Treatment of left back pain

Patients with acute back pain are currently not prescribed bed rest; they are advised to maintain their normal activity level or to limit it somewhat if the pain intensity is high.

The most effective treatment for back pain on the left is considered to be drug therapy, the drugs of choice are paracetamol and non-steroidal anti-inflammatory drugs. They are taken in a short course, and not only for pain relief.

Paracetamol, like NSAIDs, does not selectively inhibit cyclooxygenases and has a moderate anti-inflammatory effect, which achieves an analgesic effect. The drug also inhibits the thermoregulation center - it reduces elevated temperature, although this effect is usually not required for radicular syndromes and radiculopathy. Paracetamol is chosen mainly because it rarely produces side effects and they are usually insignificant. It is not recommended for patients with liver and kidney disease, or an allergy to paracetamol. It has minor hematotoxicity, which increases in combination with phenobarbital. With prolonged use, it has a hepatotoxic effect. It can also cause other side effects from the nervous system and gastrointestinal tract. Allergic reactions are usually limited to dermatosis. The drug is available and used in various forms: tablets (they are taken no more than 1.5 g per dose three or four times a day at equal intervals), suppositories and syrup. Take Paracetamol orally after meals with plenty of water.

Apart from its relative safety, Paracetamol has no other advantages over NSAIDs. If it is ineffective, intolerable or the patient has a diseased liver, a drug from the group of non-hormonal anti-inflammatory drugs is selected. Common non-steroidal drugs (Diclofenac, Indomethacin, Ketoprofen) inhibit the activity of cyclooxygenases of the first and second isoforms, have a powerful anti-inflammatory and analgesic effect, however, they negatively affect the mucous membrane of the stomach and intestines, causing their pathologies up to erosions and ulcers. Such side effects from their use develop in one case out of ten, especially often affecting elderly patients.

Later generation drugs (Movalis, Nimesil) selectively limit the activity of cyclooxygenase-2, which makes them safer for the gastrointestinal tract, since side effects are caused by cyclooxygenase-1.

Movalis (active ingredient - meloxicam, an enolic acid derivative) is quite effective in treating pain and inflammation, has high (89%) bioavailability regardless of food intake. It is used in the form of intramuscular injections and tablets once a day. Usually, for severe pain, the injection form is prescribed first, then, after 1-2 days, they switch to the tablet form. The drug is prescribed in short courses for arthrosis (7.5-15 mg per day) and long courses for ankylosing spondylitis and arthritis (at the highest daily dose of 15 mg). Like all NSAIDs, despite the selectivity of action, Movalis is not prescribed to patients with peptic ulcer disease, hematopoietic disorders, a tendency to bleeding, pregnant women and patients under 15 years of age. May cause side effects from any organs and systems. Incompatible with lithium preparations, thrombolytics. It is not advisable to combine with other NSAIDs and antihypertensive drugs. Overdose of Movalis can cause coma and lead to the patient's death.

Nonsteroidal anti-inflammatory drugs with highly selective action, such as Celebrex (celecoxib) and others from the coxibs group, have proven themselves in clinical trials to be very effective and safer than previous generation drugs. Side effects from decreased blood clotting and bleeding from the upper gastrointestinal tract were noted less frequently, however, the undesirable effect on the intestinal mucosa remains. New drugs are also recommended to be taken with all precautions, like other NSAIDs, in minimally effective doses and limiting the duration of administration. Therefore, only a doctor should prescribe drugs for pain relief and inflammation relief, based on the patient's health condition.

Local forms of NSAIDs are often prescribed - ointment, emulgel, spray, patch with diclofenac, for example, Voltaren, compresses with Dimexide. Non-steroidal anti-inflammatory drugs work well when applied locally, causing less pronounced side effects. Contraindications to the use of local forms are violations of the integrity of the skin at the site of application.

In case of acute back pain, centrally acting muscle relaxants are also prescribed. They are used as independent drugs and together with NSAIDs. They reduce muscle tissue tension without suppressing nerve impulses, allowing the patient to maintain posture and move normally. With a decrease in muscle tone, pain, nervous tension and anxiety are reduced. One of the most frequently prescribed drugs is Mydocalm, it is considered a fairly safe drug that does not cause sedation and pronounced muscle weakness, does not affect the ability to concentrate when performing dangerous work even with a long course of treatment. Use is unacceptable during pregnancy, is dangerous for patients with an allergy to lidocaine, and is not prescribed to people suffering from myasthenia.

In cases of long-term chronic back pain, antidepressants (Amitriptyline) may be included in the therapeutic regimen, both in the presence of pronounced depressive symptoms and in their absence. Their ability to change the synaptic concentration of serotonin and norepinephrine is necessary in some cases of chronic pain management.

Anticonvulsants, such as Lamotrigine or Finlepsin, are also used in the treatment of pain in radicular syndromes. Their effect on the centers of pain impulse formation is used.

