Treatment of lumbar spine: standards, medicine, exercise therapy, exercise
Lumbalia requires an integrated approach. Treatment is aimed at stopping pain on one side. On the other hand, treatment should be aimed at eliminating pathology, as well as normalizing the level of mobility of the affected area. It is also important to completely eliminate the causes of pathology (etiological treatment). In this case, most often used measures aimed at eliminating the pinch of the sciatic nerve. It is also necessary to normalize the nutrition of surrounding tissues, increase the sensitivity of the limb, the affected area. Important and symptomatic, and supportive therapy during the period of exacerbation, and during remission. It is important in this case an active way of life, regular physical training, sports.
With severe pain, symptomatic therapy, based primarily on pain relief, may be required. Various painkillers are used. Muscle relaxants may be required if a high degree of muscle tension is noted. Sometimes hormonal therapy is used.
Standards for the treatment of lumbulgia
In the acute period of lumbotherapy, mainly anti-inflammatory, anesthetics, anti-edema drugs, muscle relaxants are used. In the period of remission, except for medicamental treatment, physiotherapy, reflexotherapy is shown. The correct physical activity, physical exercise, active and passive gymnastics are important. It is important to eat properly, maintain the optimal regime of the day. It is recommended to carry out massage, manual therapy sessions, hirudotherapy, alternative and homeopathic remedies. At the heart of the drug therapy are antioxidants, vitamins, symptomatic drugs. Also, drugs aimed at normalizing microcirculation, metabolic drugs may be required. If there is a risk of infection, antibiotics, or antiviral agents, are used, respectively.
Various means are used, depending on the cause of the pathology. First and foremost, it is important to follow the precautionary measures, and not to take any funds, if the cause of the pathology development has not been previously determined. It is important to first go through a comprehensive diagnosis, then choose a treatment regimen, taking into account all the factors of pathology, and only after that start treatment. It is important to follow the scheme that the doctor prescribed, otherwise a number of complications and side effects may develop, the situation will only worsen. If the treatment regimen is not adhered to, there is a risk of a disease transition from acute to chronic, which significantly complicates the situation in the future. It is recommended to take the following medicines:
Analgin - appoint one tablet 2-3 times a day. The course of treatment is from 3 to 7 days, depending on the severity of the pathology, the severity of the pain syndrome. It should be taken with care to patients with a tendency to bleeding, since analgin is highly diluted blood.
But-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 varies from 7 days to 2-3 months. Thus it is necessary to strictly follow the scheme, which the doctor appointed.
With severe pain, diclofenac is prescribed. This is a potent analgesic, 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). Assign in the case if analgin and no-shpa do not have the proper effect.
With a strong inflammatory process, anti-inflammatory, non-steroidal preparations of combined action are prescribed. These drugs are combined action aimed at removing the inflammatory process and stopping pain. Among these drugs are, in the first place, tempalgin, pentalgin. Baralgin, Sedalgin. These are non-narcotic drugs. Usually they are prescribed one or two tablets per day.
More complex drugs that are used in severe cases, with severe, persistent pain and in the ineffectiveness of other drugs, are narcotic pain medications prescribed strictly by the doctor's prescription and under his supervision. It is impossible to take such funds independently, and it is impossible to get them, because they are sold strictly according to the doctor's prescription. Among such tools include tramadol, tramal, tramoline.
There is a rather large amount of anesthetics that can be used in cases of severe pain. It can be both preparations for oral administration, and local anesthetics. Some of them are used in the form of tablets, others - in the form of injections. It is worth noting that in the form of tablets, various drugs can be used, mainly with a pronounced pain syndrome. In acute and chronic forms it is recommended to use drugs in the form of injections, because they are so more effective. This is due to the fact that in the form of injections, the active substance penetrates much more rapidly into the blood, and then into the necessary tissues, thus rendering the therapeutic effect much faster and more efficiently. It is also worth noting that injection dosage is required much lower.
