What is radicular syndrome (pinched nerve in the back), symptoms and treatment of the disease. Nerve root inflammation, symptoms, treatment

Back pain is a common complaint of people who are forced to seek medical help.

Experts note that in almost 90% of cases the cause of such pain is a disease of the spine.

One of them is radicular syndrome lumbar region, which is a consequence of osteochondrosis.

What it is

Lumbar radicular syndrome occurs as a result of nerve damage spinal cord, accompanied by characteristic pain symptoms and demands complex treatment.
The deforming effect of this process occurs in the lumbar region of the spinal column. The disease develops slowly, its intensity increases gradually, unlike hernias intervertebral discs, or spinal injuries.
As the supporting structure of the entire body, the lumbosacral region experiences heavy loads.
It is quite durable, but over time it undergoes changes in structure. Most often, the metabolism in the cartilage is disrupted, and the possibility of its recovery after exercise is reduced.

The disease appears in the intervertebral discs, which are most susceptible to such changes. The development of osteochondrosis begins, and, as a consequence, radicular syndrome.

The cartilage is destroyed, a hernia appears, and at this point there is pressure on the nerve running along the spine.

The nerve roots of the lumbar region go to the legs, and accordingly their sensitivity and ability to move are impaired. The more the nerve is compressed, the worse the pain.

Structure of the lumbar spine

To understand how and why the disease manifests itself, you need to know the structure and function of the lumbar spinal column.
There are five lumbar vertebrae in this section. They are located one above the other, normally forming lordosis (anterior bending). The last fifth vertebra connects to the sacrum.
Normally, between the vertebrae there are intervertebral discs that act as a kind of shock absorber. WITH inside The vertebral segments have intervertebral foramina where the spinal nerve passes.
When deformation occurs intervertebral discs, the spine sags, the holes narrow, the process seizes the nerve, which leads to pain. The more damaged the nerve, the greater the consequences.

Reasons for development

Deformation of the vertebral discs can ultimately lead to the formation of bone spurs at the edges of the vertebral segments. Then, when the disc ruptures, a hernia forms.

With mechanical compression by a hernia and bone growths severe pain is observed in the nerve roots.

At the site of damage, blood flow is disrupted, swelling of the structures is formed, which makes you feel even more pain, which, spreading through the nerves, reaches the very tips of the legs.

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The main cause - osteochondrosis of the lumbar region - causes radicular syndrome, which requires serious treatment.

Radicular syndrome can also result from following reasons:

back strain during pregnancy or obesity;
violation of the normal position of the spine (scoliosis);
congenital pathology lumbar spine, foot deformity;
hypodynamic lifestyle, frequent static loads;
Availability infectious diseases causing inflammation, in particular osteomyelitis (thinning of bones and cartilage);
wearing high-heeled shoes, which puts unnecessary pressure on the spine;
injuries and their consequences;
physical work with weight lifting;
hypothermia;
lack of fluid in the diet and eating large amounts of salty foods.

Against the background of spinal deformities leading to osteochondrosis, these causes lead to radicular syndrome. In this case, it is the lumbar region that suffers the most. This is explained by the following points:

influence maximum load to this department;
The lower back is a support for the higher parts of the spinal column;
segments of the lumbar region are larger than others, large blood vessels and nerve endings pass here;
the lower back is very mobile, and the muscle corset in this place is quite weak; with a wide range of motion, displacement occurs easily.

Experts distinguish three types of disease with radicular syndrome, involving the lumbar, cervical and thoracic spine.

Among them is osteochondrosis thoracic spine with radicular syndrome is very rare, and lumbar osteochondrosis is the most painful.

Symptoms

Symptoms of the disease are divided into two types: general and concomitant (depending on the affected segment).

They are always accompanied main feature diseases - pain.

Radicular syndrome of the lumbar spine has the following clinical symptoms:

at the site of compression of the diseased nerve root, severe pain is felt, which spreads to the lower extremities;
Sensitivity is impaired along the course of the nerve, which manifests itself in the form of numbness and goosebumps;
loss of the ability to perform voluntary movements (paresis), which occurs as a result of circulatory disorders of the spinal nerve root;
against the background of nerve damage, muscle weakness is observed, leading to atrophy;
change skin(pallor, cyanosis).

