Low back pain, lumbar herniated disc, spinal disc protrusion, sciatica

 

Low back pain, lumbar herniated disc, spinal disc protrusion and sciatica

There are many disease that lead to the appearance of low back pain in the spine (acute back pain, chronic back pain, sciatica). Some of them are congenital, as spina bifida, others are due to skeletal degeneration or musculoligamentous injury (osteochondrosis, spondylosis, spondylarthritis, osteoporosis, etc.).

However, most causes of low back pain (acute low back pain, chronic low back pain, sciatica) in the working population can occur from general wear and tear, such as jobs that require constant sitting, but especially jobs that require lifting, traumatic spinal cord injuries (compression fracture of the spine) and served by affected nerve roots.

Compression of the sciatic nerve with the appearance of pain in his leg in osteochondrosis of the spine with disc herniation.

In outpatient practice in patients with osteochondrosis of the spine is most common accumulation mechanism of low back pain. The appearance of persistent pain symptoms in the spine (low back and waist pain) on the background of already existing degenerative disc disease ( protrusion or herniation of intervertebral disc) is preceded by the presence of discomfort for the patient over a long period of time.

Pain in the spine (low back and waist pain) occur much less frequently in individuals, leading sports lifestyle. Prevent the development of degenerative disc disease of the spine and the appearance of pain in the spine (low back and waist pain) contribute primarily independent gym, outdoor activities. This removes the daily workload of the same muscles, ligaments and joints of the lumbar spine.

Common causes of pain in the spine (low back and waist pain) include:

• muscle spasms (acute or chronic)
• protrusion or herniation of intervertebral disc (with the possible jamming of the nerve)
• degenerative processes of the spine (osteochondrosis, spondylosis, spondylolisthesis)
• Sheerman Mau disease
• Bechterew disease
• spinal stenosis
• sacroiliac disease (inflammation of the sacroiliac joint)
• arthrosis of the sacroiliac joint
• arthrosis of the intervertebral joints (spondyloarthrosis), etc.

Compression of the nerve by herniated disc with the appearance of pain in his leg in osteochondrosis of the spine.

 

Causes of sciatica and conditions simulating sciatica

Spinal causes

• Disk rupture with compression of L4, L5, or SI root
• Osteoarthritic impingement on roots due to spondylo¬listhesis or foraminal or lumbar stenosis
• Synovial cyst of facet joint
• Arachnoid (Tarlov) cyst
• Tumors ofthe spinal column
• Neurofibromas on lumbar and sacral nerve roots
• Arachnoiditis

Nonspinal causes

• Pelvic and gynecologic conditions, including cyclic sciatica due to endometriosis
• Piriformis syndrome and back-pocket sciatica
• Pregnancy, delivery, and prolonged time in the lithotomy position
• Zoster sine herpete (shingles without the rash)
• Diabetic radiculopathy
• Gluteal injection-site trauma
• Lumbar plexitis
• Vascular impingement on sciatic nerve (pseudo¬aneurysm of the inferior gluteal artery)
• Hip fracture and dislocation or relocation; extensive pelvic fractures
• Biceps femoris hematoma, strain, and tear
• Idiopathic causes in young persons

 

Diagnosis of back pain, degenerative disc disease of the spine, disc herniation, disc protrusion

It all starts with neurological and orthopedic examination by a doctor. This inspection assessed the neurological status of the patient, as well as the identification of possible impairments in the biomechanics of the spine with the mandatory assessment of the back muscles and gluteal area. Already at this stage, studies of patients with osteochondrosis of the spine and back pain and lower back can be diagnosed and treatment is chosen.

Sometimes, the results of neurological and orthopedic examination of the patient with pain symptoms on a background of osteochondrosis, may be appointed in addition the following diagnostic procedures:

• X-ray of the lumbosacral spine with functional tests
• CT of the lumbosacral spine
• MRI of the lumbosacral spine

Magnetic resonance imaging (MRI) of the lumbosacral spine, sagittal projection.

 

Center of the intervertebral disc is studenistoobraznoe pulposis kernel. It is surrounded and supported by fibrous ring, composed of fibrous-cartilage and connective tissue. More information about this can be found in the article about the anatomy of the spine and spinal cord of man.

The thickness of the disk decreases, the vertebral bodies close to each other, reducing the intervertebral foramen and compromising are in their nerves and blood vessels (osteochondrosis).

Spondylolisthesis (shifting vertebrae) with the instability of the spine with compression of the nerve.

