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According to the statistics, up to the patients to 25% seek medical help in the relationship formation, pain in the lumbar region. 8 out of 10 live in the world experience pain in the back, at least 1 time in my life. Most often suffer from these symptoms, the persons of working age, slightly fewer people of retirement age, but less in adolescents (to various estimates, from 8 to 40% - Russia).
Therapist, neurologist, rheumatologist
The first doctors, which address the majority of patients the pain in the lower back, the therapist and neurologist. But the young people trauma in the recent past increasingly turned to the professionals.
Diagnostic and therapeutic tactics these professionals are different. Often, the therapist directs the patient to the neurologist, the neurologist determines to "the" diagnosis and prescribes the treatment. Professionals often work "individually", and the non-steroidal anti-inflammatory drugs, applied techniques of manual therapy, physiotherapy. The main thing is that the patient that you are not lost in this situation, not to get carried away by the promises of instant cure, when you execute the techniques, you don't have to use them again in case of failing, or worse, increased against the background of such treatment of pain.
If the conservative treatment, medication treatment, you must understand that the treatment for four weeks without result, a strong argument for review of the diagnosis, the treatment, to revmatologu not to conduct repeated courses of therapy. Often there are situations when the patient's complaint of pain in the lower back get symptomatic (pain) in the treatment of some conventional system without specifying the real cause of the pain.
The main causes of pain in the lumbar region
The pain, feeling heavy mobility or increased painful muscle tension in the region of the lower ribs, the bottom marker is the phrase, "lyumbalgiya". If these symptoms include pain in the feet, this condition is called lyumbalgiya.
The most important thing is the sharpness, the pain, the remote its occurrence. Pain in the prescription, 12 weeks (3 months) is called acute, longer than 12 weeks – chronic. The chronic pain syndrome may also occur exacerbation and periods of improvement.
It is essential that pain I felt. Or feel at a certain point, or of a licence ("projection", "radiation") is pain along the nerve in the thighs, buttocks, knees, feet, or fluffy, "blunt" pain. You have to understand that the limited movement of the spine in moments of pain, or the movement is unhindered (this may indicate the mechanical nature of the injury as a fracture of the vertebra). Where a moment's pain? Doesn't occur under load, or during a night? If you have answered yes to the last question is usually a "red flag" to the experts, whether the diagnosis of inflammatory diseases of the spine of the patient, (a little later). If the pain increases with movement of the head, walking, jumping, probably the so-called expected pain, which is caused by the damage to nerve structures (often sciatica).
Osteochondrosis, or spondilez – a condition in which there is no compression, deformation of the vertebrae, with the advent of the bone surfaces than the spikes, the media, the vertebrae. For a long time it was assumed spondilez the result of the natural degenerative processes of aging. However, it has been proven that it's not just the age, because the lower back pain. Sedentary lifestyle, the increased load on the lumbar spine during prolonged work at the computer or prolonged driving (e.g., professional truck drivers) contribute to the appearance of osteoarthritis young people. Under the influence of these factors, the intervertebral discs will be thinner, buffer, the nerve roots to the spinal cord injury raised the marginal spines on the bone. The constant irritation of these roots, the pain. The Latin root is called the radix, so that the inflammation is usually called radikulit.
The so-called inflammatory diseases of the spine – the area of interests of rheumatologists. This mysterious disease "more seriously" for a few years, starting with mainly young age mainly affected the men, which at the end of the obezdvizhennost I invalidizatsiyu patients. The patients in this group usually "go last" night pain, morning stiffness in the back, weakness, decreases the health. Unfortunately, the appearance of the first symptoms of the disease before the correct diagnosis, on average, approximately seven years ago. During this time, changes in the spine can become irreversible, and functional (locomotor) activity is low. The spine will be fixed, a shape-shifter, there's a bump. I found this pathology is not as common as lower back pain, for example, but the cost of treatment and the total disability in such patients is disproportionately higher.
If in addition to the back pain patient talks about the inflammation of the joints (most often we are talking about the knee joints, the joints of the hands or the feet), pain in the ass, unstable chair unusual impurities, decreased vision, or pain in the eyes, that's a reason to immediately send him to a specialist for the implementation of further advanced studies, and the exclusion of diseases, the group spondiloartritov (e.g., the negative spondylitis, or crohn's disease).
There are some diseases, indicating the pain in the lower back, completely intact vertebrates or the neural structures. One such disease – myofascial pain syndrome. Patients (especially young patients), indicate that the expenditure for a long time in an uncomfortable situation, or physical overload, preceded the development of the pain. When the doctors drew attention to a sharp pain when the pressure on the certain points located close to the spine. This condition significantly reduces the patient's quality of life, but small changes in the muscle tissue (the local tribe) are not dangerous to the nerve roots, or internal organs. In general, the therapeutic effect can be achieved by using the goal of muscle relaxants, low-dose steroid anti-inflammatory drugs, local injection (injection) the "pain" steroidal anti-inflammatory drug.
It is considered that if a patient's complaint of pain in the lower back part of the "red flags" (below), then further investigation is not necessary, the treatment the doctor studies without x-rays. But the practice shows, almost every patient these "signs" can be detected, therefore, it is necessary that blood least common (right – immunological) analysis, and perform the x-rays of the lumbar spine in two projections (ideally, the "capture" of the pool).
Secondary back pain which is not related to the low back pain alarm symptoms, forcing you to start your search is the primary pathological process causing the pain. In short, the symptoms, which may suggest possible secondary (i.e. not directly related to the spine) character of the pain requires increased vigilance, as the doctor to the patient:
A common mistake is to comply with bed rest for acute back pain. The movement in the pathology of musculoskeletal apparatus not only necessary, but essential! In all cases, except for the compression radiculáriszt syndrome (the diagnosis is established, a neurologist) to a horizontal position increases the treatment costs and prolong the healing time. When radiculáriszt syndrome, total time spent in bed should not be more than two days.
The inflammatory diseases of the spine, sacroiliac joints physical activity is a primary tool in the fight for the upcoming live. Recall that this group of diseases is gradually progressive in nature, and the exercises are designed, flexibility in maintaining, developing and strengthening the muscular "corset" for the spine is considered to be an effective treatment method, as a special therapy anti-inflammatory drugs, the different groups of designated professionals.