Treatment of spinal lumbalgia: standards, medications, LFK, exercises

Lumbago requires a comprehensive approach. Treatment is aimed at relieving pain, on the one hand. On the other hand, treatment should be aimed at eliminating the pathology, as well as normalizing the level of mobility of the affected area. It is also important to completely eliminate the causes of the pathology (etiological treatment). In this case, measures aimed at eliminating the pinching of the sciatic nerve are most often used. It is also necessary to normalize the nutrition of the surrounding tissues, increase the sensitivity of the limb, the affected area. Both symptomatic and supportive therapy are important during the period of exacerbation and during the period of remission. An active lifestyle, regular physical education and sports are important.

In case of severe pain, symptomatic therapy may be required, which is primarily based on pain relief. Various painkillers are used. Muscle relaxants may be required if a high degree of muscle tension is observed. Hormonal therapy is sometimes used.

Standards of treatment of lumbago

In the acute period of lumbago, anti-inflammatory, pain-relieving, decongestant drugs, and muscle relaxants are mainly used. During the remission period, in addition to drug treatment, physiotherapy and reflexology are indicated. Proper physical activity, therapeutic exercise, active and passive gymnastics are important. Proper nutrition and maintaining an optimal daily routine are important. Massage, manual therapy sessions, hirudotherapy, folk and homeopathic remedies are recommended. Drug therapy is based on antioxidants, vitamins, and symptomatic agents. Drugs aimed at normalizing microcirculation and metabolic drugs may also be required. If there is a risk of infection, antibiotics or antiviral agents are used accordingly.

Medicines

Various means are used, depending on the cause of the pathology. First of all, it is important to take precautions and not take any means unless the cause of the pathology has been previously determined. It is important to first undergo a comprehensive diagnosis, then select a treatment regimen, taking into account all the factors of the pathology, and only then begin treatment. It is important to follow the regimen prescribed by the doctor, otherwise a number of complications and side effects may develop, the situation will only worsen. If the treatment regimen is not followed, there is a risk of the disease transitioning from an acute form to a chronic one, which significantly complicates the situation in the future. It is recommended to take the following medications:

Analgin - one tablet is prescribed 2-3 times a day. The course of treatment is from 3 to 7 days, depending on the severity of the pathology, the degree of severity of the pain syndrome. It should be taken with caution by patients with a tendency to bleeding, since analgin greatly thins the blood.

No-shpa is used to relieve spasms, eliminate muscle clamps, and pain. Take 1-2 tablets (25-50 mg) 3-4 times a day, depending on the severity of symptoms and pain. The duration of treatment ranges from 7 days to 2-3 months. In this case, you must strictly follow the regimen prescribed by the doctor.

In case of severe pain, diclofenac is prescribed. This is a potent painkiller, the essence of which is to block pain receptors. It is mainly used in the form of injections (the dosage is determined strictly individually, depending on the severity of the pain, its severity and duration). It is prescribed if analgin and no-shpa do not have the desired effect.

In case of severe inflammation, anti-inflammatory, non-steroidal drugs of combined action are prescribed. These are drugs of combined action, aimed at relieving the inflammatory process and pain relief. Such drugs include, first of all, tempalgin, pentalgin. Baralgin, sedalgin. These are non-narcotic drugs. They are usually prescribed one or two tablets per day.

More complex drugs, which are used in severe cases, with severe, persistent pain and when other means are ineffective, are narcotic painkillers, which are prescribed strictly by prescription and under his supervision. You cannot take such drugs on your own, and it is impossible to get them, since they are sold strictly by prescription. Such drugs include tramadol, tramal, tramoline.

Painkillers

There are quite a few painkillers that can be used for severe pain. These can be both oral medications and local anesthetics. Some of them are used in the form of tablets, others - in the form of injections. It is worth noting that various drugs can be used in the form of tablets, mainly in cases of severe pain. In acute and chronic forms, it is recommended to use drugs in the form of injections, since they are more effective. This is due to the fact that in the form of injections, the active substance penetrates the blood much faster, and then into the desired tissues, thereby providing a therapeutic effect much faster and more effectively. It is also worth noting that the dosage for injections is required much lower.

