Lumbodynia syndrome: what is it? Lumbodynia Exacerbation of lumbodynia

When lumbodynia of the lumbar spine appears, treatment is not always started. According to experts from the World Health Organization, 90% of people have experienced lower back pain at least once in their lives. However, many of them ignore the symptom and do not consult a doctor. Especially in cases where the pain is random and goes away quickly. In some cases, lumbodynia occurs as a result of physical overload, and then disappears without a trace. But if the pain appears with enviable regularity and intensifies, you should not postpone a visit to a specialist.

What is lumbodynia

Having repeatedly encountered lumbar pain, people do not know what lumbodynia of the lumbosacral spine is. Lumbodynia is the name given to acute or chronic pain in the lower back. Its variety is lumbago. - this is a sudden, severe pain of a shooting nature (lumbago) in the lumbosacral spine. Lumbodynia refers to dorsalgia (back pain). She was assigned the ICD 10 code M54.5.

The term lumbodynia was introduced into medical practice to identify pain syndrome of vertebral etiology. After all, other diseases can cause lower back pain. They can be caused by muscle inflammation, diseases of the pelvic and abdominal organs (including cancer). Such pains are called referred pains.

Pain syndrome usually develops after:

• hypothermia;
• bruise;
• injuries;
• excessive physical activity;
• overwork.

Lumbodynia can occur after a long stay in a forced uncomfortable position, against the background of psychological experiences and stress. People who have sedentary jobs suffer from lower back pain. Prolonged stay in a bent position causes. Vibration negatively affects the condition of the spine.

Sometimes sharp pain appears after coughing, sneezing, yawning or sudden movement. Pain syndrome can be a consequence of long walking with flat feet or in uncomfortable shoes. It doesn't always appear right away. In some cases, discomfort in the lower back is detected only after 1 or 2 days.

Types of lumbodynia

Acute lumbodynia can be triggered by:

• injury;
• lifting a heavy load;
• displacement of the intervertebral disc with sprain of the posterior longitudinal ligament.

In this case, the pain is often so severe that the person cannot move. Even in a lying position, any movement causes him suffering.

Acute discogenic lumbodynia occurs as a result of protrusion of the intervertebral disc. It puts pressure on neighboring tissues and compresses nearby spinal nerve roots. The defect provokes muscle spasm, which puts additional pressure on the nerve endings, aggravating the patient’s condition. Pain that occurs as a result of compression of the spinal nerves in the L1–L5 segments, at the level of their exit from the spinal cord, is called lumbodynia with radicular syndrome.

The spondylogenic form of the disease is accompanied by mild to moderate pain. Exacerbation of pain syndrome can occur only after intense physical exertion. This form of the disease is diagnosed in children and adolescents. It provokes osteochondrosis.

Chronic lumbodynia is diagnosed when lower back pain persists for more than 12 weeks. They are often moderate and tolerant. Increased intensity of pain occurs after infectious diseases, stress and overwork.

Lumbodynia syndrome can manifest itself in 2 main forms, namely Levingston and Sol-Williams syndromes:

1. Levingston syndrome is characterized by stiffness in the triangle of the multifidus muscle. There is a feeling of tightness in this area and a constant dull pain is felt.
2. With Sol-Williams syndrome, the pain intensifies with a strong sigh, during coughing and sneezing.

How does lumbodynia manifest?

The painful sensation can be localized strictly in the center of the lumbosacral region. But more often it occurs to the right or left of the spine. The pain intensifies after prolonged standing or sitting. It grows gradually, acquiring painful intensity over time.

A semi-sitting position has a negative effect on the patient's condition. Being in it, a person feels quite comfortable. However, attempts to sit down or stand up cause a sharp dagger of pain that does not allow you to straighten up. To straighten up, patients are forced to press on the lower back with their hands.

Lumbodynia of the lumbar spine increases with muscle tension. It is difficult for the patient to wash himself while leaning over the sink. The ironing process, which requires keeping the body tilted for a long time, quickly causes fatigue and pain. Leaning forward becomes more and more difficult every day. The pain intensifies if heavy objects are held in the hands. It is very painful to pick up fallen things from the floor.

While in a sitting position, the patient tries to transfer his weight to the support in front or lean against the back of a chair, pressing his back tightly against it. This allows him to reduce pain. While walking, a person takes an unnatural position, trying to minimize discomfort.

