Acute pain in the lumbar region, on the background of osteochondrosis is a common problem faced by absolutely most people. Having got us "a reward" for our bipedalism (due to the increase in axial load on the spine stripped), the disease sooner or later affects everyone on the planet, the only question is how fast this occurs and how severe symptoms. Such "joyless" statistics makes taking the iconic social pathology and diseases, and the fight against it should not be the responsibility only of the individual who is suffering the hell of the disease and global health care system as a whole. Therefore, the issue of treatment of osteochondrosis – a topic very relevant.
So what is osteochondrosis? Let us consider briefly the development of the disease. In its name, if you translate it literally from Latin, the structure changing during osteoarthritis: bone and cartilage. In order cushioning and stability and vertical loads nature has placed between the two vertebrae is a kind of fibro-cartilage "cushions" — the intervertebral discs. Their food is carried out in childhood due to the blood vessels, which lost something like 25 years, and the food begins to be diffuse due to the surrounding muscles.
In pathological loads on the vertebral ripped (sedentary work, or excessive physical activity), violations of the processes of mineral metabolism in the intervertebral disc loses its elastic and damping properties, reducing its height and changing the structure of the vertebrae, appear the phenomenon of pathological bone growths (osteophytes and zamechatelnye plates), impaired mobility in the affected section of the spine. In the later stages of disease the Central portion of the intervertebral disc called the nucleus pulposus, breaking the fibrous ring, forms a kind of saccular protrusion between bodies of vertebrae — intervertebral hernia. Herniation can cause compression of the adjacent vertebrae and nerve roots, there is intense pain in the area of compression, as well as in the field, which regulate the work of the affected nerve. Due to the constant irritation of the nerve plexus there is a reflex spasm of the skeletal muscles, in medicine called protective defense that on the one hand protects suffers spine hell excessive movements, and on the other hand increases the compression, swelling and pain in the affected area.
In the majority of cases (90%) the pain syndrome in osteochondrosis (even very distinct) due to muscle spasm! In other cases, the cause of the pain compression nerve root or the spinal cord directly a herniated disc.
Osteochondrosis of the lumbar spine: how to treat
From all parts of the spine, and there are five of them (cervical, thoracic, lumbar, sacral, and coccygeal), because the largest motor load is most often the hell of suffering symptoms of the disease the lumbar. Osteochondrosis of the lumbar spine may bright, all the familiar symptoms, and its treatment of the phenomenon is a significant social problem because it affects the quality of life not only of the elderly but active people of working age.
Pain can be localized directly in the lumbar region, and also on the front of the thigh, or across the back or outer surface of the foot, around the toes. Often give pain in the gluteal region, pelvis, perineum, and hours can be localized only in these areas, masquerading as diseases of the urogenital system and intestines and making it difficult the correct diagnosis. The pain intensity may be so high that a person loses the ability to perform the most basic movements, adopt forced postures and loses normal sleep. That much of the sciatica, which in wider circles has long been synonymous with the disease itself.
Limitation of physical activity. Violated the usual movement and sensation in the limbs, occur muscle cramps, paresthesia (tingling, burning, "pins and needles").
Dysfunction of pelvis organs. With intensive radicular syndrome is known as sciatica, or massive Grajewo the protrusion can be violated even urination and bowel, causing severe suffering of the patient.
Treatment of degenerative disc disease of the lumbar spine often becomes challenging for both patient and doctor. Every person who suffers from this disease were asked the following questions: "How to treat lumbar degenerative disc disease?", "How to treat osteochondrosis of the lumbar spine?", "If the treatment of degenerative disc disease of the lumbar at home doesn't help – Yes, what doctor to address?", "If the pills and ointment for lumbar disc disease does not help - how to treat?".
To cope with the aggravation of degenerative disc disease and prescribe proper treatment will help the following physicians: therapist, neurologist, specialist in medical massage, chiropractor, physical therapist, and if necessary, surgical treatment – doctor neurosurgeon.