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The nature of the unpleasant sensation in radicular syndrome is one-sided, painful attacks of a different nature.

Sometimes the unpleasant sensations practically do not go away and spread along the nerve. There are lumbago, when pain radiates to the legs, buttocks, and stomach.

General pain syndrome determined by how much the nerve root is affected, and what concomitant symptoms he is accompanied.

The severity of the pain increases if the patient does sudden movements and turns the body, lifts weights. The disease can worsen due to hypothermia and stressful situations.

Which part of the lower back will be painful depends on the area where the nerve root is pinched. The following departments are distinguished:

If the nerve ending of the first/third segment is damaged, the abdominal area, lower back, inner part hips, groin area. The skin may become numb or develop bumps.
Pinching of the nerve process of the fourth segment will be marked by an unpleasant sensation in the lower back, hips, knee joint and lower leg in front. The knee is very painful, the front muscle becomes hard.
The root of the fifth segment causes pain when pinched inner surface skin of the thigh and lower leg, down to the foot. Thumb goes numb. The sole becomes painful and cannot withstand the load of the body.

In case of spinal disease with radicular syndrome, less inconvenience is caused by resting on the opposite side of the disease and calm movements, eliminating heavy loads.

If the nerve root is affected by any infection, then the main and accompanying symptoms will be accompanied by an increase in temperature at the site of the disease.

Diagnostics

If there is pain in the spine, this may be the cause various diseases. Correct treatment however, it can be prescribed only after a diagnosis has been made.

The exact cause of pinched nerve endings of the spinal cord can be determined during diagnosis. It includes the following points:

medical examination;
medical history examination;
general examination methods.

The main method will be an x-ray examination of the lumbar spine. It is carried out from two sides: front and side.

If the x-ray does not give results or the diagnosis needs to be clarified, then an MRI (magnetic resonance imaging) is performed.

Treatment of the disease

Treatment of lumbar radicular syndrome consists of the following activities:

eliminating the cause of the disease;
pain relief;
restoration of the affected area of the spine.

These activities are provided by therapies that include:

ensuring peace;
taking medicines;
massage and physiotherapy;
Exercise therapy ( therapeutic gymnastics).

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

What is radicular syndrome?

This term is usually understood as a set of symptoms that develop as a result of exposure to the roots of the spinal cord. Most often, osteochondrosis leads to the development of the disease - the radicular syndrome with it is less intense than with injuries or disc herniation. Narrowing occurs, which leads to infringement of the outgoing nerves.

The main clinical signs or criteria of radicular syndrome are:

Pain. Characterized by intense, aching pain in the area of compression of the root emerging from the spinal cord, spreading to the limbs and sometimes to the internal organs.
Impaired sensitivity. Develops along the outgoing nerves. Most often it manifests itself in the form of paresthesia (goosebumps, chills).
Atrophy of innervated muscles and impaired movement. It develops due to damage to the nerves that innervate a particular area. Leads to muscle weakness and loss of their functions.

Pathogenesis of the disease

The basis of the development of radicular syndrome is the defeat of the spinal column. Stocks deplete over time nutrients contained in the intervertebral cartilage. Aggravating this state factors are age, excess weight, weakness. As a result of this, the so-called subsidence of the vertebrae occurs.

Spinal nerves exit from spinal canal through the intervertebral foramina. Due to the fact that the spine sags, these openings narrow, which leads to pinched nerves.

Aseptic inflammation develops in the compression zone, which is characterized by swelling of the adjacent tissue. This swelling further aggravates the condition, which leads to increased pain. Pain spreads along the exiting nerves, which can cause a lesion pattern internal organs(for example, radicular syndrome of the thoracic spine can create a picture of angina or myocardial infarction).

Reasons leading to the development of the disease

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

Due to the rupture of the cartilage and the exit of the nucleus pulposus beyond the spinal column, compression of the exiting nerves occurs.
Structural defects are most often the cause of the development of radicular syndrome, starting in early childhood.
Injuries. Usually, as a result of improper fusion of the vertebral processes, compression of the roots occurs.
Infectious diseases of the spine, leading to depletion of bone and cartilage tissue (osteomyelitis).

