Lumbago: treatment methods
If you overload your body with exercise, you can harm it. Often it is the spinal column in the lumbar region that suffers. Lumbago is an acute pain that results from overstrain of the spine. Although there are other factors that can cause lumbago, everyone should know.
- Lumbago - what is it?
- What is the difference between lumbago and lumbodynia?
- Lumbago causes
- Lumbago symptoms
- Lumbago disease: classification and stages of the disease
- Diagnostics of the lumbago
- Ways to quickly relieve pain
- Lumbago treatment
- Lumbago treatment during pregnancy
- Operative treatment
- Alternative treatments for lumbago
- Rehabilitation treatment after lumbago
Lumbago - what is it?
Lumbago is not a pathology, but a symptom of a disorder. It is manifested by severe shooting pain in the spine. Also, lumbago is called acute discogenic lumbodynia. With lumbago, the structures of the spine are destroyed. It is pain that indicates a developing disorder. For the first time, lumbago can occur at a young age. People aged 25 and older come to the doctor with complaints of lower back pain.
You should not endure acute pain in the spine, since the absence of treatment will lead to the chronicization of the pathological process. Pain will become a constant companion of a person, which will negatively affect the quality of his life. Therefore, when characteristic symptoms appear, it is necessary to consult a specialist.
Lumbago is characterized by increased pain during walking, bending, and coughing. As the pathology progresses, painful sensations will spread to the buttocks and lower extremities. In the future, it will become difficult for a person to even simply put the body in a straight position.
Lumbago is often confused with radiculitis. There is such a type of pathology as lumboischialgia. This disease is characterized by a combination of lumbago with sciatica. In this case, pain occurs due to deformation of muscles, ligaments and bone tissues.
What is the difference between lumbago and lumbodynia?
The main differences between lumbago and lumbodynia are presented in the table.
The pain is acute, unexpected for a person. Gains strength within a few minutes.
The pain increases gradually over several days.
The pain is acute, occurs immediately after the incident lumbago in the lower back.
The maximum intensity of pain occurs in the morning hours.
At rest, the pain goes away.
The pain becomes less severe when the person is moving.
The pain increases with coughing and sneezing.
The pain increases when a person stands or sits for a long time.
The muscles are spasmodic, but not severely.
The muscle spasm is very intense.
The center of pain is in the lumbar region.
The pain radiates to the buttocks and thigh.
People who lead an inactive lifestyle are susceptible to pathology.
People involved in sports and people who overextend the lower back are more often affected.
The pain goes away in a few days. The attack lasts no more than 7 days.
The pain is chronic, if there is no treatment, then it will haunt the person on an ongoing basis.
Backache occurs due to the intense irritation of nerve fibers. This applies to those nerves that are located in the fibrinous ring, in the surrounding ligaments and in the vertebral bodies.
The main causes of lumbago:
- Intervertebral hernia.
- Overstrain of the back muscles in the lumbar region.
- Displacement of the discs of the spinal column.
- Vertebral tumor.
- Congenital malformations of the spine with a decrease in the normal distance between the vertebrae.
Osteochondrosis is considered the leading cause of lumbago. If it is complicated by a hernial protrusion, then the pain will intensify.
Internal causes of the development of lumbago
The internal reasons for the development of lumbago include:
- Displacement of the overlying vertebra in relation to the underlying.
- Bechterew's disease.
- Chronic narrowing of the central spinal canal in the lumbar region.
- Tumor neoplasms of the liver and kidneys.
- Infectious lesion of the spinal column.
- Rheumatoid joint damage.
- The effect of stress on the body.
- Diseases affecting the nervous system.
- Inflammation of the muscles in the lower body.
Lumbago can develop under the influence of external factors, including:
- Physical overload.
- Hypothermia or overheating of the body.
- Being in a draft.
- A long time in an uncomfortable position.
- Back injuries.
- Execution of sudden movements.
- Sleep in an uncomfortable or anatomically incorrect position.