Ways of dealing with osteochondrosis of the lumbar spine
The main thing in the treatment of degenerative disc disease is the right way of life! People actively and properly engaged in physical culture and which will follow the spine, the back never hurts! Unfortunately, small who performs these simple truths.
Examining this question, we can distinguish:
- medication;
- drug-free.
Non-pharmacological methods of treatment of pathology of the lumbar spine
Distraction procedures. Their effect lies in the name itself - the use of a variety of applicators, massage mats and cushions, woolen belts, "widgets" and "rastertime" due to the impact on surface nerve endings and blood vessels reduces muscle spasm and pain. These methods can be used as an auxiliary, but insulated their use during exacerbation of osteochondrosis of lumbar segment without systemic treatment with special medicines ineffective.
Means of immobilization. Under these tools understand the bandages different designs, the wearing of which allows to protect the spine from sharp and "dangerous" movements and to redistribute the load if static work. Means of immobilization can be purchased at medical equipment stores and pharmacies however before purchasing advisable to consult a doctor who will help determine the best in your situation design, the stiffness and configuration of the bandage. It is advisable to apply them only one hour of exposure to adverse factors (driving, sedentary work, etc.), as prolonged use causes wasting of the muscles.
Physiotherapy (physical therapy) is an integral component of complex treatment of degenerative disc disease. Exercise to maintain tone of skeletal muscle of the back and the removal of pathological muscle spasm and help restore and sustain physical activity, reduction of pain syndrome intensity. A significant plus physical therapy is that after learning instructor the person can independently perform daily exercises at home, and in the existence of a set of exercises that apply even during exacerbation of the process. The most effective method of physical therapy phenomenon is mechano-therapy classes at the gym on individually developed technique, because the formation of the muscular corset is necessary to work with weights.
Massage has been known since ancient times, the most common and perhaps the most beloved by patients app prevention and treatment, however in the phase of exacerbation of osteochondrosis of lumbar segment cannot be used. In addition, to massage with osteochondrosis should only be a specialist with a medical background, knows anatomy and physiology and who owns the medical techniques of therapeutic massage.
Manual therapy and gaining popularity in recent years osteopathy is performed by a competent professional can have a significant therapeutic effect and even for a longer period to deliver a hell of exacerbations. It is also important to remember that when handling and chiropractor before you start the procedures necessary to conduct instrumental examinations of the spine (x-rays, CT or magnetic resonance imaging, osteodensitometry) in order to allow the doctor to assess the prevalence and severity of process and to exclude possible contraindications, and manipulation. Like massage, chiropractic and osteopathy are a number of contraindications, such as severe compression of the nerve root by the herniation, subluxation of the vertebrae. In the acute stages of degenerative disc disease of the lumbar use, as a rule, soft techniques of manual therapy (muscle relaxation, etc.).
Acupuncture. According to recent studies, the use of this popular in wide circles of the methodology evidence-based medicine is considered to be unreasonable in osteochondrosis of the lumbar spine, does not eliminate the symptoms of the disease, and put and unconventional method of treatment.
The physical therapyincluded in national clinical guidelines and standards of medical care in osteochondrosis, has long proved its effectiveness in the treatment of this disease. Osteochondrosis of the lumbar spine applied electromyostimulation, amplipulse therapy, shock wave therapy, interstitial myostimulation, laser. A popular method in the complex treatment remains magnetic. Yes, its advantages are a good tolerability and a short list of contraindications, possibility of application in the acute period of the disease. Acting on all links of the pathological process it already after a few treatments significantly reduces pain and allows a person to expand physical activity. In addition, by improving the trophism of the affected tissue it slows down the progression of the disease. The undisputed advantages of this method phenomena is the possibility of its independent use by the patient outside a medical institution.
But if all the above non-pharmacological methods have been ineffective - then what to treat lumbar degenerative disc disease?
