Treatment of lumbar osteochondrosis with neurological manifestations

Osteochondrosis of the lumbar spine: symptoms and treatment

The causes of osteochondrosis of the lumbar spine are not well understood. The greatest importance is attached to a hereditary predisposition, age-related changes in the intervertebral discs. The pain can be triggered by an awkward movement, prolonged forced position, lifting and carrying weights, sports overload, overweight.
Depending on the duration, acute pains lasting up to 4 weeks, subacute (from 4 to 12 weeks) and chronic (lasting over 12 weeks) are distinguished.

Neurological complications of osteochondrosis of the lumbar spine:
First stage. Clinical manifestations are associated with reflex muscle tension.

Lumbago (lumbar lumbago). Acute pain in the lumbar spine begins suddenly, provoked by minimal movements in the back. The range of movements in the lumbar spine is sharply limited, there is compensatory scoliosis. Paravertebral muscles of “stone” density.
The duration of lumbago with adequate treatment and immobilization of the lumbar is no more than 7-10 days.

Lumbalgia (lower back pain).
Patients complain of moderate pain in the lumbar region, aggravated by movement or in a certain position, discomfort with prolonged standing or sitting. The onset is usually gradual. Clinically, mobility in the lumbar spine, tension and soreness of the paravertebral muscles are often determined. In most cases, the pain disappears within 2-3 weeks, but if untreated, it can take a chronic course.

Lumbar ischialgia (lower back pain with irradiation in the leg). In the lumbar region, movements are limited, tense and painful on palpation of the paravertebral muscles.
In piriformis syndrome, the sciatic nerve is compressed, with paresthesia and numbness in the leg and foot. Laseg’s syndrome is positive.
But there are no signs of radicular syndrome.

The second stage of neurological complications of osteochondrosis of the lumbar spine.
Disc herniation with radicular syndrome or radiculopathy.
Root compression is accompanied by shooting, burning pains in the leg. The pain intensifies with movement, with coughing, accompanied by numbness along the spine, muscle weakness and loss of reflexes. Positive symptoms of tension.

In the lumbar region, the greatest load falls on the lower section, therefore, L5 and S1 roots are most often involved in the pathological process. Each root has its own zone of pain and numbness on the extremities.
Radicular syndromes are detected by a neurologist with an objective examination.

The third stage of neurological disorders of osteochondrosis of the lumbar spine.
Vascular radicular conflict.

Syndrome of paralyzing sciatica occurs when blood circulation is disturbed in the radicular artery L5 and less often S1. Radiculoischemia at other levels is rarely diagnosed.

During an awkward movement or lifting of weight, acute back pain develops with radiation radiating along the sciatic nerve. Then there is paresis or paralysis of the extensors of the foot and fingers with the “spanking” of the foot when walking (steppage). The patient, while walking, raises his leg high, throws it forward and at the same time slams his toe on the floor.
In most cases, paresis safely regresses within a few weeks.

The fourth stage of neurological complications of osteochondrosis of the lumbar spine.
Violation of the blood supply to the spinal cord and ponytail.
With spinal stenosis, several roots of the spinal nerves (ponytail) are affected. The pains at rest are insignificant, but when walking there is an intermittent claudication syndrome. Pain while walking spreads along the roots from the lower back to the feet, accompanied by weakness, paresthesias, and numbness of the legs, disappears after rest or when the body is tilted forward.

Acute spinal circulation disorder is the most severe complication of lumbar osteochondrosis. Acutely develops lower paraparesis or plegia. Weakness in the legs is accompanied by numbness of the lower extremities, impaired function of the pelvic organs.

Examination of patients with osteochondrosis of the lumbar spine.
Of great importance is the analysis of complaints and medical history to exclude serious pathology. A neurological examination is carried out to exclude damage to the roots and spinal cord. Manual examination allows you to determine the source of pain, limitation of mobility, muscle spasm.

Additional examination methods are indicated for suspected specific back pain.
An x-ray of the lumbar spine is prescribed to exclude tumors, spinal injuries, spondylolisthesis. Radiological signs of osteochondrosis do not have clinical value, since they are present in all older and older people. Functional radiography is performed to detect spinal instability. Pictures are taken in the position of extreme flexion and extension.

