Radiculopathy of the lumbosacral spine

Lumbosacral radiculopathy

Lumbosacral radiculopathy or radicular syndrome are synonymous names of the same disease. The disease is also known as radiculitis.

It affects about 5% of the adult population, equally of men and women. People with age of 45 years are more often ill.

Therefore, radiculopathy is the main cause of temporary disability.

Causes of radicular syndrome

Radicular syndrome is one of the clinical manifestations of osteochondrosis of the lumbosacral spine, complicated by the appearance of a hernia.

It has been established that hernias can form not only due to chondrosis. Their appearance is promoted by hereditary predisposition, narrowing of the spinal canal, trauma of the spine.

Among the causes of radiculopathy can be noted:

Osteoporosis or bone loss is one of the causes of radiculopathy

• infections - syphilis, tuberculosis, osteomyelitis;
• tumors of benign and malignant;
• consequences of osteoporosis - vertebral fracture;
• age;
• deforming spondylosis.

The cause of discogenic radiculopathy is always only the intervertebral hernia.

Pathogenesis

The full name of the disease is vertebrogenic lumbosacral radiculopathy. What does that mean? Degenerative - functioning tissue is gradually replaced by a defective one.

In places of damage, the growth of connective tissue is observed. Dystrophic - the nutrition of various structures of the spine, supporting the spinal column, is disturbed.

Vertebrogenic is a process that relates directly to the spine and affects muscles, ligaments, joints, etc.

Sequence of hernia and compression of the nerve root

Loss for various reasons of their mobility leads to disruption of the nutrition of intervertebral discs, they begin to lose fluid.

Initially, the changes appear in the central part of the disk - the gelatinous nucleus.

Later, a rupture of the fibrous ring occurs and an exit through the formed cracks of the gelatinous contents of the nucleus beyond its limits. So there is a hernia.

If the hernial protrusion is directed posteriorly toward the vertebral canal or toward the intervertebral foramen, it causes pressure on the nerve roots.

Clinical picture

The main manifestation of radicular syndrome is pain. As soon as the hernia has jammed the nerve endings of the spine, there is a sharp shooting pain in the lumbar region.

Its appearance is associated with irritation of the ligamentous apparatus, reflex tension of the muscles of the back and small pelvis. Pain can radiate to the back of the foot. Appears in the gluteal, popliteal region.

To reduce the pulling pain, the victim tries to bend the leg in the knee. At the slightest movement, the pain sharply increases.

Radiculopathy leads to paresthesia, leg paresis

In addition to pain, there are other symptoms of the disease - paresthesia, paresis. In the area of ​​action of the nerve root, there is a sensation of crawling, numbness of toes.

The patient with a foot is difficult to move, it is difficult to tear from the bed. When the sciatic nerve irritates, painful sensations appear on the back of the foot.

Sometimes in a sick limb the skin becomes dry, cold, cyanosis appears.

In addition to pain, the habitual posture of the patient changes. There is a lateral curvature of the spine as a scoliosis (muscle-tonic syndrome).

Herniated protrusions with radiculopathies along with nerve fibers can squeeze the vessels.

Reduced blood flow in the veins and arteries contributes to impaired blood circulation in the anterior and posterior parts of the spinal cord and can cause a part of the spinal cord to infarct. Severe complication leads to disability of patients.

Treatment

Treatment of patients with a hernia of the spine, complicated by radiculopathy, is usually stationary. The terms of hospitalization depend on the severity of the disease, ranging from 18 to 24 days. They are determined by acuity of pain syndrome, presence of paresis, paresthesia.

Careful manual therapy relieves pain in the lumbar region

The first days of illness recommended bed rest. To avoid deflections of the spine, the bed should be flat and rigid.

Otherwise, the pain will only increase. If you need to get up, the lower back should be fixed with any wide belt. In the horizontal position it is removed.

Conservative therapy includes:

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• Analgesics - baralgin, analgin, ketorol;
• non-steroid drugs - indomethacin, naproxen, diclofenac;
• paravertebral blockade 5 a solution of novocaine or lidocaine with vitamin B12;
• for the removal of muscle spasm - seduxen, sibazon, baclofen;
• physiotherapy - diadynamic currents, ultrasound with hydrocortisone, ion-galvanization with novocaine;
• acupuncture;
• manual therapy;
• physiotherapy;
• massage of the back, waist.