A person feels comfortable only in a supine position. If pathological changes have occurred in the presacral disc, the patient prefers to lie on the healthy side. If there is compression of the root near the fourth lumbar disc, he tries to lie on the sore side.

During an exacerbation, the pain increases for several days in a row, reaching its peak on the 4th or 5th day. After this, lumbodynia syndrome decreases and disappears if the patient remains calm and avoids any stress. In cases where a person does not change the rhythm of life and refuses treatment, the pain syndrome does not disappear. It may remain intense or become less pronounced.

In some cases, lumbodynia torments people for weeks or even months. Pathology develops and spreads to neighboring areas. Over time, pain appears in the buttock, leg or tailbone area, transforming into and. Its symptoms and treatment depend on the stage of development of the pathology.

How to cure lumbodynia

When pain occurs, the patient is prescribed rest. It is necessary to lie in bed more and avoid sitting. Until the pain disappears, you need to wear a special orthopedic belt that will support the vertebrae in the correct position.

If the pain is very severe, then strict bed rest is prescribed for 7-10 days. The patient is recommended to lie on his stomach more often. When a person lies on his back, a special circle or a terry towel rolled into a ring is placed under his lumbar region.

The pad allows the affected area of ​​the spine to be supported. Place a pillow or rolled blanket under your feet. Elevated legs reduce the load on the spine and help return the vertebrae to their normal position.

To eliminate severe pain and reduce inflammation, non-steroidal anti-inflammatory drugs (Diclofenac, Ibuprofen, Ketoprofen, Meloxicam) are prescribed. It is recommended to give injections on the first day. The drugs are then taken orally. The tablets should be taken during or immediately after meals, with plenty of water. If the patient has diseases of the digestive system, therapy is carried out in the form of injections. Ointment (Diclofenac, Ibuprofen) is applied to the lumbar region 2-3 times a day.

The duration of treatment with non-steroidal anti-inflammatory drugs depends on the duration of lumbodynia. For severe radicular pain, you need to take 1 type of drug for at least 3-4 weeks.

Excruciating pain is relieved using paravertebral blockades with anesthetics (Lidocaine, Procaine) in combination with hormonal drugs (Dexamethasone, Hydrocortisone).

He is prescribed:

• gentle manual therapy techniques;
• massage;
• acupuncture;
• spinal traction;
• physical therapy.

Physical therapy for lumbodynia

For the first exercise, you need to lie on your back. Legs are bent at the knees and pressed to the chest, holding them with your hands. You need to stay in this position for several minutes. At this time, the spine is unloaded and slightly stretched in the lumbar region.

For the next exercise, arms are spread to the sides (lying on your back). One leg is bent at the knee and placed on the floor. In this case, the foot of the bent leg should touch the knee of the straight leg. The head is turned in the direction opposite to the side on which the bent knee is located. The exercise is repeated 5–10 times, changing legs.

The third exercise is done by bending both legs at the knees and placing them on the floor. The head is turned in the opposite direction. Then the legs are placed on the other side, changing the position of the head. The exercise is repeated 5-10 times. When performing crunches, you should try not to lift your pelvis from the floor.

For the fourth exercise, you need to get on all fours. The back is arched, lowering the head down, then arched, raising the head up. The exercise is repeated 5–10 times.

All movements must be performed slowly and smoothly. Therapeutic exercises can be repeated 2 or 3 times a day. If sharp pain occurs during exercise, you should consult your doctor.

Lumbodynia is a collective concept denoting pain and inflammation in the lumbar region. In this case, the intervertebral discs, the spinal column itself, as well as the area around the spinal column are exposed to the inflammatory process. At the same time, nearby tissues and muscle fibers are also involved in the inflammatory process.

Is lumbodynia dangerous?

With proper treatment, the changes that occur with lumbodynia are quite easy to treat and do not pose a serious danger, leaving no traces behind. However, in the absence of treatment, or with improperly selected treatment, lumbodynia can be dangerous due to constant and intense progression, in which more and more tissues are involved in the inflammatory process. It is also worth noting that the disease progresses very quickly.

Its danger also lies in the fact that there is a serious danger of involvement of the cerebrospinal fluid in the inflammatory-infectious process, which can result in its contamination and spread of infection throughout the spinal canal, including into the brain area. This may result in an inflammatory-infectious process in the brain area. A common consequence of lumbodynia is myelitis (inflammation of the meninges), stroke (bleeding in the brain).