Medication
Disease provides for the appointment of the following drug groups:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are available in the local forms (gels, ointments, creams) and systemic treatment (tablets, suppositories, solutions for intramuscular and intravenous). Their action is based on blocking the inflammatory process on enzymatic level due to eliminating swelling in the affected area and significantly reduced pain.
In the early stages of the disease, google + enough local application of NSAIDs in combination with non-pharmacological methods (physiotherapy, magnetotherapy). When expressed pathological process and intensive pain syndrome has to go, Yes tablets, and hours and injection forms of drugs.
Sorry, have a good anti-inflammatory and analgesic effect of NSAIDs, long-term systemic use can cause the development and worsening of ulcerative and erosive processes of the gastrointestinal tract, and impaired kidney and liver. So patients for a long hour taking NSAIDs, the drugs that protect the stomach lining and regular laboratory monitoring of the performance of the liver and kidneys.
The system muscle relaxants, G. sh. drugs that relieve muscle spasm. The principle of their action lies in the name: relaxation of spastic muscles reduce the compression of nerves and blood vessels, swelling in the affected area – improves blood circulation and lymph drainage – reduces pain by reducing défense, reduced muscle tension of the ligaments decreases the bulging (protrusion) of the intervertebral disc – simmering pain, increases range of motion.
Muscle relaxants for treatment of osteochondrosis are produced in the form of tablets and solutions for intramuscular administration, to achieve therapeutic effect should be long and gradually increasing the dose. As well as NSAIDs, muscle relaxants have a number of contraindications and can cause undesirable side effects, so despite free sales in drugstores, before purchasing you should consult with your doctor.
Local anesthetics or medications for local anesthesia used for medical treatment of lumbar osteochondrosis in the form of so-called paravertebral blockade, if the solution of the drug administered first subcutaneously, and then in the processes of the affected vertebra in the projection of the anticipated compression of a nerve root.
Accumulate in the membranes of nerve fibers, the drug effectively blocks pain signal. Therapist, of course, to perform such a blockade can not, it is necessary to contact the neurologist or neurosurgeon.
For paravertebral injection hours are used solutions of glucocorticosteroids (GCS) - hormonal drugs that have a pronounced anti-inflammatory action. Local their application allows to achieve the maximum effect with the minimum risk of undesirable side effects of the drug. Such closures are held courses 2-3 times a year, to fulfill their needs a neurologist or a physician neurosurgeon.
Vitamins of group "b". In any pharmacy you can find medicines of this group as in the forms for oral administration, and intramuscular administration. They are believed to have neurotrophic and easy analgetic effect, but the exact rationale for their use in osteochondrosis of the spine evidence-based medicine is not obtained.
Physical therapy in osteochondrosis of the lumbar
Yes sorry, hours a comprehensive treatment using modern medicines, physiotherapy, massage and exercise therapy is ineffective – the person continues to feel pain, there is the limitation of physical activity significantly affects the quality of life. So google + in the later stages of the disease, when forming the three-dimensional, often from multiple gryzenia protrusions of the intervertebral discs. In this situation, surgical treatment is indicated. Additionally, surgical intervention is indicated for so-called "prolapse of the hernia" when a significant compression of the spinal canal causes pain nekupirutayasa, violations of the static-dynamic and the blockade of the functions of the bladder and intestines. In such cases, surgery is performed on an emergency basis. The purpose of surgical interventions for degenerative disc disease of the lumbar spine phenomenon is mechanical decompression of the spinal canal and nerve roots.
At the present hour in the surgical treatment of osteoarthritis are used as a long-known surgical techniques and modern medicine minimally invasive endoscopic procedures using laser and RF exposure, some of which can be carried out even under local anesthesia.
Having considered the main ways of treatment of degenerative disc disease of the lumbar spine, I want to reiterate that the patient who asks the question "how to treat lumbar degenerative disc disease?", should hope not only medical help but also on our own strength, realizing the importance of a healthy lifestyle, which encouraged proper nutrition is applied correctly dosed physical load, and most importantly, there is faith in victory over the disease.