For radicular or spinal symptoms, an MRI or CT scan of the lumbar spine is indicated. On MRI, hernias of the disc and spinal cord are more visible, and on CT, bone structures. The clinical level of the lesion and the MRI findings should be consistent with each other since the disc herniation detected on MRI is not always the cause of the pain syndrome.

In neurological deficiency, electroneuromyography (ENMG) is sometimes prescribed to clarify the diagnosis.
If somatic pathology is suspected, a thorough clinical examination is performed.

Osteochondrosis of the lumbar spine, treatment.
When the first signs of discomfort appear in the lumbar spine, regular gymnastics is indicated to strengthen the muscular corset, swimming, and massage courses.
Treatment of osteochondrosis of the lumbar is divided into 3 periods: treatment of acute, subacute and chronic period.

In the acute period, the primary task is to relieve pain as early as possible and restore the patient’s quality of life. In the presence of intense pain, immobilization of the lumbar spine with a special anti-radiculitis corset for 2-3 weeks is indicated. Bed rest should not last more than 2-3 days. In many patients, an increase in pain syndrome is possible against the background of an expansion of the motor regime. The patient should not limit himself to reasonable physical exertion.

Of the non-pharmacological methods of therapy, interstitial electrostimulation, acupuncture, hirudotherapy, massage are effective. Manual therapy is possible, but only in competent hands.

Drug treatment. In acute pain, non-steroidal anti-inflammatory drugs (diclofenac, aertal, movalis, nimesulide or arkoxia) are indicated. In combination with anti-inflammatory drugs, muscle relaxants (midocalm, sirdalud or baclofen) can be prescribed with a short course.

In osteochondrosis of the lumbar spine, therapeutic blockades with local anesthetics (lidocaine, novocaine), non-steroidal anti-inflammatory drugs (xefocam or movalis), corticosteroids (diprospan) are effective. Medicinal mixtures are introduced as close as possible to the focus of pain (in the affected muscles, exit points of the roots).

In case of radiculopathy with the presence of neuropathic pain, anti-inflammatory drugs are ineffective, in this case antidepressants, anticonvulsants, tramadol, versatis patch are prescribed.

With mixed pain, the combination of aertal 100 mg 2 times a day + midcalm 150 mg 3 times a day + gabagamma 300 mg 2-3 times a day for 2 weeks has worked well.
With paresis, numbness, vascular preparations (trental, aminophylline) and B vitamins (milgamma) are prescribed.

With prolonged myofascial pain, the introduction of non-steroidal anti-inflammatory drugs into trigger points, muscle relaxants, acupuncture, post-isometric relaxation is effective.

In chronic pain, antidepressants, physiotherapy exercises and other non-drug methods of treatment come first in the treatment.
With spinal stenosis, weight loss, wearing a corset, NSAIDs, venotonics (detralex) are indicated.

Surgical treatment is carried out with paralyzing sciatica (in the first three days) and horse tail syndrome (paresis of limbs, impaired sensitivity, urinary and fecal incontinence).

Prevention of osteochondrosis of the lumbar spine is reduced to the avoidance of long, uncomfortable positions, excessive loads. It is important to properly equip your workplace, alternate periods of work and rest. To put on a fixing belt at physical overloads. Do therapeutic exercises to strengthen your back muscles.

Osteochondrosis of the lower back: symptoms and effective methods of treatment

Osteochondrosis is a common disease. Previously, this ailment was considered an age-related change affecting people after 50 years. Modern living conditions have led to the early development of pathology. Signs of decreased elasticity of the intervertebral discs have been observed as early as 30 years. Changes can occur in all vertebrae, but osteochondrosis of the lumbar region is most often diagnosed. Symptoms and treatment will depend on the degree of the disease.

Symptoms of pathology

Signs of lumbar osteochondrosis are difficult to notice right away. Symptoms appear slowly, a diagnosis is made already at the stage of exacerbation of the disease. It is important to distinguish the destruction of the spine from other ailments in order to consult a doctor in a timely manner. The main signs of osteochondrosis of the spine in the lumbar:

  1. Soreness in the lower back. At first, it manifests itself only when lifting weights, but then it becomes constant. It can no longer be associated with any actions. At the time of exacerbation, the pain is unbearable; immediate elimination is required.
  2. Violation of the sensitivity of the legs. This occurs as a result of trauma to the nerve endings. At the very beginning, a characteristic tingling, burning sensation, the appearance of “goose bumps” below the sacrum are felt. If the disease progresses, then the extremities of the tendon reflexes and muscle weakness will begin to be observed in the lower extremities.
  3. Increased sweating.
  4. Restriction of movement that occurs due to pinched nerves. During bends, inclinations, and changing postures, bouts of pain similar to electric shocks will occur.
  5. Cooling of limbs, skin, blanching.
  6. In severe cases, sexual dysfunction occurs, problems with urination.