Disc protrusion (protrusion of the intervertebral disc) with their subsequent precipitation in the lumen of the spinal canal (slipped disk) tend to lead to compression of nerve roots, causing pain along the compressed nerve (pain, smack in the leg, arm, head, neck, intercostal spaces in Depending on the level of compression of the nerve) to the weakening of muscle strength in the areas of their innervation and sensitivity of the impairment.

Often protrusion or herniated disc is accompanied by muscle pain along the nerve (by hand or by foot). It squeezed one or all at once (rarely) two nerve.

In addition to compression of the nerve can be broken and the stability of the vertebral segment. With the instability of the spine vertebra is displaced forward (anterolistez) or back (retrolistez). To clarify the diagnosis may require an X-ray of the lumbosacral spine with functional tests.

Scoliosis of the spine with a protective spasm of back muscles against the background of osteochondrosis with a hernia, or protrusion of the intervertebral disc.

 

Most suffer from compression at the same hernia or protrusion of intervertebral disc nerve bundles, which form the sciatic nerve in view of their anatomical location. Sciatic nerve consists of fibers of L5, S1, S2, S3 - spinal nerves.

Hearth of chronic inflammation in the lumen of the spinal canal can lead to the formation of its narrowing (spinal stenosis) and compression of passing it nerves and spinal cord. That's why when spinal stenosis is always necessary to conduct a full course of treatment using a whole arsenal of different therapeutic methods, and if not effectiveness - surgical treatment.

Spinal stenosis with compression of the spinal cord.

 

Treatment of back pain, degenerative disc disease of the spine, disc herniation, disc protrusion

Depending on the severity of symptoms and causes of back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion in a patient following curative actions are possible:

• drug therapy (NSAIDs, analgesics, hormones)
• therapeutic blockade - the injection of drugs into the cavity of the channel
• manual therapy (muscle, joint and radicular technique)
• massage
• physiotherapy (UHF, SMC, etc.)
• acupuncture
• spinal traction (contraindicated in the acute stage)
• medical gymnastics and swimming (after primary treatment)
• surgical treatment

In the treatment of low back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion removal of edema, inflammation, pain, restore range of motion in joints and muscles of the lumbar region is accelerating the use of physiotherapy.

 

In the intervertebral joints (facet joints) can also be produced by therapeutic blockade, when conventional treatment does not give positive effect. Usually this is just low doses of anesthetic and cortisone, injected into the lumen of the affected joint.

Acupuncture is very effective in the treatment of low back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion.

 

When combined with a properly chosen regime of physiotherapy, the therapeutic blockade may provide a good and long-term effect of lumbar pain and pain in the rump with disc herniation or disc protrusion in patsientas osteochondrosis of the spine.

In the treatment of low back pain in his leg and buttock on the background of osteochondrosis with disc herniation or disc protrusion removal of pain, tingling and restoration of sensitivity in the leg with neuritis of sciatic nerve compression in the event of a hernia or a disc protrusion is accelerating the use of physiotherapy.

 

Wearing a semi-rigid lumbosacral corset in the treatment of back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion helps to limit the range of motion in the lumbar spine. This primarily helps to reduce pain in the area of inflammation of the intervertebral joints and removal of excess voltage protection and spasm of muscles of the back.

Alternative semi-rigid lumbosacral brace useful in the treatment of low back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion.

 

In such a corset patient with back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion can move independently at home and on the street, and even sit in the car and in the workplace. The need to wear a corset in a patient disappears as soon as is low back pain.

But we must remember that in the period of acute low back pain and lumbar degenerative disc disease on the background of the spine (with disc herniation or disc protrusion) should be avoided workloads and to comply with peace. This is a temporary restriction, but it significantly shortens recovery time, and against the background of the treatment does not develop the disease of the spine further.

Alternative semi-rigid lumbosacral brace useful in the treatment of low back pain and lumbar degenerative disc disease on the background of the spine with disc herniation or disc protrusion.

 

There are several types of semi-rigid lumbosacral corsets. All of them are selected individually by size and can be repeatedly used in case of recurrence of low back pain and lumbar degenerative disc disease of the spine in the background, as well as to prevent potential exacerbation of pain symptoms.

 

If you have any questions about the diagnosis or treatment of back pain, degenerative disc disease of the spine, disc herniation, disc protrusion, you can specify them with our neurosurgeon or neurologist by calling: +7 (926) 988-14-23