Lumbar lumbar syndrome: symptoms and treatment

Neurological diseases are one of those groups of diseases that often lead to disability or temporary disability. One of these diseases - radicular spine syndrome - occurs quite often. What does he represent?

What is radicular syndrome?

This term is usually understood as the totality of the symptoms that develop as a result of the effect on the spinal cord roots. Most often, the development of the disease leads to osteochondrosis - the radicular syndrome with it is less intense than with trauma or a herniated disc. There is a narrowing of the intervertebral foramen, which leads to the infringement of the exiting nerves.

The main clinical signs or criteria of radicular syndrome are:

• Pain. Characterized by intense, aching pain in the area of compression of the spine emerging from the spinal cord, extending to the limbs, and sometimes to the internal organs.
• Disturbance of sensitivity. It develops in the course of the emerging nerves. Most often manifested in the form of paresthesias (a sense of chills, chills).
• Atrophy of innervated muscles and impaired movement. Develops due to the defeat of nerves, innervating this or that area. It leads to muscle weakness and loss of their functions.

Pathogenesis of the disease

At the root of the development of radicular syndrome is the defeat of the spinal column. Over time, there is a depletion of stocks of nutrients contained in intervertebral cartilage. Aggravating factors are age, excess weight, adynamia. As a result, the so-called subsidence of the vertebrae occurs.

Spinal nerves come out of the vertebral canal through the intervertebral foramen. Due to the fact that the spine is sagging, these holes narrow down, which leads to the infringement of the nerves.

In the compression zone, aseptic inflammation develops, which is characterized by edema of the adjacent tissue. This swelling further exacerbates the condition, which leads to increased pain. The pain spreads over the outgoing nerves, which can cause a pattern of internal damage (for example, radicular syndrome of the thoracic spine can create a picture of angina or myocardial infarction).

Causes leading to the development of the disease

In addition to osteochondrosis, other processes can lead to the development of the disease. Among them are:

• Intervertebral hernia. Due to the rupture of the cartilage and the release of the pulpous nucleus beyond the spinal column, the nasal nerves are squeezed.
• Defects in the structure and disease of the spine. Most often cause the development of radicular syndrome, beginning with early childhood.
• Injuries. Usually, as a result of an incorrect fusion of the vertebral appendages, the roots are compressed.
• Infectious diseases of the spine, which led to the depletion of bone and cartilaginous tissues (osteomyelitis).

Often radicular syndrome develops in obese, inactive people.

Sometimes it is possible to develop it as a result of excessively heavy physical work or the so-called "backstab".

In some cases, the radicular syndrome develops due to hypothermia.

Some drugs may cause the development of radicular syndrome (but in this case this syndrome will be called pseudo-root syndrome).

Classification

As such, there is no classification of radicular syndrome. Conditionally, clinicians subdivide it according to the lesion of the anatomical zones of the spine. According to this classification, the radicular syndrome is distinguished:

• Cervical spine.
• Thoracic department.
• Lumbar.

The area of the sacrum and coccyx is affected with osteochondrosis rather rarely, therefore, these regions are not included in the classification.

Behind the scenes there is a classification of radicular syndrome due to the presence of complications (complicated and uncomplicated).

Sometimes such forms of radicular syndrome as acquired and congenital are distinguished (however, this classification is extremely rare, as in the main this syndrome is most often acquired).

Among all these forms the most common is the radicular syndrome of the lumbar spine.

The reasons for the defeat of this department

Why is this region most often affected? The reasons for which the lumbar lumbar syndrome develops are as follows:

• On the lower back is the greatest load. It is here that its redistribution occurs from heavy physical work. In addition, the lower back is loaded and the upper trunk sections, as it helps them to maintain and position.
• The lumbar region is formed by large vertebrae, forming wide enough openings. Large vessels and nerve plexuses pass through them, which are quite easily infringed as a result of disturbance of the cushioning function of intervertebral discs.
• Radicular syndrome of the lumbar region also often develops due to the fact that it is one of the most moving parts of the axial skeleton. Excessively wide in amplitude movements easily lead to displacement of the vertebrae relative to each other and cause the development of pain and nerve impairment.

Clinic

If, however, as a result of the infringement of the nerves, there is a radicular lumbar syndrome, the symptoms do not take long to wait.

The first and most common symptom is pain. She has a shooting character, appears suddenly, as a result of heavy physical work or trauma. Gradual increase in pain is characteristic of osteochondrosis. In this case, lumbago will also disturb, but the intensity of pain is not so high.

Disturbance of sensitivity usually accompanies pain. It is disturbed from the side where the infringement of nerves takes place. Radicular syndrome of the lumbar region is usually bilateral (with osteochondrosis). Most often there is a decrease in sensitivity and pain threshold. Sometimes there can be a paresthesia - perverted or wrong sensations.