Without timely treatment, lumbar osteochondrosis can lead to paralysis and disability.

Exacerbation of the disease

With relative periods of remission, exacerbations occur. They are characterized by shooting sharp pain that girdles and runs down the sciatic nerve. As a result of the development of the disease, numbness reaches the toes. Such attacks disrupt the functioning of the pelvic organs and systems. As a result, erectile dysfunction, constipation, and urinary incontinence are observed.

Features of manifestation in women of lumbar osteochondrosis

Soreness in the pelvic area with lumbar osteochondrosis adversely affects the reproductive system of the female body. With the progression of the disease, the menstrual cycle is disrupted, its dependence on attacks of osteochondrosis may be observed. During pregnancy, osteochondrosis can cause premature birth or miscarriage.

Osteochondrosis treatment: main directions

For osteochondrosis of the lumbar spine, different methods of therapy are required. Only with an integrated approach can a positive result be obtained. The use of drugs will only relieve pain, will not affect the cause of the disease. To get rid of the disease, you need to apply acupuncture, hirudotherapy, therapeutic massage, vacuum exposure, as well as change your usual lifestyle. The treatment plan should be prescribed by specialists taking into account the stage of osteochondrosis, individual drug tolerance, the presence of chronic pathologies.

Treatment regimens in the acute period and during remission are significantly different. With exacerbation, first of all, it is necessary to relieve tension from the spinal column. For this, the patient must lie. It is better to use an orthopedic mattress with rollers for the neck and lower back. It is necessary to take muscle relaxants to help relax and relieve spasm. To reduce the consequences of pinching the nerve endings, injections of lidocaine, novocaine are used.

The period of remission suggests such a treatment regimen:

  • intake of vitamin B complexes to normalize the conductivity of nerve impulses;
  • restoration of blood circulation in tissues due to vasodilator drugs;
  • passing physiotherapeutic procedures to reduce the number of exacerbations. Special baths, various types of massage, magnetotherapy, acupuncture are prescribed;
  • physiotherapy exercises, which allows you to form a corset from the muscles, restore mobility in the lumbar region, reduce the load on the vertebrae. Exercises are selected individually by the trainer, taking into account the characteristics of the body.

Medications for the treatment of lumbar osteochondrosis

Medicines are divided into forms and methods of exposure:

  1. painkillers creams, gels for external use – Diklak Diklofenak;
  2. antispasmodics – Novigan, No-Shpa (affect the nerves that lead to muscle fibers, have a relaxing effect, help reduce spasm, improve blood flow);
  3. hormonal anti-inflammatory drugs – Medrol, Metipred. They are used for severe, exhausting pain. Hormones suppress inflammation, relieve pain, but inhibit immunity, leach calcium from bones, and reduce the synthesis of their hormones.
  4. chondroprotectors for restoration of cartilage tissue – Alflutop, Chondroxide. They slow down the destruction of cartilage, activate the synthesis of intraarticular fluid, relieve inflammation, stimulate the formation of new cartilage cells;
  5. non-steroidal anti-inflammatory drugs – Ortophen, Piroxicam. Drugs reduce pain, relieve inflammation. You need to take them for a long time. They only eliminate symptoms, do not affect the cause of the pathology. Negatively affect the mucous membrane of the digestive tract, causing gastritis and ulcers.
  6. Vitamins of group B.

Additionally, with osteochondrosis, sedatives are prescribed to put the nervous system in order.

Exercise for lumbar osteochondrosis

Physiotherapy exercises should be carried out regularly, only under this condition the effect of classes will be achieved. Physical activity should be the norm for people with osteochondrosis. Not only a set of special exercises, but also hiking positively affect the spine.