A generalized inflammatory and rheumatic process may also occur, which is accompanied by damage to connective and muscle tissue. At the same time, the heart muscle is often involved in the rheumatic process, which is fraught with heart defects, the development of severe damage to the heart muscle, up to heart disease and heart failure.

ICD-10 code

M54.4 Lumbago with sciatica

Epidemiology

According to statistics, lumbodynia occurs in every 10 people in a severe, quite pronounced form. Most often it appears in winter, since during this period the body is as weakened as possible, and cases of frequent hypothermia are also observed. This entails pain in the lumbar region. In first place in terms of the incidence of lumbodynia are patients who lead a sedentary, sedentary lifestyle, as well as those who have a history of musculoskeletal diseases. In second place, strangely enough, are athletes who, on the contrary, experience excessive stress on the skeletal and muscular system, feel overload and overtraining, as well as frequent injuries and damage. In third place are elderly people, especially those who suffer from acute and chronic arthritis, osteochondrosis, and radiculitis. The fourth place is occupied by people who have had infectious diseases and are undergoing chemotherapy and radiation. In fifth place are children under one year old and newborns with genetic abnormalities in the motor system.

Causes of lumbodynia

There can be many reasons, and in almost every case they are strictly individual. For example, lumbodynia can be a consequence of frequent stress, neuropsychic stress, as well as a consequence of the development of allergic, infectious, infectious-allergic diseases. Often pain in the lumbar region develops against the background of 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 is chronic, at some point manifesting itself in the form of acute attacks of pain. In this case, it is often a concomitant factor against the background of inflammatory diseases of the upper and lower respiratory tract, nervous diseases and heart failure. It often appears during pregnancy and breastfeeding. Other tissues and organs may also be involved in the inflammatory process.

Often pain in the lumbar region is caused by hard work (physical), improperly distributed load, or excessive strain on the lower back. Often the cause is a bacterial or viral infection that accompanies the inflammatory process. Cytomegalovirus infection, herpes, and bacterial infection – streptococcal infection play an important role in maintaining inflammation. Less commonly, staphylococcal infection. Often, lumbodynia is caused by a recent infectious disease, including tonsillitis.

Sometimes congenital, genetically determined lumbodynia develops, which develops during the period of intrauterine development, and is subsequently a consequence of various diseases of the musculoskeletal system, its underdevelopment, and increased physical activity. The cause can even be intrauterine and postpartum infection of the fetus, with further progression of the infection along the spinal column and 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, a feature of this disease is that it causes intensive deposition of moles in the intervertebral discs, which causes pain and stiffness. It occurs mainly against the background of a sedentary lifestyle, with improper gait, improper sitting, and prolonged stay in one position.

Lumbodynia against the background of dorsopathy

It is a pain syndrome of inflammatory origin, the main etiological factor of which is considered to be insufficient mobility, poor hygiene and daily routine, which entails an inflammatory and infectious process. Bone and muscle structures are involved in this process, including the vertebrae and intervertebral discs. The danger is that nerve fibers can also be involved in the inflammatory process, which increases pain, which intensively spreads along the nerve fiber. The process can be manifested by severe attacks of pain, which alternate with a feeling of burning and heat in the affected area.

Post-traumatic lumbodynia

As the name suggests, this is lumbodynia, which develops in response to injury. That is, it is a severe pain syndrome in the lumbar region, which develops after an injury affecting the lower back. Any factor of high intensity and strength can be traumatic. This may be a mechanical factor of a damaging nature (fall, strong push, pressure, mechanical friction). Often this pain occurs as a result of rapid-fire violence against the lumbar spine.

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

Risk factors

The risk group includes people who often suffer from colds and infections, as well as those who take antibiotics and chemotherapy. A special group consists of people who are often exposed to traumatic influences and subject their lower back to heavy physical stress. People with dysbacteriosis, as well as with the presence of foci of infection (bacterial, viral), also have a significant risk of getting lumbodynia. The risk also increases in the presence of acute or chronic diseases of the musculoskeletal system, including osteochondrosis, arthritis, bursitis. There is also a high risk if you have diseases of the nerves and nervous system.

Pathogenesis

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

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Symptoms of lumbodynia

Acute lumbodynia

The acute phase implies the presence of an inflammatory process in the lumbar region and coccyx. Nerves are involved in the inflammatory process and are mechanically damaged. The pain is usually sharp, acute, more pronounced during the daytime, and also after a person has been in one position for a long time. Acute pain is practically not eliminated with the help of physical exercises, but requires special treatment, for example, injections or the use of local remedies. The most commonly used are ointments, gels, creams and other medications.