Due to the fact that the substance enters immediately into the blood, bypassing the digestive tract, if you take drugs in the form of tablets, they first get into the digestive tract, where they are neutralized by enzymes and hydrochloric acid, are lost when absorbed through the walls of the stomach and intestines.
The best analgesics such as analgin, but-spa, diclofenac, voltaren, orthophene, flotac, indomethacin, and others have proved to be the best ones. More powerful painkillers - ksefokam, ketolorak, ketoprofen. Also apply fairly strong drugs, including, and narcotic (purely by prescription of a doctor). Among these drugs include tramadol, tramxidol, tramoline, and others.
You can apply such ointments as Vishnevsky ointment, finalgon, menovazine, chondroxin, traumatins, traumalgon, and many others. The most effective ointments that have a warming effect on the body. This is due to the fact that by heating, they promote the resorption of seals, hematomas, and also contribute to the rapid removal of the inflammatory process. They also have an analgesic effect.
After the ointment is applied, it is recommended to cover the place of application of the ointment with dry heat. It is recommended to apply on clean, dry skin up to 5 times a day.
Has analgesic and anti-inflammatory effect. Used as a regular spray, which is sprayed on the body surface in the place where the maximum severity of pain is noted. After applying, wait until the spray is absorbed, after which it is possible to apply dry heat to the surface. This spray is especially suitable for use in the summer. Apply in cases of pain intensification, as well as with severe attacks as needed. Also feature of this spray is that it can effectively replace a similar ointment. It is more convenient to use, does not require grinding and special preparation of the body. It is recommended to apply up to 5 times a day. The duration of therapy can vary from 5 to 60 days. Follow the doctor's recommendations.
Injections with lumbula
Injections of medicines are almost always considered more effective, since the active substance penetrates directly into the inflammatory focus, it reaches the target faster, a lower concentration is required. The substance penetrates directly into the blood, and with blood spreads through the body, penetrating directly into the focus of inflammation.
Unlike tableted medicines, which fall first in the stomach. Tablets undergo in the stomach conversions, whereas when injected, the active substance penetrates directly into the site of inflammation, providing a more powerful therapeutic effect in a relatively short time.
With the development of lumbargia and sciatica, it is necessary to take vitamins, since most such 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.
Various methods of physiotherapy are used. They are especially effective in complex treatment. The main methods of physiotherapy are ultrasound, microcurrents, waves of different lengths.
These procedures work well, if they alternate with massage, manual therapy sessions. The main goal of these procedures should be relief of pain, ensuring complete relaxation of tense parts of the body, toning atonic, relaxed areas. It should be noted that an important role is given to segmental-reflex massage, actually reflexotherapy, vertebral action (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, to reduce pain. If you perform such procedures regularly, you can even completely cure the disease, or at least achieve a stable state of remission.
Electrophoresis is used, with which drugs are injected directly into the damaged tissue. The depth of their penetration is regulated by a microcurrent. Cryoprocedures, thermal procedures are shown. Sometimes electroprocedures are used.
A rather effective method is acupuncture, also known as acupuncture. It significantly improves microcirculation, normalizes metabolism in tissues, improves nutrition of the affected area, provides nutrition to the roots of the spinal cord, tissues of the affected limb, supports the nerve.
Means of physical therapy are also used. Active and passive gymnastics with which you reach the desired state of muscles, provide mobility, nutrition, normalize metabolic processes in surrounding tissues. This is especially important for the provision of normal nutrition and blood supply to the sacrum and the cecum, since individual vessels are not suitable for this area, and the food depends on the circulation of blood.
Apitherapy is also one of the most effective treatments for lumbargia and sciatica. The essence of this procedure is to bite the bees and provide therapeutic effects through the enzymes that they let in the blood when bitten. Similarly, treatment with leeches (hirudotherapy) is carried out. Especially this method is effective in the treatment of hematomas and cupping of soft tissue edema. This often allows to release the nerve from the clamp, as a result of which it returns to normal functioning.
