Acute lower back pain is a pathology that occurs at any age that occurs in pregnant women. Features of the disease, its main symptoms, diagnostic procedures and types of treatment. Sudden attacks of pain can have both pathological and physiological origin. Pain requires determining the source of its occurrence by means of a diagnostic examination to exclude the presence of serious diseases.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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Why does it hurt?
Anomaly refers to common varieties that occur in half of patients with a sedentary lifestyle, excess body weight, diseases in the lumbar region, including osteochondrosis.
There are several characteristics of the disease: it can be aching, stitching, dagger-like. The severity level depends on the root cause of its occurrence, the existing processes of inflammation, increased tone of muscle tissue near the spine, and the age of the patient. In people of the older age subgroup, acute lower back pain is characterized by a high level of severity, which is associated with aging processes, a gradual decrease in the amount of fluid in the cartilage.
The source of frequent development of discomfort in the lumbar region is the need to maintain the weight of the entire body and head. Average statistics report that deviation is the second reason for seeking professional help. For the first time, unpleasant sensations are provoked by sharp lifting of heavy things, movements, injuries or prolonged exposure to a statistical position.
Causes include injuries of muscle tissues, ligaments of the back, the presence of a hernia in the discs of the lumbar region of the spinal column. Pain occurs with cramping, sprain, violation of the integrity of ligaments and muscles.
Common sources of malaise are:
- compression fractures of the vertebrae during injuries, osteoporosis;
- increased muscle tone in the problem area;
- protrusions of the intervertebral disc;
- lumbosacral radiculitis, narrowing of the spinal canal;
- abnormal curvature of the spinal column with kyphosis, scoliosis, Scheuermann-Mau disease;
- degenerative processes and displacement of the structures of the spine;
- infectious organ lesions – with abscesses, discitis, osteomyelitis.
System-wide diseases provocateurs of pain: diffuse lesion of connective tissues, ankylosing spondylitis, malignant tumor-like process in the spinal column, rheumatoid arthritis.
Sources of acute lower back pain unrelated to diseases of the spine or adjacent tissues include abdominal aortic aneurysms, cholecystitis, gastroduodenal ulcer, pancreatitis, chickenpox virus, endometriosis, inflammatory processes in the pelvic organs, prostatitis, pyelonephritis, and renal colic.
The rapid development of the fetus, its large size and fragility of the mother’s body during pregnancy can also cause the development of pain.
The clinical picture of acute pain can have a variety of symptoms. The patient may complain of mild discomfort or a painful condition that cannot be tolerated. Pain can be combined with discomfort in the legs, feet, hips. In some patients, weakness of the lower extremities occurs.
Symptomatic features, depending on the primary pathology, are presented:
- The presence of an intervertebral hernia is discomfort in the back with irradiation in the leg, from the buttock to the foot. Painful sensations are accompanied by numbness, tingling, muscle weakness.
- Stretching the muscle tissue of the lumbar – a common pain in the department, not passing to the lower extremities. The abnormal condition worsens at the time of movement, calms down during rest.
- Spinal stenosis – leg pain is stronger than lumbar pain. The feature is associated with frequent secondary development of hernias in the intervertebral space. Deterioration is observed during movement, prolonged standing on the legs, relief occurs when bent position or rest. Pain can affect one or both sides of the body.
- Diffuse lesion of connective tissues – characterized by pain in several articular apparatuses, sensation of heat, decreased body weight, persistent weakness.
- Osteomyelitis or discitis is a constantly present discomfort, with normal temperature readings. Clinical blood tests do not exceed regulatory standards, there is an increase in ESR or C-reactive protein.
When contacting a district clinic, the patient is referred for consultation by a neurologist, vertebrologist. Primary suspicions arise when examining and studying the symptomatic features of the pathological process.
To confirm the presumptive diagnosis, the patient receives directions:
- On radiographic images of the spinal column – the procedure allows you to detect deviations in the intervertebral spaces, the growth of osteophytes. It provides comprehensive information on the last stages of osteochondrosis.
- On MRI – gives maximum information about the condition of the spine, its structural elements, joints. With the method, the initial forms of osteochondrosis, spondylarthrosis are revealed.
- For myelography – an X-ray contrast study of the spinal column. Manipulation determines tumor-like processes, abscesses, narrowing of the canal cavity, hernia, violation of the integrity of the intervertebral discs.
General clinical laboratory tests determine the presence of latent inflammatory processes, diseases of the kidneys, pancreas.
Therapy begins with the appointment of a half-bed regimen – the patient must exclude any fast movements, sharp bends and bends, do everything in slow motion. An orthopedic mattress is desirable, in a pinch, a fitted cardboard or wooden board is suitable. When moving around housing, crutches should be used, a specialized belt to stabilize the lumbar.