Dysfunction of muscles can develop in the event that for a long time there is a lumbar osteochondrosis. Radicular syndrome leads to muscle atrophy, loss of opportunity to active physical work, weakening of the muscle contraction force.

Diagnostics

Diagnosis of this disease is necessary, given most factors. First of all, it is necessary to pay attention to the patient's complaints, since it is on the basis of the latter that it is possible to make assumptions about the localization of the pathological process.

Ancillary information during examination can be given by palpation of the pain zone - local muscle tension will be felt. Visually, one can detect the slope of the patient to the sore side (thus, he can reduce the pain sensation).

The general analysis of blood is poorly informative - only a relative increase in leukocytes can be observed due to limited inflammation.

The main advantage in the diagnosis of radicular syndrome is the MRI of the lumbar spine. This study can detect even the slightest infringement of the nerve and accurately determine the localization of the process. However, the difficulty is the very conduct of the tomography. MRI of the lumbar spine is a rather costly procedure, so it is not carried out by everyone.

Treatment of radicular syndrome

What to do if this disease develops? Can I be treated at home or better still go to the hospital?

If you nevertheless developed radicular lumbar syndrome, treatment should begin immediately and preferably in the hospital.

Like any kind of treatment of diseases of the musculoskeletal system, this should include non-drug methods, drug therapy and surgical interventions.

If the symptoms of the disease do not have a significant effect on vital activity, general methods can help - proper nutrition, avoidance of physical exertion, massage, relaxing hot baths.

If nevertheless begins to disturb the radicular lumbar syndrome, treatment at the initial stages should include the use of non-steroidal anti-inflammatory drugs ("Nimesulide", "Diclofenac") inside or intramuscularly. If the intense pain begins to disturb, the use of intervertebral blockades is recommended. If the condition worsens, it is recommended to consult a neurologist or neurosurgeon to determine the further treatment tactics.

Physiotherapy treatment

According to many traumatologists, neurologists and physiotherapists, some diseases of the musculoskeletal system can be cured with the help of physiotherapy procedures.

To eliminate radicular syndrome, electrophoresis, electropulse currents are often used.

Electrophoresis with certain drugs allows to achieve such effects as:

• Removal of the inflammatory process.
• Elimination of pain syndrome.
• Improved metabolism in the affected roots.
• Restoration of trophism of affected muscles and joints.

The use of EIT (electropulse therapy) is aimed at relaxation of stressed muscles, improved nutrition of atrophied tissues, tonic acting.

In addition to the instrumental methods, exercises in the pool or sessions of physiotherapy exercises are also useful.

Treatment of the lumbar spine can be performed with the help of acupuncture and manual therapy sessions. These methods are not widely used in conventional medicine, but they help a fairly large number of people.

Surgery

The main factor that characterizes radicular syndrome is symptoms. Treatment in a surgical hospital is recommended when they begin to acquire a threatening character.

The main indications for surgical intervention are:

• Intensive pain syndrome, not controlled by the intake of NSAIDs and narcotic analgesics.
• Violation of limb function with complete loss of active movements.
• Irreversible changes in the osteochondral apparatus, leading to compression.
• Complicated intervertebral hernia.
• Complete loss of limb sensitivity.

Operations are conducted in specialized hospitals. Under anesthesia, operative access to the site of compression of the roots is created, the vertebral particles that prevent the normal position of the spine are removed. With a hernia, excision of the exposed area is performed. Currently, with hernial root syndrome, nucleoplasty is increasingly used-the correction or excision of the disc that fell out with little access.

Complications of the disease

As it was said, untimely treatment of the lumbar spine can lead to other other diseases. For example, the main complications may be:

• Lameness. Develops due to the forced position of the body. Subsequently, it can lead to flat feet and worsening of the disease (vicious circle).
• Mental disorders. Intense pain in the limbs and back will not give rest day and night. Against the background of overwork may develop neuroses and psychoses.
• Ankylosis and contracture of joints. The reason for their development is again a long stay in a certain position and little activity.
• In severe cases, nerve damage can lead to complete paralysis of the limbs.
• The onset of inflammation can retrograde into the spinal cord, causing a picture of meningism, a spinal cord infarction, or an increase in the spread of the process to other roots.

Prevention of disease

In order to prevent the development of radicular syndrome, you should remember a few simple rules:

• Daily morning exercise. Helps stretch the muscles, bring them to tone.
• Control of excess weight. As it was said, it is a factor worsening the course of the disease.
• Prophylactic massage sessions. They help in warming up the muscles and vertebral joints, prevent the displacement of the vertebrae relative to each other, and also prevent the intervertebral disc from falling out of its bed.
• Proper nutrition. One of the factors in the development of osteochondrosis is a decrease in the content of nutrients in the cartilaginous tissue. Properly composed diet allows you to suspend the flow of the process.
• Pool. Allows to lower a load on departments of a backbone, incidentally leading in a tonus all muscles.
• Competent distribution of work and leisure. This rule avoids fatigue and injuries during physical labor.