These violations are most often found in everyday life of a person and during physical education and sports..

In sports practice, these violations most strongly affect the training process and the health of athletes..

Chinese experts believe that "

In everyday life, disorders in the lumbosacral spine are especially common among people who, by the nature of their profession, are in a position bent at the waist for a long time.. It can be said that with the exception of children, almost all other age groups of the population have one of the highest rates of exposure to this type of disease..

Disorders in the lumbosacral spine are divided into two main groups: acute (fracture, dislocations, muscle strain, protrusion of the intervertebral disc, damage to the synovium, rupture of the supraspinous ligament) and chronic (muscle strain, degeneration of the vertebral bodies, rheumatic pain).

In clinical practice, most often there are disorders in the soft tissues of the lumbar spine, fractures and dislocations are less common.. Soft tissue disorders can be divided into acute injuries and overexertion.. Acute injuries usually appear suddenly, accompanied by acute pain due to disorders in the musculoskeletal system and intervertebral discs..

Chronic overexertion disorders are difficult to localize and are accompanied by gradually increasing or unexpressed pain.. This type of disorders, in turn, is divided into soft tissue overstress and destructive disorders of the bone tissue of the spine..

Rheumatic pain in the lumbar spine develops, as a rule, in the post-traumatic period (usually from six months to several years), is aching, pulling, depends on weather conditions and is most closely associated with chronic overstrain of soft tissues. It has been statistically proven that the majority of patients subject to chronic overstressing of the soft tissues of the lumbar region later develop rheumatoid syndrome..

Thus, disorders in the lumbar spine have an acute or chronic manifestation and are characterized by a whole complex of various symptoms..

Pain.

It can be different: acute, aching, bursting, hidden, point, manifested in a certain place during palpation, piercing and spilled. Bursting and hidden pain is usually associated with chronic soft tissue overexertion or rheumatism..

This pain is characterized by unexpressed localization, a large pain area, dependence on the change of day and night (pain increases at night), on motor activity (pain is stronger at rest). Point pain on palpation is characteristic of acute injuries. It is usually localized at the site of an injured muscle, ligament, or vertebra.. Acute stabbing or cutting pain is characteristic of comminuted fractures of the spine.

Movement disorders.

Functional disorders in the lumbar spine are manifested by a serious limitation of mobility. It is impossible to bend forward, backward, to the sides, turn the body to the right, to the left. In a severe form of the disease, the patient is unable to straighten up and eventually loses the ability to move..

Violation of posture and curvature of the spine. These disorders occur in the sagittal and frontal planes..

There are flat, round, concave backs, as well as lateral curvature of the spine, which, as it progresses, can turn into scoliotic disease. Complex curvature of the spine very often leads to severe functional disorders of all body systems, up to spinal cord injury with inevitable paralysis and paresis..

Muscle contracture.

It should be noted that in all patients with acute and chronic forms of disorders, an increase in muscle tone of the lumbar spine necessarily appears.. When examining the lumbar and adjacent areas, a general hardening is found in the form of strands or knots, a dense muscular "

Exacerbation of muscle pain depending on weather changes. In diseases of the lumbosacral region, all patients are very sensitive to changes in weather and climatic conditions.. As a rule, with an increase in humidity and a cold snap in patients with diseases of the lower back, unbearable, bursting and aching pain occurs or worsens..

A local decrease in body temperature leads to an increase in sensitivity to cold, which, in turn, increases muscle contracture.. Ancient Chinese healers in this case said:. If there is pain, then there is no flow of qi in the blood..

Before proceeding to diagnostic methods and tests that determine the degree of disorders, it is necessary to briefly highlight the anatomical and physiological features of the structure of the spine, taking into account the specifics of Chinese traditional medicine..

The human spinal column consists of: 24 separate true vertebrae, sacrum (formed by 5 fused sacral vertebrae), coccyx (formed by 4-5 fused coccygeal vertebrae), 23 intervertebral discs and ligamentous apparatus. The spinal column is divided into the following parts: cervical (7 vertebrae), thoracic (12 vertebrae), lumbar (5 vertebrae), sacral (5 vertebrae) and coccygeal (4-5 vertebrae).

The lumbosacral articulation is the connection of the 5th lumbar vertebra with the sacrum (with its 1st vertebra) through intervertebral discs. The position of the vertebrae is stabilized by large anterior and posterior ligaments, as well as ligaments of the spinous and transverse processes.. The articular processes form a flat, with low mobility, intervertebral joint.