There are certain restrictions that must be implemented to reduce the risk of injuring the lower back during gymnastics. For example, weights cannot be performed. This will lead to additional stress on the vertebrae, which are in a destroyed state. It is also not recommended to perform twisting in the lumbar. This is especially true for patients with protrusions and hernias.

Physiotherapy exercises should not be performed if the patient has injuries, tumors of various origins, and hematomas, in addition to lumbar osteochondrosis. For diseases of the spine, active sports are not recommended.

Dietary nutrition as a treatment

A well-composed menu will help in maintaining health, strengthen the body’s strength. The diet should include:

  • all kinds of cabbage;
  • beef liver;
  • green pea;
  • sea ​​fish;
  • berries;
  • eggs;
  • carrot;
  • dried fruits.

Salt, pickles, marinades, condiments, alcoholic beverages, strong coffee and tea should be limited.

Surgical intervention

Surgery for lumbar osteochondrosis is prescribed only with the development of serious complications, for example, intervertebral hernia. Most often, a damaged disk is deleted. Surgical intervention is considered a radical measure, they resort to it when other methods have not brought a positive result within six months. Modern medicine has high-tech methods of microsurgical and endoscopic treatment, which are less traumatic.

Neurological symptoms in osteochondrosis of the lumbar

Ways to eliminate neurological manifestations

– lumbago, lumbalgia, lumbar ischialgia. Goosebumps and tingling in the legs, Lumbar lesion is manifested by acute attacks of lower back pain (lumbago). An attack can be triggered by a lift of gravity, a sloppy turn of the body, or even a cough, and lasts about 5-6 days. Often pain gives to the leg, paresthesia in the form of numbness or tingling in the limb is observed.

Physiotherapeutic and manual procedures to eliminate clamps of nerve endings and correcting the position of the spine; pulsating; -Timely treat diseases of the internal organs and small pelvis, especially the intestines, make sure that there are no constipation.

  1. 1. The main tasks in the treatment of patients with neurological manifestations of lumbar osteochondrosis are: In the autonomic-vascular syndrome of lumbar ischalgia, laser therapy and acupressure in combination with cryotherapy are used in the vasospastic form. Such a treatment regimen is acceptable: acupressure-segmental massage – mobilization techniques or PIR – light dry traction – rest 1,5-2 hours, then physiotherapy (laser therapy) – rest followed by baths (pearl or oxygen). Patients in this group are prescribed vasodilators and substances that improve venous outflow.
  2. A feature of this stage is the use of predominantly non-pharmacological methods of treatment and a minimum amount of drugs.In general, in the treatment of patients with neurological manifestations of spinal osteochondrosis, the following basic principles must be observed:
  3. Treatment of Lumbar Osteochondrosis Radicular

Chilliness of the legs, spasm of the arteries of the feet – the pulse sometimes even disappears. The neurologist examinations complex begins with a visual examination of the patient in a standing position, sitting and lying on the couch. In this case, the neurologist assesses the symmetry of the scapula and the presence of deformities of the spinal column. With the help of palpation, the doctor assesses the muscle tone, their soreness and the estimated level of damage.

Acupuncture; aggravated by coughing, sneezing, changing body position.

– Watch your body, posture, avoid excess weight. – Elimination of factors that compress, irritate the nerve roots in the spine,

It is possible to get a good effect by prescribing acupuncture.Treatment of this group of patients with severe pain syndrome (pains remain at rest, but their severity is somewhat less, patients can hardly move, taking analgesic poses) it is advisable to carry out in specialized departments, wards, dispensaries .

If necessary (with persistent pain and the presence of symptoms of loss of function of the spinal roots, etc.), drugs are prescribed.the use of pathogenetic therapy aimed at unloading the spine, strengthening the muscle corset, destroying blocks in the vertebral joints, as well as improving blood circulation in the system of vertebral arteries, improved microcirculation;

Described in the general section “Osteochondrosis, treatment.” – vertebrogenic (discogenic) lumbosacral radiculitis with damage more often than the fifth lumbar or first sacral root.

Violation of sweating. Also, at the initial examination by a neurologist, the amplitude of movements in the joints and the presence of contractures are assessed. A neurologist examination is supplemented by radiography, computed tomography or MRI of the spine. These studies allow you to accurately determine the location of the lesion and prescribe the appropriate treatment for osteochondrosis. Physiotherapy exercises.

