Lumbalgia syndrome: what is it?

Lumbago is a collective term for pain and inflammation in the lumbar region. The inflammatory process affects the intervertebral discs, the spinal column itself, and the area around the spinal column. The inflammatory process also involves nearby tissues and muscle fibers.

Is lumbodynia dangerous?

With proper treatment, the changes that occur with lumbago are fairly easy to treat and do not pose a serious danger, leaving no traces behind. However, if left untreated or with improperly selected treatment, lumbago can be dangerous due to its constant and intense progression, in which more and more tissues are involved in the inflammatory process. It is also worth noting that the disease progresses very quickly.

Its danger also lies in the fact that there is a serious risk of involvement of the cerebrospinal fluid in the inflammatory-infectious process, which can end in its infection and the spread of infection throughout the spinal canal, including the brain area. This can end in an inflammatory-infectious process in the brain area. A frequent consequence of lumbago is myelitis (inflammation of the meninges), stroke (bleeding into the brain).

A generalized inflammatory and rheumatic process may also occur, which is accompanied by damage to the connective and muscle tissue. In this case, the heart muscle is often involved in the rheumatic process, which is fraught with heart defects, the development of severe damage to the heart muscle, up to heart defects and heart failure.

Epidemiology

According to statistics, lumbago occurs in every 10th person in a severe, quite pronounced form. Most often, it appears in winter, since during this period the body is maximally weakened, and there are also cases of frequent hypothermia. This entails pain in the lumbar region. In first place in terms of the frequency of lumbago are patients who lead a sedentary, inactive lifestyle, as well as those who have a history of diseases of the musculoskeletal system. In second place, as strange as it may seem, are athletes, who, on the contrary, experience excessive stress on the bone and muscle system, feel overloaded and overtrained, as well as frequent injuries and damage. In third place are elderly people, especially those who suffer from acute and chronic arthritis, osteochondrosis, radiculitis. Fourth place is occupied by people who have suffered infectious diseases, undergo chemotherapy, radiation. In fifth place are children under one year of age and newborns with genetic abnormalities in the motor system.

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Causes lumbalgia

There may be many reasons, and in almost every case they are strictly individual. For example, lumbago may be a consequence of frequent stress, nervous and mental overstrain, as well as a consequence of the development of allergic, infectious, infectious-allergic diseases. Often, pain in the lumbar region develops against the background of general hypothermia of the body, the development of inflammation of muscles and tissues with the involvement of other tissues in the inflammatory process.

Often the disease is chronic, at a certain point manifesting itself in the form of acute attacks of pain syndrome. At the same time, it is often a concomitant factor against the background of inflammatory diseases of the upper and lower respiratory tract, nervous diseases and heart failure. It often manifests itself during pregnancy and breastfeeding. Other tissues and organs can also be involved in the inflammatory process.

Often, pain in the lumbar region is caused by heavy work (physical), improperly distributed load, excessive overload of the lumbar region. Often the cause is a bacterial or viral infection that accompanies the inflammatory process. An important role in maintaining inflammation is played by cytomegalovirus infection, herpes, from bacterial infections - streptococcal. Less often - staphylococcal infection. Often, lumbago is caused by a recently suffered infectious disease, including tonsillitis.

Sometimes congenital, genetically determined lumbago develops, which develops during the period of intrauterine development, and is subsequently a consequence of various diseases of the musculoskeletal system, its underdevelopment, increased physical activity. The cause can even be intrauterine and postnatal infection of the fetus, with further progression of the infection along the spinal column, the body.

Osteochondrosis

It is an inflammatory disease of the cervical spine, in which not only the vertebrae themselves, but also the intervertebral region are involved in the inflammatory process. Another feature of this disease is that it involves intensive deposition of moles in the intervertebral discs, which causes pain and stiffness. It occurs mainly against the background of a sedentary lifestyle, with improper gait, improper sitting, and prolonged stay in one position.

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Lumbago against the background of dorsopathy

It is a pain syndrome of inflammatory genesis, the main etiological factor of which is considered to be insufficient mobility, violation of hygiene and daily routine, which entails an inflammatory and infectious process. Bone and muscle structures, including vertebrae and intervertebral discs, are involved in this process. The danger is that nerve fibers can also be involved in the inflammatory process, which contributes to increased pain, which spreads intensively along the nerve fiber. The process can manifest itself in severe attacks of pain, which alternate with a feeling of burning and heat in the affected area.