Lumbago appears unexpectedly for a person. The pain is sharp, stabbing, like a lumbago, but sometimes it can be pulsating. It is so intense that it forces a person to leave everything and freeze in their original position. The attack lasts from 30 minutes to several hours. Then it decreases slightly, but by nightfall it gains strength again.
The main symptoms of lumbago:
Muscle spasm. It is concentrated in the lumbar region, but the pain forces the person to tighten the glutes, lower back, and thighs. They become dense to the touch, swell.
Decreased mobility. It is difficult for the patient to straighten or bend the body, to change its position.
Lying position. If a person accepts it, then the pain is more tolerated.
Numbness of the lower limbs. It develops due to muscle spasm, in which the blood supply to the legs deteriorates.
Other symptoms of lumbago include:
- Strengthening general weakness.
- Deterioration of digestive processes.
- Frequent urination.
- Disorders in the genital organs.
Lumbago disease: classification and stages of the disease
Depending on the duration of the attack, there are 3 forms of the disease:
Acute lumbago. The attack lasts about 4 weeks.
Subacute lumbago. The attack lasts no longer than 3 months.
Chronic lumbago. Pain follows a person for more than 3 months.
This classification is used by doctors in medical institutions.
There are also 2 stages of lumbago:
Active stage. It is characterized by intense pain and corresponds to the acute period of the attack. Any, even the smallest, movements are painful for a person.
Passive stage. The pain in a person persists, but does not arise with such force and not as often as during the active stage. Physical activity on the body can provoke painful sensations. Most often, people with a passive stage of lumbago do not go to the doctor.
Diagnostics of the lumbago
To diagnose lumbago and find out the cause of the attack, you need to visit a neurologist. During the examination, the doctor will determine the degree of pain intensity, its nature. He will assess the condition of the muscles of the lower back, as well as the range of motion that is available to a person.
After the examination, the doctor will give the patient a referral for urine and blood tests. This will determine the degree of intensity of the inflammatory process.
Other diagnostic measures include:
Radiography. The study allows you to assess the degree of damage to the vertebrae, to identify their possible injury, tumor neoplasms and developmental abnormalities. X-ray is informative in terms of detecting osteochondrosis and displacement of the vertebrae.
MRI. The study provides information about the condition of the spinal cord and intervertebral discs.
CT. This diagnostic procedure is more informative than radiography. Thanks to its implementation, it is possible to obtain a three-dimensional image of the spine, which will allow the doctor to detect even minor damage to the tissues under study.
Scintigraphy. During the procedure, an isotope is injected into the patient's body, which accumulates in the vertebrae. The doctor then takes a series of images. All areas with damage in the form of purulent cavities, tumor neoplasms, and inflammatory processes will be visible on them.
Ways to quickly relieve pain
It is never possible to predict at what point a person will develop lumbago. Therefore, everyone should know how to help themselves in case of an acute attack of pain.
- It is necessary to take a position in which painful sensations are minimal.
- You should not perform sudden movements. In general, you need to move as little as possible. If possible, then you should seek the help of another person.
- To reduce the intensity of pain, you need to take any of the following drugs: Ibuprofen, Nurofen, Diclofenac, Ortofen, Voltaren.
- An anesthetic ointment should be rubbed into the lumbar region, for example, Ketoprofen, Voltaren, Fastum-gel, Diclofenac, Finalgel, etc.
- To enhance the effect of the ointment, you can put an elastic wool belt on the lower back. It has a warming effect, helps to reduce tissue swelling, and also fixes the spinal column.
- With acute pain, lie on your back on a hard surface. Legs should be at right angles. For convenience, a roller is placed under them. Alternatively, you can lie on your stomach with a pillow underneath.
The primary goal of lumbago treatment is to relieve an acute attack of pain. This will require completely unloading the lumbar spine. To reduce the intensity of the inflammatory process, to relieve spasm and pain, it is necessary to take medications. The doctor should prescribe drugs.
Tablets help to cope with the main manifestations of lumbago.
Aspirin. It relieves pain and inflammation. The drug is taken at a dosage of 0.25-1 g 3 times a day.