In diseases of the musculoskeletal system, vitamins may be prescribed as part of complex therapy. Calciferols or vitamins of group D are necessary for the absorption of calcium and strengthening of bone tissue, ascorbic acid is involved in the biosynthesis of connective tissue (collagen) fibers, vitamins of group B - in the formation of nerve fibers, help improve nerve conduction and normalize hematopoiesis, and therefore - the nutrition of bones, joints and cartilage, which make up the spine.

Physiotherapy treatment for back pain includes the following main procedures: electrical therapy, massage and therapeutic exercise.

Medicinal electrophoresis is used to help deliver drugs directly to damaged areas, thereby increasing their effectiveness and reducing doses.

Phonophoresis, magnetic therapy, darsonvalization allow to quickly relieve swelling and inflammation, and consequently – pain. Laser and ultrasound therapy of the spine are also used.

Massage helps improve blood circulation in tissues and helps to relax tense muscles, while therapeutic exercise helps to build up the muscle corset that supports the spine.

Physiological procedures not only help to cure back pain, but also prevent further development of the pathology and further relapses.

Folk remedies

The first remedy for back pain at home is warming and rubbing. Use everything you can find in the house - woolen shawls and scarves, cabbage, horseradish, honey, ginger, dry mustard and regular table salt.

Such measures help to quickly relieve musculoskeletal pain caused by pinched nerve roots or muscle spasms, however, in case of infectious lesions, neoplasms, inflammations and joint degeneration, they will be ineffective, and time will be lost. Therefore, modern diagnostics for back pain syndrome is necessary.

Dry heat, namely heat, not the application of hot objects, pleasant and warming can be provided by an old woolen scarf placed on the sore spot. A woolen scarf can be soaked in a saline solution (2 tablespoons per liter of water), dried and worn, practically without removing, until the symptoms disappear. However, the pain usually comes sharply and unexpectedly, often in the evening, after physical excesses, and the scarf will take a long time to dry. You can use a dry one right away, and then replace it with a salty one. It is good if there is an object knitted from dog wool in the house, it does not need to be soaked.

It is good to warm the sore spot with a bag of salt, make paraffin applications, apply potatoes boiled in their skins, crushed and placed in a tight bag. They cool slowly and give off heat to the sore spot for a long time.

You can make compresses, for example, from cabbage. Melt a tablespoon of honey in a bath and mix it with the same amount of table vinegar. Apply this mixture to a cabbage leaf and fix it on the sore spot. Wrap it with a woolen scarf on top. You can sleep with such a compress until the morning. If there is no honey in the house, but only cabbage, you can lightly beat a cabbage leaf warmed in warm water and wrap it to the sore spot with a scarf.

You can make a horseradish compress if you have fresh horseradish root at home, preferably with leaves. Grind all the raw materials in a meat grinder, spread the resulting gruel on a piece of natural (linen, cotton) fabric and make a compress on the sore spot. Put a hot water bottle on top of the compress. After a few minutes, remove the compress and replace it with horseradish leaves, which can be left on until the morning. After such a procedure, the patient should rest, so it is best to do it at night.

You can make a homemade ointment from ginger root by making a paste out of it in a blender, on a fine grater, in a meat grinder with the addition of a few drops of eucalyptus oil. This ointment is applied to the sore spot two or three times a day.

Herbal treatment is widely used in any folk medicine. Burdock is applied to sore joints. In summer - fresh leaves. They are tied overnight. For winter, you can dry the leaves. Dry ones are used as follows: take several pieces, soak them in a vinegar solution (vinegar-water - 1:1), stack them on top of each other and tie this stack to the sore area, previously lubricated with sunflower oil. You can leave it overnight.

Hot compresses with wrapping are made with infusions of various medicinal herbs - St. John's wort, thyme, chamomile. Tinctures and ointments are made from horse chestnut. The main thing is not to harm, because if back pain is caused not by radiculitis, but by diseases of internal organs, then it is not recommended to heat and rub the sore spot.

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Homeopathy

This alternative medicine copes well with many tasks that are beyond the power of even modern pharmacology. Considering the mild action of homeopathic drugs and the practical absence of side effects, in many cases, for example, for pregnant women and allergy sufferers, and NSAIDs cause sensitization reactions in many, this is a real way out. To use classical homeopathic remedies, it is necessary to be supervised by a homeopathic doctor; self-medication in this case is unlikely to be successful. For back pain, 44 drugs are used, others may be prescribed depending on your constitutional type. Therefore, the appointment should be made by a specialist.

Pharmacies sell drugs made on the principle of small doses, which act no worse than NSAIDs, only more gently and without negative consequences for the body. Traumeel S helps well with musculoskeletal pain. This drug can be used locally, applied to the site of pain in the form of an ointment or gel, and damage to the integrity of the skin is not a contraindication to application. Moreover, the drug will promote the regeneration of the epidermal layer. It is also used orally and parenterally. Injections are made in any way, including at acupuncture points and segmentally, specifically blocking pain.