Due to the fact that the substance enters the bloodstream directly, bypassing the digestive tract, if you take medications in tablet form, they first enter the digestive tract, where they are neutralized by enzymes and hydrochloric acid, and are lost during absorption through the walls of the stomach and intestines.

The most effective painkillers are analgin, no-shpa, diclofenac, voltaren, orthofen, flotak, indomethacin, and others. Stronger painkillers are xefocam, ketolorac, ketoprofen. Quite strong drugs are also used, including narcotic drugs (strictly on prescription). Such drugs include tramadol, tramxidol, tramoline, and others.

Ointments

You can use such ointments as Vishnevsky ointment, finalgon, menovazin, hondroxin, travmatin, travmalgon, and many others. The most effective ointments are those that have a warming effect on the body. This is due to the fact that by warming, they promote the resorption of seals, hematomas, and also promote the rapid removal of the inflammatory process. They also have an analgesic effect.

After the ointment has been applied, it is recommended to cover the area where the ointment has been applied with dry heat. It is recommended to apply to clean, dry skin up to 5 times a day.

Menovazin spray

It has an analgesic and anti-inflammatory effect. It is used as a regular spray, which is sprayed on the surface of the body in the place where the pain syndrome is most pronounced. After application, wait until the spray is absorbed, after which you can apply dry heat to the surface. This spray is especially convenient for use in the summer. It is used in cases of increased pain, as well as during severe attacks as needed. Another feature of this spray is that it can effectively replace a similar ointment. It is more convenient to use, does not require rubbing and special preparation of the body. It is recommended to use up to 5 times a day. The duration of therapy can vary from 5 to 60 days. Follow the doctor's recommendations.

Injections for lumbago

Injections of drugs are almost always considered more effective, since the active substance penetrates directly into the inflammation site, it reaches the target faster, and a lower concentration is required. The substance penetrates directly into the blood, and is carried throughout the body with the blood, penetrating directly into the inflammation site.

Unlike tablet medications, which first enter the stomach, tablets undergo transformations in the stomach, whereas with injections, the active substance penetrates directly to the site of inflammation, providing a more powerful therapeutic effect in a relatively short time.

Vitamins

When developing lumbago and sciatica, it is necessary to take vitamins, since most of these diseases are directly or indirectly associated with a violation of vitamin metabolism and their deficiency in the body. Pain and damage to nerves, tissues, active maintenance of the inflammatory process, are associated primarily with a deficiency of vitamins A, E, PP. Therefore, it is recommended to take vitamins in the following daily concentrations:

• Vitamin PP – 60 mg
• Vitamin A – 240 mg
• Vitamin E – 45 mg
• Vitamin C – 1000 mg.

Physiotherapy treatment

Various methods of physiotherapeutic treatment are used. They are especially effective in complex treatment. The main methods of physiotherapeutic treatment are ultrasound, microcurrents, and waves of various lengths.

These procedures work well if they are alternated with massage and manual therapy sessions. The main goal of these procedures should be pain relief, ensuring complete relaxation of tense areas of the body, toning atonic, relaxed areas. It is worth noting that an important role is given to segmental-reflex massage, reflexology itself, vertebral impact (massage of the vertebrae and intervertebral discs). Such procedures allow not only to improve the condition, but also to normalize metabolic processes in the affected area, reduce pain. If such procedures are carried out regularly, it is even possible to completely cure the disease, or at least achieve a stable state of remission.

Electrophoresis is used, with the help of which medicinal preparations are introduced directly into the damaged tissue. The depth of their penetration is regulated by microcurrent. Cryoprocedures and thermal procedures are indicated. Sometimes electrical procedures are used.

Acupuncture, also known as acupuncture, is a fairly effective method. It significantly improves microcirculation, normalizes metabolic processes in tissues, improves nutrition of the affected area, provides nutrition to the spinal cord roots, tissues of the affected limb, and supports the nerve.

