Lumbar ischialgia is one of the most common neurological diseases. It is it that makes patients often consult doctors in outpatient health care facilities. At the same time, it is not always possible to quickly eliminate the symptoms of this pathology.
general characteristics
Lumbar ischialgia is a disease of the spine, which is characterized by pain in the lumbar region, radiating to the back of the thighs.
This disease is one of the most common. Almost every person has encountered him at least once in his life. Many try to cope with it on their own, but this can lead to an aggravation of the pathological process and the need for serious, including surgical, interventions.
Main reasons
The main mechanism for the development of this pathology is damage to the spinal roots. The provoking factors for the development of such a disease are the following:
- intervertebral hernia;
- arthrosis of the intervertebral joints;
- curvature of the spine (scoliosis, lordosis, kyphosis) ;
- severe physical exertion on the lumbar spine;
- damage to the vertebrae;
- hypothermia of the lumbar region;
- a change in the structure of the vertebrae due to age-related changes in bone tissue;
- increased weight of a person;
- damage to the ligamentous and / or muscle apparatus of the lumbar spine;
- inflammatory diseases of the articular surfaces of the vertebrae.
Often, the same patient has several provoking factors that contribute to the development of such a pathological process as lumbar ischialgia. In this case, treatment will require the use of several drugs with different mechanisms of action, and sometimes surgical intervention.
Clinical manifestations
This disease often leads to the development of very serious symptoms. The main clinical manifestations of lumbar ischialgia are as follows:
- Severe pain in the lumbar region.
- Pain can spread to the back of the thighs.
- Numbness in the lower extremities.
- Difficulties in movement, including due to increased pain.
- The practical impossibility of active movements in the lumbar spine.
In connection with the occurrence of this symptomatology, the patient is often forced to take a pose with the body tilted forward or to the side on which the root of the spinal nerve is damaged.
Diagnostic measures
In case of pain in the lumbar spine radiating along the back of the hips, the doctor may prescribe the following examination options:
- general urine analysis;
- general blood analysis;
- radiography of the lumbar spine;
- CT scan;
- Magnetic resonance imaging.
A general urine test is performed to differential diagnosis of lumbar ischialgia with kidney disease. If there is a large number of leukocytes in the urine, pyelonephritis can be suspected, red blood cells - urolithiasis, protein - glomerulonephritis. If the indicators of the general analysis of urine are within normal limits, then pain in the lumbar spine with almost 100% probability will not be associated with kidney damage.
A general blood test is performed to exclude inflammatory diseases. This can be done using an indicator such as the erythrocyte sedimentation rate.
Radiography of the lumbar spine allows you to determine the presence of changes in the bone tissue of the vertebrae. This technique is generally available, but not always accurate enough. In the case when it is necessary to obtain a three-dimensional model of the vertebra, the patient is sent for computed tomography. As part of such a study, a person is placed in a special chamber, where thanks to all the same X-rays, it is possible to obtain the most complete information about the state of the bone tissue of the investigated spine.
Magnetic resonance imaging is most often prescribed for lumbar ischialgia in cases where the doctor suggests the presence of an intervertebral hernia. This is due to the fact that this research option allows you to visualize soft (including nervous) tissue.
Treatment of lumbar ischialgia of the lumbar spine
This disease often brings a very pronounced pain to the patient. As a result, as soon as symptoms of lumbar ischialgia occur, treatment at home and subsequent treatment by a specialist doctor are not long in coming. The patient immediately tries to take anesthetic medicine or apply a warming ointment to the skin of the lumbar spine.
Treatment of lumbar ischialgia at home is not recommended. This is due to the fact that lower back pain can occur not only with this, but also with many other diseases. As a result, there is a chance of harming your own body with improper treatment.
The main methods of therapy
Symptoms of lumbar ischialgia and the frequent multicomponent pathogenesis of their occurrence force specialists to resort to the use of various techniques in the fight against this pathology. The main ones are the following:
- Taking medications.
- Physiotherapeutic treatment.
- Acupuncture.
- Physiotherapy.
- The use of bandages.
- Surgical intervention.
The need for a specific technique should be determined by a specialist doctor.
Drug treatment
Currently, a fairly large number of drugs are used to treat this pathology. The most common among them are funds from the group of non-steroidal anti-inflammatory substances. Most often, the following drugs are used from this group:
- Nimesulide;
- "Ketorolac";
- Meloxicam
- Diclofenac.
A common feature of these drugs, in addition to reducing the severity of pain, is a negative effect on the gastric mucosa. In this regard, the use of such drugs should be after a meal.
If the symptoms of lumbar ischialgia are very pronounced, treatment with injections and tableted drugs can be used together. All injections in this case are performed intramuscularly.
Also, patients often use various kinds of ointments. Usually they contain the same non-steroidal anti-inflammatory drugs and, in addition to the pain medication, also have a warming effect. Moreover, monotherapy with ointments is ineffective.
The use of physiotherapeutic techniques
These methods of treating vertebrogenic lumbar ischialgia have been used for a long time. The most popular among them are:
- electrophoresis with an analgesic (most often with novocaine);
- ultra-high frequency exposure;
- magnetotherapy;
- darsonvalization.
Usually, doctors prescribe several physiotherapy options at once. A distinctive feature of darsonvalization is the fact that the first few procedures can slightly increase pain, so this method should not be used in acute conditions.
It is important to understand that physiotherapy is a supplement to the treatment of lumbar ischialgia with drugs and is not used independently.
Acupuncture
This technique is very complex in its execution. Only an experienced specialist is able to qualitatively implement it, while being in a healthcare organization.
Treatment of lumbar ischialgia at home with the help of acupuncture, calling a specialist to yourself, is not recommended. This is due to the lack of both conditions for the provision of medical care (sometimes during the procedure the patient’s blood pressure drops sharply, even if the specialist did everything right), and the proper level of sterility (needles are inserted directly into the body, and pathogens can get into them microorganisms).
Bandage technique
More often it is used in those patients in whom the development of lumbar ischialgia is due to some kind of damage to the bone tissue of the vertebrae. Bandages help reduce the load on the lumbar spine, thereby reducing the severity of the symptoms of lumbar ischialgia. It makes sense to use them only in cases where the pathology is chronic. Naturally, this technique is auxiliary.
Surgery
By injections, tableted preparations, ointments, physiotherapeutic methods, it is far from always possible to eliminate the expressed pain in the lumbar spine and the very cause of its occurrence. As a result, the patient is invited to undergo surgical treatment. Before its implementation, magnetic resonance imaging is mandatory to determine the location of the pathological process. Most often, surgery has to be performed to treat intervertebral hernia.
Surgical treatment does not always relieve back pain. Sometimes doctors are unable to eliminate the pain in this area. In some cases, the patient’s condition even worsens after surgery. That is why it is important to begin treatment of lumbar ischialgia with drugs and physiotherapeutic methods and resort to surgical intervention last.
Preventive actions
Significantly reduce the likelihood of developing lumbar ischialgia, as well as any other diseases associated with the spine, by observing the following recommendations:
- Avoid excessive loads on the lumbar spine.
- Engage in physical exercises aimed at strengthening the muscular apparatus of the back (press, push-ups).
- Eat enough calcium-rich foods (hard cheese, cottage cheese).
- After 40 years, take 1-2 times a year courses of chondroitin sulfate (the preparation contains ready-made "building material" for intervertebral discs).
Compliance with these simple rules will avoid not only quite pronounced soreness, but also the need to spend money on the purchase of expensive drugs for the treatment of lumbar ischialgia of the lumbar spine.