The primary drugs in the treatment of radiculopathy of the lumbosacral section are nonsteroidal preparations of general and local action. Apply in the form of injections, ointments, blockades. Distracting analgesic effect I render irritating ointments - nikofleks, finalgon, kapsikam.

With prolonged course of the disease, corticosteroids - hydrocortisone, methylprednisolone - are more effective.

They are injected epidurally into the space between the solid cerebrospinal membrane and the roots of the lumbar spine.

With radiculopathy in the lumbosacral spine helps compress, consisting of dimexide diluted in water in the proportion: novocaine, vitamin B12, hydrocortisone.

Relieve pain, reduce swelling, relax the muscles, improve local blood circulation - this action has a modern nanoplastiry. It includes magnetic powder from rare earth metals, nanopowder, which produces infrared radiation.

The plaster acts quickly, the healing properties retains a long time.

Dimexide - an effective anti-inflammatory, anti-edema

Prevention

Radicular and muscular-tonic syndromes as manifestations of lumbosacral osteochondrosis can repeatedly repeat themselves and become chronic. To prevent relapse, it is recommended to strengthen the muscles of the back and waist. A durable muscular corset reliably protects the spine from overload.

To strengthen muscles, swimming and special exercises in swimming pools are shown. It is necessary to be constantly careful of hypothermia, not to lift and not to transfer weights. Annually you need to do repeated courses of massage. Strengthens the results of treatment in specialized sanatoriums.

Physiotherapy

Exercises in the root syndrome are performed in a sparing mode after the pain subsides. They are done slowly, calmly, under the control of breathing.

Useful exercises for lumbosacral radiculitis

1. Lie on a hard surface, legs bend at the knees, clasp your knees with your hands and slowly pull up to your chest as possible. Also slowly lower back. 10-12 repetitions are done for 3 doses.
2. The position is the same as in the previous exercise. Bent at the knees should be torn off the floor, stretching socks. Simultaneously lift the trunk with arms extended and raised to the level of the knee.
3. Lie on a hard surface with your stomach. Hands stretched out and withdrawn behind their backs, their feet rest on the floor with their fingers. Raise the body as high as possible, wait for 2-3 seconds. Repetitions - 8, approaches - 3.

Many problems of the spine arise from low physical activity, malnutrition, excess weight. Lumbar pain is a signal for help. If it appeared, you need to help the body regain lost health.

A source: http://MoyaSpina.ru/bolezni/poyasnichno-krestcovaya-radikulopatiya

Treatment of radiculopathy of the lumbosacral spine

Dangerous pathology of radiculopathy of the lumbosacral spine can begin in a person of any age.

This is a very common disease, from which no one is immune. However, to protect yourself from radiculopathy is still possible.

How to do this, the proposed material will tell.

General information

Radiculopathy, or radicular syndrome, develops as a result of enhanced compression of the nerve roots of the spinal cord. This is a special kind of neuralgia.

There are several varieties of this disease. Depending on the localization of the main focus, radiculopathy may develop:

• cervical;
• thoracic;
• lumbar;
• lumbosacral.

In the presence of two or more lesions, a mixed form of radiculopathy also develops. To clarify the nature of pathologies caused by radicular syndrome, radiculopathy of infectious and discogenic types differs.

Radiculopathy of the lumbosacral spine is the most common form of this pathology. After all, this section of the spinal column has the maximum load.

Causes of radicular syndrome

Discogenic radiculopathy l5, s1 and / or l4 in most cases develops in the presence of such reasons as:

1. trauma or serious damage to the vertebrae;
2. violation of the structure of the spinal column in the lumbar region;
3. incorrect posture;
4. random displacement or shift of the intervertebral disc and vertebra;
5. diseases of the musculoskeletal system;
6. formation of tumors in the spine of a good and / or malignant character;
7. prolonged hypodynamia;
8. violation of the hormonal background;
9. degeneration, dystrophy and / or metabolism of the structure of the spinal column;
10. dysfunction of the body's immune system;
11. period of gestation;
12. congenital damage, displacement or other pathologies of vertebral discs;
13. elderly and / or advanced age;
14. lack of balanced nutrition;
15. tendency to overeating, overweight;
16. excessive physical activity for a long time;
17. constant supercooling in the autumn-winter period.

The above causes lead to the onset of pathological processes in the lumbosacral spine. One or more vertebrae can be damaged. As a consequence, the first symptoms of radiculopathy appear, which can not be ignored.