Subacute lumbodynia

The subacute form of the disease is characterized by a relatively mild form of the course, in which pain bothers a person only in the presence of appropriate conditions. For example, if a person sits or lies for a long time without moving, he will experience pain. The pain is less piercing, rather aching, pulling, which easily spreads to neighboring areas. It goes away quite quickly under the influence of physical exercises aimed at the lumbar region.

Chronic lumbodynia

The pain, which 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, this could be severe hypothermia, excessive nervous and mental stress, heavy physical activity, and even improper distribution of the load with its predominant localization in the lumbar region.

Moderate lumbodynia

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

Complications and consequences

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

You should also be wary of the possibility of degenerative processes, which are accompanied by conduction disturbances, inflammation of the nerves, and inflammation of the myelin sheaths.

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Exacerbation

Occurs mainly in spring and autumn, since it is during this period that most inflammation occurs. This is due to the fact that this period is accompanied by maximum weakening of the body, defense mechanisms, and resistance.

It happens under the influence of various unfavorable factors on the body: excessive stress, overexertion, increased load on the body. Quite often, an exacerbation occurs in the summer, when a person performs various physical activities, swims in a river, bathes, sunbathes on cold ground, freezes, a sharp change in temperature occurs - after tanning in the sun, a person plunges into cold water in the river. Failure to adhere to the daily routine, poor diet, abuse of non-dietary foods, alcohol - all these can be factors that trigger an exacerbation.

It should also be noted that in winter, exacerbations also occur quite often, especially in severe frost (due to hypothermia, draft, cold, piercing wind). Also often exacerbation occurs from stress, neuropsychic overstrain.

Remission

Characterized by a state of relative calm and improvement. Almost always occurs in any chronic pathology. A fairly long remission can occur after an acute attack of lumbodynia has been cured. Treatment with special medications, as well as after injections of painkillers, usually results in a state of remission.

If this condition is not maintained with special supportive therapy, preventive medications and physiotherapeutic procedures, remission can quickly develop into a state of new exacerbation. But if you maintain this regime, remission can last quite a long time - from several months to several years. There are cases when, after the onset of remission, no more exacerbations occurred, and a person lives for decades without new attacks, although due to various circumstances, the diagnosis was not finally removed.

Persistent lumbodynia

This condition can also be quite long-lasting. The pain is usually not relieved by any medications or ointments. But in order to prevent persistent lumbodynia from becoming chronic, mandatory treatment is required. In most cases, mandatory hospitalization is required, since inpatient treatment is ineffective.

Recurrent lumbodynia

It often happens that lumbodynia is completely cured, and after a few weeks it returns again. This return of the disease after improvement is called relapse. At the same time, in a repeated case, treatment is also required. If possible, comprehensive treatment should be carried out, and hospitalization may even be required (as this is the most effective, comprehensive form of treatment). It is worth noting that the treatment of relapse must be approached with the utmost seriousness, since if not cured immediately, the disease can become chronic.

Diagnosis of lumbodynia

As soon as you feel acute pain, contact a neurologist or surgeon. A neurologist will conduct an examination and check basic reflexes. It is also important to consult a surgeon, who in most cases palpates the pathology and determines its cause and pathogenesis. If these specialists are not available, help can be provided by a traumatologist, or an orthopedist, or an orthopedic surgeon.

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

As a last resort, if the clinic does not have specialists in such areas, you should contact a therapist, who will refer you to the necessary specialists. In such cases, almost always, a consultation with a surgeon and a neurologist is prescribed.

Usually the diagnosis is made based on the results of the examination: severe pain. There is a decrease in basic reflexes. First of all, 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. Lasègue symptoms are observed.

Instrumental diagnostics

It is impossible to do without the use of instrumental research methods. The main methods are such methods as X-ray examination, as well as computed tomography and magnetic resonance imaging. These are methods that make it possible to determine the cause and exact localization of the pathology as accurately as possible and in a relatively short time.

The main goals of such a study are to determine at what level (part of the spine) the pinching occurred. An X-ray examination is carried out. CT and MRI are used in relation to the affected area.

Sometimes electroneuromyography may be required to determine not so much the cause as the violation of muscle contractility. It records how and at what speed/intensity nerve impulses travel.