Exercise therapy for lumbargia
Physiotherapy is one of the methods without which none of the therapies will be effective. The choice of exercises is carried out individually, depending on the pronounced pathologies and degree of lesion of the vertebrae. In combination with other methods has a powerful restoring effect. It is recommended to perform the exercises at least twice a day. We need approaches small, for 15-20 minutes, but several times a day. In the morning it is important to stretch the muscles, work through all the affected areas. Morning exercises are held before meals, after water procedures. In the afternoon, you can increase the duration of classes to 30-40 minutes, in the evening - the duration of the procedure is 15-20 minutes as well. Dosage of the load should be moderate: a slight fatigue should be felt, but not excessive fatigue.
Performing physical exercises, it is important to work out all muscle groups. During the contraction and relaxation of the muscles, active work is carried out in them, and tissue contractility, conduction of the nerve impulse, and tissue sensitivity increase. Accordingly, the activity of the cerebral cortex is improving.
Morning exercise also allows you to activate the body, bring it out of sleep, activate. Muscular activity improves blood circulation, trophic tissue, improves not only the penetration of nutrients to tissues, but also ensures the excretion of metabolic products. The speed of blood flow increases, becomes a rhythmic and calm breathing. All this contributes to the recovery of the body. It is important to ensure a comprehensive impact on the body.
First and foremost, the complex of exercises №1 is important - the study of the hands and upper shoulder girdle. This set of exercises includes exercises aimed at working out brushes, elbows, shoulder, as well as zones of collarbones, shoulder blades. These can be ups and downs of hands, turns, breeding-mixing.
Complex No. 2 is aimed at examining the chest and trunk. It can be information and the dilution of the hands, which provide the study of the chest, intercostal space. Also used rotations, torso torso, rotating movements,
Complex number 3 should be aimed at the pelvic area and legs. This includes squats, mixing - breeding legs, slopes.
The complex №4 provides the general maintenance of balance, harmonization of an organism. This includes such exercises as the torso of the trunk, the bending of the hands in the abutment, the removal of the legs to the side, jumping, running.
The average exercise should be repeated 8-10 times. You need to periodically change the exercises, include exercises to work out various parts of the body, carefully work on the affected areas, using both active and passive methods. It is also necessary to gradually increase the load. This can not be done abruptly, but approximately every 2-3 days, the load should be made several times higher. Also, the procedure for doing the exercise should gradually become more complicated. It is necessary to observe the sequence of exercises. It is better to observe the regime of the day: do exercises at the same time. It is also important to observe the hygiene of performing physical exercises - to do them in a comfortable environment, in the open air, pre-tuned and work, relaxed. It is important to build the right breathing - this is the key to effective training. It is also important to train regularly. It should be borne in mind that single trainings of the effect do not give.
We begin the lesson with a warm-up. To begin with, walking is done at a normal, slow pace. After that, the step is gradually accelerated. Then there is an alternation of fast and slow steps. After - walking on toes, on the heels, on the inner and outer lateral surface of the foot. Then we step with a roll from the heel to the fingers. Then we make steps in a circle, scrolling around our own axis. At this basic warm-up ends.
We pass to the warming up of the upper shoulder girdle and hands. We occupy the starting position - hands on the sides. We rise on fingers, as it is possible above, we try to lift hands upwards, as though to reach the sky with fingertips. Then we drop everything sharply, make a slope, put our hands on the floor. We make a sharp exhalation. Then on inhalation we rise upwards, we take the initial position.
Hold hands on the sides, make turns with your neck: first 10 times one way, then 10 times the other way. We try to maximally extend the front ,. Lateral surface of the neck, stretch. Then we start to make semicircles, then - a full circle. After that, we lower the head to one shoulder, then to the other. Repeat 10 times.
We pass to the study of the hands. Shrink the shoulders - do 10 turns in the shoulder (in a circle), then - put the brush to the shoulders, do circular motions to the left, to the right - 10 times. After that, raise your hands together with your shoulders, sharply lower down. Then - we do a spin back (10 times), then - turn back (10 times).
