Lumbago (backache) - is a sharp pain that occurs in the lumbar region, most often after lifting. The lumbago can be caused not only by spinal cord ligament sprain, but also by pinching one of the lumbar short roots of the spinal cord with an osteophyte during spinal osteochondrosis or squeezing the pulpous nucleus into the spinal canal with a compressed spinal cord (Fig.). In many cases, a provocative factor can be a cold. Spinal osteochondrosis develops as a result of aging and intervertebral cartilage wear: they lose moisture, crack and bulge both along the anterior and posterior surfaces of the vertebrae. Osteochondrosis, however, can also occur in young people, either as a result of previous injuries of the spine or in connection with defects in the development of intervertebral cartilage. When lumbago patient, bent over, can not straighten because of the sharp pain.
The position of the pulpal nucleus in the intervertebral disk: left - normal; on the right - when squeezing and pinching it. 1 — intervertebral cartilage, or disk; 2 - fibrous ring; 3 - pulpous nucleus.
Any movement that does not relieve the spine from compression is extremely painful. Each patient finds a pose in which the pain subsides slightly. This may be lying on the side, on the stomach, in the knee-elbow position, etc. Acute pain can last for several minutes, hours or days. When a patient begins to get up, he may experience scoliosis (curvature of the spine) for some time, caused by a protective analgesic reaction, the patient’s desire to weaken the nerve root osteophyte compression or reduce nerve tension.Go
Treatment lumbago . It is necessary daily, after consulting a neurologist, to stretch the spine for half an hour or more on specially adapted sliding beds, fixing the shoulder girdle and hanging the load on the legs.
In addition, anti-neuralgia should be used [a good effect is given by a combination of 0.3 g of amidopirin (pyramidone), 0.15 g of amytal-sodium, 0.015 g of codeine and 0.05 g of caffeine, 1 powder 2 times a day], massage , Exercise therapy , mustard plasters on the lower back, erythemal dose of quartz, paraffin, ozokerite, hot sand in bags, intradermal novocainic blockade in the lumbar region before the formation of "lemon peel", which requires approximately 25 ml of 0.25% novocaine solution (see Anesthesia).
For the prevention of lumbago, it is recommended to do morning exercise ; with existing spinal osteochondrosis, do not lift weights, protect the lower back from injuries.
Lumbago (lumbago; from the Latin. Lumbus - lower back; synonym for backache) is a suddenly developing acute pain in the lumbar muscles and the lumbar-dorsal fascia. The disease occurs mainly in persons engaged in heavy physical labor in case of overstressing (fatigue) of the lumbar muscles and hypothermia. Sometimes the cause of lumbago are acute and chronic infections, in which muscle bundles swell and become painful with the slightest pressure, and especially when stretched.
Pathomorphologically marked phenomena fibromiositis, hemorrhage in the muscles, tearing of muscle bundles, tendons, proliferation of connective tissue.
Some authors attribute the lumbago to the acute form of dyskalgia caused by osteochondrosis of intervertebral disks. In their opinion, the primary change in the fibrous ring of the intervertebral disk and the initial protrusion phase of the pulpal nucleus are clinically consistent with lumbar lumbago. The reflex muscular contractures observed in this case and sympathalgia arise in connection with stimulation of the sympathetic endings of the recurrent nerve, which innervate the intervertebral disk and the posterior longitudinal ligament. DI Shamburov believes that lumbago can be caused by inflammatory and degenerative changes in the spine and its ligamentous apparatus.Go
Lumbago usually begins suddenly, shortly after physical exertion or hypothermia, with acute shooting back pain that holds down the slightest movement in it; the patient can not bend and straighten, sometimes falls from the pain. In some cases, back pain develops over several days and, gradually increasing, acquire the character of a backache. The pains are aggravated by a slight change in the position of the body, with light active movements, with various kinds of tension (coughing, sneezing, straining, etc.). At rest, they subside or even disappear. The position of the patient is forced: the trunk is tilted forward. Movement sharply limited and painful. Rising from a lying or sitting position is especially difficult, it can be carried out only by means of auxiliary methods (fig.). In the most severe cases, there is a compensatory scoliosis, bulging in a healthy way. The lumbar muscles are thickened, tight, and tight. They often feel dense and very painful nodules (traces of hemorrhages or areas of altered muscle tissue).
Lifting from a sitting position with lumbago (according to L. S. Minoru).
Pain of the type of lumbago may be associated with the so-called osteofibrosis (dystrophic changes in the junction of fibrous tissue with bone protrusions of the vertebrae). Changes can be not only in the joints of the fibrous ring and the marginal rim of the vertebra, but also in the ligaments and muscle tendons in the spine.
Often with lumbago, acute back pain can move down to the area of the sacral plexus and sciatic nerve. Relapse is possible. Backache lasts several days, but not more than 2-3 weeks.
Lumbago treatment . Dry heat is applied - sollux, hot iron, bag with hot sand, light baths, cans, mustard plasters. Subcutaneous injections of novocaine (Novocaini 0.2, Sol. Natrii chlorati 0.89% —20.0, Sol. Adrenalini hydrochlorici 0.1% gtt X, twice a day subcutaneously in the lumbar region) or intradermal injections of 0.5— A 1% solution of novocaine according to Astvatsaturov in the amount of 20-30 ml again in 3-4 days. Anesthetic ointments and salicylic preparations (for example, Methylum salicylicum per se) and in combination with menthol or other drugs (for example, Methyli salicylici, Chloroformii, Ol. Hyosciami equally) have analgesic effects, as well as physiotherapeutic procedures: Bernard currents, ultraviolet radiation diathermy, ionization with novocaine, lithium, iodine. Further shows massage and therapeutic exercises, spa treatment (Matsesta hydrogen sulphide and radon baths).
It is necessary to avoid physical surges, stay in damp and cold rooms. With frequent recurrences of lumbago in the lower back, associated with heavy physical labor, it is recommended to switch to lighter work, hygienic gymnastics, and rehabilitation of chronic foci of infection in the body.