Lumbling syndrome: what is it?

Lumbalia is a collective concept, denoting painful and inflammatory syndrome in the lumbar region. 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.

Is lumbulgia dangerous?

With proper treatment, the changes that occur with lumbula are easy enough to treat, and do not pose a serious danger without leaving any traces. Nevertheless, in the absence of treatment, or with improperly selected treatment, lumbulgia can be dangerous by constant and intensive progression, in which more and more tissues are involved in the inflammatory process. It is also worth noting that the disease progresses very quickly.

The danger is also that there is a serious danger of involvement in the inflammatory-infectious process and cerebrospinal fluid, which can result in its infection and the spread of infection throughout the spinal canal, including the brain. This may result in an inflammatory-infectious process in the brain. A frequent consequence of lumbargia is myelitis (inflammation of the meninges), stroke (cerebral hemorrhage).

A generalized inflammatory and rheumatic process can also occur, which is accompanied by a lesion of connective, 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 cardiac muscle damage, up to the heart defect and heart failure.

Epidemiology

According to statistics, lumbalia is found in every 10 people in a severe, rather pronounced form. Most often, it appears in winter, because during this period the body is weakened as much as possible, and also cases of frequent hypothermia are observed. This entails pain in the lumbar region. In the first place in the frequency of occurrence of lumbulgia - patients who lead sedentary, sedentary lifestyle, as well as those who have a history of locomotor system diseases. In second place, as it is strange - athletes who, on the contrary, experience excessive loads on the bone and muscle systems, feel overload and overtraining, as well as frequent injuries and injuries. In third place are the elderly, especially those who suffer from acute and chronic arthritis, osteochondrosis, radiculitis. The fourth place is occupied by people who have undergone infectious diseases, undergoing chemotherapy, irradiation. In fifth place - children under one year and newborns with genetic abnormalities in the motor apparatus.

[1], [2]

Causes of the lumbodynia

The reasons can be many, and in almost every case they are strictly individual. For example, lumbulgia can be a consequence of frequent stresses, neuropsychic overstrain, as well as a consequence of the development of allergic, infectious, infectious-allergic diseases. Often the pain in the lumbar region develops against the background of a 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 runs chronically, at a certain moment manifesting itself in the form of acute attacks of pain syndrome. It is often a concomitant factor against inflammatory diseases of the upper and lower respiratory tract, nervous diseases and heart failure. It often occurs during pregnancy and during lactation. In the inflammatory process, other tissues and organs may be involved.

Often pain in the lumbar region is due to hard work (physical), improperly distributed load, excessive lumbar overload. Often the cause is a bacterial or viral infection that accompanies the inflammatory process. An important role in the maintenance of inflammation is played by cytomegalovirus infection, herpes, from bacterial infection - streptococcal. Less commonly - staphylococcal infection. Often, lumbalia is caused by a recently transferred infectious disease, including angina.

Sometimes congenital, genetically conditioned lumbalgia develops, which develops during the period of intrauterine development, and is subsequently the consequence of various diseases of the musculoskeletal system, its underdevelopment, and increased physical exertion. The cause may be even intrauterine and postpartum infection of the fetus, with further progression of infection through the spine, 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. Also, the peculiarity of this disease is that with it there is an intensive deposition of moles in the intervertebral discs, which causes painful sensations, stiffness. It arises mainly against the backdrop of a sedentary lifestyle, with a wrong walk, wrong sitting, a prolonged stay in one position.

[3], [4], [5]

Lumbalia in the background of dorsopathy

It is a pain syndrome of inflammatory genesis, the main etiological factor of which is considered insufficient mobility, violation of hygiene and the regime of the day, which entails an inflammatory and infectious process. In this process, bone and muscle structures are involved, including vertebrae and intervertebral discs. The danger is that the nerve fibers can also be involved in the inflammatory process, which contributes to the intensification of pain, which intensively spreads along the course of the nerve fiber. The process can be manifested by severe bouts of pain, which alternate with a burning sensation and heat in the affected area.

Post-traumatic lumbalgia

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

According to statistics, this is most often the result of a fall, impact, damage to a vehicle. It can arise from the bending of the bone and the spine beyond the limit of its elasticity, with strong compression and tearing, twisting and crushing. A special place is occupied by lumbulgia, provided with traumatic effect of the painful process of bone, in particular, caused by congenital fragility, purulent inflammation, rickets, syphilis, tuberculosis.

Risk factors

The risk group includes people who are often ill with 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 influences, subject the lower back to heavy physical exertion. People with dysbacteriosis, and also with the presence of foci of infection (bacterial, viral), are also significantly at risk of getting lumbulgia. The risk also increases in the presence of acute or chronic diseases of the musculoskeletal system, including osteochondrosis, arthritis, bursitis. There is also a great risk in the presence of diseases of nerves and the nervous system.