Post-traumatic lumbago

As the name suggests, this is lumbago that develops in response to trauma. That is, it is a severe pain syndrome in the lumbar region that develops after a trauma affecting the lumbar region. Any factor of high intensity and force can be traumatic. This can be a mechanical factor of a damaging nature (a fall, a strong push, pressure, mechanical friction). Often, such pain occurs as a result of rapid violence against the lumbar region of the spine.

According to statistics, this is most often a consequence of a fall, a blow, damage by a vehicle. It can occur from bending of the bone and spine with exceeding the limit of its elasticity, with strong compression and rupture, twisting and crushing. A special place is occupied by lumbago, caused by the traumatic effect of the disease process of the bone, in particular, caused by congenital fragility, purulent inflammation, rickets, syphilis, tuberculosis.

Risk factors

The risk group includes people who often suffer from colds and infectious processes, as well as those who take antibiotics and chemotherapy. A special group consists of people who are often exposed to traumatic effects, subject the lower back to heavy physical loads. People with dysbacteriosis, as well as with the presence of foci of infection (bacterial, viral), also have a significant risk of getting lumbago. The risk also increases in the presence of acute or chronic diseases of the musculoskeletal system, including osteochondrosis, arthritis, bursitis. The risk is also high in the presence of diseases of the nerves and nervous system.

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Pathogenesis

The pathogenesis is based on the development of pathological processes in the lumbar spine. This may result in a disruption of normal blood circulation, disruption of innervation, and disruption of metabolic processes in the lumbar region. There may also be deposition of salts and stones between the vertebrae, and the release of intervertebral matter into the space between two vertebrae. Gradually, the inflammatory process develops, the infection progresses, which entails the progression of the disease, its spread, and the formation of new foci of infection.

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Symptoms lumbalgia

The first signs of lumbago, which indicate the development of lumbago, are severe pain. It is usually accompanied by dysfunction (stiffness, pain when moving, and in severe injuries and damage - the inability to stand up, and other dysfunctions of the spine). Sometimes a hematoma and tissue swelling may appear.

Forms

There are several stages of development of lumbago. Basically, researchers and clinicians distinguish three stages.

At the first stage, there is a feeling of pressure, discomfort in the lumbar region. Moderate pain may appear when staying in one position for a long time, during prolonged sleep. It is usually quite difficult to straighten up in the morning, a sharp, piercing pain occurs when trying to get up, with sharp and careless movements.

At the second stage, the pain intensifies and becomes quite persistent. During the day, there may be a constant aching pain that subsides with moderate physical activity and intensifies with sudden movements and attempts to stand up. As a rule, at this stage, severe pain bothers in the morning, and in the evening and during the day it becomes less pronounced. Also at this stage, the pain sharply radiates to the buttocks, thighs, and even shins.

At the third stage, the pain affects mainly the entire lower back, as well as the sacrum and coccyx area, and rather sharply and strongly radiates to the pelvic area, lower limbs, and even to the ribs and intercostal space.

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Acute lumbago

The acute phase implies the presence of an inflammatory process in the lumbar region, the coccyx. Nerves are involved and mechanically damaged in the inflammatory process. The pain is usually sharp, acute, more pronounced during the day, and also after a person has been in one position for a long time. Acute pain is practically not eliminated by physical exercise, but requires special treatment, such as injections, the use of local remedies. Most often, ointments, gels, creams and other medications are used.

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Subacute lumbago

The subacute form of the disease is characterized by a relatively mild course, in which pain bothers a person only under appropriate conditions. For example, if a person has been sitting or lying for a long time without moving, he will experience pain. The pain is less piercing, rather aching, pulling, which easily spreads to neighboring areas. It passes quite quickly under the influence of physical exercises aimed at the lumbar region.

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Chronic lumbago

Pain that spreads to adjacent areas causes severe tingling and burning. As a rule, exacerbation occurs under the influence of various factors that trigger the development of the disease. For example, this can be severe hypothermia, excessive nervous and mental stress, heavy physical exertion, and even improper distribution of the load with its predominant localization in the lumbar region.