Analyzes

Laboratory methods are ineffective and are rarely used in the diagnosis of lumbodynia. At the very least, standard methods, such as clinical and biochemical blood tests, will not show an accurate picture of the pathology. But sometimes these research methods may be required. For example, if an X-ray or tomography shows pinched and compressed nerves, tests can be used to determine what exactly caused the compression. For example, you can use a biochemical blood test to identify a tumor and determine its location. A routine clinical blood test is often 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 is taking place - septic or aseptic.

The most common reason for people turning to a neurologist is pain in the lower back or lumbodynia syndrome (from the Latin. lumbus – small of the back and Greek algos – pain). According to data from various sources, the frequency of this pathology among neurological patients varies from 57 to 59%. Most often, middle-aged men and elderly women complain about it, although cases of lumbodynia have also been reported in children. The cause of lumbar pain can be various serious diseases of the musculoskeletal system or internal organs. Therefore, professional diagnosis when symptoms of lubalgia appear, as well as qualified medical care and treatment are simply necessary.

Lumbodynia is a type that in the international classification of diseases ICD-10 is encrypted with code M54.5 (low back pain, lumbar pain). The following types of lumbodynia are distinguished:

• acute – sudden severe pain in the lower back, which intensifies with the slightest movement;
• chronic – pain in the lower back, which lasts for several weeks, gradually intensifying;
• vertebrogenic - in this case it leads to lumbodynia;
• non-vertebrogenic – pain syndrome is caused by non-vertebral pathologies.

Anyway, lumbodynia is a pain syndrome, in which pain can be caused by various reasons, but always localized in the lower back and is accompanied by severe spasm of the spinal muscles.

The mechanism of development of lumbodynia is as follows:

1. For a number of reasons described below, a person begins to experience pain in the lower back, which may be:
   • – if the roots of the spinal nerves are compressed;
   • referred – lumbar pain is caused by a disease of the internal organs of the abdominal cavity or pelvis;
   • local – pain caused by irritation of the musculoskeletal structures located directly in the lumbar region.
2. As a result of constant discomfort, a suffering person tends to involuntarily take a position that temporarily alleviates his condition.
3. The back muscles are constantly tense and cannot relax on their own.
4. Spasm of the spinal muscles causes pain, which aggravates the patient's condition.

Causes of pain in the lumbar spine

The causes of lumbodynia can be combined into two groups:

1
Vertebrogenic, that is, associated or caused by a person’s existing spinal diseases: 2
Nonvertebrogenic or not directly related to diseases of the spinal column:

• diseases of internal organs (reproductive, kidneys, intestines);
• myofascial pain syndrome, which develops as a result of long-term antiphysiological disorders of posture or mechanical damage to the muscles and fascia of the back;
• inflammatory diseases (herpes zoster,).

What causes lumbodynia?

Risk factors for developing lumbodynia include:

Symptoms of vertebrogenic lumbodynia

• Pain in the lower back is localized mainly on one side and can be of varying degrees of intensity. The most severe “shooting” pain develops due to pinching of the spinal nerve roots. Its result may be forced immobilization of the patient. If the pain is aching and of low intensity, this may indirectly indicate that the cause of lumbodynia is non-vertebrogenic.
• The pain worsens with movement, coughing, sneezing, and straining during bowel movements. The patient feels better if he lies on his side.
• Severely limited range of movements. It becomes almost impossible to bend forward. Lateral bending and bending your back back are less painful. It is difficult for the patient to quickly sit down, cross his legs or go down the steps. In the latter case, he tries to transfer the entire load to the leg on the healthy side.
• It is very difficult for the patient to straighten up from a bent position. To do this, he helps himself with his hand placed on the lower back.
• The psoas muscles are very tense. The patient cannot relax them completely.
• Feeling the spine and surrounding muscles is very painful.
• Gate's symptom is positive: sharp pain occurs if, while lying on your back, you try to sharply bend the leg on the affected side at the hip and knee, bringing it closer to the stomach.

Diagnostic examination

Diagnosis of lumbodynia is not difficult and is based on:

• thorough examination of the patient using appropriate neurological and neuroorthopedic techniques;
• analysis of the medical history and the dynamics of its development.

It is much more difficult to establish the immediate cause of lumbodynia. To do this you will need:

• A thorough somatic examination to exclude all possible non-vertebral causes of lumbodynia. It is necessary to undergo laboratory tests, do an ultrasound of the abdominal organs, and visit a urologist and gynecologist.
• Take an x-ray of the lumbosacral spine in 2 projections: direct and lateral. Using this instrumental study, it is possible to detect a number of spinal pathologies that may be the cause of lumbodynia.
• Tomography - computer or magnetic resonance imaging - is the most informative diagnostic method for any form of lumbodynia.

