Lombalgias agudas são muito comuns e possuem como causas movimentos realizados de forma errada
Dor nas costas. Com a vida moderna nas grandes cidades, tempo gasto no trânsito e o dia todo dentro de um escritório, quem nunca reclamou? Difícil, pois de acordo com o neurocirurgião e especialista em cirurgia de coluna vertebral do Hospital 9 de Julho, Alexandre José Reis Elias, 90% da população terá pelo menos um episódio ou crise de dor na coluna ou lombalgia no decorrer da vida. E os motivos para isso estão cada vez mais frequentes.
— Podemos dizer que o número de pessoas que sofrem de dor nas costas tem aumentado principalmente em função do sedentarismo, do sobrepeso e do estresse — afirma o médico.
Mas, como definir quando a dor nas costas é passageira ou pode indicar um problema mais grave? Alexandre explica que o problema mais comum é a lombalgia aguda, com duração da dor menor que 12 semanas. Trata-se de uma dor que aparece na coluna lombar (entre a última costela e as nádegas), que piora muito ao fazer qualquer movimento com o corpo. Por isso, o paciente “anda com o corpo duro”.
A causa mais comum da lombalgia aguda é algum movimento errado que o paciente fez como carregar peso em excesso ou de forma errada; abaixar o tronco para pegar algum objeto, com as pernas esticadas; fazer rotação do corpo mantendo os pés parados no chão ao invés de rodar todo o corpo; ou, ainda, pegar algum objeto em uma estante alta inclinando o corpo para trás.
Quando a dor nas costas dura mais que 12 semanas é caracterizada como lombalgia crônica e, por ter causa multifatorial, é bem mais difícil de ser tratada, requerendo a procura de um centro especializado em dor, com equipe multidisciplinar formada por neurocirurgião, reumatologista, fisiatra, ortopedista etc.
Independentemente da duração da dor, o indicado é, ao surgimento dos sintomas, que a pessoa procure um especialista para avaliar a gravidade do problema e iniciar o tratamento.
— Apesar de rara, a causa da dor pode ser a presença de fraturas, tumores ou até mesmo uma infecção da coluna. Somente com uma avaliação médica podemos saber se é alguma doença mais grave ou não — completa.
Lombalgia aguda
Os casos de lombalgia aguda são, normalmente, quadros benignos e autolimitantes, ou seja, o paciente melhora da dor utilizando medicações ou não. É muito importante deixar claro para o paciente que a dor não vai desaparecer em alguns dias mas em algumas semanas. O tratamento pode ser avaliado pelo próprio paciente: se a cada semana ele estiver melhor que na semana anterior, é porque o tratamento está indo bem.
— Os pacientes não orientados desta forma ficam preocupados, pois a dor não desaparece em poucos dias e eles ficam perambulando pelos pronto-socorros e consultórios — afirma o especialista.
No entanto, para aliviar o sofrimento do paciente, o médico pode indicar medicações analgésicas, anti-inflamatórias e relaxantes musculares que, associadas à fisioterapia e à acupuntura, proporcionam alívio importante da dor. Outro fator importante é encorajar o paciente a não ficar em repouso e reassumir suas atividades assim que a dor apresentar uma melhora inicial. Mesmo em casos de dor lombar de forte intensidade, o paciente deve evitar o repouso prolongado.
— Após o tratamento da crise, inicia-se o tratamento de prevenção de novas ocorrências com RPG – Reeducação Postural Global, controle do peso, combate ao sedentarismo etc. — explica o médico.
Lombalgia crônica
No caso das lombalgias crônicas, o diagnóstico preciso é de fundamental importância para o tratamento correto. Isto nem sempre é fácil e, muitas vezes, o especialista em coluna necessita do auxílio de outros profissionais para o diagnóstico. Daí, a importância do tratamento multiprofissional.
Por exemplo, pacientes com dor lombar mecânica, que piora com movimentação e melhora com o repouso, são a maioria e devem ser avaliados para os possíveis diagnósticos envolvendo este tipo de dor. Por outro lado, pacientes com dor lombar de padrão inflamatório, que piora ao repouso e melhora com a movimentação, devem ser sempre avaliados pelo reumatologista.