The complex remedy includes various components used in homeopathy as monopreparations in cases of:

• any acute painful injuries, sprains, fractures, pinched nerve endings, even with damage to the skin - Arnica (Arnica montana), Aconite (Aconitum napellus), Belladonna (Atropa Belladonna), in addition St. John's Wort (Hypericum perforatum) is effective for damage to sensitive nerve endings (strong and fast-acting agents are used in first aid);
• For prolonged, excruciating dull pain, treatment is prescribed with drugs that strengthen the immune system - Echinacea purpurea and Echinacea angustifolia;
• lumbago, neuralgia, abscesses – Magic nut (Hamamelis virginiana), Chamomile (Chamomilla recutita);
• post-traumatic edema, sprains, injuries, especially in the lower back, Daisy (Bellis perennis) is prescribed;
• fresh and old fractures, bruises, poor bone healing, damage to synovial bags, tendons, bone tissue, its fragility, stabbing and pain, sensitivity of the affected areas, use Comfrey or Comfrey (Symphytum officinale);
• For rheumatic pains and swelling, painfully sensitive spine, Hepar sulfuris is used, and Hahnemann's Mercury (Mercurius solubilis Hahnemanni) has an anti-inflammatory effect when applied locally, in addition, it is a well-known left-sided remedy.

The remaining ingredients Yarrow (Achillea millefolium) and Calendula (Calendula officinalis) are able to cope with bruises, suppurations and, if necessary, restore the damaged skin surface.

All forms of Traumeel are indicated for the treatment of musculoskeletal pathologies - they effectively relieve pain, reduce inflammation and stop non-specific infections. If necessary, at the beginning of treatment, internal use of the drug can be combined with the application of local forms to the foci of pain.

In acute conditions, injections are given once a day, then they switch to using it once or twice a week or taking tablets.

The ointment can be used to treat lesions in the acute period up to five times a day, then switch to two or three times a day.

The dosage and duration of use should be prescribed by a doctor familiar with the action of the complex homeopathic preparation.

The homeopathic complex preparation Ziel T copes well with degenerative-dystrophic processes in the spine (osteoarthrosis, osteochondrosis, lumbago, inflammatory processes in joints and ligaments, metabolic disorders in bone tissue, post-traumatic disorders). In addition to the analgesic effect and the elimination of inflammation, it stimulates the formation of chondrocytes by activating proliferative processes, thereby promoting the restoration of cartilage and bone tissue. Homeopathic Sulfur (Sulphur) restores the structural components of cartilage, sius-organ active components (Placenta suis, Cartilago suis, Embrio suis, Funiculus umbilicalis suis) inhibit degenerative processes in bone and cartilage tissue, improve their nutrition and blood circulation. Patients experience a slowdown in destruction and even some restoration of vertebral structures. Joints become more elastic and mobile, pain goes away.

Biological catalysts of oxidation-reduction reactions in the body - Acidum alpha-liponicum, Natrium diethyloxalaceticum, Acidum silicicum colloidal, Nadidum restore cellular respiration, disrupted as a result of various negative processes (age-related changes, intake of hormonal or antibacterial agents).

Ingredients of plant origin Comfrey (Symphytum officinale); Arnica (Arnica montana); Poison sumac (Rhus toxicodendron); Bloodroot (Sanguinaria canadensis); Dulcamara (Solanum dulcamara) complement the action of bioactive substances, promote tissue regeneration, pain relief, relief of inflammation, swelling, and stiffness of the paravertebral muscles.

The forms of release are also varied: ointment, sublingual tablets and injection solution. Local forms can be combined with parenteral or oral. The drug should be dosed by a doctor, it is used both independently and in combination with Traumeel, as well as tissue respiration stimulants Coenzyme and Ubiquinone compositum.

Surgical treatment

Chronic back pain, that is, pain observed for three months or more, which does not respond to medication and negatively affects the patient’s quality of life, can be treated surgically.

Surgeries are indicated in cases of progressive spinal disease, when it is accompanied by constant pain and neurological symptoms.

Quite common is the operation to eliminate intervertebral disc herniation, patients with spinal stenosis are treated for the causes of nerve fiber compression, tumors and compression fractures are operated. An indication for surgical intervention is neurogenic intermittent claudication in spondylolisthesis.

Depending on the damage, various surgeries are performed. For example, restoration of part of the disc using bone cement (vertebroplasty), removal of the vertebral arches to release a pinched nerve root or parts of the intervertebral disc that have shifted outward, removal of bone growths on the vertebrae (osteophytes) to eliminate compression of the nerves or spinal cord. Minimally invasive technologies are used whenever possible.

In case of irreversible damage to the vertebral discs, endoprosthetics is performed; in complex cases, when several diseases associated with degenerative processes in the spine are combined, it becomes necessary to implant a special structure that allows for the expansion of the intervertebral space and the maintenance of the natural position of the spinal column.

Spine surgeries are performed to eliminate pain syndrome and return the patient to a normal range of motion. Modern medicine has a sufficient arsenal of tools to perform successful surgeries to restore the mechanics of the back and eliminate pain, although it is not without complications. When deciding on the need for surgery, it is advisable to consult with several vertebrologists.