumboischialgia and which ones to avoid.
Immediately after an acute pain attack has been relieved, when a person can already move painlessly, you can perform the following exercises from a lying position:
- taking a deep breath, stretch and raise your hand up, while exhaling, return to the starting position (5-6 times for both hands);
- flexion and extension of the feet in ankle joint(5-6 times);
- bending your legs, bring your knees together and spread them (5-6 times);
- bend and straighten the leg at the knee without lifting the heel from the bed (perform 3-4 times for both legs).
- As you recover, you can complicate the program and add exercises in sitting and standing positions.
During the period of remission of the disease, you should undergo courses of massage and special procedures at least 2 times a year. To reduce the risk of re-exacerbation of the disease, the patient is recommended to exercise therapeutic exercises independently during the entire period of remission - this is the most effective method prevention of new attacks.