[6],

Pathogenesis

The pathogenesis is based on the development of pathological processes in the lumbar spine. In this case, there may be a violation of normal blood circulation, a violation of innervation, a violation of metabolic processes in the lumbar region. Also, deposition of salts, stones between the vertebrae, and the release of the intervertebral substance into the space between the two vertebrae can occur. Gradually, the inflammatory process develops, the infection progresses, which leads to the progression of the disease, its spread and the formation of new foci of infection.

[7], [8], [9]

Symptoms of the lumbodynia

As the first signs of lumbulgia, which indicate the development of lumbula, is severe pain. It, as a rule, is argued by a violation of the function (stiffness, pain during movement, and in severe injuries and injuries - the inability to stand up, and other disorders of the spine). Sometimes there can be hematoma and swelling of the tissues.

Forms

There are several stages of development of lumbargia. In general, researchers and clinicians distinguish three stages.

At the first stage there is a feeling of pressure, discomfort in the lumbar region. Mild pain may occur with prolonged stays in one position, with prolonged sleep. Usually it's quite difficult to straighten up in the morning, there is a sharp, piercing pain when trying to stand up, with sudden and careless movements.

In the second stage, the pain intensifies, acquires a fairly stable character. During the day there may be a constant aching pain, which calms down with moderate physical exertion and increases with sudden movements, attempts to get up. As a rule, at this stage severe pain disturbs in the morning, by evening and during the day it becomes less pronounced. Also at this stage the pain sharply gives to the buttocks, thighs and even the lower leg.

In the third stage, the pain mainly affects the whole of the lower back, and also the area of the sacrum and the cob, quite sharply and strongly gives to the pelvic region, lower extremities, and even to the ribs and intercostal space.

[10], [11]

Acute lumbargia

The acute phase implies the presence of an inflammatory process in the lumbar region, the cob. In the inflammatory process, the nerves are also mechanically damaged. Pain, as a rule, is sharp, acute, more pronounced in the daytime, and also, after a person is long in one position. Acute pain is almost not eliminated by exercise, but requires special treatment, for example, injections, the use of local remedies. Most often used ointments, gels, creams and other medicines.

[12]

A swollen lumbalgia

A subacute form of the disease is characterized by a relatively easy form of flow, in which pain disturbs a person only if there are appropriate conditions. For example, if a person has been sitting or lying for a long time without moving, he will have pain. The pain is less piercing, rather aching, pulling, which easily spreads to neighboring areas. Quite quickly passes under the influence of physical exercises aimed at the waist region.

[13]

Chronic lumbalgia

Pain that spreads to neighboring 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, it can be severe hypothermia, excessive nervous and mental overexertion, heavy physical stress, and even an incorrect load distribution with its predominant localization in the lumbar region.

[14]

Moderate lumbalgia

As a measure of moderation is controlled pain, which can easily be stopped with various medications, as well as with the help of proper physical activity. There is a special set of exercises aimed at unloading the waist. It is the regular exercise of physical exercises is the key to control of the condition of the waist and allows you to eliminate any pain in a relatively short time.

Complications and consequences

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

Also, it is worthwhile to fear the possibility of degenerative processes, which is accompanied by a violation of conduction, inflammation of the nerves, inflammation of the myelin sheaths.

[15], [16], [17], [18]

Exacerbation

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

It happens under the influence of various adverse factors on the body: excessive stress, overstrain, increased stress on the body. Quite often, exacerbation occurs in the summer, when a person performs various physical activities, swims in the river, bathes, sunbaths on cold ground, freezes, there is a sharp change in temperature - after sunbathing in the sun, a person is dipped into cold water in the river. Failure to comply with the regime of the day, malnutrition, abuse of non-dietary food, alcohol - all this may be those factors that trigger an exacerbation.

Also it should be noted that in winter there are also frequent exacerbations, especially in severe frost (with hypothermia, from drafts, colds, piercing winds). Also, often exacerbation occurs from stress, neuro-psychic overexertion.

[19], [20]

Remission

It is characterized by a state of relative calm, improvement of state. Almost always occurs in any chronic pathology. Quite prolonged remission can occur after an acute attack of lumbargia was cured. Treatment with the help of special medications, as well as after injections of painkillers, usually comes a state of remission.

If you do not maintain this condition with special supportive therapy, preventive medicines and physiotherapy procedures, remission can quickly grow into a new exacerbation state. But with the maintenance of such a regime, remission can last a long time - from several months to several years. There are cases when, after the onset of remission, there are no more exacerbations, and for decades people live without new attacks, although due to various circumstances, the diagnosis was not finally withdrawn.