We now turn to the elbow joint. We perform rotational movements in the elbow first in one direction, then in the other. After a complete elbow work, we move on to developing the brushes. Hands bring forward, we make circular rotational movements in the hands in one direction, then - in the other.
After the arms and shoulder girdle are fully worked out, go to the thorax. We make circular movements of the chest in different directions. Then we take our shoulders back, we push the sternum forward. After that we lead the chest back, then - to the side. After that, we put our hands back, connect them behind our backs and make a slope forward. After - round the back, then level, we reduce the shoulder blades from behind.
After a full study of the sternum, we move on to working out the lumbar spine. Make a slope forward. Try to touch the palm of the floor. Then we tilt back, then - lateral slopes. After this, make circular rotational movements in one direction, then - in the other. Maximum stretch up, then exhale down. Repeat 10 times.
Then we turn to the study of the pelvic region. We make circular movements in one direction, then - in the other. We withdraw the pelvis as much as possible, then we set it back as far as possible. Then we perform pendulum movements from left to right, and in the opposite direction.
To work out the belt of the lower extremities and the lower extremities proper, we proceed to circular motions in the region of the femoral joint. Raises a leg, we begin to perform rotational movements. Then bend the leg in 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. We sit down on the floor, legs bend at the knees, take a comfortable position. Close our eyes, then inhale - lift the abdomen, then - the thorax, then - the collarbone. We try to fill the cavities as much as possible with air. Then we exhale: first we lower the area of the clavicles, then lower the area of the sternum, after that - blow off the stomach, as if pressing it to the spine. Breathing is recommended for at least 5 minutes.
To complete the training, follow the relaxation exercise. Lay down on the floor, close your eyes (on your back). After that, we try to maximally relax every muscle, every cell of our body. Thoughts drive away: they should not be in our head. We try to distance ourselves from all problems, from the outside world. We try to feel here and now. You can imagine that we are on the sea coast, where the sun is warmly affectionate, we are caressed by the sea surf, and we smoothly go into bliss under the light touch of a warm summer breeze. You can include pleasant music (classical music, the sounds of nature, the sound of the surf, etc.).
Gymnastics with lumbula
The gymnastic complex with elements of hatha yoga, which allows quickly and efficiently to work out all the departments of the spine, has proved quite successful.
The starting position is lying on the back. After that we raise hands in the parties, palms we lift upwards. The legs should be on the width of the shoulders. Shoulders and shoulders are pressed to the floor as much as possible, we place the feet one on top of the other. With an inhalation, the head turns in one direction, with an exhalation, we try to squeeze it as much as possible to the floor. At exhalation we lower we come back in a starting position then we turn a head in other party, we press an ear to a floor.
Then lift the legs, put them one on the other (fingers to the feet), then try to turn the head in a similar way, first to the left, then to the right, while lowering the head to the ear.
Then we lay down on the back, legs bend at the knees. Hands apart, on the floor. We try to take our bent legs apart, touching the knees of the floor. We repeat about 10 times in one direction, 10 times in the other direction.
We raise our legs up, then slowly lower two legs first into one side, then - into the other. Repeat 10 times, then - do a similar exercise, just raise one leg up, and the second one left below. We lower the raised leg to the opposite side. Do the same exercise on the other side. Then bend both legs in the knees, lower them bent first to one side, then - to the other. Then a similar exercise is done for even legs.
Then we bend both legs in the knees, press them to the chest, hide the head in the "legs". After that, we roll on our backs, leaving them on the shoulder blades, then on the pedicle. Exercise is called "kachalochka." Repeat 10 times.
Such a gym should be performed at least twice a day, especially with acute pain. It allows to strengthen the muscular frame of the back, paravertebral muscles, aligns the back, also improves the nutrition of the ligaments, muscles, discs, and muscles that surround each vertebra. Provide flexibility, ease and mobility of the back. It is recommended to perform at least a month. Ends with a set of breathing exercises (dynamic and static breathing exercises). Relaxation practice is then performed.