Often, radicular syndrome develops in obese, sedentary people.

Sometimes it may develop as a result of excessively hard physical work or the so-called “back breakdown”.

In some cases, radicular syndrome develops due to hypothermia.

Some drugs can cause the development of radicular syndrome (however, in this case, this syndrome will be called pseudoradicular).

Classification

There is no classification of radicular syndrome as such. Conventionally, clinicians subdivide it according to the defeat of the anatomical zones of the spine. According to this classification, radicular syndrome is distinguished:

Cervical spine.
Thoracic department.
Lumbar.

The region of the sacrum and coccyx is rarely affected by osteochondrosis, so these areas are not included in the classification.

Behind the scenes, there is a classification of radicular syndrome according 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, since basically this syndrome is most often acquired).

Among all the listed forms most widespread has radicular syndrome of the lumbar spine.

Causes of damage to this department

Why is this area most often affected? The reasons due to which the lumbar radicular syndrome develops are as follows:

The lower back bears the greatest load. This is where its redistribution from heavy physical work occurs. In addition, the lower back is also loaded by the overlying sections of the body, as it contributes to their maintenance and position.
The lumbar region is formed by large vertebrae that form fairly wide openings. Large vessels pass through them and nerve plexuses, which are quite easily infringed as a result of a violation of the shock-absorbing function of the intervertebral discs.
Lumbar radicular syndrome also often develops due to the fact that it is one of the most mobile areas axial skeleton. Excessively wide range of motion easily leads to displacement of the vertebrae relative to each other and causes the development of pain and pinched nerves.

Clinic

If, however, lumbar radicular syndrome occurs as a result of pinched nerves, symptoms will not take long to appear.

The first and most common symptom is pain. It is of a shooting nature and appears suddenly as a result of heavy physical work or injury. A gradual increase in pain is characteristic of osteochondrosis. In this case, the lumbago will also bother you, but the intensity of the pain is not so high.

Sensory impairment usually accompanies pain. It is disrupted on the side where the nerves are pinched. Lumbar radicular syndrome is usually bilateral in nature (with osteochondrosis). Most often, there is a decrease in sensitivity and sometimes paresthesias may occur - perverted or incorrect sensations.

Muscle dysfunction may develop when long time lumbar osteochondrosis occurs. Radicular syndrome leads to muscle atrophy, loss of opportunity to be active physical work, weakening the strength of muscle contractions.

Diagnostics

This disease must be diagnosed taking into account most factors. First of all, attention should be paid to the patient's complaints, since it is on the basis of the latter that one can make assumptions about the localization pathological process.

Auxiliary information during the examination can be given by palpation of the area where the pain is located - local muscle tension will be felt. Visually, you can detect the patient's inclination to the affected side (thus he manages to reduce pain sensation).

A general blood test is not very informative - it can only be observed relative increase leukocytes due to limited inflammation.

The main advantage in diagnosing radicular syndrome is MRI of the lumbar spine. This study allows you to detect even the slightest pinched nerve and accurately determine the localization of the process. However, the difficulty lies in the tomography itself. MRI of the lumbar spine is a rather expensive procedure, so it is not performed on everyone.

Treatment of radicular syndrome

What to do if this disease develops? Is it possible to be treated at home or is it better to go to the hospital?

If you still develop lumbar radicular syndrome, it should be treated immediately and preferably in a hospital.

Like any type of treatment for 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 impact on life, they can help general methods - proper nutrition, avoidance physical activity, massage, relaxing hot baths.

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

Physiotherapeutic treatment

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

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

Electrophoresis with some drugs allows you to achieve such effects as:

Removing the inflammatory process.
Elimination of pain syndrome.
Improving metabolism in the affected roots.
Restoration of trophism of affected muscles and joints.

The use of EIT (electropulse therapy) is aimed at relaxing tense muscles, improving the nutrition of atrophied tissues, and a general tonic effect.

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

Treatment of the lumbar spine can also be carried out with the help of acupuncture and manual therapy sessions. These techniques are not widely used in conventional medicine, but they help quite a bit. a large number of people.