Also, pain can occur not only in the area of ​​damage, but also “give” to the limbs. Provoking moments for the occurrence of lumbar osteochondrosis can be:

– In case of lumbar pain, contact a specialist doctor – suppression of the resulting pathological and the use of mobilization and manipulation techniques often leads to deterioration.

One of the leading therapeutic measures of this period is spinal traction, especially indicated for reflex syndromes (lumbago, lumbalgia, lumbar ischialgia with muscular-tonic, autonomic-vascular, neurodystrophic manifestations). For dry traction, a traction force of 5 to 20 kg is used for a duration of 10 to 40 minutes (horizontal or extension of the spine on an inclined plane).

The complexity of therapeutic measures, the impact on all pathogenetic links (spine, extravertebral pathological foci, nervous and immune systems);

Great help in the treatment of lumbar osteochondrosis can be provided by the therapeutic analgesic anti-inflammatory patch NANOPLAST forte.

Dryness and peeling of the skin in places of pain or loss of sensitivity.

In the acute period of the disease, the main goal of treating osteochondrosis is the relief of a pain attack. For this, a neurologist advises the patient to observe strict bed rest and prescribes pain medications. A good effect in the treatment of acute stage osteochondrosis is exerted by medical blockades and physiotherapy (exposure to ultrasound, magnetic field, UV radiation, etc.).

Since the treatment of lumbar osteochondrosis is a long process, the use of traditional medicine recipes will not be out of place:

The implementation of recommendations on the motor regime, maintaining the tonus of the musculoskeletal system, nervous system is the key to your success in the prevention of lumbar pain and other manifestations of lumbar osteochondrosis.

Stimulation of recovery reactions,

In case of the neurodystrophic lumbar ischalgia syndrome, the following scheme is recommended: relaxing massage (or thermal relaxation): deep forms of massage with treatment of foci of neuroosteofibrosis – reflexotherapy procedures (laser puncture or acupuncture) – rest 2 hours – physiotherapeutic procedures. In the afternoon – light traction with manual therapy, vacuum electrophoresis or relaxing massage.

  • Corsetting with a linen towel 50-60 cm wide and 6-8 meters long is advisable and convenient to use. Corsetting is carried out in a prone position, in tight circles in order to unload the spine. A “weightlifter belt” is also used; a special collar is placed on the collar area.
  • Staging in compliance with a clear sequence and continuity in such a way that treatment measures naturally pass into treatment and rehabilitation and rehabilitation up to a steady improvement of the patient’s condition;
  • With therapeutic
  • – sciatica, or compression along with the root of the vessels (radicular artery, vein).
  • In the event that spinal cord is pinched during lumbar osteochondrosis, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.

In the subacute period, treatment of osteochondrosis is carried out to improve the patient’s motor activity and prevent the progression of the disease. Most commonly used:

As a good warming agent, you can use horseradish tincture on vodka. To do this, mix 1: 1 vodka and grated fresh horseradish and insist for hours. Weight lifting is suitable;

Maxim Vodpianov – the formation of an adaptive motor stereotype.

In radicular syndrome, the following sequence of treatment procedures is advisable: muscle relaxation on a spherical table or on a rigid couch on the abdomen with legs down, bent at the hip and knee joints – massage according to the generally accepted method using mainly the point-segmental method – dry traction, with small loads on special tables – manual therapy using only at the VDS level with the affected root – corsetting – rest 2 hours – physiotherapy and balneological procedures s.

The prevalence of non-pharmacological treatment methods (manual therapy, traction, physiotherapy, CT, reflexology, etc.) over the pharmacological in the treatment and rehabilitation complex;

Treatment of lumbar osteochondrosis

The most unpleasant complication

Such a tool for rubbing the sore spot and for compresses (applied no more than 30-60 minutes).

Uncharacteristic physical activity;

Finely chop the 40 knees of the golden mustache, pour 0,5 vodka, insist 3 weeks in a dark, cool place, shaking occasionally. Take externally in the form of compresses and rubbing and at the same time inside – 3 times a day for 1 tbsp. l an hour before meals.

These tasks are successfully solved with the stage treatment, which allows you to streamline the medical care of this large category of patients.