Para a lombalgia crônica, também são indicados tratamentos com outros profissionais, quando necessário. Pessoas com depressão devem ter acompanhamento psiquiátrico e psicoterápico; obesos devem fazer avaliação com endocrinologista e nutricionista.
Cirurgias
As cirurgias de coluna evoluíram muito nos últimos anos e há diferentes tipos para diferentes patologias. É possível fazer desde uma lesão de uma raiz nervosa dolorosa com agulha através da pele, até reconstruir a coluna utilizando parafusos e barras, de forma que o paciente pode sair da cama no dia seguinte como, por exemplo, nos casos de tumores na coluna. Quanto à recuperação, a maioria dos pacientes é estimulada a deambular no primeiro ou segundo dia após a cirurgia, diferentemente do que ocorria no passado, quando se preconizavam longos períodos de repouso na cama.
Uma pequena parcela dos pacientes são tratados com cirúrgica. Os candidatos ao tratamento cirúrgico são aqueles que fizeram o tratamento clínico e não obtiveram melhora da sua dor; aqueles em que foram diagnosticadas outras patologias, por exemplo, tumores na coluna; e os que desenvolveram alteração do exame neurológico, como fraqueza nos braços, fraqueza nas pernas ou dificuldade para urinar ou evacuar.
— É sempre bom lembrar que, assim como todos os tratamentos da medicina, estes também envolvem riscos, que devem ser avaliados pelo cirurgião e pelo paciente — ressalta o neurocirurgião.
Dicas para evitar a sobrecarga na coluna e a dor
:: Melhor posição para dormir
Não durma de bruços, mas de lado e com um travesseiro entre os joelhos; ou de barriga para cima, com um travesseiro atrás do joelho.
:: Tipo de colchão
A peça não deve ser muito mole, nem muito duro. Os semiortopédicos são uma boa opção, porém não existe regra e a escolha é individual.
:: Melhor forma de levantar da cama
Vire o corpo para o lado e comece a levantar-se de lado. Não levantar-se para frente.
:: Transporte de objetos pesados que estão no chão
Agache-se dobrando os joelhos, próximo ao objeto, e pegá-lo sem inclinar a coluna. Não carregar peso excessivo.
:: No trabalho em escritórios
Utilize cadeiras que não reclinem para trás, com apoio para os braços. Sente-se usando todo o encosto. Os pés deve tocar totalmente o chão. A tela do computador deve ficar na altura dos olhos para a coluna cervical ficar confortável.
:: Carregando mochilas
Utilize mochilas nas costas usando alças dos dois lados e cuidado com excesso de peso, principalmente para as crianças.
:: Usando salto alto
O salto pode acarretar dor na coluna lombar. Deve-se ter bom senso de usar eventualmente e, caso provoque dor, evitar o uso.
:: Ao dirigir
Fique sempre com as costas apoiadas no banco e os braços parcialmente fletidos, ou seja, não esticados totalmente.
:: Gestantes
Mantenha atividades físicas supervisionadas e permaneça dentro do peso recomendado. Lembre que as dores lombares em gestantes são comuns e, na maioria das vezes, não representam nenhum problema sério de coluna. Deve-se procurar um especialista em coluna para fazer o diagnóstico correto, tratamento e prevenção de novas crises.
:: Massagem e outros tratamentos alternativos
Terapias locais como a massagem, por exemplo, podem trazer alívio para o paciente. Muitas vezes não cessam a dor propriamente dita, mas causam bem-estar e só isso já justificaria o seu uso, sempre com a indicação de um médico especialista.
:: RPG e Pilates
Para os pacientes com forte dor aguda é indicada a fisioterapia analgésica junto com RPG. Para os pacientes que melhoraram, a indicação é RPG ou Pilates para tentar prevenir novas crises de dor.