Examination of patients with disorders in the lumbosacral region is carried out in standing, sitting or lying positions..

Inspection in a standing position.

The patient turns his back to the doctor. The patient's back is examined, the symmetry of the muscles is checked and the curvature of the spine in the frontal and sagittal planes is determined, that is, cervical and lumbar lordosis, thoracic and sacrococcygeal kyphosis. Lateral curvature of the spine, as a rule, indicates an acute period of stretching of the muscles of the lumbar region or protrusion of the intervertebral disc.

Flat back, t. flattening of the spine and posterior protrusion in the lumbar region, indicates the presence of a chronic form of the disorder. The long duration of the disease and the anterior protrusion of the vertebrae indicates disorders in the intervertebral joints or congenital separation in the region of the cavity of the vertebral arch (the border area between the upper and lower articular processes of the vertebra is the thinnest and narrowest part of the arch).

Next, the mobility of the spine is checked.. The patient bends forward, backward, to the sides. Normally, when leaning forward by 90 °, the lumbar spine arches, but if there is a pathology, then leaning forward is difficult and is accompanied by pain when the intervertebral disc protrudes, stretches the muscles and ligaments in the lumbar region, inflammation of the muscle fascia, disorders in the intervertebral joint and.

In case of severe complications, the pain may radiate to the buttocks and legs. Normally, the tilt back is an angle of 30 °. The inability to bend back and a strong pain syndrome occur with injuries of the spinous processes of the vertebrae (for example, their fracture), infringement of the synovial membrane of the intervertebral joint, stretching of the square muscle of the lower back.

It should also be borne in mind that bending back can be difficult with tuberculosis of the thoracic spine and tetanus spondylitis (inflammation of one or more vertebrae). The tilt to the side is normally about 20 °. Patients with protrusion of the intervertebral disc, as a rule, have a curvature of the midline of the spine and retain the possibility of lateral tilt only to one side..

When stretching the muscles in the lumbar region, it is impossible to bend to the right and to the left. According to the characteristics of the rotational movements of the spine, it can be stated that the turns of the torso to the sides (to the right and left) are usually 30-45 °, restrictions can occur in case of violations in the intervertebral joints, fractures of the transverse processes of the vertebrae and stretching of the square muscle of the lower back.

Finishing the examination in a standing position, the doctor observes the movements of the patient, pays attention to the gait, body position when walking. Most often, patients with disorders in the lumbar region when walking press one or two hands to the waist, move with an inclination forward or backward, avoid fast walking and shaking movements..

Sitting examination.

The patient sits with his back to the doctor. With the pad of the thumb, the doctor first palpates the line formed by the spinous processes of the vertebrae, then with three fingers of one hand draws from top to bottom along the spinous processes of the vertebrae and depressions along the spine. Normally, all three lines should be parallel.. If palpation reveals deviations from the norm and a painful point, then this indicates a local displacement in the intervertebral joint or its inflammation.

If pain from a local point radiates to the legs, a narrowing of the intervertebral distance is detected, then we can assume a protrusion of the intervertebral disc. The pain sensation that occurs during palpation of the spinous processes themselves indicates their inflammation or injury, the point pain that occurs during palpation between the spinous processes, and the sensation of a dense “cord” moving under the fingers indicates a possible stretching of the supraspinous ligament.

Then motion testing is done.. The patient in a sitting position tries to bend forward, backward and to the sides, as well as turns the body in both directions.. Painful descent that occurs during movements, coinciding with pain during similar testing in a standing position, indicates disorders in the lumbosacral articulation.

If the pain sensation in the sitting position is less than in the standing position, this indicates disorders in the sacroiliac joint. This conclusion can be drawn because in the sitting position, the thigh muscle group is in a relaxed state and does not stabilize the position of the pelvis..

Inspection in the supine position.

To diagnose disorders in the lumbosacral spine in Chinese traditional medicine, there are ten basic tests that confirm a particular disorder..

Pressure in the lumbar region.

Pain that occurs in the lower back with pressure in the supine position may indicate a compression fracture of the vertebral body or destruction of the edges of the vertebral body.

Straight leg raise test.

The patient from a supine position on his own or with the help of a doctor raises the leg straightened at the knee (alternately right and left). The test is considered positive if there is a characteristic " This indicates inflammation of the sciatic nerve or its compression by a displaced intervertebral disc..

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