Treatment of lumbodynia syndrome

Treatment of lumbodynia should be simultaneously:

1. symptomatic, the purpose of which is to eliminate the pain symptom;
2. etiological, the purpose of which is to eliminate the immediate cause of lumbodynia.

Rules to follow when treating lumbodynia:

There is no universal treatment regimen for lumbodynia, since each case of this disease is unique. That is why you cannot treat lower back pain on your own, on the advice of friends and acquaintances - this can provoke a serious deterioration of the condition and lead to emergency hospitalization.

Practiced methods of treating lumbodynia:

Treatment method	Short description
Drug treatment	Groups of drugs used: non-steroidal anti-inflammatory drugs: Ibuprofen, Nurofen diuretics: Lasix antihypoxants: Actovegin muscle relaxants: Mydocalm, Sirdalud, chondroprotectors: Chondroitin, Dona, Elbona neurotropic: Finlepsin, Medazepam antidepressants: Amitriptyline drugs for the treatment of specific somatic diseases that have caused the development of non-vertebrogenic lumbodynia Drug blockades with painkillers and in case of severe pain
Non-pharmacological and physiotherapeutic treatments	massage and hydromassage physiotherapy magnetotherapy ultrasound therapy laser therapy electrotherapy shock wave therapy thermal applications with paraffin and ozokerite medicinal electrophoresis with analgesics and anti-inflammatory drugs manual therapy, in particular post-isometric muscle relaxation traction therapy: dry or underwater traction of the spine acupuncture
Folk remedies	massage and applications with pine resin mixed with vegetable oil;

Lumbodynia is a collective term denoting local pain in the lumbar region. Among all back pain that is localized in the lumbar region, lumbodynia ranks first. About 20% of the world's population suffers from lumbodynia.

With timely treatment, the discomfort is relieved and the patient feels much better. Lack of treatment leads to progression of the pathological process, the formation of irreversible damage to bone, cartilage tissue, nearby muscles, and nerve roots. In some cases, the situation reaches the point of disability.

Reasons for the development of lumbar lumbodynia

Many patients confuse the names of pathological conditions: lumbodynia and lumboischialgia. In the first case, the pain is localized in the lumbar region, manifested by acute attacks of discomfort, often provoked by coughing, heavy lifting, and excessive physical activity. In the case of radiating pain, we are talking about lumboischialgia.

Lumbodynia develops against the background of many negative factors. Experts identify several pathological conditions that provoke the appearance of lower back pain:

• flat feet, excess body weight;
• natural processes of aging of the body;
• hypothermia of the lumbar region and the body as a whole;
• genetic predisposition;
• lack of nutrients in the body;
• surgery, various traumatic injuries of the lower back;
• during pregnancy, frequent stress;
• incorrect choice of shoes (tight shoes, wearing high heels);
• a sharp growth spurt in children and adolescents;
• infectious lesions of the spine, the presence of systemic chronic diseases.

Lack of therapy leads to the spread of pain to the area of ​​the buttocks and lower extremities, which is caused by pinched nerve endings. Often, lumbodynia is accompanied by urological, gynecological ailments, problems with the intestines and digestive tract. Considering the danger of lumbodynia, When the first signs of pathology appear, immediately visit a doctor, get treatment.

Spinal diseases are one of the few that can be prevented by following preventive recommendations:

• sport. Train gradually, no need to lift heavy weights, the best option is to work with a trainer. Over time, you will build up enough muscle mass that lumbodynia will definitely not appear;
• If you stay in one position for a long time, do short exercises regularly. There are exercises that can be done in a sitting position; such manipulations are recommended to be done during flights or long trips;
• watch your body weight. Obesity leads to an increase in the load on the spine, slows down metabolic processes, and has a detrimental effect on blood circulation and other functions in the body;
• sleeping place is very important. Buy an orthopedic mattress on which the muscles will be as relaxed as possible, the spine will take the correct anatomical position during the night's rest. The pillow should also be low.

Simple rules will protect you from various diseases of the spine, help you travel comfortably and have a quality rest. If lumbodynia does develop, consult a doctor and start treatment on time.