In case of radiculoemia syndrome, vasoactive drugs that improve arterial and venous blood flow, dehydration agents and neurostimulants, repeated courses of treatment with the Myotonic device are introduced into treatment complexes.

Acupuncture is applied in the form of two courses: the first course of 15-18, the second – 10-13 procedures.

The individuality of the appointment of medical complexes, taking into account the characteristics of pathogenesis and the variant of neurological manifestations of the disease, course, as well as the state of the whole organism.

Various means are used, such as NSAIDs, muscle relaxants, and other drugs. All these funds are effective, but with prolonged use can harm the body. Therefore, it is very important to minimize side effects and increase the effectiveness of treatment of lumbar osteochondrosis. A new generation drug – the analgesic anti-inflammatory therapeutic patch NANOPLAST forte can help with this.

– acute, like lumbar, lumbar pain. It usually occurs after lifting weights, awkward movement, sometimes – coughing, sneezing.

Hop cones are crushed and mixed with fresh butter in a 1: 1 ratio. Cooked ointment should be applied at night. It should be stored in the refrigerator, and slightly warmed before use.

How to diagnose the disease?

Examinations confirming cervical osteochondrosis with neurological manifestations should be carried out by a neurologist. Initially, he carries out a visual examination of the patient in a standing position, lying and sitting. In addition, the doctor makes an assessment of the symmetry of the shoulder blades and confirms or refutes the presence of deformities of the spinal column. Using palpation, he can assess muscle tone, determine the degree of their soreness and the estimated level of damage.

At the initial examination, the neurologist checks the amplitude of movements in the joints and determines the presence of contractures. Diagnostic examinations such as radiography, computed tomography and MRI of the spine complements the examination. Thanks to such a study, it is possible to determine the affected area with high accuracy and prescribe effective treatment.

MED24INfO

Yarotskaya E.P., Fedorenko N.A. et al. Oriental treatments, 1999

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

I have been treating joints for many years. I can say with confidence that the joints are always treatable, even in the very ripe old age.

Hondrostrong is an innovative drug that is created to combat joint diseases. It helps with arthritis, arthrosis and other diseases. Thanks to the use of cream, joint mobility quickly returns. Damaged cartilage tissue is regenerated, which prevents the further development of the problem.

Hondrostrong gel for joints

Our medical center was the first to receive certified access to the latest drug for osteochondrosis and joint pain - Hondrostrong. I confess to you when I heard about it for the first time, I just laughed, because I did not believe in its high efficiency.

But I was amazed when we completed testing: 4567 people were completely cured of diseases of the organs of the musculoskeletal system, and this is more than 94% of all subjects. 5.6% felt significant improvement, and only 0.4% did not notice any improvement.

Hondrostrong cream allows you to forget about back and joint pain in the shortest possible time, literally from 4 days, and even very difficult cases can be cured within a couple of months. In addition, the manufacturer of this product is now offering a 50% discount of the full cost of Hondrostrong cream.

Neurological manifestations of osteochondrosis of the lumbar spine

Pain in the lumbar region can occur not only in osteochondrosis of the lumbar spine, but also in urolithiasis, prostatitis, and inflammatory diseases of the kidneys and intestines. Therefore, in each case, it is necessary to conduct differential diagnostics.
With lumbar osteochondrosis, pain can occur acutely (lumbago) or subacute (lumbalgia). The cause of pain is most often injuries, sudden movements, especially bending forward, lifting weights, excessive effort when pushing or moving heavy objects in front of you, prolonged stay in an inconvenience
new pose and, finally, any awkward movement. Pain usually worsens with prolonged sitting, standing, movements, coughing, sneezing, etc. One cause may be hypothermia.
The pain can spread in one, and sometimes in both limbs (lumbar ischalgia). The patient tries to find and take a pose in which the pain is not so intense (antalgic posture). On palpation, a sharp pain in the points corresponding to the spinous processes, intervertebral joints is detected.
In radicular syndromes, the fourth and fifth lumbar roots (L4 5), as well as the first sacral (sacral S,), are more often affected than others. With radicular syndromes, there can be not only pain, but also impaired sensitivity, motor function, as well as various vegetative-vascular disorders.
With osteochondrosis of the spine, various neurodystrophic changes in organs and tissues occur. This can be periarthrosis, coxatrosis, neurodystrophic changes in the sacroiliac joint, which lead not only to pain even when trying to move, but also to limit the function of the joints.
In addition to the pathology of the hip joint, periarthrosis of the knee or ankle joints, the formation of calcaneal spurs and even calcification of the calcaneal tendon can occur. Such changes in the joints can be associated not only with osteochondrosis of the spine, but also with joint trauma, as well as other various diseases, including inflammatory ones. An important role is also played by metabolic disorders in the body.
With a pronounced pain syndrome, the patient must provide a strict bed rest. The bed should be rigid or semi-rigid. Blockade with the addition of glucocorticosteroids and local anesthetics is advisable. Dry or underwater traction is appropriate. At home, “dry” traction can also be arranged. However, the load should not exceed 9 kg at home. Start with 5 kg, gradually increasing. Traction is applied for 2-3 hours after 1-2 hours after reflexology.
Most often, root damage occurs at the level of C – S, however, the level may be different. Depending
bridges from this on the meridian of the bladder use points (V-22, 23, 25, 27, 31, 32, 33, 34, 36, 40, 54, 57, 58,