Surgery

The main factor characterizing radicular syndrome is symptoms. Treatment in surgical hospital It is recommended when they begin to become threatening.

The main indications for surgical intervention are:

Intense pain syndrome that cannot be relieved by taking NSAIDs and narcotic analgesics.
Impaired limb function with complete loss of active movements.
Irreversible changes in the osseous-ligamentous apparatus leading to compression.
Complicated intervertebral hernia.
Complete loss of sensation in the limbs.

Operations are carried out in specialized hospitals. Created under anesthesia online access to the place of compression of the roots, vertebral particles that interfere with the normal position of the root are removed. In case of a hernia, the prolapsed area is excised. Currently, for hernial radicular syndrome, nucleoplasty is increasingly used - reduction or excision of a prolapsed disc with limited access.

Complications of the disease

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

Lameness. Develops due to forced body position. Subsequently, it can lead to flat feet and worsening of the disease (vicious circle).
Violations mental state. Intense pain in the limbs and back will haunt you day and night. Due to overwork, neuroses and psychoses can develop.
Ankylosis and the reason for their development is, again, a long stay in a certain position and low activity.
In severe cases, nerve damage can lead to complete paralysis of the limbs.
The onset of inflammation can retrogradely enter the spinal cord, causing a picture of meningism, spinal cord infarction, or increased spread of the process to other roots.

Disease prevention

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

Daily morning work-out. Helps stretch muscles and tone them.
Control excess weight. As mentioned, it is a factor that worsens the course of the disease.
Preventive massage sessions. They help warm up the muscles and spinal joints, prevent displacement of the vertebrae relative to each other, and also prevent them from falling out. intervertebral discs from your bed.
Proper nutrition. One of the factors in the development of osteochondrosis is a decrease in the content of nutrients in cartilage tissue. A well-designed diet allows you to stop the process.
Pool. Allows you to reduce the load on the spine, simultaneously toning all muscles.
Proper distribution of work and rest. This rule allows you to avoid overwork and injuries during physical labor.

This disease is a symptom complex of a number of manifestations associated with destructive processes in the spine. Often, radicular syndrome makes itself felt with such multiple and varied signs that a serious differential diagnosis is required to clarify the causes of the pathology. Therefore, a timely visit to a specialist is so important.

Pinched nerves are a very serious condition that requires immediate attention. medical care. You should contact a neurologist who will conduct an examination and carry out a series of diagnostic measures, will prescribe treatment and monitor its progress. Don't try to help yourself on your own. Signs of radicular syndrome may indicate other diseases provoked by similar phenomena. Only an experienced specialist can figure this out.

The clinical picture usually clearly indicates what radicular syndrome is. The main factor in the development of this condition is a pinched nerve in the spine. It can arise for a number of reasons. Usually these include osteochondrosis. But, in addition, it could be:

hard physical work;
staying in an uncomfortable position for a long time;
physical inactivity;
hormonal imbalance;
cold.

A pinched nerve in the spine does not manifest itself immediately. Therefore, it is sometimes difficult to determine the cause of its occurrence. The pathogenic factor serves only as an impetus to the beginning degenerative changes cartilage tissue and nerve roots extending from it. Edema occurs and develops venous stasis, a strong inflammatory process is formed, which involves all surrounding tissues.

This is a symptom complex associated with the occurrence of an extensive pathological process of the spine affecting the root. When a nerve is pinched in the back, the resulting syndrome is usually accompanied by a triad, which includes: pain; change in sensitivity in the affected area (on the opposite side it remains completely, which can serve as a bright diagnostic sign); severe muscle spasm that prevents the implementation of a complete range of movements.

Radicular pain syndrome is also characterized by aggravation of the patient’s condition from any stress.

When a pinched nerve occurs in the back, the symptoms are usually quite severe. The patient experiences severe pain. It often spreads to nearby areas, as well as to internal organs.

Symptoms of a pinched nerve in the spine usually directly relate to the limitation of the patient's mobility. Every slight turn of the head or change in posture causes severe attack pain. Sometimes they continue constantly, disturbing him even at night.