Video - a set of exercises to relieve severe lower back pain due to lumbodynia:

The spine is the structure of the human skeleton that is subject to enormous stress, especially during walking and lifting weights. In this regard, the spine is more susceptible to various pathological processes, among which one of the most common is lumbodynia of the lumbar spine.

In medical terminology, the term lumbodynia means a disease accompanied by painful sensations in the lumbar region of various etiologies. This pathology is not independent; it develops under a huge number of concomitant factors, most of which are separate diseases.

The pathological process can be divided into two main types:

1. Spondylogenic lumbodynia - the development of the disease is caused by compression of blood vessels, which leads to impaired blood circulation in the lumbar spine. The pathological process also involves intervertebral joints and the vertebrae themselves.
2. Discogenic lumbodynia - this term implies deformation of the joints in the mentioned area of ​​the spine, accompanied by severe pain in the lower back. The deformity is caused by pathological changes in the intervertebral space.

The disease lumbodynia is predominantly neurological in nature and can be diagnosed in people of any age group. For example, in adolescents, pain is caused by active stages of growth; in middle-aged people, increased physical activity, injuries, and illnesses. But still, older people are most susceptible to lumbodynia, in whom most diseases arise in connection with age-related changes in the body, affecting the nervous system, cartilage and bone tissue, muscles and ligaments.

Classification

Lumbodynia according to ICD 10 is a type of another back disease - dorsalgia, caused by tissue degradation or spinal injuries.

Lumbodynia was assigned a separate code according to ICD 10 - M 54.5. As for the formulation, according to the international classification, this pathology is characterized by pain in the lower back, lumbar pain, which has a different etiology.

It is also worth understanding that the disease, in addition to the two types described earlier, has several separate types, differing in the duration of the course and the specificity of painful sensations:

• Acute lumbodynia - it is characterized by sudden intense pain in the lumbar region, aggravated by the slightest movements, walking, turning the body, bending, etc. In some cases, pain in the lower back may not be associated with injuries or pathologies of the spine. A striking example would be lumbodynia with radicular syndrome, in which prolapse of the intervertebral disc occurs with subsequent pinching of the nerve roots.
• Chronic lumbodynia - in this case, pain in the sacrum and lower back can also appear suddenly, but initially their intensity is extremely low. Painful sensations do not go away for a long time (systematically accompany a person for 6 months or more), and are gradually increasing in nature. The pain radiates to the buttocks, then the legs, and also up the back.
• Vertebrogenic – painful sensations vary in specificity, but are almost always long-lasting. The cause of lumbago lies in various diseases of the spine, including osteochondrosis, osteoporosis, protrusions, injuries and much more.
• Nonvertebrogenic - pain that occurs in the lower back is not related to lesions of the spinal column. They are provoked by other diseases of the lumbar localization, for example, kidney pathologies.

When pain occurs in the lumbar back, it is always customary to talk about lumbodynia. However, this concept is general; it requires further study of the nature and causes of pain in order to make an accurate diagnosis and further treatment.

Causes of pathology

The cause of pain, called the generalized concept of lumbodynia, can be many different factors. In this case, we are talking about diseases of the spine, internal organs of the abdominal cavity, and various external factors.

First, let's look at the list of the most likely causes of lumbodynia that are not related to diseases:

In addition to injuries and other factors mentioned, you can also add hypothermia of the back, excess weight, constant exposure to stress and age-related changes to this list.

As for the more dangerous causes of the development of the pathological process, that is, diseases, these include:

• – wear of the intervertebral discs occurs with subsequent damage to the roots of the spinal nerves with subsequent swelling.
• Arthrosis is accompanied by thinning of the intervertebral discs, which leads to the abrasion of cartilage tissue.
• , as well as protrusions affecting these joints.
• Pathological narrowing of the spinal canal caused by the proliferation of bone tissue and compression of the spinal cord.
• Spondylitis is an inflammatory process affecting the spine. Pathology can develop under the influence of diseases such as tuberculosis, syphilis, gonorrhea or due to damage to the body by fungi.
• Osteoporosis is a violation of microcirculation within bone tissue leading to its destruction. The result is not only lower back pain, but also various complications.

This list contains the most likely causes of the development of lumbodynia due to the progression of various diseases. However, this can also include pathologies accompanied by damage to nerve tissue and much more.

We must also not forget about non-vertrebrogenic lumbodynia, in which a person suffers from pain associated with pathologies of the kidneys, organs of the reproductive system and parts of the gastrointestinal tract, and oncology of the corresponding localization.