A secondary form of discogenic radiculopathy is considered a vertebrogenic variety of the disease. In this case, the nerve endings of the spinal cord are jammed with pathological outgrowths formed under the influence of the above-mentioned reasons.

Infectious lumbosacral radiculopathy develops due to severe infectious lesions of this area.

With time started and properly conducted treatment, the disease can be cured without harmful consequences for the general condition of the body.

Therefore, if you find any suspicious symptoms, you should immediately consult a doctor.

Symptoms of lumbar radiculopathy

Most often, when the nerves of the spinal cord are trapped in the vertebrae l5, s1 and / or l4, the patient develops symptoms such as:

• pain along the waist line from the vertebral column to the middle of the peritoneum;
• acute pain in the lower back;
• pain, imitating the defeat of adjacent organs;
• redness and / or pallor of the skin in the lumbar region;
• sensation of muscular overstrain in the lumbar region;
• swelling in the indicated area;
• convulsions of a clonic nature, affecting the muscles in the anterior part of the peritoneum;
• pain in the pelvis and / or upper thigh.

All of these symptoms can appear both to the left and to the right of the spinal column. When examined by palpation, as well as with even minor physical exertion, the pain and discomfort that these symptoms cause is markedly enhanced.

What are the neurological manifestations of the disease? Radiculopathy invariably causes such manifestations as:

1. Allodynia - pain that occurs even with a slight touch;
2. paresthesia - numbness of tissues, tingling, "creepy etc. Feel;
3. hyperalgesia - damage to nerve endings, causing excessively high sensitivity;
4. Hyperpathy is a tactile pathology expressed in partial tactile immunity to external stimuli, for example, to the force of their action.

Diagnosis of radiculopathy

To clarify the clinical picture of the disease and the specific reasons that caused the observed symptoms, a thorough examination of the patient should be performed to the left or right of the spine.

Initially, anamnestic conversation and examination by palpation.

In addition, the patient, on the instructions of the doctor, performs some simple movements with his legs, body twists, deep breaths and sudden exhalations.

Unpleasant and / or painful sensations at their performance specify the nature of pathology development.

Then, if necessary, it is assigned:

• radiography;
• magnetic resonance imaging;
• CTG;
• lumbar punctures;
• laboratory research.

Specific symptoms that are manifested in this patient determine the necessary methods of examination. This will help the doctor determine which treatment should be prescribed.

Treatment of radiculopathy

Lumbosacral radiculopathy, as a rule, begins to be treated with the elimination of pain syndrome and other symptoms of the disease. This is done with the help of drugs such as:

1. non-steroids of anti-inflammatory action - NSAIDs;
2. muscle relaxants;
3. analgesics;
4. glucocorticosteroids;
5. antidepressants;
6. anticonvulsants;
7. vitamins of group B.

All appointments should be done only by a doctor. After all, these funds may have contraindications and / or side effects.

Treatment of radiculopathy is carried out at home or in a hospital. Hospitalization is required for patients who need constant supervision of specialists. In this case, complete immobility can be shown, placing on a special bed.

To remove the pain syndrome of increased intensity, blockades of the damaged spine are performed. They are made with the use of lidocaine, novocaine and other drugs.

How useful is the physical culture? Regular sessions of physiotherapy exercises are an obligatory component of the complex treatment of lumbosacral radiculopathy. The complex of exercises is selected for each patient strictly individually.

A correctly performed complex of exercise exercises will help:

• normalize metabolic processes in the lumbar region;
• Spread the vertebral disks to the required distance;
• intensify blood circulation;
• restore the original anatomical position of the vertebral column.

In the beginning, the classes are conducted under the supervision of a doctor, an instructor for exercise therapy or a rehabilitation specialist. Then the patient can perform the recommended complex of exercise therapy independently. The main thing is not to overexert the lower back during the exercises, do not overwork and do not make sudden movements.

Positive results achieved with the help of drugs and exercise therapy are recommended to be strengthened with the help of such physiotherapeutic procedures as:

1. hydrocortisone;
2. diadynamic current;
3. ion-galvanization;
4. EHF-therapy;
5. laser irradiation;
6. paraffin treatment;
7. electrostimulation;
8. electrophoresis.

The results obtained will help to consolidate the massage, conducted according to special recommendations, as well as acupuncture sessions.

When an operation is performed

In particularly difficult cases, the patient may need surgical intervention. The main indicators for the operation are:

• severe pinching of nerve processes;
• intervertebral hernia;
• dysfunction of the pelvic organs;
• oncological and / or other neoplasms.