Fonte: www.clicrbs.com.br
eu sinto uma dor que sai da coluna do meu lado direito e desce pela minha perna ate chegar ao calcanhar e nao consigo colocar o meu pe no chao pois a dor e muita fazer uma caminhada longa entao nem penssar fiz uma resonancia e deu o seguinte diagnostico discopatia no nivell1 el2 e minima discopatia ao nivel da l4 el5 o que significa tudo isso por favor
Isso significa que você tem compressão do nervo na região da coluna lombar, por isso essa irradiação para perna, a intensa dor que você está sentindo é causada pelo processi inflamatório, você deve imediatamente procurar um ortopedista e iniciar fisioterapia, seria muito interessante que o profissional fisioterapeuta tenha experiência na área principalmente se o mesmo possa utilizar uma associação de terapias manuais e eletroanalgesias, a acupuntura também favorece nesse estado relatado. Boa recuperação.
Sinto dor no lado direito, no meio das costas. Parece que o lado direito está com um relevo um pouco maior do que o esquerdo. Oque pode ser isso? Não doi quando respiro fundo….. Ele apenas é um incômodo.
tenho pobleme de hernia de dico e tambem tenho poblemas piçicologicos uso anti depresivos rivotril e fluoxcetina tem dias ques estou com dores nos braços tem veses quje a dor esta so em um braço ja tem veses que esta nos dois braços e no corpo todo tem veses que estou com dor lobar do lado direito indo para as pernas ja tem veses que a dor lobar esta do lado esquerdo indo para as perna e ja tem veses como estou sentindo agora a tarde de hoje começou uma dor lobar do lado direito e foi espalando pelas pernas coxas virilha e acabou tomando conta do corpo todo fico preucupado com isto nervoso senpre procurando os prontos chocorros e nas maiorias das veses sou medicado com injeçoes que alivia por ums poucos dias depois vouta tudo o medico dise que eu dei umas artroses tambem nao sei se e por isto so sei nao estou legal nao estou bem eu trabalho em construçao civil de pedreiro estou senpre pegado peso mais sera que tudo isto que eu espliquei seria nomau estas doraiadas no corpo por favor me ajudem me responda desde ja agradeço
Sinto dor no lado direito, no meio das costas. Parece que o lado direito está com um relevo um pouco maior do que o esquerdo. Oque pode ser isso? Não dói quando respiro fundo….. Ele apenas é um incômodo. O que é?
Estive passando em pronto socorros para uso de medicação, devido dor no lado direito das costas ao menos 4 vezes nas ultimas 2 semanas
e por fim passei em um especialista em coluna que aparentemente não achou nenhum problema em mim. Acontece que a dor continua forte. Ontem usei medicação de corticoides aplicada por farmacêutico e após 4 horas a dor aliviou, mas não passou. Hoje está doendo e começo a me preocupar com outros possíveis problemas que não sejam da coluna. Pode me ajudar?
Estou com dor na coluna lombar do lado esquerdo e essa dor desse par a coxa e varilha ao ficar certo tempo em pé ou caminhando, dor que ja venho sentindo faz um bom tempo, mais que piorou a cerca de uns vinte dias, estou tomando antinflamatório por indicação médica mas melhorou muito pouco.
O que pode ser isso?.
ola boa tarde sinto uma dor muito forte lonbar do lado direito e no meio das costats muitas queimações ja faz uns tres meses fui ao médico emergencia e ele pediu vários exames,gostaria de saber se no RAIO X mostra o q tenho pois ele me pediu um raio x lombar. obrigada por sua atenção
Estou com dor na coluna lombar do lado esquerdo .
Tenho dores muito forte,quando caminho,qd fico muito tempo em pé e quando varo a casa não chega a dar 10 minutos ja começa a doer mais mesmo assim continuo meus afazeres,paro um pouco e depois continuo novamente.Já fui ao médico ele achou que podia ser problema de rim,fiz exame e deu normal,logo em seguida fiz mais exames e tudo normal,então ele me mandou para fisioterapia,mais sinto que a fisioterapia não esta ajudando,pois a dor vem pior a cada seção de fisioterapia,fiquei com essa dor logo após meu parto (Normal-Induzido)…O que posso fazer? O que pode ser isso?