Symptoms

Of course, with lumbodynia, the main symptom is pain in the lumbar region, because it is this clinical sign that determines the existence of the medical term under discussion.

But, firstly, the pathology also has other manifestations, and secondly, the pain symptom has its own specificity, which may indicate the reasons for the development of the pathological process.

So, the clinical picture of lumbodynia is as follows:

• The first symptom is painful sensations, which are of a different nature. In some cases there is a sharp pain, in others it is dull and aching.
• The pain can be paroxysmal (in this case it is cyclical) or constant.
• Depending on the specific nature of the damage to the vertebral joints or other causes, the pain is localized on one side or covers the entire lumbar region.
• In the case of lumbodynia, pain intensifies with movement, exertion, coughing, palpation, and often radiates to the pelvic region and legs.
• In addition to painful sensations, if we are talking about damage to the spinal nerves, the skin in the lumbar region may become numb, goosebumps, and tingling.
• Stiffness of the lower back muscles and spinal ligaments, their rigidity.

In some cases, there are disorders of stool and urination, and men have problems with potency.

Diagnostics

To make an accurate diagnosis, certain diagnostic methods are required. In addition to the initial examination of the patient and collection of anamnesis, the doctor may refer the patient for the following examinations:

• back to identify spinal deformities.
• - a procedure that can establish in detail the nature of the pathology.
• – is required to determine how the development of the identified pathological process affects nearby tissues and nerve branches.

Treatment of the disease

Treatment of lumbodynia requires mandatory consultation with a doctor. At the same time, for a full-fledged fight, not only a systematic, but also an integrated approach is required, which involves the use of the following methods:

• Drug therapy.
• Massages.
• Physiotherapy.
• Pharmacopuncture.
• Reflexology.
• Ethnoscience.
• Surgical intervention.

To fully understand the principles of treatment of lumbodynia, let’s consider each point separately.

Drug therapy

The doctor prescribes certain medications, sets dosage and duration of administration of each, followed by adjustment of treatment. Let's consider the main groups of drugs aimed at combating symptoms and treating pathology:

• In order to improve the patient's condition and relieve pain, antispasmodics and analgesics are prescribed.
• Non-steroidal anti-inflammatory drugs are often prescribed in the form.
• If swelling occurs, resort to the use of diuretics.
• In some cases, vasodilators are required.

Much depends on the causes of lumbodynia, because, say, the methods of treating a pinched nerve and usually a bruise will be radically different.

Massage

A massage performed by a specially trained health worker (physiotherapist), provided the massages are carried out over a long course, gives excellent results. Therapeutic massages are aimed at:

• Strengthening ligaments and muscles, increasing their elasticity;
• Restoring spinal mobility and flexibility;
• Relieving muscle spasms;
• Normalization of blood circulation;
• Elimination of pain;
• Acceleration of regeneration processes.

Physiotherapy

Physiotherapy treatments are also prescribed by a doctor. In this area, you may need a course of the following procedures:

• Exposure to ultrasound;

Operative surgery

Surgical intervention is resorted to only in extreme cases, when pathological processes in the vertebrae threaten a person’s life or, for example, create a threat of paralysis.

Depending on the nature of the pathology, discectomy and other implantation methods may be required.

Pharmacopuncture

A relatively new trend in medicine, which involves treatment through subcutaneous injections of drugs. Injections in the lumbar region quickly relieve pain, normalize the patient's condition and promote recovery.

Reflexology and acupuncture

Reflexology and acupuncture involve influencing biologically active points through acupuncture and acupressure. This is an auxiliary treatment method, however, it allows you to speed up regeneration and metabolic processes, speeding up recovery. The pain disappears after 1-2 sessions.

Folk remedies

Treatment with folk remedies is also an auxiliary method and yet it is an excellent help to the methods already described. Let's look at the most effective traditional medicine recipes:

• Ointment with the addition of pine resin - to prepare, take 20 grams of resin and 200 milliliters of any vegetable oil. Mix both ingredients thoroughly and rub into areas of pain. Repeat the procedure daily for 14 days.
• Infusion for rubbing - soak 4 tablespoons of chopped walnuts in 500 milliliters of alcohol. The tincture is “prepared” for 14 days, all this time it stands in a dark, cool place, it needs to be shaken daily. After 2 weeks, the patient rubs a small amount of tincture into the lumbar area every day.