After a careful study of the clinical picture of the disease, the patient's health status and the indicators of the conducted studies, a decision is made about the feasibility of performing a cavitary operation.

The main purpose of surgical intervention in most cases is the removal of damaged vertebral disks. Subsequently, rehabilitation procedures are carried out according to a special scheme.

For example, complex exercise therapy, acupuncture, physiotherapy and / or restorative massage.

Dangerous consequences

Radiculopathy of the lumbosacral spine should be treated with constant supervision of a specialist. Otherwise, such dangerous consequences may arise, such as:

1. hernia;
2. decreased mobility of the lower limbs;
3. chronic sciatica;
4. paralysis of the legs and / or the whole body.

To avoid new attacks after suffering radiculopathy of the lumbosacral spine, compliance with the prescribed recommendations and periodic observation of the doctor are necessary.

Preventive measures

Avoid the emergence of radiculopathy in the lumbosacral and / or other parts of the spinal column will help comply with such rules as:

• absence of hypothermia;
• avoidance of mechanical effects on the vertebral column;
• regular physical education;
• avoid excessive physical overload;
• refusal to drink alcohol and / or nicotine;
• balanced diet.

A careful attitude to your health will help to protect yourself not only from radiculopathy, but also from many other problems.

A source: https://OrtoCure.ru/pozvonochnik/radikulit/radikulopatiya-poyasnichno-kresttsovogo-otdela.html

Lumbosacral radiculopathy: diagnosis and treatment of pathology

Radiculitis or radiculopathy are terms used in medical practice to refer to a complex of symptoms that arise when damaged, inflamed or pinched roots of the spinal nerves - bundles of nerve fibers emanating from the dorsal the brain.

Radiculitis affects 10% of the world's population. It is most common, according to statistical studies, among people over forty.

The cause of the development of radiculitis are the pathological processes occurring in the spine, namely:

• damage to vertebral bodies, intervertebral discs, soft tissues surrounding the vertebral column, due to trauma;
• degenerative-dystrophic processes - osteochondrosis and its complications: protrusions and herniated intervertebral discs;
• malformations of the musculoskeletal system, accompanied by a change in muscle tone;
• disorders of posture, curvature of the spine - scoliosis.

To give rise to an attack of radiculitis can be unsuccessful movement, a prolonged stay in an uncomfortable position, a sharp rise in gravity. Smoking, alcohol and caffeine abuse, excessive diets obsession worsens the blood supply of the spine and burdens the course of radiculopathy.

Radiculopathy of the lumbosacral spine. Symptoms

Radiculitis of the lumbosacral spine is most common. It is characterized by severe pain in the lower back, which also extends to the posterior surface of the thigh. Its nature depends on the localization of the lesion.

With compression of the fifth lumbar spine, patients complain of wavy pain in the buttock area, the outer lateral surface of the thigh, the front surface of the shin and the inner part of the foot in the region of the large finger. In a number of cases, the skin sensitivity is also disturbed in these areas.

When the first sacral spine is injured, unpleasant sensations spread along the buttock, the back and outer surface of the thigh, the lower leg, the plantar and outer part of the foot to the little finger. There is a weakening or disappearance of the Achilles tendon reflex.

Lumbosacral sciatica most often develops sharply and quickly. Any activity increases pain. When examining the patient, the tension of the muscles of the back is revealed, the pulsation of the arteries of the foot is weakened, the skin becomes whiter and becomes cold.

Diagnostic examination

Since radiculitis is not an independent disease, it is important in the diagnostic process to find out what exactly is the cause of pressure on one of the roots of the spinal cord, leading to the emergence of a whole complex symptoms.

For accurate diagnosis, the doctor performs a number of activities. As a rule, the sequence of diagnostic stages is as follows:

1. In acute pain in the lumbosacral region, an examination and palpation of the lower back is performed, which allows us to identify a spasm of paravertebral muscles.
2. Neurological examination necessarily includes testing of motor functions, detection of loss of sensitivity of various sites of the lower limbs.
3. At the final stage, instrumental diagnostics are carried out.

The discogenic radiculopathy of the lumbosacral section with the phenomena of sciatica (inflammation of the sciatic nerve) is clearly manifested in the gait of the patient, which becomes slow and cautious.

The patient slightly tilts his torso when walking. It is more convenient for him to stand or lie, the sitting position of him causes painful sensations. When the Valsalva test is performed, the pain intensifies.