Signs of pinching are usually quite obvious:

pain;
muscle tension;
staying in a forced position;
difficulty moving;
numbness of the limbs;
swelling;
decreased sensitivity;
changes in blood circulation;
hyporeflexia;
tissue ischemia.

Often, discomfort manifests itself most strongly not even in spinal region, but in the upper or lower limb. A person cannot raise his arm, move his shoulder, or roll over from side to side.

The patient often experiences general malaise, chills, and sweating. If you postpone a visit to the doctor, the infringement will worsen, the pinched nerve ending will begin to experience increasingly strong compression, swelling and myospasm will only increase due to severe pain. Inflammatory process will naturally continue to grow rapidly. Then paresis, dystrophic effects on surrounding tissues, and even death of the nerve are possible.

Diagnosis of pathology

All this can be absolutely irreversible damage to the nerves in the spine. The main reason for such a severe pathology is that it is of a long-term progressive nature. All structures involved in this process gradually become deformed, lose their functions and, over time, simply begin to die.

Treatment of radicular syndrome begins with establishing its cause. The neurologist usually determines what to do first. Usually, a lot of clear and reliable data is provided by radiography in two projections, computed tomography and magnetic resonance imaging, and electroneuromyography.

It is very important to carry out differential diagnosis, since the symptoms of a pinched nerve in the back may be similar to those of other spinal nerve diseases. These include intervertebral hernia, spondyloarthrosis, bone tuberculosis, malignant or benign neoplasm, congenital anomalies, trauma, vertebral fractures, infection, osteoporosis.

They are characterized by the development of a pathological process at the point of contact of the nerve ending with the tissues of the back and the spinal column. Therefore, there is a very large area of damage, including internal organs. All this can last for a very long time, until the patient receives full medical care.

Pharmacotherapy of the disease

Treatment of radicular syndrome is usually associated with the degree of nerve damage. Usually the doctor prescribes strict bed rest to the patient. To alleviate his condition, analgesics (Analgin, Ketanov, Baralgin), anti-inflammatory drugs (Diclofenac, Indomethacin ointment, Ibuprofen), glucocorticosteroids are used.

Have a good effect local remedies, contributing to the removal of edema caused by congestion, increased blood circulation, and facilitated movements. Their influence helps to eliminate nerve compression, relax muscles, and normalize reflexes. Painful sensations begin to gradually pass, as well as the local hyperemia and fever associated with them.

When the doctor determines what to do to relieve the most pronounced manifestations of the disease, pepper patch, ointments, gels, balms (Fastum gel, Voltaren, Diclofenac, Finalgon), local anesthetics are most often used.

Muscle relaxants help restore nerve roots (Baclofen, Mydocalm, Sirdalud), antispasmodics, epidural blockade using painkillers, anticonvulsants. These measures prevent the development of further degenerative processes and greatly alleviate the patient's condition.

In the treatment of a pinched nerve in the spine, chondroprotectors (Alflutop, Dona, Teraflex, Chondroxide), immunostimulants, and substances that promote tissue regeneration help restore tissues. To normalize blood circulation, angioprotectors are used, vasodilators, venotonics.

They activate impaired blood flow due to the development of radicular syndrome, relieve lymphostasis, and strengthen the walls of blood vessels. As a result, the threat of muscle atrophy, ischemia of nearby tissues and limbs, as well as internal organs is eliminated.

Symptoms intervertebral hernia decrease, the nerve is released, blood supply and innervation are completely restored.

To stabilize nervous condition the patient is usually prescribed sedatives, sleeping pills, tranquilizers. Self-medication is unacceptable, since these medications are prescribed only by prescription and are taken under the strict supervision of a specialist. In addition, it should be noted that they have a number side effects and can cause unwanted reactions organism.

It also stabilizes the patient's condition. regular intake vitamins of group B and series minerals, which include Magnesium, Calcium, Manganese, Bromine, Sodium, Potassium. They contribute to a significant strengthening of the central and peripheral nervous system, trigger tissue regeneration processes, and also prevent irreversible narrowing of the openings through which the affected spinal roots emerge.