  1. 62, 64, 67); on the meridian of the gallbladder (VB-30, 34, 39); on the meridian of the stomach (E-36, 41, 44); on the posterior median meridian (T-2, 4); on the meridian of the small intestine (IG-3), on the meridian of the colon (GI-4). To fulfill the rule “top-bottom”, and according to other theories, to “block” channels, use points V-11, 41, 60; T-14 (see the section “Meridians”).

Points are chosen taking into account the maximum localization of pain and its irradiation. So, when radiating pain along the back of the thigh, points V-36, 37, 40 stimulate; on the outside – VB-30, 31, 32, 33, 34; with pain in the calf muscle V-57, 58, 40, 60. In addition, points outside the meridians are widely used (TBM-71, 72, 75, 76, 81,

  1. 139), as well as “new” points (NT-56, 58, 103, 109).

With the introduction of needles, the braking method is used, with severe pain syndrome “strong” with all the sensations provided. The exception is patients with hypertension and very elderly people.
To enhance the effect of unilateral pain, points on a healthy leg are used, stimulating them according to an exciting method.
In the area of ​​the auricle use points: 40, 38,

  1. 54, 53, 29. On the ear, you can leave microneedles for 2-3 days.

The pain in the treatment process can move, then during corporal acupuncture it is customary to “chase” the pain using the appropriate acupuncture points.
After a acupuncture session, it is advisable to warm up several points at once, using the “ironing” Chiu.
In cases where it is necessary to carry out manual therapy, acupuncture should be performed before and after manipulations.
Traction should be carried out until the pain syndrome passes and the sensitivity and functions of the damaged roots begin to recover, and then prophylactically 2-3 times a week and after physical exertion for 2-3 hours. After the disappearance of acute

pain it is necessary to begin static gymnastics, which must be practiced systematically. Exercises and their execution time must be selected individually so that the pain syndrome does not intensify.
Location of points (Fig. 103, 104)
IG-3. Hou-si – in the fossa posterior to the ulnar margin of the fifth metacarpophalangeal joint, at the end of the palmar fold. Indications: lumbalgia.
V-22. San-jiao-shu – by 1,5 p.p. outside of the gap between the spinous processes of the I and II lumbar vertebrae. Indications: pain in the lumbar region.
V-23. Shen-shu – by 1,5 bp outside of the gap between the spinous processes of the II and III lumbar vertebrae. Indications are the same.
V-25. Da-chan-shu – by 1,5 bp outside of the gap between the spinous processes of the L4-C vertebrae. Indications: lumbalgia, ischalgia.
V-31. Shan-liao corresponds to the I posterior sacral foramen. Indications: pain in the lower back, sacrum, tailbone, along the sciatic nerve.
V-32. Tsy-liao corresponds to the II posterior sacral foramen. Indications are the same.
V-33. Zhong Liao corresponds to the III posterior sacral foramen. Indications are the same.
V-34. Xia-lao corresponds to the IV posterior sacral foramen. Indications are the same.
V-36. Cheng Fu – in the center of the gluteal fold. Indications: swelling, pain in the thigh, sciatica.
V-37. Yin-men – in the middle of the back of the thigh, below the center of the gluteal fold by 6 p. Indications: pain in the lower back and spine, sciatica, paralysis of the legs.
V-40. Wei-chung – in the center of the popliteal fossa. Indications: lumbar pain, sciatica, pain in the lower extremities. intermittent claudication.
V-54. Zhi-bian – by 3 p.p. outside of the fourth sacred hole. Indications: back pain, sacrococcygeal pain, sciatica.
V-57. Cheng Shan – on the back surface of the lower leg, in the corner formed by the heads of the calf muscle, on
the middle of the distance from the upper edge of the medial ankle to the fold of the popliteal fossa. Indications: crushing pain in the leg, cramps of the calf muscle, sciatica.
V-60. Kun-Lun – in the middle of the distance between the Achilles tendon and the lateral ankle. Indications: pain in the lower back, back, sciatica, pain in the lower leg with irradiation in the foot, pain in the ankle joint, in the outer ankle, sole, foot, fingers.
V-62. Shen-may – under the lateral ankle, at the lower edge of the calcareous protrusion of the calcaneus. Indications: breaking pain in the lower back, leg, ankle joint, leg muscle weakness.
V-64. Jing-gu – down and anterior to the base of the V metatarsal bone. Indications: lumbosacral sciatica, pain in the hip, headaches.
V-67. Chih-yin – 0,3 cm outward from the nail bed