The compression of the nerve root with the ruptured disc is revealed with the help of a test with the lifting of the straightened leg in the supine position. Doing this exercise is limited and causes back pain giving up in the leg. Painful sensations are enhanced by bending the foot.

Testing of motor functions allows you to examine the most frequently affected nerve roots.

For this, an assessment is made of the patient's ability to walk on the heels and toes of the feet, squatting, bending of the foot and fingers.

• Compression of root S1 can lead to weakness of plantar flexion when the patient loses the ability to stand on toes.
• Pressing the root of L5 can lead to disruption of the rear extensor of the foot and thumb, the appearance of the effect of a drooping foot.
• The defeat of the nerve root L4 can lead to a decrease in the strength of the quadriceps muscle, cause the patient to have a feeling of instability in the leg.
• The pathology of the L5-S1 disc causes a decrease in the ankle reflex.
• The loss of the knee reflex indicates the pathology of the L3-L4 disc.

The decrease in the sensitivity of various parts of the limb can indicate the rupture of intervertebral discs of the lumbosacral spine:

• When the hernia of the disk L5-S1 - possible loss of sensitivity and numbness of the little finger and the outer edge of the foot.
• When the hernia of the disk L4-L5 - loss of sensitivity and numbness of the big toe and the inside of the foot.
• With herniated disc L3-L4 - decreased sensitivity in the region of the front surface of the thigh and lower leg.

As instrumental research methods apply:

1. X-ray to determine the degree of degenerative changes in the spine;
2. magnetic resonance imaging (MRI) and computed tomography (CT) for visualization of root compression;
3. EMG (electromyography) to detect the extent of damage to nerve fibers.

Treatment of radiculopathy of the lumbosacral spine should begin immediately after confirmation of the diagnosis. Such early medical intervention helps to prevent dangerous consequences of the disease:

• chronic pain syndrome;
• spasms of the muscles of the back and lower limbs;
• violations of the pelvic organs.

The most pronounced effect is provided by complex therapy of the disease.

Elimination of symptoms must be accompanied by a thorough examination aimed at identifying the underlying disease that caused the development of lumbosacral radiculitis. If his treatment is not carried out, the probability of recurrence of radiculitis in the patient will remain very high.

Drug therapy

It is an obligatory stage in the treatment of lumbosacral radiculitis. It is performed with the use of drugs for local treatment and systemic therapy.

With local treatment, medications, most often ointments, are rubbed into the skin at the waist and sacrum.

Means of local irritating effect (Finalgon, Capsicum, Gymnastalog) and containing snake or bee venom (Apizarthron, Viprosal, Mellivenon) are not recommended if the skin is damaged.

Medicinal preparations for systemic therapy are prescribed for oral or parenteral administration: subcutaneous or intramuscular injections, adhesion.

It consists of corticosteroid hormones, B vitamins, preparations for local anesthesia.

During systemic radiculitis therapy, the following are used:

1. Muscle relaxants.
   They quickly stop the spasm of skeletal muscles, which helps to eliminate the compression of nerve fibers. In clinical practice, most often used drugs tolperisone, baclofen, tizanidine.
2. Non-steroidal anti-inflammatory drugs.
   Have analgesic and anti-inflammatory effect, relieve swelling. To this end, improved medicines of the new generation are increasingly being used, such as meloxicam or celecoxib, causing the least risk of complications from the gastrointestinal tract. The greatest effect is provided by the combination use of NSAIDs and muscle relaxants.
3. Antidepressants.
   Sleeping and sedative drugs are used to improve the general condition and well-being of the patient.
4. Vitamin Complexes.
   Contain vitamins B1, B6, B12. They help to normalize metabolic processes in the inflamed nerve root, reduce pain sensations, block the action of inflammatory mediators and slow down their synthesis.
5. Biologically active substances.
   Restore normal blood circulation and tissue metabolism in the affected area.

Patients need to understand that medical treatment of radiculitis can and should be performed strictly according to the doctor's prescription! Since such treatment requires an individual approach based on accurate diagnosis, and taking into account possible adverse events when taking patients with certain drugs.

But it is impossible to cure radiculopathy only with medicines!

Non-drug treatment

When symptoms of acute lumbosacral radiculopathy are shown to the patient, bed rest is indicated. To maximize the discharge of this part of the spine, the bed on which the patient lies must be quite rigid.