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Moderate lumbago

An indicator of moderation is controlled pain, which can be easily relieved with the help of various medications, as well as with the help of proper physical activity. There is a special set of exercises aimed at unloading the lower back. It is the regular performance of physical exercises that is the key to control over the condition of the lower back and allows you to eliminate any pain in a relatively short time.

Complications and consequences

First of all, the main adverse effect is pain, which is quite intense and bothers a person for quite a long period of time. It is also worth noting that there is another unpleasant consequence - irradiation of pain, inflammation or mechanical damage to the nerve. Gradually, aseptic inflammation can spread around the affected area, but sometimes a normal inflammatory process can develop, accompanied by infection.

It is also worth worrying about the possibility of degenerative processes, which are accompanied by conduction disorders, inflammation of the nerves, and inflammation of the myelin sheaths.

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Exacerbation

It occurs mainly in spring and autumn, since it is during this period that most inflammations occur. This is due to the fact that this period is accompanied by the maximum weakening of the body, defense mechanisms, and resistance.

It occurs under the influence of various unfavorable factors on the body: excessive stress, overexertion, increased load on the body. Quite often, an exacerbation occurs in the summer, when a person performs various physical activities, swims in a river, bathes, sunbathes on cold ground, freezes, there is a sharp change in temperature - after sunbathing, a person plunges into cold water in a river. Failure to follow the daily routine, poor nutrition, abuse of non-dietary food, alcohol - all this can be the factors that trigger an exacerbation.

It should also be noted that exacerbations are also quite common in winter, especially in severe frost (due to hypothermia, drafts, colds, piercing wind). Exacerbations also often occur due to stress, nervous and mental strain.

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Remission

Characterized by a state of relative calm, improvement of the condition. Almost always occurs with any chronic pathologies. Quite a long remission can occur after an acute attack of lumbago has been cured. Treatment with special medications, as well as after injections of painkillers, usually results in a state of remission.

If this condition is not maintained with special supportive therapy, preventive medications and physiotherapy procedures, remission can quickly develop into a new exacerbation. But if such a regime is maintained, remission can last for quite a long time - from several months to several years. There are known cases when after the onset of remission, there were no more exacerbations, and the person lives for decades without new attacks, although due to various circumstances, the diagnosis was not finally removed.

Persistent lumbago

This condition can also be quite long-lasting. The pain is usually not relieved by any medications or ointments. But in order for persistent lumbago not to become chronic, mandatory treatment is required. In most cases, mandatory hospitalization is required, since inpatient treatment is ineffective.

Recurrent lumbago

There are often cases when lumbago is completely cured, and after a few weeks it returns again. Such a return of the disease after an improvement in the condition is called a relapse. In this case, in a repeated case, treatment is also required. If possible, it is necessary to carry out complex treatment, perhaps even hospitalization will be required (since this is the most effective, complex form of treatment). It is worth noting that the treatment of a relapse must be approached with all seriousness, since if not cured immediately, the disease can become chronic.

Diagnostics lumbalgia

As soon as you feel acute pain, contact a neurologist or surgeon. A neurologist will conduct an examination, check the main reflexes. Also important is a consultation with a surgeon, who in most cases palpates the pathology, determines its cause and pathogenesis. If these specialists are not available, a traumatologist, or orthopedist, orthopedic surgeon can provide assistance.

First of all, quality diagnostics are important, which will help to make the correct diagnosis, choose the best treatment. Without a diagnosis, it is impossible to choose a treatment, and it is also impossible to cure a person. Therefore, it is ideal to visit a good diagnostician. But in our country, the practice of visiting diagnosticians is still not widespread enough. This scheme is practiced mainly in the USA and Europe: when a person goes to one person who conducts a comprehensive examination and makes a single diagnosis based on data from various tests, examinations, as well as an analysis of all the results obtained and available information.

In extreme cases, if the clinic does not have specialists in such areas, it is worth contacting a therapist, who will refer you to the necessary specialists. In such cases, a consultation with a surgeon and a neurologist is almost always prescribed.

Usually the diagnosis is made based on the results of the examination: severe pain. A decrease in the main reflexes is noted. First of all, it is possible to diagnose a violation of the knee reflex, a violation of the normal functioning of the Achilles tendon, and the absence of the corresponding reflexes. Lasegue's symptoms are observed.

