Treatment of vertebrogenic lumbalgia

It should be said that the treatment regimens for pain syndrome in various types of dorsalgia are practically the same, but there are differences in the management of patients with acute and chronic diseases. Let's talk in more detail about what clinical recommendations exist for the treatment of acute vertebrogenic lumbago.

Acute lumbago is characterized by the same acute pain of high or moderate intensity, which also increases with movement. To reduce the severity of such a pain syndrome, rest is primarily required, so the patient is recommended bed rest until the pain subsides. In case of severe pain, rest will have to be observed from 1 to 5 days, but if the pain is moderate, limiting physical activity is enough.

To relieve and fix the spine, with the pathologies of which the pain syndrome is associated, doctors advise using orthoses. The recommendation is especially relevant in case of instability of the spine. And dry heat, which in combination with complete rest is an effective pain-relieving procedure, will help reduce pain before the start of treatment.

But it is unlikely that you will be able to cope with severe or moderate pain syndrome without using pharmacological drugs. In addition, it is necessary to treat not only the pain itself, but also other symptoms of pathologies that cause the development of vertebrogenic lumbago. We are talking about edema, inflammation, trophic disorders, tissue ischemia, neurological symptoms.

To combat pain and inflammation, patients are prescribed drugs from the analgesic and NSAID category. In case of severe tissue edema, diuretics and corticosteroids will be more effective. The latter, unlike non-hormonal anti-inflammatory drugs, are recommended to be prescribed in a minimally effective course due to the many early and late side effects they cause.

However, in case of acute severe pain, the most effective procedures are blockades with anesthetics and corticosteroids (for example, lidocaine with dexamethasone), which are carried out at intervals of 2 days. The course of treatment in this case consists of 4-5 procedures. In the development of radicular syndrome, epidural blockade with hormonal anti-inflammatory drugs is effective, which quickly relieve tissue swelling and reduce compression of nerve endings, which significantly reduces the intensity of the pain syndrome. In this case, the drug is injected not into the soft tissues at the site of pain localization, but into the space between the dura mater of the spinal cord and the periosteum of the vertebrae.

NSAIDs for vertebrogenic lumbago, depending on the severity and duration of the pain syndrome, are used in various forms: tablets, injections, rectal suppositories, external agents in the form of creams and ointments. Effective NSAIDs for spinal pain include Diclofenac, Amelotex, Ketorolac, Meloxicam and its analogue Movalis, although in the absence of the above-described drugs, you can use the help of Aspirin, Ibuprofen, Nimid, Nise and other NSAIDs.

In the first days of the acute phase of the disease, preference is given to injection treatment, later, when the intensity of pain decreases, you can switch to tablets, ointments, gels, solutions. The ointment "Diclofenac", creams and gels "Ketonal", "Nimesulide", "Nise", as well as local agents with a warming and improving blood circulation effect "Capsicam" and "Finalgon" have proven themselves well. It is not bad to additionally make compresses with medicinal solutions (for example, a compress in "Dimexidum"), rub the lower back and apply compresses with "Bishofite" (there is also a form of the drug in the form of a gel).

If there is a compaction of soft tissues in the place where the pain is felt, the use of muscle relaxants (Mydocalm, Sirdalud, etc.), which are also muscle spasmolytics, will be effective. In the presence of ischemic processes caused by compression of nerve roots and blood vessels, anti-ischemic agents are prescribed:

• antioxidants, which include vitamins A, C, E and the microelement selenium, popular drugs "Solcoseryl", "Actovegin", etc.
• antihypoxic agents,
• venotonics and angioprotectors,
• drugs that improve blood supply to nerve tissues and metabolism in them (vasoactive agents): nicotinic acid preparations, Pentoxifylline, etc.
• B vitamin preparations, actively used in neurology (Neurovital, Neurobeks, multivitamin complexes, etc.).