After the end of the acute period of the disease, the patient is prescribed physiotherapy. In the system of treatment of radiculitis are most effective:

• Electrophoresis. Helps to stop painful sensations.
• Reflexology. Also helps reduce pain and inflammation.
• Shock Wave Therapy. This kind of micromassage of tissues stimulates blood circulation, stops the inflammatory process.
• Magnetotherapy. It is aimed at reducing edema, reducing painful sensations. The procedure improves microcirculation in tissues, has anti-inflammatory and soothing effects.

A set of physiotherapeutic procedures prescribed for radiculopathy of the lumbosacral spine may also include orthopedic measures (wearing corsets and bandages), treatment with diadynamic currents, heating, ultraviolet irradiation and cryotherapy.

To restore the healthy biomechanics of the spine and the normal stereotype of movements, patients are prescribed therapeutic physical training.

The complex of exercises is selected individually, classes are conducted in a sparing mode. Often doing exercises due to the redistribution of load vectors helps to eliminate the compression of the spine.

LFK allows to stop degenerative changes in the spine. Classes have a positive effect on the elasticity of ligaments and muscles, thus increasing the patient's movements. Exercise in the system is an excellent prevention of recurrence of sciatica.

Surgical intervention

If no methods of conservative therapy do not eliminate the pain syndrome, and it progresses when it is not possible to eliminate compression of the nerve, which provokes numbness of the limbs, disruption of the intestine and urogenital system, surgical operation.

A source: http://pomogispine.com/zabolevaniya/radikulit/v-poyasnichno-krestcovom-otdele.html

Methods of treatment of radiculopathy of the lumbosacral department

According to statistics, every fifth inhabitant of the country suffers from osteochondrosis. Often against the background of this disease there is radiculopathy (radiculitis) or radicular syndrome - pinched beams of spinal nerves.

Most often, the lesion occurs in the lumbosacral spine. This condition is the cause of sharp, penetrating pain in the back, which lead to limited mobility of the spinal column.

Radiculopathy caused by osteochondrosis of the lumbosacral spine can lead to disability.

Provoking factors of radicular syndrome

The causes of the radicular syndrome of the lumbar spine are:

1. trauma and subluxation of the vertebrae;
2. tumors of the spinal cord;
3. weak muscular back skeleton;
4. sedentary lifestyle;
5. permanent, excessive strain on the spine;
6. infectious diseases (syphilis, tuberculosis);
7. supercooling;
8. obesity.

Radicular syndrome caused by herniated intervertebral discs is called discogenic radiculopathy.

Symptoms of radiculopathy

The main symptom of radicular syndrome is a strong, shooting pain in the area of ​​lesion of neural bundles.

Painful sensations in the lesion of the lumbosacral can give to other parts of the body: buttock, thigh, calf, shin and foot.

In this case, cramps in the lower limb and numbness of the toes can be noted.

Complications of radiculopathy

The lack of timely therapy with radiculitis leads to a curvature of the spine. Against the background of the squeezing of the roots, blood circulation is disturbed, which can lead to paralysis and complete loss of mobility.

The most rare complication is a violation of the internal organs of the small pelvis.

Diagnosis of radiculopathy

The main task of diagnosis is to identify the cause, which provoked radicular syndrome. For this purpose, the neurologist appoints the following types of examination:

• radiography;
• computed tomography (CT);
• magnetic resonance imaging (MRI).

Radiography and MRI establish a pathology that caused the appearance of radiculopathy (osteochondrosis, intervertebral hernia, etc.). CT gives a complete picture of the onset of the disease.

Methods of therapy for root syndrome

Treatment of radiculopathy requires an integrated approach and should include the following measures:

1. drug therapy;
2. blockade;
3. physiotherapy;
4. physiotherapy;
5. reflexology;
6. massage.

The purpose of therapy for root syndrome is to relieve painful spasm and inflammation, improve blood circulation and restore cartilaginous tissue of the intervertebral discs.

Medication Therapy

At a radiculitis the following group of medicamentous preparations is appointed or nominated:

• NSAIDs;
• muscle relaxants;
• painkillers;
• chondroprotectors;
• vitamins of group B.

NSAIDs are non-hormonal anti-inflammatory drugs, whose task is to remove puffiness and inflammation in the place of lesion of the nerve roots. This group of medicines includes diclofenac, voltaren, aceclofenac, naproxen, etc.

To relieve muscle spasm and pain syndrome prescribed muscle relaxants: baclofen, tizanidine, noophen, tolperisone, etc.