Therapeutic exercise is also used. Active and passive gymnastics, with the help of which the desired state of muscles is achieved, mobility, nutrition are provided, and metabolic processes in the surrounding tissues are normalized. This is especially important for ensuring normal nutrition and blood supply to the sacrum and coccyx, since separate vessels do not approach this area, and nutrition depends on blood circulation.

Apitherapy is also one of the effective means of treating lumbago and sciatica. The essence of this procedure is bee stings and providing a therapeutic effect through enzymes that they release into the blood when biting. Leech therapy (hirudotherapy) is carried out in a similar way. This method is especially effective in treating hematomas and stopping swelling of soft tissues. This often allows the nerve to be released from the clamp, as a result of which it returns to normal functioning.

Exercise therapy for lumbago

Physiotherapy is one of the methods without which no therapy will be effective. Exercises are selected individually, depending on the expressed pathologies and the degree of damage to the vertebrae. In combination with other methods, it has a powerful restorative effect. It is recommended to do exercises at least twice a day. Small approaches are required, 15-20 minutes, but several times a day. In the morning, it is important to stretch the muscles, work out all the affected areas. Morning exercises are performed before meals, after water procedures. During the day, you can increase the duration of classes to 30-40 minutes, in the evening - the duration of the procedure is also 15-20 minutes. The dosage of the load should be moderate: you should feel slight fatigue, but not excessive fatigue.

When doing physical exercises, it is important to work out all muscle groups. During contraction and relaxation of muscles, active work is performed in them, and tissue contractility, nerve impulse conductivity, and tissue sensitivity increase. Accordingly, the activity of the cerebral cortex improves.

Morning exercises also help to activate the body, to bring it out of sleep, to activate it. Muscle activity improves blood circulation, tissue trophism, improves not only the penetration of nutrients to tissues, but also ensures the removal of metabolic products. The blood flow rate increases, breathing becomes rhythmic and calm. All this helps to restore the body. It is important to ensure a comprehensive effect on the body.

First of all, exercise set No. 1 is important – working out the arms and upper shoulder girdle. This set of exercises includes exercises aimed at working out the hands, elbow joints, shoulder, as well as the collarbone and shoulder blade area. These can be raising and lowering the arms, turning, spreading and bringing them together.

Complex #2 is aimed at working out the chest and torso. This can be bringing the arms together and spreading them, which ensures working out the chest and intercostal space. Also used are turns, torso bends, and rotating movements,

Complex #3 should be aimed at the pelvic area and legs. This includes squats, adduction and abduction of the legs, bends.

Complex No. 4 ensures general maintenance of balance, harmonization of the body. This includes exercises such as torso bends, bending arms in a support position, abduction of legs to the side, jumping, running.

On average, exercises should be repeated 8-10 times. You need to periodically change exercises, include exercises to work out different parts of the body, carefully work out the affected areas, using both active and passive methods. It is also necessary to gradually increase the load. You can’t do this abruptly, but approximately once every 2-3 days, the load should be made several times higher. Also, the procedure for performing the exercise itself should gradually become more complicated. You need to follow the sequence of exercises. It is better to follow the daily routine: do exercises at the same time. It is also important to observe the hygiene of performing physical exercises - do them in a comfortable environment, in the fresh air, having previously tuned in to work, relaxed. It is important to establish correct breathing - this is the key to effective training. It is also important to train regularly. It is necessary to take into account that single training does not give an effect.

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Exercises

We begin the lesson with a warm-up. First, we walk at a normal, slow pace. After that, the step gradually accelerates. Then there is an alternation of fast and slow steps. After that, we walk on our toes, on our heels, on the inner and outer lateral surfaces of the foot. Then we walk with a roll from our heels to our toes. Then we take steps in a circle, spinning around our own axis. This is where the basic warm-up ends.

We move on to warming up the upper shoulder girdle and arms. We take the starting position - hands on the sides. We rise on our toes, as high as possible, we try to raise our hands up, as if to reach the sky with our fingertips. Then we sharply drop everything down, bend over, lower our hands to the floor. We exhale sharply. Then, on an inhale, we rise up, take the starting position.