Ibuprofen. This is a well-known anti-inflammatory and analgesic agent, which is taken 3 times a day, 1-3 tablets. The analogue of Ibuprofen is Nurofen.
Diclofenac. This remedy is good for relieving back pain. It is prescribed at 0.025-0.05 g 3 times a day. When the pain is managed, the dose is reduced to 0.025. take the drug once a day. In order not to harm the digestive organs, Omeprazole is prescribed simultaneously with Diclofenac. Diclofenac's analogs: Ortofen, Voltaren.
Midocalm and Sirdalud. These drugs help relax the muscles. If you combine them with NSAIDs, the pain will quickly subside. The initial dosage is 50 mg 3 times a day, after which the dose is increased to 150 mg 3 times a day.
Meloxicam. This is an effective drug from the NSAID group.
Papaverine and Andipal. They are antispasmodics that relieve muscle tension and relieve pain.
Furosemide. It is a diuretic that can help reduce tissue swelling and relieve pain. Its reception is recommended to be combined with Panangin in order to prevent the leaching of potassium from the body.
Ointments that can be used to treat lumbago:
Diclofenac. The ointment has anesthetic and anti-inflammatory effect. It is applied to the skin 2 times a day, rubbing into the lower back.
Traumeel S, Zel T. These are homeopathic remedies that contain natural ingredients. Their use can eliminate inflammation and pain.
Fastum gel. This external agent has an analgesic effect, pleasantly cools the application area. It contains menthol and ibuprofen.
Dimexide. This drug is applied in the form of a compress, moistening a napkin with it. You need to keep it on the skin for 30 minutes, not forgetting to cover it with a cotton cloth on top. Compresses can be applied 3 times a day.
In addition to ointments, you can use patches for lumbago.
A good analgesic effect is possessed by such drugs as:
Zb Pain Relief. This patch contains exclusively natural ingredients. Its use allows you to eliminate pain, relieve swelling from tissues, and reduce the inflammatory response.
Patch Voltaren. Its analgesic effect is provided by diclofenac.
Versatis. This patch contains lidocaine, which can temporarily relieve pain. It has no effect on the cause of lumbago.
If you cannot cope with the problem with pills and local remedies, then you need to resort to injections.
Injections that can be given to patients with lumbago:
Diclofenac, Voltaren, Ortofen. The drug is administered to the patient in 1 ampoule inside the muscle. Injections can be given 1 or 2 times a day.
Milgamma compositum. This drug can improve metabolic processes, relieve pain. The drug is administered intramuscularly.
The course of treatment should not exceed 7 days. After that, the patient is offered drugs in tablet form. Pain relievers will need to be taken for another week.
Even if the injections fail to relieve low back pain, the patient is given a block. Novocaine or a hormonal drug is injected directly into the affected area. Only a trained doctor can be engaged in setting the blockade. If the drug is administered incorrectly, then the person may remain disabled due to significant damage to the spine.
Video: Doctor neurosurgeon Zorin Nikolay will tell you how to treat lumbago:
Lumbago treatment during pregnancy
Pregnancy often provokes the onset of lumbago. This is due to the displacement of the vertebrae and the expansion of the pelvic bones. Most often, women over 25 years old suffer from lumbago.
To cope with the disorder and reduce pain, you need to see a chiropractor or osteopath. Experts recommend that women engage in physiotherapy exercises, visit a masseur, and wear a special bandage.
Pregnant women are prohibited from taking NSAIDs and chondroprotectors, as they can cause serious damage to the health of the child, causing developmental abnormalities in him.
You should not use warming ointments and compresses, as the risk of uterine bleeding and spontaneous abortion increases. If a woman has an acute attack, it is necessary to lie down and apply ice to the lower back. Provided that the pain persists for 2 days, you need to see a specialist.
Attention! Pregnant women should not have X-rays and CT scans. These procedures are especially dangerous in the early stages.