Analgesics are prescribed during the period of exacerbation of the symptoms of the disease. For anesthesia appoint ketorol, pentalgin, baralgin and the like.

Chondroprotectors stop degenerative processes in intervertebral discs and trigger the restoration of cartilaginous tissue. This group of drugs include glucosamine and chondroitin sulfate.

Vitamins of group B help to restore the function of the affected root.

Blockade

One of the most effective methods of treatment of radiculitis is the injectable administration of a drug that has anti-edematous, anti-inflammatory and analgesic effects.

During the procedure, the lumbar and sacral region of the spine is involved, where the solution with the drug is injected. Anesthetics are used as the basic means for blockade.

Additional drugs are steroid drugs that are not addictive due to the method of exposure.

Physiotherapy

For the treatment of radicular syndrome in the background of osteochondrosis, additional therapy is used:

1. electrophoresis;
2. magnetotherapy;
3. laser therapy;
4. shock-wave therapy;
5. UHF and ultrafonose.

In the period of remission, paraffin treatment and ozoceritherapy are prescribed. Procedures contribute to better blood circulation and accelerate the recovery process.

Physiotherapy

The action of therapeutic exercises, appointed by the physician of exercise therapy, is aimed at restoring the mobility and strengthening of the muscular corset. A gymnastics is prescribed after the period of exacerbation subsides.

LFK helps not only strengthen muscle tone, but also improves local blood circulation, thanks to which the spinal nerves are provided with nutrients.

Patients with a diagnosis of radiculopathy need to perform therapeutic gymnastics not only during rehabilitation, but also in the following time.

The complex of exercises is selected exclusively by the physician. The specialist determines the degree of permissible load.

At the first stage, exercise therapy is performed exclusively under the supervision of a doctor.

In the future, gymnastics can be done at home. Perform exercises should be two hours before meals or half an hour after a meal. Before conducting classes, the patient is recommended to wear loose clothing made of cotton or wool.

Perform exercises from the prone position, sitting, on all fours or standing. The choice of position is determined by the attending physician depending on the patient's condition.

On the day at the exercise room is given 20 minutes.

The full course is 1 month, after which a short break is made, and then the patient is recommended to return to the classes for a preventive purpose.

When there is fatigue and malaise, the load is somewhat reduced. When there is severe discomfort or pain from training, you should temporarily give up.

Reflexology

In the acute period, reflexotherapy is an additional method of arresting pain. The procedure is carried out using a needle or fingers, pressing on special points. Reflexotherapy is contraindicated in hemophilia, heart failure, tumors, liver and kidney diseases.

Massage

The procedure for massage with radiculopathy is carried out with the aim of increasing blood circulation, eliminating stagnant phenomena and restoring metabolism.

This technique also helps to improve muscle elasticity and eliminate accumulated interstitial fluid, which can further squeeze the damaged rootlet.

Massage allows you to remove inflammation, stop pain and improve the mobility of the lumbar spine. The procedure is not recommended for blood diseases, high temperature, acute infections, neoplasms and acute thrombophlebitis.

Conduct manual therapy only after the elimination of the acute course of the disease. The doctor uses the technique of flexion and extension, twisting and stretching of the spinal column.

During the procedure, there may be a crunch, which, if properly manipulated, does not cause discomfort, but, on the contrary, contributes to the flow of pleasant warmth to the tissues.

Operative intervention

Surgical method with radiculopathy is used when other methods of treatment did not give a positive effect.

During the operation, the hernia or bony enlargement is removed, which contributed to the onset of radicular syndrome.

After decompression of the spine, the patient feels a significant improvement in general condition.

A popular method of surgical intervention in recent years is minimally invasive technology, thanks to minimal blood loss and traumatism. This method is the most safe, has a high efficiency and significantly reduces the rehabilitation period after the operation.

The technology is under the radiological control or endoscopic way under video surveillance.

After surgical intervention, the patient is prescribed a course of exercise therapy, massage, heat treatment and other physiotherapy procedures.

Prognosis for radiculopathy

The prognosis for the root syndrome is favorable, provided that you have a timely call to the doctor. Most patients respond well to conservative treatment and do without surgery.

During, -3 months, 7 out of 10 patients diagnosed with radiculopathy of the lumbar region are fully rehabilitated. The rest of patients need a longer recovery period, which can range from 3 months to 6 months.

With prolonged exacerbation, which can be observed for 6 months, clinical manifestations can persist up to 2 years.