Additional treatments for radicular syndrome

When deciding how to treat a pinched nerve, advantages are given to certain methods of influencing tissue. A number of auxiliary procedures are carried out, which include back massage, physiotherapy, therapeutic exercises, reflexology, paraffin, mud, UHF, phonophoresis, electrophoresis, sulfide and radon baths, acupuncture, manual therapy, special therapeutic nutrition, drinking mineral waters.

These methods eliminate the main symptoms of damage to the radicular nerve, help restore intervertebral cartilage and reduce the intensity of the inflammatory process.

Only a doctor can say with absolute certainty how to cure this pathology and how long it will take to restore the patient’s health. If there is significant pinching of the spinal nerve, it may be necessary surgical intervention. Then the spine is released. To do this, an operation is performed to eliminate the intervertebral hernia.

What to do in this case and how the surgical intervention will be carried out can only be decided by the attending physician, based on the patient's condition, the degree of neglect of the disease, and the complications that have arisen.

Prognosis and prevention

Timely treatment of radicular syndrome usually ends in recovery. However, when running forms The disease may become chronic.

Such a course of pathology leads to a gradual degenerative lesion of all surrounding tissues. The functions of the spine and associated limbs are severely limited. The consequence of this may be the onset of disability.

In order for the symptoms of radicular syndrome not to manifest themselves again, a number of restorative and preventive measures. It is necessary to constantly take medications that help normalize the activity of the nerve of the back and the cartilage tissue surrounding it, therapeutic exercises, swimming, balneology, wearing a corset, careful weight control, and spa treatment.

All these measures should be carefully and strictly observed, since neglect of the doctor’s instructions can cause a relapse of the disease.

Description:

Radicular syndrome is a fairly common neuralgic syndrome, which includes a complex of symptoms resulting from compression (compression) of the spinal roots (spinal nerves). Radicular syndrome can manifest itself in the form of pain in completely different places: in the neck, limbs, lower back and even in the area of internal organs, such as the heart or stomach.

Symptoms:

Radicular syndrome does not occur immediately; as a rule, it is caused by a long-term degenerative process in intervertebral discs which ends in the formation of a hernia. In turn, the hernia, growing and shifting, can damage the spinal root and ganglion, which leads to its compression and development inflammatory reaction, as a result, radiculopathy and radicular syndrome develop.

Standard instrumental method Diagnosis of radicular syndrome includes radiography of the spine in anterior and lateral projections. Today, the most sensitive and informative method for diagnosing spinal pathology is magnetic resonance imaging. However, when diagnosing radicular syndrome important role clinical symptoms play a role.

First and most characteristic feature radicular syndrome is pain along the affected nerve. So, the process in cervical spine spine causes pain in the neck and arm, in the chest - in the back, sometimes there are sensations of characteristic pain in the heart or in the stomach (such pain disappears only after treatment of the radicular syndrome), in the lumbar - in the lower back, buttocks and lower limbs and so on. When moving or lifting something heavy, the pain intensifies. Sometimes the pain occurs in the form of lumbago, radiating to different parts of the body in accordance with the location of the corresponding nerve; in the lumbar region such a lumbago is called. The pain may be constant, but it still intensifies with any careless movement (for example, lumbodynia - pain in the lumbar region). Attacks of pain can be provoked by physical or emotional stress, hypothermia. Sometimes pain occurs at night or during sleep, accompanied by redness and swelling of the skin, and increased sweating.

Another sign of radicular syndrome is a violation of sensitivity in the zone of innervation of this nerve: with a slight tingling with a needle in this zone, a sharp decline sensitivity compared to a similar area on the opposite side.

The third sign of radicular syndrome is a violation of movements that appear as a result of changes in the muscles that occur against the background of damage to the nerves that innervate them. The muscles dry out (atrophy), become weak, sometimes this can be seen even by eye, especially when comparing two limbs.

The pain is localized in the area of compression of the root and in those organs that are innervated by the damaged spinal nerve. For example, if the root is affected at level 5 lumbar vertebra(L5) pain is determined in the lumbar region (lumbodynia), when walking - in the upper outer quadrant of the buttock, radiating along outer surface thighs and lower legs to the II-IV toes (lumbar ischialgia). When the L4 root is damaged, pain spreads from the buttock through the anterior surface of the thigh and the anterior-inner surface of the lower leg to the inside of the foot.