Massage with lumbalgia
The main task is to improve muscle nutrition, normalize metabolic processes, increase the mobility of the vertebrae, actually the spine.
The general plan of massage can be represented as a sequential impact on the paravertebral parts of the spine, as well as the effect on various segments of the spine. In the presence of pain in the limb and buttocks, massage of the diseased limb is performed.
The method of massage consists in that the zone along the spine is first massaged. Gradually, all zones are being studied, from the lumbar zone to the sacrococcygeal zone. Then we gradually rise upwards - we study the sections of the thoracic spine, intercostal areas, then - the cervical spine, the occipital part. First, the general stroking of the entire back is performed, and only after this we proceed directly to the elaboration of individual parts of the spine. After stroking, we move on to more stringent squeezing, then to rubbing. We finish the massage with vibratory movements, which allow us to relax as much as possible, and at the same time, tone the areas we are working on.
After working on the spine, we turn to the limb and pelvic area: we make a pelvic concussion, a slight vibration of the extremities. After that, we massage by the above-described seed: we start with light strokes, end with intensive kneading of the muscles, then with vibratory movements. To stimulate the basic reflexes, we intensively squeeze and unclench muscle regions, which leads to muscle tone, increases their sensitivity and reactivity. Usually the muscles are worked in the longitudinal direction. Also, an important technique is patting and quilting, which normalizes the sensitivity of the receptors in the muscular system. The duration of the procedure is an average of 20 minutes. It's better to do it at about the same time. Usually the duration of treatment is a month, when conducting sessions every other day.
Treatment of lumbulgia in the home
At home, one can not only cure a disease, but maintain a stable state and prevent the development of exacerbations. Self-medication can not be done in any case, but all the doctor's recommendations must be strictly followed. At home, you have to do something to achieve recovery, since lumbar treatment does not occur only in the doctor's office. This is a complex set of therapeutic measures, which includes both medical activities performed by professional medical staff in a clinic: for example, injections, special massage, active-passive gymnastics, physiotherapy.
At home, treatment should be supplemented by taking medication as prescribed by the doctor. Alternative and homeopathic remedies can be used. It is important to master physical exercises, gymnastics. Means of recovery and therapeutic exercise, and even self-massage. These are the means, without which treatment and recovery is impossible.
In order to pick up a set of exercises for performing a house, you need to consult a physician of therapeutic physical training. He will diagnose and pick up those exercises that will suit you. Only individual selection of exercises, according to the peculiarities of your pathology, can be effective. Then it is recommended that these exercises be performed several times under the supervision and supervision of a physical training instructor who can correct you, if necessary, correct the correctness of the exercise, determine the optimal strength and intensity of the load in your individual case. After this, you can proceed to the independent exercise at home.
Before performing self-massage, you also need to consult a massage therapist, or a physician of manual therapy. He will advise which movements and techniques are best for carrying out in your individual case, teach basic techniques, and control the correctness of their implementation.
Recipe number 1.
Ointment from the known balm "Asterisk" and extract of propolis is used for lubrication and grinding in an area where the pain is expressed as much as possible. 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 to it about 5 grams melted on a water bath or a couple of propolis, thoroughly stirred and allowed to freeze until a uniform mass is formed. Apply a thin layer for about 15-20 minutes on the affected areas, then cover with dry heat.
Recipe number 2.
For the general strengthening of the body use balm. It is prepared on the basis of alcohol. For cooking, 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 leaves of lavender, chamomile flowers and marigold. Drink at 50 grams per day.
Recipe number 3.
To apply compresses to the area of affected areas, use an anti-inflammatory composition: 3-4 tablespoons of sage grass and plantain pour a liter of boiling water, cover with a lid. Insist until the broth becomes warm. Then use for compresses.