A source: https://poyasnica.com/bolezni/drugie-zabolevaniya/radikulopatiya-poyasnichno-krestcovogo-otdela-pozvonochnika.html

Radiculopathy of the lumbosacral spine

Very many people over the age of forty experience back pain of varying intensity. The causes of these pains can be completely different.

If the pain is caused by the compression of the spine nerve root, it is about the radicular syndrome, or otherwise, radiculopathy.

Depending on the location of pinching, radiculopathy is divided into cervical, thoracic and lumbar, or lumbosacral.

Lumbosacral radiculopathy is one of the most severe forms of pain syndrome, manifested by prolonged and severe pains, as well as by limitation of mobility.

Causes of the disease

To the risk factors leading to the disease lumbosacral radiculopathy, in the first place is attributed to heavy physical labor, a constant impact vibration, poor climatic conditions of work, sudden lifting of weights, a long stay in a tilt position, obesity, poor heredity, harmful habits.

The causes of radicular syndrome include:

• Intervertebral hernia. This is the most common cause of lumbar radiculitis;
• Osteophytes and other manifestations of osteochondrosis;
• Stenosis of the spinal canal in the lumbar region;
• Disorders of posture;
• Inflammatory diseases of the spine;
• Tumors;
• Injury of the spinal column;
• Age changes;
• Hypodinamy;
• Infectious diseases, for example, tuberculosis.

Symptoms of lumbosacral radiculitis

Symptomatology in lumbar radiculopathy is very pronounced.

1. Intense prolonged back pain;
2. Pain increases with coughing, sneezing and tension of the muscles of the press;
3. Lumbago in the posterior surface of the leg and gluteal muscles;
4. Pain can spread to the abdominal wall;
5. Disturbances of sensitivity, paresis, numbness of toes;
6. Limitations of motion when the body is tilted;
7. It is not possible to stand on your toes or bend your toes;
8. Atrophy of the muscles of the legs and the press.

Symptoms vary somewhat depending on the nature of the pain syndrome:

• Lumbalia- pain in the lower back. The pains are acute, appear during physical activity or immediately after them. Can cause an attack of hypothermia and overheating. Pain can last several minutes or several days.
• Ischialgia- the pain extends into the gluteus muscle, the back surface of the foot and reaches the foot. The shooting and burning pains are the result of irritation of the sciatic nerve.
• Sciatica- aching pain localizes in the lower back and extends into the buttock and the back surface of the foot, but does not reach the foot. Pain often becomes chronic and becomes more pronounced over time.

Lumbosacral radiculopathy- a serious threat to work capacity.

Discontinuation of the normal conductivity of nerve impulses, leading to muscle atrophy, circulatory disorders, malfunctioning of internal organs can lead to disability.
How to treat lumbosacral radiculopathy

The package of treatment measures includes:

1. Bed rest in the first days of illness;
2. Drug therapy NSAIDs (Diclofenac, Ibuprofen, Orthofen), analgesics, muscle relaxants (Midokalm, Sirdalud), antidepressants, vitamin complex;
3. Massage, which helps to normalize blood circulation in the affected area and to alleviate the pain syndrome;
4. Manual therapy, designed to remove clamps and muscle spasms;
5. Physiotherapy: electrophoresis, diadynamic currents, ultrasound;
6. Physiotherapy;
7. Acupuncture.

Gymnastics with radiculitis

To practice physical therapy, you can start only after the acute period of the illness subsides. Performing exercises should be in a sparing mode very slowly and calmly, keeping even breathing.

• You need to lie with your back on a hard surface. Bend both legs in the lap and pull them towards the chest, clasping their hands with their knees. Run 10 repetitions, do three approaches.
• Perform the movement as in the previous exercise, but the hands should be stretched at the knee level.
• Lying on his stomach and resting his toes on the floor, raise the upper part of the body. Hold in this position for a few seconds.
• Various stretching exercises are performed, for example, bending and arching of the back in a position on all fours.

If within 3-4 months the pain syndrome could not be managed with conservative methods or dysfunction of internal organs and motor disorders was detected, surgical intervention.

Radiculopathy has the property of passing into a chronic form. In order for this to happen, it is necessary to strengthen the muscular corset. Favorable for the health of the waist is swimming and gymnastics. It is necessary to beware of hypothermia and avoid lifting weights.

A source: https://helportoped.ru/zabolevaniya/radikulit/radikulopatiya-poyasnichno-kresttsovogo-otdela-pozvonochnika.html