Treatment and exercises in an enhanced lumbar lordosis
Lordosis of the spine physiological bending of the cervical and lumbar spine. Normally, when you perform lateral radiographs and measurement of lumbar concavity according to the method of Cobb (by connecting the points at the top and at the base of the triangle formed by the curvature), the angle is in the range from 20 to 40 degrees.
This anatomical structure of the spine is necessary to reduce the depreciation pressure on the intervertebral discs located between the vertebral bodies during weight lifting, walking, and also during tilting of the body.
Anatomical features of the lumbar lordosis
On x-ray physiological lordosis in the lumbar spine characterized by the following features:
- Width of the transverse processes and bodies of the vertebrae gradually decreases from top to bottom;
- If you draw a horizontal line between the crests of the iliac bones on both sides (see picture), it is located in a horizontal plane;
- Vertical lines along the outer portion of the sacrum (a and a’) should be projected on the bottom of the depressions acetabulum iliac bones;
- On the x-ray in oblique projection angle of the sacrum is about 30 degrees. It is measured between lines drawn through the upper surface of the sacrum and the horizontal line (see figure 2);
- the angle between the axis of the sacrum and the Central axis of 1st sacral vertebra (s1) is equal to about 140 degrees
- the Value of the slope of the pelvis is calculated between the horizontal and the line connecting the pubic symphysis to the upper edge of the Cape, is equal to 60 degrees;
- Connection of the rear edge of the L1 vertebra and the dorsal portion of the l5 (fifth lumbar vertebra) forms the index of lumbar lordosis (f). If we draw a perpendicular to the line of lordosis of the lumbar region at L3 will turn the corner, which allows us to estimate its value. When he straightened, the index will turn negative;
- In images of the spine in the back projection estimate the distance between the rear edge L5 and the vertical line extending from the rear upper edge of the first lumbar vertebra L1. This distance can be negative, positive or zero.
Causes physiological changes concavity
Changes in the physiological lordosis possibly due to several reasons:
- Myopathy (impaired tone of the back muscles);
- Osteopathy (pathology of the skeletal system of the spine);
- Metabolic (metabolic disorders)
- Idiopathic (cause not determined);
- Rare form.
The Myopathic lordosis can be cured only after the removal of asynchronous spasmodic contractions of skeletal muscles on both sides of the back. For these purposes, is appointed medical gymnastics. It helps to strengthen muscles and abdominals to prevent straightening of the lumbar concavity. Therapeutic exercises for the myopathic form should be selected after evaluating the tone of the skeletal muscles.
Osteopathic form more difficult to treat. In 2% of cases it is provoking abnormalities of the lumbar vertebrae (cleft arches, globalizacija (the appearance of additional 5-th vertebra)).
Congenital forms of pathology often becomes lordoscoliosis, in which there is not only the strengthening of the lordosis, but also offset it to one side.
Metabolic lordosis is caused by disturbance of metabolism in diseases such as gout (a metabolic disorder uric acid), rickets (vitamin D deficiency), arachnodactyly (excessive growth of the bones of the limbs). Metabolic types of pathology it is difficult to cure, as they combine with weak bony structures of the vertebrae.
Idiopathic kind is almost impossible to fix, as the cause of the disease remains unknown. In this situation it is necessary to analyze the symptoms and prescribe the therapy depending on the clinic.
Classification patologicheskoi deviations
The Physiological lordosis is the angle in between 20-40 degrees and is not accompanied by pain when walking. When the lumbar lordosis is straightened (chipolatas), you experience the following symptoms:
- Compression syndrome;
- Myofascial pain syndrome
- Neurological disorders.
Compression syndrome occurs on the background of infringement of the nerve root is displaced vertebrae or a prolapsed intervertebral disc. Appears sharp or aching pain in the lumbar region.
Myofascial syndrome is accompanied by asynchronous functioning of the muscular system of the back on both sides of the spinal column. It becomes the cause of further spinal deformity.
Neurological symptoms in flattening of the lumbar lordosis initially characterized by loss of skin sensation in the lumbar region or lower extremities. For their evaluation a special test is applied:
- Take the needle from the syringe and touch her skin withboth sides of the spine;
- In the place where the sensitivity is less, a high probability of infringement of the nerve fibers.
Physiological lordosis can also be accompanied by pathological symptoms. Even if the bending is maintained, is not excluded loss of the intervertebral disc, the rotation (rotation around multiple vertebrae axis) or torsion (twisting of one vertebra with a deformity of his body).
When hyperlordosis increases the normal values of the lumbar concavity. The angle of curvature exceeds 45 degrees. While in human form specific gait. He can't bend forward with the knees unbent, and if the movement rests mainly on one leg. To cure such a stereotype of the gait only at the beginning of the disease.
Treatment of lordosis is based on eliminating the causes of disease and strengthening of the muscle corset back. In the initial stages of weakness in the skeletal muscles necessary to wear an orthopedic belt for the waist.
Daily exercises to Dikul, Machines or Bragg will help to strengthen muscles that will support the spine in the correct position. To correct the curvature, of medical gymnastics is assigned for a long time and should be conducted regularly. It must be administered by orthopedic trauma, or spine specialists who will conduct a thorough diagnosis of your back and pick up exercises to increase the strength of one group of muscles with simultaneous relaxation of the other.