If we are talking about degenerative processes occurring in the vertebrae and intervertebral discs, which are associated with the chronic course of vertebrogenic lumbago, the treatment of the pathology cannot be done without chondroprotectors of different groups: "Chondroxide", "Rumalon", "Dona", "Teraflex", "Arteparon", which must be taken for a long time (from 2 to 6 months). Particular attention should be paid to complex drugs that have an antirheumatic and anti-inflammatory effect ("Arthrodar", "Diamax", "Ortserin").

These drugs, like anti-inflammatory drugs during an exacerbation, are prescribed in injection form, and then you can switch to oral ones, taking them in a course of about 1 month.

Physiotherapy treatment

Physiotherapy has long been famous for its effectiveness in the treatment of pain syndromes. Treatment schemes for vertebrogenic lumbago cannot do without its methods. The following are considered relevant methods for combating spinal pain: exposure to diadynamic currents, medicinal electrophoresis, UHF and UV therapy (quartz). Shock wave and balneotherapy also improve microcirculation in tissues and help relieve pain.

To prevent exacerbations, magnetic field exposure, laser therapy, and vibration massage are used (not used in the acute phase of the pathology, as it can only increase pain). These methods help prevent the occurrence of pain syndrome, improve blood circulation and metabolic processes in tissues, and reduce the severity of degenerative changes.

Such treatment methods as manual therapy and massage are actively practiced for pain syndromes arising against the background of spinal diseases. They are considered to be quite safe procedures if they are performed by a specialist. Massage implies a course of treatment with at least seven sessions. Massage techniques can be different: stroking, tapping, rubbing, kneading and they are aimed at relaxing muscles and joints, improving blood supply to tissues in the affected area, reducing pain.

The massage procedure is not performed in case of severe acute pain, since at first the massage therapist's manipulations can only increase the pain syndrome. But when the pain subsides a little, you can start the procedures, which in the first days of treatment may be somewhat painful, but will subsequently bring noticeable relief.

Manual therapy for spinal pathologies involves stretching the spine. There is no danger in this, but such manipulations help reduce compression of nerve roots and vessels, improve tissue trophism, restore the normal position of vertebral discs, etc., which has a positive effect on the condition of patients with diseases of the spine and musculoskeletal system.

Today, professional manual therapists have mastered many practices that allow them to treat a wide variety of diseases. In their sessions, they perfectly combine spinal stretching with therapeutic massage, so they can treat bones, cartilage, and muscles when they are tense and compacted.

To relieve pain, you can turn to acupuncture and acupuncture, which relieve pain by affecting certain points on the body.

Physiotherapy

Doctors also assign a major role to therapeutic exercise in vertebrogenic lumbago. Immobilization of the spine and rest in the acute period of the disease are recommended only for a short period, until the pain subsides a little. Further hypodynamia will only aggravate the situation, while dosed physical activity will contribute to recovery (in the chronic course of the pathology with pain lasting more than 1 month, regular exercise will help to increase the period of remission).

Patients should regularly take walks in the fresh air, do feasible housework, they are allowed and even useful to engage in swimming, running, cycling and skiing. The main thing is to avoid sudden movements, overwork and lifting weights. In addition to the standard daily motor activity, which after the acute period of the disease should be gradually increased, special exercises are also recommended according to the exercise therapy program for spinal pathologies.

Gymnastics for vertebrogenic lumbago is indicated as soon as severe pain goes away. It includes bends and turns of the body, lunges, the popular "Bridge" since childhood, rotational movements of the legs in a lying position, clasping the legs. Exercises in a lying or sitting position are no less relevant than those performed in a standing position on the legs or knees. The main thing is to choose those that stimulate blood circulation in the lumbar tissues and thereby prevent stagnation and complications of spinal diseases. Stretching and relaxing exercises for the lumbar region are a relevant means of combating chronic pain if they are performed regularly.

All exercises of therapeutic gymnastics for diseases of the spine are performed at a slow pace and with great caution no more than 5-7 times. At the same time, strong muscle tension and the appearance of painful sensations should not be allowed. Exercises should bring relief, and not increase pain and discomfort in the organ affected by the disease.

It is better to discuss the program of exercises and recommended exercises at different stages of the disease with a physical therapy trainer. Ideally, it is better to perform exercises under the supervision of a specialist, especially during the period of exacerbation of the existing disease and the increase in pain caused by it.

Effective drugs

To treat acute and chronic vertebrogenic lumbago, doctors use drugs from various groups. The treatment regimen for the syndrome depends on the form of its progression and the nature of the pathology that causes pain in the lumbar spine. Thus, the list of prescribed drugs will be individual.

Today, there are a great many drugs from the group of NSAIDs, corticosteroids, antioxidants, chondroprotectors, muscle relaxants and other drugs used for spinal pathologies. We will consider only some of the drugs that a doctor can include in the treatment regimen for pain in the lumbar region caused by these diseases.

"Amelotex" is one of the non-hormonal anti-inflammatory drugs based on the substance meloxicam, among the effects of which we find the relief of pain, fever and inflammation in diseases of the spine and musculoskeletal system. The drug is produced in the form of tablets, rectal suppositories and a solution for intramuscular injections.

In the first 5 days of treatment of exacerbation of vertebrogenic lumbago, preference should be given to the drug in ampoules, which is administered intramuscularly. The daily dose for severe pain syndrome is 1.5 ml (15 mg). Injections are usually given once a day.

Rectal suppositories have the same indications for use. They are used once a day in a standard dosage (1 suppository 15 mg or 2 suppositories 7.5 mg) after complete bowel movement.

Tablets are also taken once a day, every day. It is recommended to do this during meals. Depending on the underlying disease, the effective daily dose is from 7.5 to 15 mg. When the pain syndrome decreases, the maximum dose is recommended to be reduced to the minimum effective dose.

For patients with severe renal impairment, the recommended dose is halved.

Despite the effectiveness of the drug in the treatment of pain syndrome in vertebrogenic lumbago, it should be taken with special caution, given the contraindications for use. Among such contraindications are: severe cardiac pathologies, the recovery period after coronary artery bypass grafting, the "aspirin" triad, intolerance to non-steroidal anti-inflammatory drugs.

The drug has an irritating effect on the mucous membrane of the stomach and intestines, so it is not recommended for erosive and ulcerative diseases of the gastrointestinal tract, including inflammatory bowel pathologies. Due to the ability to affect blood clotting, it is not prescribed for bleeding of any localization and genesis.

Meloxicam is quite toxic, so it is not recommended for severe liver and kidney pathologies, during pregnancy and lactation. In pediatrics, it is used at 15 years of age.

Caution should be exercised in using the drug in patients with CHF and brain pathologies, diabetes mellitus, peripheral vascular pathologies, somatic diseases, smoking and alcoholism, in old age. Doses for concomitant therapy with antiplatelet agents, anticoagulants, oral hormonal agents and some antidepressants should be discussed with the attending physician.

Common side effects of the drug include dyspepsia, abdominal pain, nausea, bowel disorders, headaches and dizziness, swelling of the legs, itching and rashes on the body. Less common are liver problems, changes in blood and urine composition, lethargy, tinnitus, increased heart rate and increased blood pressure, and a feeling of hot flashes. The use of rectal suppositories may be accompanied by frequent urge to defecate, itching in the distal rectum and anal area. With parenteral use, tissue irritation at the injection site is possible.

"Compligam B" is a multivitamin complex (vitamins B1, B6, B12, necessary for the health of the nervous system) with the inclusion of an anesthetic component (lidocaine). The drug is produced in the form of an injection solution for deep intramuscular administration.

It is prescribed for the treatment of vertebrogenic lumbago, occurring with both muscular-tonic and radicular syndromes. It has a stimulating effect on the process of hematopoiesis, improves blood circulation and blood supply to neuromuscular tissues, replenishes the deficiency of B vitamins, and anesthetizes the affected area.

Like the previous drug, in case of severe pain syndrome, Compligam B is used during the first 5 days of treatment with the possibility of increasing the course to 10 days. The drug is administered once a day. Good results are shown by the simultaneous administration of two drugs: Compligam B and Amelotex. Usually, a 5-day course of treatment is enough to relieve pain syndrome.

Then the patient is transferred to tablet forms of the drugs or the frequency of injections of "Compligam B" is reduced to 2-3 per week. Such treatment can be carried out for another 2 or 3 weeks.

The drug is not prescribed in case of hypersensitivity to its components, as well as in acute or severe chronic myocardial insufficiency. The drug is not used in pediatrics, and during pregnancy it is prescribed only for strict indications.

The drug has few side effects. These include: attacks of tachycardia, breathing problems, increased sweating (hyperhidrosis), and acne on the body. Some categories of patients may experience hypersensitivity reactions: itching and rashes on the skin, Quincke's edema, and even anaphylactic shock, which is most likely associated with the presence of lidocaine.

"Finalgon" is a complex preparation with a warming effect for local use, which is prescribed for muscle and joint pain. This drug does not belong to the category of NSAIDs or analgesics. Its effect is different - vasodilator, helping to restore normal blood circulation in the affected area. This is facilitated by both active substances of the drug: nonivamide and nicotinic acid ester (vitamin PP). But nicotinic acid is more conducive to tissue warming (heat indirectly reduces pain syndrome), while nonivamide additionally has a direct analgesic effect.

The drug is produced in the form of an ointment, which is sometimes called a gel. The product is squeezed onto the skin in the area of localization of pain with a strip no more than half a centimeter and gently with light movements using the attached applicator spread over the skin in a radius of no more than 5-6 cm. The feeling of warmth appears almost immediately and reaches its peak within half an hour.

With subsequent applications, in the absence of side effects, the dosage may be increased, and the frequency of application may be increased to 3 times a day, but no more.

The drug should not be used if the patient has individual sensitivity to at least one of the components of the ointment. It should not be used on very sensitive skin, in the area of open wounds or local inflammations, or in dermatitis. The ointment is not used in pediatrics due to the lack of information about its safety. It is also not recommended for pregnant women.

Before applying the preparation, it is not recommended to carry out warming procedures, for example, taking a bath with hot water. After the procedure, you will also have to refrain from such manipulations for some time, so as not to provoke tissue overheating.

The drug may cause allergic reactions and the development of contact dermatitis, which is caused by the content of sorbic acid. A burning sensation in the area of application, cough, local and systemic allergic reactions, anaphylaxis are also possible. Other side effects, such as skin rashes and itching at the site of application of the ointment, a feeling of heat, impaired tissue sensitivity in the area of application of the drug, are observed infrequently.

The popular drug "Hindroitin" (analog of "Teraflex"), which has pronounced chondroprotective properties, due to which it is actively prescribed for pathologies of the spine and joints, is used to treat chronic vertebrogenic lumbago caused by these diseases. The drug does not have an analgesic effect, but it helps to reduce the severity of degenerative changes in bone and cartilage tissue, which is the prevention of pain in the future. If such drugs are used for a long time, the duration of the remission period of lumbago can be significantly increased.

Chondroitin is available in capsules and ointments. The capsules should be taken half an hour before meals. For 21 days, patients should take 1 capsule twice a day, and then continue treatment, adhering to the dosage - 1 capsule per day. The minimum course of treatment with the drug is 2 months, but to obtain sustainable results, treatment should be continued for six months or more.

The use of the oral form requires reducing the amount of sugar consumed per day and avoiding alcoholic beverages.

"Chondroitin" in the form of an ointment is applied to the lumbar region and thoracic spine 2 or 3 times a day. It is assumed that a thin layer of ointment is applied, which does not need to be actively rubbed in. The average course of treatment with an external agent is usually limited to two to three weeks.

The oral form of the drug has the following restrictions on use: taking capsules is contraindicated in case of hypersensitivity to the components of the drug, severe kidney pathologies, phenylketonuria, and a tendency to bleeding. It is not prescribed to pregnant women and nursing mothers. In pediatrics, the drug is approved for use at 15 years of age.

The ointment is not used for thrombophlebitis, acute inflammation in the area of application, a tendency to bleeding and intolerance to the components of the dosage form. During pregnancy, it is used only according to strict indications, and is not used at all in pediatrics.

Side effects when using the chondroprotector are extremely rare. These may be local allergic reactions, occurring in a mild form, dizziness and headaches, discomfort in the epigastric area (nausea, vomiting, bowel disorders, abdominal pain). The use of the ointment may be accompanied by a burning sensation, reddening of the skin, the appearance of a rash on it, itching. Such reactions require discontinuing the drug.

"Sirdalud" is a drug from the group of muscle relaxants, which provide muscle relaxation by affecting the sensitive receptors of the spinal cord and inhibiting polysynaptic signal transmission responsible for excessive increase in muscle tone, which is observed in the form of their strong tension and pain. The drug can be prescribed both in case of acute pain in muscle spasms and in case of chronic spasticity associated with damage to the spinal nerves. After taking the muscle relaxant, pain goes away and motor activity of the spinal muscles improves due to normalization of muscle fiber contraction.

The dosage of the drug is always strictly individual. But taking into account the risk of developing undesirable consequences, treatment always begins with a minimum dose of 2 mg. In case of muscular-tonic syndrome and painful spasms, the drug is prescribed in a single dose of no more than 4 mg three times a day. If back pain interferes with a good night's rest, you can take another dose of the drug just before going to bed.

For neurological disorders associated with spinal pathologies, the dosage of the drug is identical. Treatment begins with a minimum dose three times a day and gradually increases it every 3-7 days to a daily dose of 12-24 mg, but not more than 36 mg. The frequency of administration can be 3 or 4 times a day.

The drug is not recommended for use in patients who have previously shown hypersensitivity to the active substance of the drug (tizanidine) or auxiliary components, as well as those who have been diagnosed with severe liver and kidney diseases with impaired functionality. In pediatrics, the muscle relaxant is not usually prescribed, and during pregnancy it is indicated only in life-threatening situations for a woman. You should not resort to this drug during breastfeeding, since some of the active substance can enter the milk, and with it, the baby's body.

Caution should be exercised when taking Serdalud in parallel with inhibitors or inducers of the CYP1A2 protein. The former can increase the concentration of tizanidine in the blood, causing an overdose and intoxication of the body, the latter act on the contrary, thereby reducing the therapeutic effect of the muscle relaxant. In case of an overdose, drinking large amounts of water and diuretics, as well as repeated administration of activated carbon preparations, will be relevant.

Side effects of the drug depend on the doses taken. At low doses, drowsiness, fatigue, dizziness and fainting, and a decrease in blood pressure may occur. Some patients note symptoms such as dry mouth, nausea, and gastrointestinal problems. Laboratory tests may show minor liver dysfunction. All these symptoms quickly pass and do not have serious consequences.

Taking high doses may be accompanied by muscle weakness, depression of the heart (drop in blood pressure, tachycardia), sleep disorders, hallucinations, liver dysfunction with the development of non-infectious hepatitis, and sometimes even stroke. All the above symptoms are more pronounced for withdrawal syndrome, which is diagnosed at the end of long-term treatment or against the background of stopping taking high doses of the muscle relaxant.

Most drugs (NSAIDs, analgesics, chondroprotectors, antioxidants) used in the treatment of vertebrogenic lumbago can be easily purchased at any pharmacy. You don’t even need a doctor’s prescription for this. But this does not mean that when pain in the lumbar spine occurs, you should self-medicate. The drugs have certain contraindications that need to be taken into account, and the list of drugs, depending on the cause of the pain syndrome, can change significantly. And it is the doctor’s job to find out the cause of the pathology. It is he who must, based on previously acquired knowledge and experience, make a diagnosis and choose an effective treatment regimen.

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Surgical treatment

Pain in vertebrogenic lumbago can be caused by various diseases, the drug treatment of which can be more or less successful. In some cases, it is necessary to try several different treatment regimens to achieve a positive result.

If, over a long period of time, it is not possible to achieve a lasting result in reducing pain either through medications, physical therapy, manual techniques or alternative treatments, doctors prepare the patient for surgery.

In most patients, vertebrogenic lumbago occurs with muscular-tonic syndrome. But there is a certain proportion of patients who are characterized by radicular syndrome, the treatment of which is often carried out surgically. The fact is that with this type of pathology, the spinal nerve roots are pinched, which manifests itself in the form of pain of greater intensity than with muscular-tonic syndrome, which also tends to spread to the legs.

Radicular syndrome is more typical of unilateral lumbago, when pain appears on the right or left, depending on the location of the damaged nerve root.

It is not always possible to effectively combat nerve pain, so it is necessary to resort to surgical intervention. Depending on the underlying pathology and the type of pain syndrome, the relevant operation is selected: removal of a herniated disc, laminectomy (used for stenosis and compression in the spine and involves the removal of part of the vertebra), removal of tumors, destruction of the intervertebral disc to release the nerve, i.e. excision of tissues causing compression of the nerve root.

Indications for such operations on the spine are severe persistent pain syndrome, provided that previous treatment has been unsuccessful, and dysfunction of the pelvic organs caused by radicular syndrome in the lumbar region.

Folk remedies

Pain syndrome of varying intensity and localization is a condition that people have encountered since ancient times. It is not surprising that over many millennia, many recipes for combating pain have accumulated. Spinal pain, as we have already reminded, is one of the popular reasons for visiting a doctor, but just as many people suffer from pain, do not go to the hospital and try to combat the problem in their own ways.

Among the traditional medicine recipes applicable to vertebrogenic lumbago, the pain of which is caused by spinal pathologies, the following will be relevant:

• Treatment with resin of coniferous trees, which is called oleoresin, is a very popular method of combating pain syndrome. You can buy oleoresin in herbal pharmacies or collect the resin yourself, but only from coniferous trees. Before preparing the medicinal composition, the solid resin is melted in a water bath. Now 1 teaspoon of resin is added to 200 ml of good vegetable oil, mixed well and used as an auxiliary means for massage and rubbing.

With pure resin you can also make applications to the sore spot. The resin is applied to a cloth napkin and applied to the skin, securing it well, because you will have to walk around with it all day, replacing it with a new one after a day. The course of treatment is on average one and a half weeks, but if the pain does not go away, you can continue further.

• Mountain wax is used for applications on a sore lower back according to the same principle. It is sold under the name "Ozokerite".
• The simplest option for rubbing the back for muscle and nerve pain is rubbing with melted pork fat. The fat itself does not have an analgesic effect, but it warms the body well, and the pain subsides. However, to enhance the effect after rubbing, it is recommended to wrap the lower back warmly.

Melted pork fat can be mixed with vegetable oil, then the rubbing will be more flexible when hardened and will be easier to apply. This composition can also be used for wraps.

• You can also use indoor plants to rub the body in the area of pain. We are talking about aloe, but the plant must be at least 3 years old, otherwise the therapeutic effect will be significantly lower. The leaf of the plant is first placed in the refrigerator for several hours, then cleaned and the viscous juice is squeezed out of the pulp. This juice should be rubbed into the lower back up to 3 times a day.
• Pain along the spine can also be treated with a tincture of walnut fruits and membranes in alcohol. For half a liter of alcohol or vodka, take 4 tablespoons of crushed raw materials and insist for 14 days in a dark place. Use the tincture for daily rubbing.
• For inflammatory pathologies of the spinal column, an alcohol infusion of nettle is prepared for local use. To prepare it, take the juice of a fresh plant and mix it with medical alcohol in equal proportions.
• But if we are talking about calcium salt deposits in the joints and spine, the celery diet will come to the rescue. Celery, especially leafy, helps remove calcium from the body. But with a deficiency of this mineral, such treatment can only cause harm.

Herbal treatment is not aloof from the problem of lumbar pain. Many plants have anti-inflammatory effects and help relieve pain of various types. In pathologies of the spine and musculoskeletal system, such plants as cinquefoil and comfrey have become very popular.

The grass of the meadowsweet with its ability to stop inflammatory processes is used for acute pain in the lower back in the form of poultices. To do this, three spoons of crushed plant material are poured with half a glass of boiling water and infused for about 10 minutes. Then the water is drained and the remaining cake is lightly squeezed out. It is wrapped in gauze and applied to the sore spot while still hot.

Comfrey root is no less popular for back pain. The peeled and crushed root of the plant is poured with boiling water in equal proportions, left for half an hour to soften. Then the root is ground with water into a gruel and mixed with butter 1:1. The finished ointment is used for fifteen-minute rubbing twice a day. After each procedure, the lower back should be wrapped.

An effective ointment can be prepared on the basis of several herbs with anti-inflammatory, analgesic and soothing effects, which will be useful for any type of vertebrogenic lumbago. The herbal collection consists of equal parts of marshmallow and dandelion roots, yarrow, lavender and horsetail. Using a coffee grinder, grind all the plants to a powder state. Brew 3 tablespoons of this powder with ½ cup of boiling water and put on low heat for another 5 minutes. Cool the composition slightly and mix with melted pork fat (150 g) until a homogeneous mass is obtained. The ointment is used similarly to the recipe based on comfrey root.

For acute lumbago, which is popularly called lumbago, it is useful to take hop infusion internally. It is prepared on the basis of 1 glass of boiling water and 2 tablespoons of crushed plant material. Take 1 spoon three times a day in combination with external remedies until the pain disappears.

When using traditional medicine recipes to combat pain, you need to understand that most of them involve local application and are capable of combating only the symptom of the disease, while the main, internal cause of the pathology may remain unaffected. Such treatment will give results, but they will only be temporary. To combat the underlying disease, long-term and complex therapy is required, which includes drug treatment, physiotherapy, massage, and non-traditional methods of treatment, which include traditional medicine.

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Homeopathy

This section of medical science also refers to alternative medicine, although it has recently become increasingly popular due to the relative safety and naturalness of homeopathic medicines. These medicines do not treat the disease itself, but help to reveal the body's natural powers so that it can cope with the disease and its symptoms. Homeopathy is based on the fact that the human body has great potential, which we do not even suspect, and it can cure itself of almost any disease, you just need to push it to do so.

There are many homeopathic medicines that can help a person with vertebrogenic lumbago. But they should be prescribed by a specialist who, based on the symptoms and characteristics of the patient's body, will be able to choose exactly the medicine that will help the person heal. In this case, healing will not occur at the level of simply relieving symptoms, but in terms of the body's fight against the underlying disease that caused the lower back pain.

What medications can help patients with spinal pain:

• Aesculus hippocastunum or horse chestnut extract. The drug is prescribed for dull, aching pain in the lower back, which can radiate to the hip. A characteristic feature of the pain is its intensification during bending and walking.
• Aconitum napellus or blue aconite extract. It is prescribed for acute vertebrogenic lumbago, called lumbago. The patient may complain of piercing pain in the lower back, itching and numbness in the legs, which cause fear and anxiety.
• Bryonia alba or white bryony. The drug is indicated for acute pain in the lower back caused by hypothermia. The pain increases with pressure and subsides at rest. It is prescribed to patients who do not respond well to thermal procedures.
• Zincum metallicum. It is prescribed for acute pain at the junction of the thoracic and lumbar vertebrae.
• Phosphorus. The drug is indicated for severe, excruciating pain in the lower back with paresthesia and weakness of the legs.
• Calcarea fluorica. This homeopathic remedy helps patients with spinal instability caused by weakness of connective tissue. The pain is burning, intensifies with any strain on the back and at the beginning of walking. After which it subsides a little. The drug is suitable for the treatment of lumbago.
• Dioscorea or Caucasian Dioscorea extract. The drug can be prescribed for vertebrogenic lumbago with pain on the right. The pains intensify with movement and subside at rest.
• Eupatorium perfoliatum or Eupatorium perforatum extract. Identical to the previous drug in its action, but it is prescribed for pain on the left side of the back.
• Goldenseal or goldenseal extract. The drug is prescribed for moderate pain syndrome with dull, aching pain, tension in the lower back muscles and stiffness of movement. If a person sits for a long time, it is difficult for him to get up without help.
• Kali carbonicum. The drug is indicated for acute pain in the lower back, a feeling of numbness of tissues, weakness of the lumbar spine. The drug is useful for spinal pain during pregnancy, before or after menstruation. The pain is localized in the lower back, but can radiate to the buttocks and thigh.
• Nux vomica or extract of the vomit nut. The drug is prescribed for pain in the lower back and back, which are characterized as tearing or cramping. The pain does not allow patients to sleep normally, since turning in bed is too painful and forces the patient to raise himself or stand up. The pain syndrome intensifies in the middle of the night, during movement, turning the body and bending, while sitting. Warmth brings improvement.

This drug is more suitable for emotionally unstable people with high sensitivity to pain, susceptibility to acute pain syndrome in the back with the slightest hypothermia.

• Ruta. A medicine prescribed for morning pain in the lower back, which occurs before getting out of bed.
• Berberis. A drug recommended for persistent chronic back pain that is aggravated by fatigue and is accompanied by unusual weakness in the lower back and legs.
• Aceticum acidum. Can be prescribed to patients who complain that they feel better only when lying on their stomach.

There are quite a lot of drugs that homeopathic doctors can recommend to relieve pain in acute or chronic forms of vertebrogenic lumbago. But in order to wait for the desired result from their use, the drugs must be prescribed by a specialist who will determine in what form and dosage the drug will bring maximum benefit without harm to human health.

The healing power of minerals

I would like to mention another natural preparation that is actively used to relieve symptoms of diseases of the spine and musculoskeletal system. The preparation is called "Bishofite" and is a kind of brine with a high magnesium content and rich mineral composition, which is effective for neuromuscular disorders that cause pain in the back and lower back.

Bischofite has a general strengthening, anti-inflammatory, antithrombotic, analgesic, vasodilatory (warming and improving tissue blood supply) and many other effects. For diseases of the spine that cause pain in the lumbar region, the mineral solution is used as baths, rubs, massages, compresses. The procedures are carried out daily or every other day in a course of 10-12 procedures or more.

The drug can be used for physiotherapy: magneto-, phono- and electrophoresis, which are relevant for vertebrogenic lumbago. Contraindications to its use are only hypersensitivity to minerals included in the brine, and the acute stage of the disease (for active procedures). It can cause skin irritation only if there are wounds and scratches on it.

The drug is produced in the form of a solution with an attractively low price and a gel containing salts of about 20 microelements and vitamin PP. The gel is used 2 or 3 times a day, and there is no need to warm the lower back after the procedure of rubbing the medicine. The course of treatment with the gel form of "Bishofite" is 1.5-2 weeks. If necessary, the treatment can be repeated after a month.

There are also other external remedies based on bischofite: creams, balms, pastes, which may have different names and contain additional components. Most of these preparations can be safely used to treat vertebrogenic lumbago. They will not only relieve pain, but also act directly on its cause, simultaneously saturating the body with minerals necessary for normal functioning.