Importante exames por imagem.
Há três dias, ao descer do carro, senti uma fisgada na lombar esquerda (devo ter feito um movimento inadequado), com dor, quando movimento a perna esquerda, principalmente. Em repouso ou sentado, não sinto quase nada, porém dói um pouco, quando me levanto. A dor não é grande e consigo fazer quase tudo. principalmente não parei de fazer caminhadas. Mas as pessoas dizem que estou andando “duro” e me perguntam se estou com problemas no nervo ciático. A dor que sinto é interna e parece ser muscular, pois apalpando quase não sinto. Fazendo caminhada eu quase não sinto dor.
sinto uma dor horrivel no meu lado esquerdo td dores muito forte nao consigo nem me mexer direito .pode eer coluna?
Comecei a mais ou menos umas duas semanas a sentir uma dor forte na coluna, na altura do bumbum…quando estou sentada ou deitada ao me levantar sinto tanta dor q ando curvada e vou esticando o corpo devagar. Marquei uma consulta e estou aguardando. O que poderia ser?
eu tenho dores fortes sempre no lado esquerdo da coluna q se enrradeia pras pernas com fortes dores, q me impossibilitam de me movimentar. e fico sem andar e acabo indo pras urgências, mesmo tomando anti-inflamatorios fortes a base de codeina e a cada intervalos tomo relaxante muscular e a odor alivia por uns 3 a 4 dias mesmo assim ela volta com maior intensidades q nem pareçe que tomei medicaçoes por favor me ajudem o que devo fazer. obg
Fiz uma cirurgia na coluna a dois anos atras coloquei 6 pinos.Fiquei em casa afastada do trabalho e fazendo tratamentos necessários por 9 meses . Voltei a trabalhar comecei a sentir algumas dores fracas que com os meses foi aumentando , Não suportei mais e fui ao medico as dores veio mais intensa , o medico meu deu alguns dias em casa não foi suficiente e fui afastada novamente com diagnostico de edema no lombar baixo. Estou super triste por nao poder fazer nada devido as dores, preciso de ajuda urgente !!! Já ate pensei em procurar alguma ajuda na mídia pois nao tenho situação financeira para fazer tratamentos mais específicos.
Bem descritivo, faltou falar da Quiropraxia e sua forma de atuação. Ainda pouco conhecida no brasil, mas amplamente utilizada nos Estados Unidos, Europa e Austrália.
Atenciosamente;
Dr. Fabio Corsini Motta –
Quiropraxia Clínica – Escolha Quiropraxia e Viva bem.
/
Oi bom dia estou com muita dor na coluna ja fui no medico e ele som passa remedio nao passa mim a jude porfavo a dor vai atem os pes
A legislação brasileira permite que você procure fisioterapia sem a necessidade de ir ao médico.
Oi eu sou a elisete fui no medico e medico so passa diclonatrom passa mais nao passa
Ola… Sinto uma dor insuportável na minha coluna TDA….fiz raio X e deu escoliose em S…. Trabalho pegando mto peso na metalúrgica q trabalho. O excesso d peso pode piorar essa doença? Amo usar salto alto isso tbm pode piorar??? E tbm sou louca pra ser mãe… Posso ter complicações na gestação devido a dor?
Ola estou com fortes dores na coluna ela esta fraca agora pq passei no medico e to tomando remedio e tomei duas injeçoes.Gostaria de saber que tipo de dor eh essa e pq ela foi causada,ela doi bem no meio das costas e se curvo o pescoço pra tras doi mais ainda isso ja ta incomodando e to ficando preocupada pois nunca tive dores na coluna, eu trabalho de empregada domestica e ando passando por estresses repentinos me ajude por favor pois agradeceria muito obrigada
Colega abaixou (inclinou) para pegar galão de água 20 litros. Agora não consegue ficar com a coluna reta o q pide set? Idade 83
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