We hold our hands at our sides, and turn our necks: first 10 times in one direction, then 10 times in the other direction. We try to stretch the front, side surface of the neck as much as possible, stretch it. Then we start making semicircles, then a full circle. After that, we lower our head to one shoulder, then to the other. We repeat 10 times.

Let's move on to working out the arms themselves. We warm up the shoulders - we do 10 rotations in the shoulder (in a circle), then we place the hands on the shoulders, we do circular movements to the left, to the right - 10 times. After that we raise our arms together with the shoulders, sharply lower them down. Then we do a back rotation (10 times), then a back rotation (10 times).

We move on to working out the elbow joint. We make rotational movements in the elbow first in one direction, then in the other. After fully working out the elbow, we move on to working out the hands. We bring the hands forward, make circular rotational movements in the hands in one direction, then in the other.

After the arms and shoulder girdle are fully worked out, we move on to working the chest. We make circular movements with the chest in different directions. Then we move the shoulders back, push the sternum forward. After that, we move the chest back, then to the sides. After that, we move our hands back, connect them behind the back and bend forward. After that, we round the back, then straighten it, bring the shoulder blades together from behind.

After fully working out the sternum, we move on to working out the lumbar region. We bend forward. We try to touch the floor with our palms. Then we bend backwards, then side bends. After that, we make circular rotational movements in one direction, then in the other. We stretch upward as much as possible, then lower ourselves down as we exhale. We repeat 10 times.

Then we move on to working the pelvic area. We make circular movements in one direction, then in the other. We bring the pelvis forward as much as possible, then move it back as much as possible. Then we make pendulum-like movements from left to right, and in the opposite direction.

To work the lower limb girdle and the lower limbs themselves, we move on to circular movements in the hip joint area. Raise the leg, begin to perform rotational movements. Then bend the leg at the knee, rotate in a circle in both directions. After that, stretch the leg forward, make circular movements in one direction, then in the other.

After this, it is advisable to finish the training with breathing exercises. Sit down on the floor, bend your knees, take a comfortable position. Close your eyes, then inhale - lift your stomach, then your chest, then your collarbone. Try to fill the cavities with air as much as possible. Then exhale: first lower the collarbone area, then lower the sternum area, after that - deflate the stomach, as if pressing it to the spine. It is recommended to do the breathing for at least 5 minutes.

The workout should be completed with a relaxation exercise. Lie down on the floor, close your eyes (on your back). After that, try to relax every muscle, every cell of your body as much as possible. Drive thoughts away: they should not be in your head. Try to distance yourself from all problems, from the outside world. Try to feel yourself here and now. You can imagine that you are on the seashore, where the sun is gently warming, the surf is caressing us, and we are smoothly moving into bliss under the light touch of a warm summer breeze. You can turn on pleasant music (classical music, sounds of nature, the sound of the surf, etc.).

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Gymnastics for lumbago

A gymnastic complex with elements of hatha yoga has proven itself quite well, allowing you to quickly and effectively work out all parts of the spine.

Starting position: lying on your back. After that, spread your arms to the sides, raise your palms up. Your legs should be shoulder-width apart. Press your shoulder blades and shoulders to the floor as much as possible, place your feet one on top of the other. Inhale, turn your head to one side, exhale, try to press it to the floor as much as possible. Exhale, lower and return to the starting position, then turn your head to the other side, press your ear to the floor.

Then we lift our legs, place them one on top of the other (toes on the feet), after which we try to turn our head in a similar way, first to the left, then to the right, while lowering our head to our ear.

Then we lie on our backs, bend our knees. Hands apart, on the floor. We try to move our bent legs to the sides, touching the floor with our knees. We repeat about 10 times in one direction, 10 times in the other direction.

Raise your legs up, then slowly lower both legs first to one side, then to the other. Repeat 10 times, then do a similar exercise, only raise one leg up and leave the other down. Lower the raised leg to the opposite side. Do a similar exercise on the other side. Then bend both legs at the knees, lower them bent first to one side, then to the other. Then do a similar exercise for straight legs.

Then bend both legs at the knees, pull them to the chest, hide the head in the "legs". After that roll on your back, going out on the shoulder blades, then on the tailbone. The exercise is called "rocking". Repeat 10 times.

