Low back pain or LBP is a condition characterized by the appearance of pain in the lumbar spine. LBP can be associated with the pathology of the spine and a number of other diseases of the internal organs.
Factors provoking lower back pain
LBP is divided into two types, depending on what causes triggered the onset of the disease. Vertebrogenic LBP – occurs due to pathological, degenerative and dystrophic processes in the spinal column and LBP of the non-vertebrogenic type – occurs due to various diseases, the aetiology of which is not associated with the pathology of the spinal column.
Causes of vertebrogenic LBP:
- degenerative changes in the muscular corset of the spine;
- haemangioma of the vertebral body;
- kyphosis, scoliosis, kyphoscoliosis;
- central and foraminal stenosis;
- protrusion, prolapse, herniated disc;
- spinal column instability syndrome.
Causes of non-vertebrogenic LBP:
- kidney pathology;
- diseases of the gastrointestinal tract;
- excess weight;
- passive lifestyle;
- uncomfortable shoes;
- flat feet;
- oncological neoplasms.
Signs of the disease
LBP has various manifestations, depending on which particular factors led to this pathology. Common symptoms of LBP, which are found in most patients:
- lumbago – backache;
- pain on one or both sides of the lower back;
- increased pain during body movements;
- inability to fully straighten your back;
- sharp pain with static, prolonged standing;
- muscle spasms in the lower back (myofascial syndrome);
- restriction of movements;
- cooling, numbness of the legs of the lower extremities due to circulatory disorders (symptoms of radiculopathy);
- pain in the lower limb, unilateral or bilateral (symptoms of lumbar ischialgia);
- disruption of the biomechanics of gait due to severe pain;
- increased pain during sneezing, coughing, leaning of the torso forward (tension symptoms);
- violation of posture due to pain (antalgic posture).
Treatment of LBP should begin with a thorough diagnosis. Without knowledge of what triggered the development of the disease, it is impossible to conduct the correct treatment. In addition to examining the patient and studying his medical history, a number of medical tests are prescribed that give a complete picture of the state of health, the work of internal organs and systems, and identify the factors that triggered the appearance of non-vertebrogenic or vertebrogenic lumbar ischalgia:
- blood and urine tests;
- X-ray of the spine;
- therapeutic examination;
- consultations of narrow specialists if necessary – a gynaecologist, urologist, infectious disease specialist.
The treatment of lumbar ischalgia is complex. First of all, the cause that leads to the appearance of pain in the lumbar spine is treated. At the same time, physiotherapy procedures are appointed, aimed at stopping the painful symptoms of LBP, restoring blood circulation, releasing the roots of nerve endings from the pressure. The main procedures that help return the patient lumbar mobility are:
- manual therapy;
- percutaneous electrical stimulation.
To stop the pain, the patient is prescribed painkillers and analgesics. It is possible to use drugs with a local spectrum of action – warming ointments, creams and gels, which not only relieve pain but also muscle spasms, restoring lumbar mobility.
In cases of inefficiency of the above-mentioned methods, the MedClinic Medical Center uses modern, effective, minimally invasive (non-surgical) methods adopted by the world medical community for the treatment of back pain:
- selective transforaminal radicular blockade;
- interlaminar (epidural blockade);
- caudal epidural block for pelvic pain;
- radiofrequency ablation of the medial root branch (facet syndrome);
- radiofrequency neuromodulation of the spinal roots;
- block/ neuromodulation / ablation of the solar plexus;
- block/ neuromodulation / ablation of ganglion impar (coxalgia);
- block of ganglion stellate;
- block of triggering points
The advantages of these techniques:
- performed on an outpatient basis under local anesthesia;
- duration of the procedure is 15-30 minutes;
- duration of being under medical supervision is up to 1 hour;
- there are practically no restrictions in the post-procedural period;
- minimal risk of complications;
- effective and safe;
- have a high level of evidence;
- there are practically no contraindications;
- can be performed in combination with other treatment methods, provide a faster and more stable treatment result.
Surgical methods for treating back pain used at the MedClinic Medical Center:
- spinal fusion (in degenerative processes);
- microdiscectomy (removal of a hernia of the intervertebral disc from a mini-access);
- kyphoplasty (with compression fractures);
- vertebroplasty (in the presence of neoplasms);
- corpectomy (removal of the vertebral body with prosthesis);
- laminectomy (in case of damage to nerve endings due to stenosis of the spinal canal);
- foraminotomy (when the roots of nerve endings are squeezed at the level of the intervertebral foramen).
Surgical method is selected by the doctor individually.