  • toe. Indications: diseases of the genitourinary system, foot pain, hemiplegia, difficulty in nasal breathing, general malaise.

VB-30. Huan-chiao – posterior to the hip joint, on the lateral hollow of the buttock, at the intersection of two lines – the scallop of the ilium and the ischium. Indications: lumbar ischalgia, pain in the pelvic area, leg, knee joint, numbness in the legs, contracture and pain in the thigh.
T-2. Yao-shu – above the entrance to the sacral canal, in the center of the sacrococcygeal joint. Indications: lower back pain.
T-4. Min-men – between the spinous processes of L2-L3 vertebrae. Indications: lower back pain, lumbago, a feeling of tension in the muscles of the spine.
TVM-71. Xia-ji-shu – under the spinous process of the L3 vertebra. Indications: pain in the lumbar region.
TVM-72. Hou-ching-men – on the posterior upper part of the iliac crest. Indications: pain in the lumbar region, hips.
TBM-75. Shi-qi-chui-xia – under the spinous process of the L5 of the cowslip. Indications: lumbalgia, sciatica.

TVM-76. Chung-kun – by 3,5 bp outside of the lower edge of the spinous process of the L5 vertebra. Indications: lumbalgia.
TBM-81. Yu-tien – under the spinous process of the S4 vertebra. Indications: lumbalgia, sacralgia.
TVM-139. Quan Sheng Zu – on the back of the heel, in the middle of the upper edge of the calcaneus, on the Achilles tendon. Indications: lumbalgia.
NT-56. Shen-ji – by 0,5 bp outside of the lower edge of the spinous process of the L2 vertebra. Indications: lumbalgia, paralysis of the lower extremities.
NT-103. Yin-shan – by 4 pp. below the center of the gluteal fold. Indications: pain in the back, lower back, along the posterior surface of the lower extremities.
Auricle points (Fig. 103)
29. Nape point – in the upper third of the outer surface of the anti-tragus. Indications: sciatica.
38. The point of the sacral spine is at the beginning of the lower leg of the antihelix, on the inside. Indications: pain in the sacral spine, a feeling of “constriction”.
40. The point of the lumbar spine is on the inner edge of the upper cartilage of the antihelix. Indications: pain, parasthesia in the lumbar spine.

  1. The point of the sciatic nerve is somewhat anterior to the middle of the lower leg of the antihelix. Indications: lumbosacral radiculitis.

55. Shen-men – under the lower edge of the upper legs of the anti-virus. Indications: chronic pain syndrome.

  1. Aperture, zero – at the transition point of the horizontal part of the curl leg to its ascending part. Indications: pain.

104. The point of the three parts of the body is in the region of the lower edge of the auditory opening. Indications: pain.

  1. The point of lumbalgia is in the most protruding part of the cartilage of the beginning of the lower leg of the anti-virus. Indications: lumbalgia.

92. The point of the bladder is under the lower leg of the anti-helix, somewhat anterior to the middle of it. Indications: lumbalgia, neurasthenia.

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

Expertnews