The drug direction involves the use of several pharmacological subgroups of drugs.
To suppress attacks of acute pain in the lumbar region, it is recommended to take painkillers: Sedalgin, Baralgin, Analgin, Paracetamol. If the medications did not stop the pain, then re-use after an hour is allowed. Only your doctor should prescribe drugs.
To obtain the effect, strong analgesics may be prescribed to the patient. Their use is allowed only a few times, the therapy is carried out by Ketorol, Diclofen, Trigan, Solpadein. Suppression of the symptoms of spasm occurs with No-shpa, Drotaverin hydrochloride, Papaverine, Spazmol, Spazmonet, Spazoverin, Nosh-bra.
Reducing the level of tissue swelling requires the appointment of diuretic drugs – Veroshpiron, Diakarba, Furosemide, Toasemide, Amilorida, Spironolactone.
To stabilize the immune system and make up for an insufficient amount of vitamins and minerals, multivitamin complexes are prescribed: Alphabet, Complivit, Centrum, Vitrum, MultiMax, MultiTabs.
The relief of inflammation and acute pain in the lower back is performed with the help of NSAIDs – Ibuprofen, Arthrokam, Nekst, Ibunorm, Ibutard, Suprafen. Severe inflammatory process is treated with hormonal therapy using hydrocortisone, dexamethasone, prednisolone, cortisone.
Local preparations for application to the lumbar region are Vipratox, Viprosal, Virapin, Apizartron, Dolgit-cream, Finalgon, Boromentol, Alvipsal, Kapsikam. Medications do not solve the problem, but only relieve the symptoms of pathology.
In the presence of hematomas, bruising, angioprotectors are used – Troxerutin, Troxegel, Veronutinol, Phleboton, Lyoton.
Help with injuries includes the following algorithm:
- the victim must be laid on a hard, even surface;
- limit as much as possible the possibility of free movement;
- place an ice warmer on the place of impact, any bag of food from the freezer.
Experts advise not to forget about the possibility of getting a cold illness due to prolonged retention in the problem area of ice. It is forbidden to keep a heating pad for more than 10 minutes – an increase in time will lead to frostbite on the tissues. If acute pain in the lower back does not go away, then after a half-hour break an ice bladder is applied a second time.
In the process of assistance, one should monitor the condition of the victim: whether there are complaints of numbness, loss of sensation in the lower extremities, whether the patient can bend his toes. The feature is associated with damage to the spine and, in the presence of these symptoms, requires an ambulance call. Self-transportation of a patient with a fracture is prohibited.
If there are no threatening signs, then the patient should visit the local clinic and consult a traumatologist. The specialist will send him for radiography in order to exclude biases or violation of the integrity of the vertebrae. After receiving the diagnostic data, the doctor will prescribe the appropriate drugs.
Acute pain can exclude a person from public life, interfere with his homework and labor. Preventive measures are intended for individuals included in the subgroup of probable risk for pathologies of the spinal column. To prevent the formation of intervertebral hernias, osteochondrosis, radiculitis and other diseases, certain rules should be followed:
The correct selection of bedding – preference should be given to an orthopedic mattress, pillow. Properly selected, they provide prevention of the development of all types of osteochondrosis. In the absence of the possibility of acquiring specialized products, it is necessary to select them according to their rigidity – excessively soft ones contribute to the gradual curvature of the spine.
Tracking posture and posture – a long pastime at the office table provokes the occupation of a comfortable but harmful body position. Minimal motor activity is also a source of problems and requires periodic warm-up for 5 minutes every hour. It is enough to walk around the office, bend over or sit down 10 times.
Sports training – diseases of the spinal column are provoked by problems with blood circulation, muscle weakness. Their development can be prevented by daily activities as far as the body’s strengths and capabilities. Morning exercises, evening walks, classes on home exercise machines will improve muscle tone, normalize blood circulation.
Specialized diet – implies a sufficient intake of protein, vitamins and mineral elements. The deficiency is partially filled with fresh fruits, vegetables and herbs. It is recommended to reduce the amount of table salt, fatty, fried, smoked and spices.
In the presence of diseases of the spine, it is necessary to avoid hypothermia, to reduce the negative impact of stressful situations. Patients should undergo seasonal vitamin therapy to strengthen the immune system, improve the functioning of internal systems and organs – replacement therapy is carried out with multivitamin complexes.
For injuries, bruises, falls on ice, you should seek help in a timely manner. In addition to hematomas and bruising, situations are threatened by cracks, fractures of bone tissue, and displacement of vertebral arches. Grown pathologies are difficult to treat, can lead to disability and subsequent disability.
Acute lower back pain should not be ignored – a timely detected problem will help to avoid complications and consequences of any disease.