It is best to use herbs in the form of broths and infusions inside, as they have a complex effect on the body, which allows you to quickly remove the inflammatory process, eliminate pain, and in general, improve your health, increase the body's resistance.
In the treatment of lumbulgia, neuralgia, myositis, radiculitis, grasses such as sage, chamomile, lavender, aloe, calanchoe, ivan-tea, arnica, and dogrose were the best ones.
Sage, chamomile have an anti-inflammatory effect;
lavender - antiseptic and soothing effect, removal of irritation and inflammation, relieves pain;
Aloe and Kalanchoe have an anti-inflammatory effect;
Ivan-tea calms, relieves the inflammation of nerves, muscle elements;
arnica, dogrose fill the body with vitamins, have an antioxidant effect, increase immunity.
It is recommended to use these herbs as decoctions for oral administration, and also for compressing the affected area. The broth is made from the calculation of 2 tablespoons of the product for a glass of boiling water.
Accepting homeopathy requires caution and strict adherence to precautions. There are two main precautions - carefully study the composition of these funds, and before taking a test to make sure that you do not have allergies or individual intolerance of the drugs that make up the composition. Otherwise, such side effects as an allergic reaction (from simple swelling, irritation, and ending with anaphylactic shock and a severe progressive Quinck edema) may occur.
The second precaution is always to consult a doctor, since only a doctor can know all the nuances and peculiarities of interaction of medicinal components among themselves, and will be able to build a treatment scheme that will have the maximum therapeutic effect with minimal risk and minimal side effects.
Recipe number 1. Balsam strengthening
For cooking, take a tablespoon of raspberries, arnica leaves, buds or birch earrings, pour about 500 ml of vodka or pure alcohol, then add half a teaspoon of dried juniper, ground cinnamon and ginger. All this insists at least 3-4 days, drink 50 ml per day. The course of treatment is at least 28 days (complete biochemical cycle).
Recipe number 2. Balm rejuvenating
Take in equal shares leaves of nettle, stevia and bones of cherries (without flesh). Take about 2-3 tablespoons of each component, add about 20 grams of cloves dried, pour 500 ml of alcohol, insist at least 5 days, I drink in small amounts twice a day, 28 days.
Recipe number 3. Anti-inflammatory ointment
This ointment can be prepared at home on your own. Can be applied in a thin layer on the affected areas. To prepare as a base, take the butter, melt it in a water bath. Then add about a tablespoon of the following oils: sea buckthorn oil, cloudberry, cranberries, cedar and Siberian flax. Stir until a uniform consistency is formed, after which it is set aside and allowed to freeze.
Recipe number 4. Moisturizing cream
Apply for application to affected areas. Apply light massaging movements, until completely absorbed. It can be used after a shower, after a massage, before going to bed. In a conventional baby cream, or any other body cream, add a few drops of essential oil of juniper, mint and fir. Then, 5-10 drops of base oil of spruce and burdock are introduced.
Lumbalia can be treated by operative methods. But this is an extreme case, which is resorted to if other methods are ineffective. Surgical methods are used if the cause of compression of the nerve is, for example, a tumor, large hematoma, which should be removed. Also, the reason for requiring surgery is a hernia of the spine, or damage to the intervertebral discs. The operation is planned. To which a person is prepared in advance. It is carried out after the pain is completely stopped. During the operation, attempts should be made to eliminate the cause of the pathology. Also, an indication for the operation is disruption of the genitourinary system, violation of defecation, or urination, resulting from lumbargia.
Found an error? Select it and press Ctrl + Enter.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
It should be said that the treatment regimens for pain syndrome with various types of dorsalgia are practically the same, but there are differences in the management of patients with acute and chronic course of the disease.
In this inflammatory process, the intervertebral discs, the vertebral column itself, and the area around the spinal column are exposed. At the same time, the nearby tissues, muscle fibers are involved in the inflammatory process.
Share on social networks
You are reporting a typo in the following text:
Simply click the "Send typo report" button to complete the report. You can also include a comment.