Lumbar strain (acute, chronic)
A lumbar strain is a stretching injury to the ligaments, tendons, and / or the muscles of the lower spine. Events stretching result in different levels of microscopic tears in these tissues. Lumbar strain is considered one of the causes of the most common of back pain. Injury can occur due to excessive use, inappropriate use, or serious injury (trauma). Soft tissue injuries are usually classified as "acute" if it has been present for several days or up to several weeks. If the strain lasts longer than three months, was referred to as "chronic."
Lumbar strain most often occurs in people in their forties, but it can occur at any age. This condition is characterized by an unpleasant feeling that is localized in the lower spine area with onset after an event that mechanically pressing the lumbar tissues. Severity of injuries range from mild to severe, depending on the degree of tension and muscle spasms under the resulting spine.
Diagnosis is based on the history of lumbar wound, location of pain, and spending the possibility of nervous system injury. Typically, x-ray test is only useful to exclude the possibility of bone abnormalities.
The treatment of lumbar strain consists of resting the spine (to avoid back injury), medications to relieve pain and muscle spasm, use of local heat, massage (massage), and finally (after the acute episode disappear) exercises to strengthen renew lower spine and abdominal muscles. Long periods of inactivity in bed are no longer promoted as this treatment may actually slow healing. Spinal manipulation for periods up to one month have been found useful in some patients who do not have signs of nerve irritation. Injuries in the future be avoided by using the techniques of spinal protection during activities and supporting tools if needed in the home or workplace.
Nerve Irritation
Nerves of the lumbar spine can be diiritasi by a collision-mechanical impingement or disease any where along their entire length - from their roots in the spinal cord to the skin surface. These conditions include lumbar cushioning disease (radiculopathy), bone disorders, and inflammation of the nerves caused by a viral infection (shingles).
Lumbar radiculopathy
Lumbar radiculopathy is nerve irritation caused by damage to the discs between the vertebrae. Damage to the discs occur due to deterioration (degeneration) ("wear and tear") from the outer disc lingkarn, severe injury (traumatic injury), or both. As a result, the softer middle portion can be torn (herniate) through the outer circle of the disc adjacent to the spinal cord or nerves-nerves as they exit the spinal column. This tear is what causes the illness commonly known as "sciatica" which fell to the feet. Sciatica may be preceded by a history of local pain in the lower spine or it can follow a feeling (sensation) "popping" and accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with time coughing or sneezing. In events more severe, sciatica can be accompanied by incontinence of bladder and / or colon
Lumbar radiculopathy is suspected based on the above symptoms. Pain that spreads increased when the foot is lifted supports the diagnosis. Nerve tests (EMG / electromyogram and NCV / nerve conduction velocity) of the legs can be used to detect nerve irritation. Disc hernia (disc herniation) can be detected by real radiological tests, such as CAT scans or MRI.
Treatment of lumbar radiculopathy extends from medical management to surgery. Medical management includes patient education, medications to relieve pain and muscles spasm, cortisone injection around the spinal cord (epidural injection), physical therapy (heat, massage, ultrasound, electrical stimulation), and the rest (not strict bed rest , but to avoid back injury). With the pain that does not stop, severe attenuation function, or incontinence (which can indicate spinal cord irritation), surgery may be needed. Operations are carried out depending on the overall condition of the spine, and the age and health of patients. These procedures include removal of disc hernia (herniated disc) with laminotomy (a small lubag on the spine that surrounds the spinal cord), laminectomy (removal of the bony wall), by needle technique (percutaneous discectomy), disc procedures destroy ( chemonucleolysis), and others.
Bone Disorders
Any condition that results in movement or growth of the lumbar vertebrae can limit room (noise) to the spinal cord and adjacent nerves. The causes of bone disorders of the nerves of the spine including forminal constriction (narrowing of the portal through which the spinal nerves of the spinal column, spinal canal to exit the body), spondylolisthesis (slippage of one vertebra relative to another) , and spinal stenosis (pressure on nerve roots or spinal cord by bony spines (bony spurs) or the soft tissues inside the spinal canal). Pressure on the spinal cord in these conditions can lead to sciatica pain that spreads down into the legs down. Spinal stenosis can cause pains in the legs that worsen at run time and disappear when resting (mimicking poor circulation). Treatment of the sufferings of this varies depending on the severity ranging from resting to decompression surgery to remove bone that suppress neural networks.
Conditions Bone and Joints
The conditions of bones and joints that lead to back pain including those already present at birth (congenital), resulting from the use of (degenerative) or injury, and inflammation of the joints (arthritis).
Congenital bone conditions-back pain causes congenital (present at birth) including scoliosis and spina bifida. Scoliosis is a sideways curvature of the spine (lateral) that can be caused when the foot is one foot shorter than the other (functional scoliosis) or because of a design (design) is abnormal from the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment by supporting and / or surgery on the spine. The adults more often treated with surgery, but often benefit by retaining the support (support bracing).
Spina bifida is a birth defect in the arch above vertrebra spinal canal, often with absence of spinous process. This birth defect most commonly affects the lumbar vertebrae at the bottom and top of the sacrum. Occasionally, there are piles of abnormal hair over the skin of the area telibat. Spina bifida can be a minor abnormality of the bones without symptoms. However, this condition can also be accompanied by neurological abnormalities that serious of the legs.
Conditions decline of Bones and Joints-As we age, the content of water and proteins from cartilage body changes. These changes result in cartilage weaker, thinner and more fragile. Because both the discs and joints that make up the vertebrae (facet joints) are partly composed of cartilage, these areas exposed to erosion from use over time (degenerative changes). The process of degeneration of the disc is called spondylosis. Spondylosis can be seen on x-rays of the spine as a narrowing of the normal disc spacing between vertebrae. Is the decline / deterioration of the disc tissue that predisposes the disc to memburut (herniation) and lumbar pain at that location ("lumbago") in patients who are older. Deterioration of arthritis (osteoarthritis) of the facet joints (facet joints) also is a cause of lumbar pain that can be tracked by x-ray tests are simple. The causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitation exercises, and pain relief drugs, muscle spasms, and inflammation.
Injuries to the Bones-Bones and Joints-Fractures of the lumbar spine and sacrum bone most commonly affects elderly people with osteoporosis, especially those that have been taking long-term cortisone medication. For these individuals, occasionally even miminal pressures on the spine (such as bending to tie shoes) can lead to broken bones (bone fracture). In this event, the vertebra can collapse (vertebral compression fracture). Fractures cause a localized pain that arises very soon that could spread around the waist and more deteriorated with body movements. The pain usually does not spread down to the legs. Vertebral fractures in patients younger occur only after severe injuries (severe trauma), as from motorcycle accidents.
In patients younger and older, vertebral fractures take weeks to heal premises rest and pain relievers. Vertebral fractures due to stress associated with osteoporosis can also be treated with a procedure called vertebroplasty, which can help reduce pain. In this procedure, a balloon is blown into the vertebrae are depressed, often restore some of the lost height. After that, a "cement" (methymethacrylate) were injected into the balloon and settle to maintain that structure.
Arthritis, spondyloarthropathies are inflammatory types of arthritis that can affect the lower spine and sacroiliac joints. Examples of spondyloarthropathies include reactive arthritis (Reiter's disease), ankylosing spondylitis, psoriatic arthritis, and arthritis of inflammatory bowel disease. Each of these diseases can lead to lower back pain and stiffness, which is typically worse in the morning. These conditions usually begin in the second and third decades of life. They were treated with drugs intended to reduce inflammation. Drugs newer biology has been successful in eliminating both the disease and stop the progress of the disease.
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