This gymnastic complex should be performed at least twice a day, especially in case of acute pain. It helps to strengthen the muscular frame of the back, paravertebral muscles, aligns the back, and also improves the nutrition of the ligaments, muscles, discs, and muscles that surround each vertebra. Provide flexibility, lightness, and mobility of the back. It is recommended to perform it for at least a month. It ends with a set of breathing exercises (dynamic and static breathing exercises). Then a relaxation practice is performed.

Massage for lumbago

The main objective is to improve muscle nutrition, normalize metabolic processes, and increase the mobility of the vertebrae and the spine itself.

The general plan of massage can be presented as a sequential impact on the paravertebral areas of the spine, as well as impact on various segments of the spine. If there is pain in the area of the limb and buttocks, the sore limb is massaged.

The massage technique consists of first massaging the area along the spine. Gradually, all areas are worked on, starting from the lumbar area and ending with the sacral-coccygeal area. Then we gradually move up - we work on the areas of the thoracic spine, the intercostal areas, then the cervical spine, the occipital part. First, a general stroking of the entire back is carried out, and only after that we move directly to working on individual areas of the spine. After stroking, we move on to more rigid squeezing, after that - to rubbing. We finish the massage with vibration movements, which allow you to relax as much as possible, and at the same time, give tone to the areas being worked on.

After working on the spine, we move on to working on the limbs and pelvic area: we shake the pelvis, lightly vibrate the limbs. After that, we massage according to the sequence described above: we start with light stroking, finish with intensive kneading of the muscles, then with vibration movements. To stimulate the main reflexes, we intensively squeeze and unclench the muscle areas, which tones the muscles, increases their sensitivity and reactivity. Usually, the muscles are worked in the longitudinal direction. Another important technique is patting and whipping, which normalizes the sensitivity of the receptors of the muscular system. The duration of the procedure is on average 20 minutes. It is better to do it at about the same time. Usually, the duration of treatment is a month, with sessions every other day.

Treatment of lumbago at home

At home, you can not only cure the disease, but also maintain a stable condition and prevent the development of exacerbations. Self-medication is prohibited in any case, but you must strictly follow all the doctor's recommendations. At home, you must do something to achieve recovery, since the treatment of lumbago does not only occur in the doctor's office. This is a complex of therapeutic measures, which includes both therapeutic measures performed in a clinic by professional medical staff: for example, injections, special massage, active-passive gymnastics, physiotherapy.

At home, treatment should be supplemented by taking medications according to the doctor's prescribed regimen. You can use folk and homeopathic remedies. It is important to master physical exercises, gymnastics. Rehabilitation and therapeutic exercise, and even self-massage. These are the means without which treatment and recovery are impossible.

In order to select a set of exercises to do at home, you need to consult a physical therapy doctor. He will make a diagnosis and select the exercises that will suit you. Only an individual selection of exercises, in accordance with the characteristics of your pathology, can be effective. Then it is recommended to perform these exercises several times under the supervision and control of a physical therapy instructor, who, if necessary, can correct you, adjust the correctness of the performance, determine the optimal strength and intensity of the load in your individual case. After this, you can move on to independently performing the exercises at home.

Before performing self-massage, you should also consult a massage therapist or a manual therapy doctor. He will advise you on which movements and techniques are best to perform in your individual case, teach you the basic techniques, and monitor the correctness of their implementation.

Folk remedies

• Recipe No. 1.

An ointment made from the well-known balm "Zvezdochka" and propolis extract is used for lubrication and rubbing in the area where the pain is most pronounced. This ointment can be used during massage instead of massage oil. The main effect is achieved due to the warming effect on the body. To prepare the ointment, take the contents of the jar of this balm. Add about 5 grams of propolis melted in a water bath or steam, mix thoroughly and allow to harden until a homogeneous mass is formed. Apply a thin layer for about 15-20 minutes to the affected areas, then cover with dry heat.

• Recipe No. 2.