If conservative therapy does not bring the desired results, surgery is required. It is performed by a neurosurgeon, the patient will be under general anesthesia. Such treatment is aimed not only at eliminating pain, but also at eliminating the cause of lumbago. The main types of surgery are:
Kyphoplasty. The operation allows you to give the vertebrae the correct shape. It is prescribed for patients with an injury or severe spinal deformity. Dentures are made from surgical steel or other material.
Discectomy. This operation is aimed at removing the hernia. During the procedure, the damaged vertebral disc is removed (partially or completely).
Foraminotomy. During the procedure, the doctor removes fragments of the disc or spine that press on the nerve roots.
There are other ways to help patients with lumbago. However, they are used in extreme cases.
Alternative treatments for lumbago
You can resort to the help of a physiotherapist no earlier than 2 or even 3 days from the onset of an attack. The procedures will be aimed at normalizing blood circulation in the lumbar region, reducing tissue swelling and relieving the inflammatory response. Undergoing physiotherapy procedures can reduce the amount of drugs taken.
Magnetotherapy. The lumbar region is influenced by magnetic fields. This allows you to reduce tissue swelling, eliminate the inflammatory response, and reduce the intensity of pain. One procedure takes about 20 minutes.
Diadynamic therapy. The doctor acts on the affected area with a pulsed current, thereby reducing swelling and pain. Treatment can continue for 7-12 days. The procedures are carried out daily.
Amplipulse therapy. The impact on the body is carried out by sinusoidal currents. Such treatment allows you to cope with pain and start recovery processes in nerve fibers and muscles. The course consists of 7-10 procedures.
Ultraviolet irradiation. Irradiation of tissues makes it possible to increase their resistance to destructive processes, thereby preventing an increase in pain. Within 3-5 days, 3 biodoses of radiation are administered.
Electrophoresis. This procedure is aimed at relieving the inflammatory reaction and relieving pain, since the drugs are delivered directly to the affected area.
Moxibustion. The procedure is aimed at warming up the lumbar spine. This allows you to relieve the spasm and provide an analgesic effect.
Stone therapy. Effects of the procedure: relieve spasm, improve metabolism, restore damaged tissues.
Acupuncture for lumbago
Acupuncture refers to the methods of traditional medicine. The specialist influences the biological active points. Although doctors do not consider this method of treatment for lumbago effective, many patients indicate that they have managed to cope with the pain with the help of acupuncture.
A variation of this technique is pharmacopuncture. With the help of needles, drugs are injected into the tissue. Doctors strongly advise against treating lumbago only with alternative medicine methods.
Manual therapy for lumbago
Manual therapy involves working out the affected areas with the hands of a specialist. The doctor acts on the patient's vertebrae, thanks to which it is possible to cope with the problem. Sometimes the help of a chiropractor can completely get rid of lumbago. However, resorting to this method of treatment is possible only after stopping the acute stage of the disease.
Rough influence of the masseur's hands on the lower back of a patient with lumbago is prohibited. The optimal duration of the procedure is 15 minutes.
The main techniques used by specialists:
- Relaxing back massage to relax muscles and reduce the intensity of the inflammatory response.
- Relaxation of the lumbar region.
- Rubbing the lumbar region. Rubbing is often combined with warming up.
The main purpose of massage is to eliminate pain and inflammation. If the masseur acts rudely, then there is a risk of displacement of the vertebrae. This will lead to serious health consequences. Therefore, you only need to trust your body to a specialist with a medical education.
You can start therapeutic exercises only after the acute phase of the disease has passed. Exercise therapy is not aimed at helping a person eliminate the symptoms of lumbago, but at preventing a relapse of the attack.
The diet for lumbago must be strictly observed. It is forbidden to eat spicy, fatty, salty and fried foods. If you do not follow these recommendations, then the pain will intensify.
Rehabilitation treatment after lumbago
After the therapy, you must adhere to the following recommendations:
- Wear a corset that supports the lower back.
- Allocate adequate rest time.
- Be in the fresh air more often.
- Take medicinal baths.
- Perform a lumbar massage.
- Sleep on your side. This will reduce the stress on the spine.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".