Since the spinal root includes motor processes of the neuron and sensory nerve fibers, then with radicular syndrome there may be a violation (reduction) of tissue sensitivity. For example, with L5 radicular syndrome, skin sensitivity (hypoesthesia) in the area of the outer surface of the thigh and lower leg decreases.

Causes of occurrence:

The main cause of the development of radicular syndrome is. However, this syndrome can develop due to spina bifida, compression fracture vertebrae (with osteoporosis), spondylolisthesis, tumor development (neurinoma), lateral displacement of vertebral bodies, compression of the root by lateral osteophytamy, as well as infection vertebrae (osteomyelitis, tuberculosis).

Treatment:

For treatment the following is prescribed:

The basic principles of treatment of radicular syndrome include strict bed rest on a hard surface, taking painkillers (Baralgin, Ketorol), non-steroidal anti-inflammatory drugs (Nurofen, Diclofenac, Ketonal, Movalis) and local irritants (Finalgon ointment, Capsicam ointment, Nicoflex ointment, pepper patch) . In case of severe muscle spasm, muscle relaxants are used - Mydocalm, Sirdalud, Pentoxifylline. It is possible to perform an epidural block using anesthetics (painkillers). Anticonvulsants and antidepressants are prescribed according to indications.

Since radicular syndrome is accompanied not only by acute, but also by chronic aching pain, then during treatment this disease The duration of the course of NSAIDs and analgesics should be taken into account. Usually, medicines This group has a number of side effects that increase with long-term use, therefore during therapy chronic pain more gentle methods should be used - reflexology, manual manipulation, physiotherapy (electrophoresis, phonophoresis), massage, therapeutic exercises, diet (aimed at weight loss and salt removal).

Medication measures consist of prescribing B vitamins (B6, B12, B1, Neuromultivit complex, Magne-B6), chondroprotectors (Structum, Chondroxide (tab.), Chondrotek, Teraflex, Artra), NSAIDs for external use (Mataren plus cream, Ketonal cream, Fastum-gel).

Sometimes patients suffering from radicular syndrome take muscle relaxants in the hope that the drugs will relieve muscle spasms and the pain that accompanies them. However, it should be remembered that muscle relaxants can only be used as prescribed by a doctor, otherwise the medicine may do more harm than good.

In some cases, surgical intervention is indicated to treat radicular syndrome.

Measures to prevent the development of radicular syndrome include primary prevention degenerative processes in the spine, strengthening the muscular frame of the back with with the help of physical therapy and massage, as well as weight normalization.

Back pain is the most common symptom after headaches. According to statistics, about 80% of discomfort occurs due to degenerative processes in the spine, in particular, against the background of osteochondrosis. Constant pain, impaired mobility accompanies the disease. In addition to unpleasant symptoms, radicular syndrome (radiculopathy) occurs.

The pathological process is a set of neurological clinical signs that are formed against the background of compression of nerve endings in the branches of the spinal cord. Radicular syndrome leads to mass discomfort, can provoke irreversible serious complications leading to disability of the patient.

Features of pathology and predisposing factors

In most cases, radicular syndrome is formed against the background of progressive osteochondrosis, when complications appear (grow, form,). The disease appears as a result of deformation intervertebral hernia due to metabolic disorders and normal blood circulation. Against this background, the height of the discs decreases, they move beyond the boundaries of the vertebrae, damaging neighboring tissues.

With this pathology, the nerve root suffers, which is pinched or irritated by the vertebrae. The spinal root includes motor, sensory nerve fibers, enveloped blood vessels. Damage to this bundle by osteophytes and hernia leads to the formation of radiculopathy. The most common location of radicular syndrome is the lumbar region. This zone withstands enormous loads every day and is more susceptible to degenerative changes than others.