For general strengthening of the body, a balm is used. It is prepared on the basis of alcohol. To prepare, take a tablespoon of hawthorn berries, about 50 grams of walnut partitions, 2 tablespoons of black currant, as well as 2-3 tablespoons of crushed lavender leaves, chamomile flowers and calendula. Drink 50 grams per day.

• Recipe No. 3.

To apply compresses to the affected areas, use an anti-inflammatory composition: 3-4 tablespoons of sage and plantain herbs are poured with a liter of boiling water, covered with a lid. Infuse until the decoction becomes warm. After that, use for compresses.

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Herbal treatment

It is best to use herbs in the form of decoctions and infusions internally, since they have a complex effect on the body, which allows you to quickly relieve inflammation, eliminate pain, and generally improve well-being and increase the body's resistance.

In the treatment of lumbago, neuralgia, myositis, radiculitis, herbs such as sage, chamomile, lavender, aloe, Kalanchoe, fireweed, arnica, and rose hips have proven themselves to be the best.

• Sage and chamomile have anti-inflammatory effects;
• lavender – antiseptic and soothing effect, relieves irritation and inflammation, relieves pain;
• aloe and kalanchoe have anti-inflammatory effects;
• calendula – relieves inflammation, restores damage;
• Ivan tea has a calming effect, relieves inflammation of nerves and muscle elements;
• arnica and rose hips fill the body with vitamins, have an antioxidant effect, and increase immunity.

It is recommended to use these herbs as decoctions for internal use, as well as under a compress on the affected area. The decoction is made at the rate of 2 tablespoons of the product per glass of boiling water.

Homeopathy

Taking homeopathy requires caution and strict adherence to safety precautions. There are two main precautions - carefully study the composition of these products, and before taking them, make sure that you do not have an allergy or individual intolerance to the products included in the composition. Otherwise, side effects such as an allergic reaction may occur (ranging from simple swelling, irritation, and ending with anaphylactic shock and severe progressive Quincke's edema).

The second precaution is to always consult a doctor, since only a doctor can know all the nuances and features of the interaction of medicinal components with each other, and will be able to build a treatment regimen that will provide maximum therapeutic effect with minimal risk and minimal side effects.

• Recipe #1. Strengthening balm

To prepare, take a tablespoon of raspberries, arnica leaves, birch buds or catkins, pour in about 500 ml of vodka or pure alcohol, then add half a teaspoon of dried juniper, ground cinnamon and ginger. Leave it all for at least 3-4 days, drink 50 ml per day. The course of treatment is at least 28 days (full biochemical cycle).

• Recipe #2. Restorative balm

Take equal parts of nettle leaves, stevia and cherry pits (without pulp). Take about 2-3 tablespoons of each component, add about 20 grams of dried cloves, pour 500 ml of alcohol, leave for at least 5 days, drink in small quantities twice a day, 28 days.

• Recipe #3. Anti-inflammatory ointment

This ointment can be prepared at home by yourself. It can be applied in a thin layer to the affected areas. To prepare it, take butter as a base and melt it in a water bath. Then add about a tablespoon of the following oils: sea buckthorn oil, cloudberry oil, cranberry oil, cedar oil and Siberian flax oil. Mix until a uniform consistency is formed, then set aside and allow to harden.

• Recipe #4. Moisturizing cream

Apply to affected areas. Apply with light massaging movements until completely absorbed. Can be used after a shower, after a massage, before bed. Add a few drops of juniper, mint and fir essential oil to regular baby cream or any other body cream. Then add 5-10 drops of spruce and burdock base oil.

Surgical treatment

Lumbago can also be treated with surgical methods. But this is an extreme case, which is resorted to if other methods are ineffective. Surgical methods are used if the cause of nerve compression is, for example, a tumor, a large hematoma that should be removed. Another reason for which surgery may be required is a herniated disc or damage to the intervertebral discs. The operation is planned. For which the person is prepared in advance. It is carried out after the pain is completely relieved. During the operation, it is necessary to attempt to eliminate the cause of the pathology. Also, an indication for surgery is a disorder of the genitourinary system, a disorder of defecation, or urination that has arisen as a result of lumbago.