Sharp, piercing lower back pain with awkward movement or after lifting the weight - this condition is familiar to many people who have reached the age of 30 - 35 years. As a rule, with the primary admission of a therapist or neurologist, a diagnosis of lumbar osteochondrosis is established and treatment with nonsteroidal anti-inflammatory drugs is prescribed. But it is worthwhile to understand that in about 70% of such cases there is a lumbar intervertebral hernia, which is already the next "stage of development" of osteochondrosis of the spinal column. This is a peculiar complication against the destruction of the cartilage of the intervertebral disc. The most common lumbar intervertebral hernia at the junction of vertebrae L5-S1 is the thoracolumbar localization. The second most frequent spread of the development of the lumbar intervertebral hernia is the articulation of the vertebrae L4-L5.
How the herniated intervertebral disc of the lumbar department of the
develops. To understand the general clinical picture of the pathology, it is necessary to have an idea of how the herniated intervertebral disc of the lumbar spine develops, what pathological processes occur in the cartilage tissue and the surrounding muscle fibers.
Meanwhile, it is in the pulpous cartilaginous ring that the substance of the spinal cord is located, from which the paired radicular nerves, responsible for the innervation of certain parts of the body, leave. In particular, the lumbar radicular nerves are responsible for the performance of all the organs of the abdominal cavity. In the sacral section, nerves are located innervating the lower extremities and organs of the small pelvis. In total, five vertebral bodies are located in the lumbar spine.
In the development of osteochondrosis, a slight protrusion( thinning) of the intervertebral disk is first observed. Then, its stretching and prolapse is formed. At this stage, the appearance of a herniated intervertebral disc of the lumbar region. At the same time, the outer fibrous ring is stretched and the substance of the pulpous core gets into the formed "pocket".The symmetry of fixation of the vertebra is broken, against which background the radicular nerves may be impaired.
Consequences of intervertebral hernia of the lumbosacral section
The most difficult diagnosis is the intervertebral hernia of the lumbosacral region, which occurs in about 10% of patients. It develops at the junction of the sacral junction of the bones of the spine and the lower lumbar vertebra. The intervertebral hernia of the lumbosacral segment is characterized by acute lamp pain in the lower extremities, disruption of the pelvic organs: pathology of urination, erectile dysfunction in men, infertility, stagnation of blood in the pelvic cavity.
When the bundle of sacral and lumbar nerves is infringed, acute pain with immobility arises. This is the so-called infringement of the horse's tail, accompanied by sakrodinia( pain in the sacrum).The process of urination and defecation can be completely disrupted. The patient experiences excruciating burning pains on the inner and outer surface of the thigh, giving to the heel. Muscular weakness of the lower extremities may occur, a decrease in their sensitivity. Any movement leads to an increased pain syndrome. The consequences of the intervertebral hernia of the lumbar region can be severe: disability, impaired internal organs.
Symptoms and signs of intervertebral hernia of the lumbar spine
Intervertebral hernia of the lumbar spine for a long time can develop without the appearance of clinical signs of pathology. Symptoms of the intervertebral hernia of the lumbar region appear in the event that there is a squeezing of the substance of the pulpous nucleus or pinching of the radicular nerves due to the uneven distribution of the load.
Usually, the intervertebral hernia of the lumbar spine "makes itself felt" after significant or unusual physical exertion. This can be lifting weights, working in an inclined position, prolonged body finding in a static position. It is not rare to provoke the appearance of pain in the fall, bumps, improper position during the night rest. People with a sedentary lifestyle who do not receive sufficient physical exertion are at risk. Age "qualification" - people who are older than 30 years old get sick. Gender differences do not exist - equally pathologies are experienced by both men and women.
The first signs of the lumbar disc herniation may include the following manifestations:
- sharp pain in the lower back, which does not pass even in a lying position;
- weakness in the legs, lack of freedom of movement;
- burning pain spreads over the inner or outer projection of the thigh, reaches the lower leg and gives to the heel when attacking it.
There are other specific symptoms of the intervertebral hernia of the lumbar spine, which can be expressed as:
regular abnormalities of the thin and large intestine: dyspepsia, constipation or diarrhea;
violation of the process of bile separation - dyskinesia of the bile ducts can be formed, leading to the development of cholelithiasis;
of stagnation of venous blood in the pelvic cavity and lower limbs - thrombophlebitis, varicose veins, hemorrhoids may occur.
But the leading symptom is a sharp pain that literally binds and does not allow you to make the usual movements. In particular, the patient can not sit on a chair or climb from it without additional support. There is no possibility of free extension of the bent leg from the supine position on the back. Decreased skin sensitivity. With a long course of the disease, dystrophy of the gastrocnemius and femoral muscles, light paresis and paresthesia can occur.
Treatment of the intervertebral hernia of the lumbar spine
After the removal of the pain syndrome, the treatment of the intervertebral hernia of the lumbar spine is aimed at restoring the structure of the cartilaginous tissue. The leading role here belongs to therapeutic massage and special sets of physical exercises. Only at the expense of these measures it is possible to get rid of the hernia of the intervertebral disc of any size within 6 to 8 months. Moreover, you will be completely immune from relapse of pathology, as you will have a fairly developed muscular skeleton of the spinal column.
In order to activate the processes of restoration of cartilaginous tissue, special preparations are also used - chondroprotectors. The most popular among them: "Khondroksid", "Honda", "Structum", "Alflutop".Recently, excellent results are given by "Arkoksia", is prescribed for all types and sizes of intervertebral hernias.
In order to improve the regenerative functions of the radicular nerves and the substance of the spinal cord, group B vitamins are used. These are the so-called neurological vitamins, which are offered in a complex form as part of the preparations "Milgamma", "neuromultivite."Although a separate intramuscular injection of pyridoxine hydrochloride, thiamine chloride and cyanocobalamin is permitted. To improve blood microcirculation processes, nicotinic acid is used by courses of 20 intramuscular injections.