Some negative factors influence the appearance of pathology:

congenital anomalies of the structure of the spine;
infectious lesions of the vertebrae (osteomyelitis);
vertebral fractures caused by weakened bone tissue;
excessive stress on the spine during intense sports and heavy lifting;
hypothermia, prolonged stress;
physical inactivity;
hormonal imbalances (obesity, diabetes);
various tumors, consequences of spinal surgeries;
various traumatic injuries(bruises, sprains, fractures);
flat feet.

Characteristic signs and symptoms

In the sacrolumbar region Clinical signs radiculopathies are the most severe and affect the lower extremities.

Lumbar radicular syndrome is characterized by a specific list of symptoms:

severe pain that spreads to one leg in the affected direction. It is difficult for the patient to bend his leg, which reduces motor activity or confines the victim to bed;
discomfort may increase during movements and sharp turns. There is discomfort varying degrees severity, the pain can be burning, pulling, cutting, tugging;
advanced stages of lumbar radiculopathy are characterized by disturbances in the excretory system and sexual dysfunction;
intestinal function is disrupted, the digestive organs suffer;
the skin over the affected area of the nerve roots changes its color (becomes pale, peeling, swelling appears);
discomfort is acutely felt immediately after waking up, subsides in the evening, then appears with renewed vigor;
the lower limbs lose their motor activity, appears muscle weakness, numbness of the legs.

Warning! Lack of timely and competent therapy can lead to complete disability. A negligent attitude towards health is fraught with irreversible disturbances in the functioning of the genitourinary system and digestive organs.

Diagnostics

Radicular syndrome in the lumbar region can be suspected based on two main signs:

pain of varying severity in the lower back,
decrease pain in a supine position on the healthy side.

To prescribe effective therapy, a physician needs to carry out diagnostic procedures to find out the root cause of the disease, the severity and characteristics of the pathology:

radiography. It is carried out in direct and lateral projection. Allows you to identify violations bone tissue, X-ray indirectly indicates the course, which is accompanied by radiculopathy in the lumbar region;
. It is an expensive, informative diagnostic method that allows you to evaluate changes not only in the vertebrae, but also in nearby tissues (vessels, muscles, ligaments, nerves);
myelography. The study involves studying the condition of the spinal nerve roots using contrast agent under the control of a special device.

Only correct diagnosis- assignment deposit adequate therapy without serious complications. Listen to your feelings; any changes, even minor ones, are a reason to visit a doctor and engage in therapy at an early stage in the development of the pathological process.

General rules and effective methods of treatment

Physiotherapeutic procedures

With radicular syndrome in the lower back, the following procedures are prescribed:

acupuncture. Special needles are inserted into biologically active points, which helps relieve pain, relieve muscle spasms, and eliminate congestion;
laser therapy. The laser allows you to get rid of inflammation, pain, swelling. The procedure also runs metabolic processes, improving blood circulation, tissue nutrition;
paraffin applications. Thermal impact will help activate blood circulation, restore nerve connections.

UHF, magnetic therapy, and other techniques that the doctor prescribes to the victim are also used. Physiotherapy is combined with drugs, increasing their effectiveness.

Surgery

At severe course ailments, persistent unpleasant symptoms that cannot be bought conservative methods treatment. Such situations require surgery.

Indications for surgery are the following pathological conditions:

chronic pain syndrome that cannot be eliminated with medication;
violations motor activity(paralysis, paresis);
malfunctions genitourinary system, intestines.

Experts prefer minimally invasive techniques that almost do not affect healthy tissue, eliminating only damaged elements. For complicated osteochondrosis, microdiscectomy, nucleoplasty, removal of diseased spinal tissues, followed by their replacement with implants are used.

Prevention measures

Following special rules will help prevent the formation of lumbar radicular syndrome:

eat right, quit bad habits;
do not load your spine, train your back muscles;
sleep on a hard orthopedic mattress, use a low pillow;
When the first signs of radicular syndrome appear, immediately visit a doctor, do not allow serious irreversible changes.

Radicular syndrome in the lumbar region is very common and requires adequate therapy and timely diagnosis. Consider possible risks when postponing going to the doctor. Take care of your health, follow the preventive recommendations of a specialist.

The following video shows effective exercises that will help cope with radicular syndrome in the lumbar region: