First, the causes of lumbar muscle strain
1, long-term repeated lumbar muscle strain.
2. The treatment after acute lumbar sprain is not timely and the treatment method is improper.
3. Long-term repeated excessive waist movement and overload, such as sitting for a long time, standing for a long time, or taking heavy objects and lifting things from bending posture to upright posture, can make the lumbar muscles in a state of high tension for a long time, which can lead to chronic lumbar muscle strain over time.
4. Chronic lumbar muscle strain is also related to climate and environmental conditions. Too low temperature or too high humidity will promote or aggravate lumbar muscle strain.
Second, the pathology of lumbar muscle strain
The waist is the midpoint of the human body, and the lumbosacral joint is the hub of waist activities, which involves leaning forward, leaning back, bending left and right, and turning around. No matter exercise or activity, all life and work of human body need the support of waist after getting up, so the muscles of waist are prone to fatigue and injury. Some people have little physical activity and labor intensity, but because of the wrong posture, the spine is in a semi-bent state, and the back muscles are always tense. Over time, it will cause strain, which will further develop into aseptic inflammation, stimulate nerve endings and cause pain. Frequent and repeated cumulative minor injuries (strain) can cause congestion, edema, exudation, fibrous tissue hyperplasia, adhesion and other pathological changes in muscle attachment points, periosteum and ligaments. And stimulate and compress nerve endings to cause low back pain. After the lesion occurs, in order to reduce the activity of the lesion site, some muscles are often in a state of spasm, and persistent lumbar muscle spasm can also cause accumulated strain of soft tissue, further aggravate the pathological changes of tissue and form a vicious circle.
Third, clinical manifestations
The main symptoms are lumbosacral pain or lumbosacral pain, recurrent attacks. Pain can change with climate change or fatigue, sometimes light and sometimes heavy, lingering. There may be extensive tenderness in the waist, and there is no abnormality in spinal activity. At the time of acute attack, various symptoms are obviously aggravated, and muscle spasm, scoliosis and limited functional activities may occur. Some patients may have lower limb traction pain, but there is no string pain and skin numbness. The nature of pain is mostly dull pain, which can be confined to a certain part or spread all over the back. It can show pain or swelling in the waist, and some will sting or burn.
Fatigue is aggravated, relieved at rest, relieved when exercising properly and changing positions frequently, and aggravated when exercising excessively. You can't bend over to work all the time. Often forced to stretch out from time to time or hit the waist with his fist to relieve the pain. There are tender points in the waist, mostly in the sacrospinous muscle, the back of iliac crest, the stopping point of sacrospinous muscle or the transverse process of lumbar spine.
Fourth, the treatment of chronic lumbar muscle strain
Lumbar muscle strain affects the normal life and work of patients. Some patients seek medical treatment everywhere, have repeated attacks, and even cast a shadow over their psychology. They think that lumbar muscle strain is an incurable disease. In fact, lumbar muscle strain can be completely cured, but we need to pay attention to three links: 1, timely and clear diagnosis; 2. Timely and effective comprehensive treatment; 3. Reasonable functional exercise and daily health care. These three links are indispensable. Treatment of lumbar muscle strain mainly includes the following methods:
1, eliminating the cause: Because chronic lumbar muscle strain generally has a long-term repeated injury cause, the primary problem in treating chronic lumbar muscle strain is to eliminate the cause, such as improving working posture and posture and avoiding bending for too long. For occupations where the waist must maintain a certain posture, the waist posture should conform to biomechanics as much as possible, pay attention to the frequent movement of the waist, and don't keep the waist in the same posture for too long. Moisture-proof, cold-proof, cold-proof Sleeping in a hard bed and a soft mattress can't keep the normal physiological curvature of the spine, which is easy to make the lumbar muscles tired. Restrain sexual intercourse, "the waist is the home of the kidney", frequent sexual intercourse will inevitably damage the kidney, and kidney deficiency will lead to low back pain.
2, drug treatment: you can choose Chinese medicines that relax muscles and promote blood circulation, warm meridians and dispel cold, dispel wind and dredge collaterals, and tonify liver and kidney, such as Duhuo Jisheng Decoction and Bushen Zhuangjin Decoction; You can also choose Jinwenluotong Ointment and Musk Tiger Bone Ointment for external application. Oral indomethacin, voltarin and other western medicines can be taken in acute stage, but it is not suitable for long-term use.
3. Manipulation therapy: On the basis of relaxing muscles by kneading, press the tender points hard, and push, knead and roll along the sacrospinous muscle from top to bottom. For adhesion or muscle tension, plucking can also be used.
4. Acupuncture and cupping therapy: the pain point is Ashi point or along bladder meridian and Weizhong point.
5, back muscle exercise: mainly muscle exercise, increase the strength of sacrospinous muscles. There are "arch bridge type" and "flying swallow type".
6. Others: physical therapy methods such as infrared ray, ultrashort wave, wax therapy and magnetic therapy can also be used, and local sealing and small needle knife can also be used.