Instrumental diagnostics

It is impossible to do without the use of instrumental research methods. The main methods are such methods as X-ray examination, as well as computer and magnetic resonance imaging. These are methods that allow you to determine the cause of the exact localization of the pathology as accurately as possible and in a relatively short time.

The main goals of such a study are to determine at what level (section of the spine) the pinching occurred. An X-ray examination is performed. CT and MRI are used in relation to the affected area.

Sometimes electroneuromyography may be required - it is not so much the causes that are determined, but the impairment of the contractile ability of muscles. It records how and at what speed/intensity nerve impulses pass.

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Tests

Laboratory methods are ineffective and are rarely used in diagnosing lumbago. At least, standard methods such as clinical and biochemical blood tests will not show an accurate picture of the pathology. But sometimes these research methods may be required. For example, if an X-ray or tomography shows pinching and compression of a nerve, tests can determine what exactly caused the compression. For example, a biochemical blood test can be used to identify a tumor and determine its location. A routine clinical blood test is often used to determine the presence of an inflammatory process. Also, with the help of these tests, it is possible to determine what type of inflammation is taking place - septic or aseptic.

If there is a suspicion of a septic inflammatory process, the development of an infectious process, if there is a suspicion of degenerative processes, a study of the cerebrospinal fluid takes place. A puncture is taken, after which further microbiological examination and microscopy are performed. Bacteriological culture is performed for the purpose of further identification of the inflammatory process and the presence of infection.

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Differential diagnosis

Differential diagnostics is based on the need to differentiate various types of pathology that have similar features from lumbago itself. Instrumental research methods are mainly used for differentiation.

Thoracalgia

This diagnosis implies a pinched nerve in the thoracic spine. The leading symptom is pain. Most often, thoracalgia is also accompanied by neuralgia in the intercostal areas.

Cervicalgia

A similar lesion of the cervical spine (the cervical nerve is damaged), and nearby areas are also involved. Mandatory treatment is required, since damage to the cervical spine can lead to increased blood pressure, the development of persistent hypertension. The development of cervical osteochondrosis can also be observed. Moreover, cervicalgia is accompanied by a violation of blood pressure, cerebral circulation, which can lead to hypoxic changes in the brain.

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Treatment lumbalgia

Treatment of lumbago is divided into therapy in the acute period, which is aimed at eliminating the acute inflammatory process, as well as maintenance therapy, which is used during the period of remission and during the period of stabilization of the condition in chronic pathology. Sometimes maintenance therapy is used as a preventive one, preventing the development of lumbago and sciatica in the future.

Prevention

Prevention is based on avoiding hypothermia, drafts, regular exercise, an active lifestyle, observing hygiene rules when sitting at a table, when staying in one position for a long time. It is also important to eat right, include the necessary amount of vitamins and minerals in the diet.

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Forecast

If the cause is identified in a timely manner and the necessary treatment is carried out, the prognosis for lumbago will be favorable. It is necessary to follow the doctor's recommendations. The treatment will be long and complex. You need to be patient and strictly follow all the doctor's recommendations. If you delay diagnosis and treatment, the prognosis may be unpredictable, even leading to disability.

Sick leave

Everything depends on how you feel, the severity of the disease and the treatment. So, if the disease is mild and does not require specific treatment or hospitalization, a sick leave of 5-7 days may be given, since due to severe pain, the ability to work is still limited.

As for moderate and severe cases of the disease, more severe treatment and even hospitalization may be required. In this case, sick leave may be given for a period of 7 days to 2-3 months. In severe cases that require serious treatment, hospitalization, and further rehabilitation, sick leave may be required for up to 7 months. In the future, the doctor usually issues a recommendation to change the type of activity to a simpler job that does not require serious physical activity or without hypodynamia.

Do they take people with lumbago into the army?

It is impossible to give a clear answer, since the decision is made by the commission individually in each individual case. In this case, a set of accompanying factors, features of the course of the disease, the treatment, and the prognosis of the disease are analyzed. There are known cases in which lumbago was not an obstacle to military service. There are also cases in which a person was recognized as unfit for military service.