Persistent lumbulgia

This state is also quite lengthy. Pain is usually not removed with any medicines, ointments. But in order to ensure that resistant lumbalgia has not passed into a chronic form, mandatory treatment is required. In most cases, mandatory hospitalization is required, since inpatient treatment is ineffective.

Recurrent lumbalgia

Often, there are cases when lumbalia is completely cured, and after a few weeks it returns again. Such a return of the disease after the improvement of the condition, was called a relapse. In this case, in the second case, treatment is also required. If possible, complex treatment should be carried out, perhaps even hospitalization will be required (since this is the most effective, comprehensive form of treatment). It is worth noting that the treatment of relapse should be approached with all seriousness, since if not cured at once, the disease can go into a chronic form.

Diagnostics of the lumbodynia

Once you feel a sharp pain - contact a neurologist, or a surgeon. The neurologist will conduct a survey, check the main reflexes. Also important is the consultation of the surgeon, who in most cases probes the pathology, determines its cause and pathogenesis. If there are no such specialists, the help can be rendered by a traumatologist, or orthopedist, an orthopedic surgeon.

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

In an extreme case, if the clinic does not have specialists in similar areas, it is worthwhile to turn to the therapist, who will direct to the necessary specialists. Almost always in such cases, a surgeon and neuropathologist are consulted.

Usually the diagnosis is based on the results of the examination: severe soreness. There is a decrease in the main reflexes. In the first place, 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 appropriate reflexes. There are symptoms of Lasega.

Instrumental diagnostics

Do not 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, as accurately as possible and in a relatively short time, make it possible to determine the cause of the exact localization of pathology.

The main objectives of such a study is to determine at what level (spine department) there was a pinch. X-ray examination is carried out. CT and MRI are used in relation to the affected area.

Sometimes it may be required electroneuromyography - it is determined not so much by the causes as the violation of the contractile ability of the muscles. There is a recording of how and with what speed / intensity pass the nerve impulses.

[21], [22], [23]

Analyzes

Laboratory methods are ineffective in the diagnosis of lumbargia rarely. At least, standard methods, such as a clinical and biochemical blood test, do not show an accurate picture of the pathology. But sometimes these methods of research may be required. For example, if the x-ray or tomography shows pinching and nerve compression, with the help of tests you can determine what exactly caused the compression. For example, you can use a biochemical blood test to identify the tumor, determine its location. Often, a routine clinical blood test is 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 there is to be - septic or aseptic.

If suspicion of a septic inflammatory process, the development of an infectious process, if there is a suspicion of degenerative processes, there is a study of cerebrospinal fluid. Puncture is taken, after which further microbiological examination, microscopy is performed. Bacteriological culture is conducted to further identify the inflammatory process and the presence of infection.

[24]

Differential diagnosis

The basis of differential diagnosis is the need to differentiate the different types of pathology, which have similar features, from lumbalgia proper. For differentiation, mainly instrumental methods of investigation are used.

Torakalgia

Under this diagnosis is meant pinch of the nerve in the thoracic spine. The leading symptom is pain. Most often, thoracalgia is accompanied by neuralgia in the intercostal areas.

Cervicalgia

A similar lesion of the cervical spine (the cervical nerve is damaged), and adjacent areas are also involved. Mandatory treatment is required, since damage to the cervical region can lead to an increase in blood pressure, the development of a stable hypertension. There may also be a development of cervical osteochondrosis. Moreover, cervicalgia is accompanied by a violation of blood pressure, cerebral circulation, which can lead to hypoxic changes in the brain.

[25]

Treatment of the lumbodynia

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

Prevention

At the heart of prevention is the prevention of hypothermia, drafts, regular exercise, a flexible lifestyle, hygiene when sitting at a table, with prolonged stay in one position. It is also important to eat right, to include in the diet the required amount of vitamin, minerals.

[26]

Forecast

If the cause is determined in time and the necessary treatment is carried out, the prognosis of lumbargia will be favorable. At the same time, it is necessary to follow the doctor's recommendations. Treatment will be long and complex. You need to be patient and strictly follow all the doctor's recommendations. If you tighten with diagnosis and treatment - the forecast can be unpredictable, up to disability.

Sick leave

Everything depends on the state of health, severity of the disease and treatment. So, if the disease proceeds in a mild form, and does not require specific treatment, hospitalization, the patient may be given a sick leave for 5-7 days, because due to severe pain the work capacity is still limited.

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

Is the army taking lumbalgia?

An unequivocal answer can not be given, since the decision is made by the commission individually in each individual case. At the same time, the complex of accompanying factors, the features of the course of the disease, the treatment being conducted, the prognosis of the disease are analyzed. There are known cases in which lumbalia was not a hindrance to military service. There are also cases in which a person was found not fit for service in the army.