People with osteochondrosis of the lumbar spine always avoid sudden movements, gently bend and turn to the sides, sit up and slowly stand up. Thus, they try to prevent sharp, piercing pain in the lower back, forcing them to freeze in one position of the body. Osteochondrosis also manifests itself with crushing, clicking, limited mobility. Treatment is often conservative, but if the discs and spine are severely damaged, surgery is required.
What is lumbar osteochondrosis
Lumbar osteochondrosis is a degenerative-dystrophic pathology that primarily affects the intervertebral discs. They lose their ability to retain moisture due to insufficient food supply. The update process slows down, the discs become flat and broken. The distance between adjacent vertebrae is reduced, so bone tissue grows to stabilize the lumbar spine affected by osteochondrosis. Osteophytes are formed - when they move, bone growth, soft tissue structures, nerve roots and blood vessels are damaged.
Osteochondrosis is a stage of the disease characterized by certain destructive changes in the discs and spinal cord. Installed using X-ray examination. The obtained images clearly show specific signs of destruction of vertebral structures. Each stage corresponds to the severity of osteochondrosis with a number of symptoms. The higher it is, the more difficult the disease is to treat conservatively.
|Stage of lumbar osteochondrosis||Radiographic signs and clinical manifestations|
|First (preclinical)||There are no signs of osteochondrosis on radiography. Occasionally there is discomfort in the lower back after physical exertion or prolonged standing.|
|seconds||There is correction of lordosis, less - inclination of vertebral bodies, deformation of lunar processes. The height of the discs is slightly reduced. Painful sensations appear more often, the duration increases|
|third||There is subchondral sclerosis of the last plates, the defeat of a large number of lunar processes, a mild decrease in disc height. In the clinic, in addition to pain in the lower back, there is a crush, stiffness|
|fourth||Lunate processes are directed outwards and backwards. There is a compensatory growth of bone tissue, the formation of numerous osteophytes. Pain occurs when moving and at rest|
Causes of the disease
Increased load on the lumbar spine is often the cause of osteochondrosis. The discs are constantly micro damaged and do not have time to recover in time. A significant part of them is gradually damaged and causes deformation of the bony bodies of the spine. Such pathological conditions can also lead to the destruction of the lumbar segment:
- Congenital or acquired anomalies - flat feet, scoliosis, kyphosis, hallux valgus, hip dysplasia;
- systemic pathologies - rheumatoid arthritis, scleroderma, lupus erythematosus;
- endocrine and metabolic diseases - gout, diabetes mellitus, hypo- and hyperthyroidism, obesity;
- previous injuries - subluxation of vertebrae and their fractures, spinal cord injuries;
- Circulatory disorders, including against the background of a sedentary lifestyle.
One of the main reasons for the development of osteochondrosis is the natural aging of the body. After 50 years, the recovery process slows down, collagen production decreases and the condition of the gardens deteriorates.
Characteristic signs and symptoms of the disease
In the early stages of development, osteochondrosis does not manifest itself clinically. A person gets a mild back pain after a day of work for muscle tension and does not go to the doctor. But the severity of the symptoms gradually increases - soon the body bends and turns, a crisis is added to the pain, emotional disorders, stiffness.
This is the name of a lesion of the spinal cord that causes motor, autonomic, and pain disorders. Radicular syndrome develops with osteochondrosis of 3-4 degrees of severity. At these stages, an intervertebral hernia is formed by squeezing the spinal roots. The pathology persists according to the type of lumbago, lumbodynia and lumbar ischialgia. In addition to severe pain, radicular syndrome is characterized by numbness, tingling, crawling, decreased or no sensitivity at all.
In the later stages of lumbar osteochondrosis, it is possible for large blood vessels to constrict with a hernia. The pelvic organs stop receiving enough food, which leads to dysfunction. Spinal cord trophism is also disturbed, neurological deficits occur - intermediate claudication occurs, temperature and pain sensitivity decrease.
Decreased distance between adjacent vertebral bodies, increase in bone tissue, and gradual deformation of spinal segments. The condition is aggravated by persistent compensatory tension of the back muscles with subsequent atrophy. A person's gait and posture change pathologically due to improper distribution of loads. The probability of involvement of other parts of the spine and leg joints in the destructive-degenerative process increases significantly.
There is a large sciatic nerve in the lower back formed by the roots of the sacral spine. Hernia protrusion occurs when bone growths are disrupted by spasmodic muscles, sciatica - a typical symptom of lumbar osteochondrosis. Acute pain appears, spreading along the sciatic nerve to the thighs, knees, legs (lumboischialgia). Another specific symptom of the pathology is lumbago, or a sharp bending or twisting, "lumbago" in the waist after hypothermia.
The most informative X-ray images made in two projections when making a diagnosis. MRI is performed to examine the affected lumbar segment in more detail. The study allows you to assess the condition of the spinal cord, soft tissue structures, blood vessels, nerve roots. It is possible to determine the degree of damage to nerve trunks using excited potentials, electroneurography, electromyography. Discography is used for targeted examination of affected discs.
How to treat
An integrated approach to the treatment of lumbar osteochondrosis. Treatment aims to relieve pain, restore range of motion, and prevent the spread of pathology to healthy discs and vertebrae.
The use of non-steroidal anti-inflammatory drugs, glucocorticosteroids, muscle relaxants allows you to get rid of back pain. Therapy uses drugs to improve blood circulation. Patients should be prescribed B vitamins, chondroprotectors.
This is the most effective and affordable method of treating osteochondrosis. After 1-2 months of daily physical therapy, not only the lumbar but also all lumbar muscles are strengthened, posture improves and blood supply to damaged connective tissue structures is accelerated. Sports therapy physicians recommend that patients turn slowly, smoothly, and bend their torso, shallow squats, and lungs.
Patients with lumbar osteochondrosis are provided with all types of massage - vacuum, acupuncture, connective tissue, segmental. But the most popular is the classic. During the session, the masseur performs basic massage movements: caressing, rubbing, kneading, vibrating. The goals of the procedures are to relieve muscle spasms, improve blood circulation in the affected area, and strengthen skeletal muscles.
In the acute and subacute period, patients are given electrophoresis or phonophoresis with glucocorticosteroids, anesthetics, B vitamins, laser therapy sessions in remission, magnetotherapy, shock wave therapy, UHF therapy. Ozokerite therapy, paraffin application, hirudotherapy, mud therapy, radon and hydrogen sulfide baths are also used.
The main indication for surgery is damage to the spinal cord with a hernia. During the operation, the intervertebral hernia is removed and the spinal canal is decompressed. The most commonly used surgical methods for lumbar osteochondrosis are microdiscectomy, puncture evaporation or laser disc reconstruction, implant placement, and spinal segment stabilization.
After the main therapy, home-made ointments, herbal teas, compresses, ointments and alcohol rubs are used to achieve a stable remission. Folk remedies do not affect the cause of osteochondrosis, so it is used for mild, excruciating pain, heaviness in the waist after hypothermia, a sharp change in the weather or increased physical activity.
Consequences of not being treated
The development of almost all complications of lumbar osteochondrosis is stimulated by the resulting intervertebral hernia. Discogenic myelopathy is especially dangerous, and it cannot always be eliminated by surgical treatment. It manifests itself in pelvic disorders, including fecal and urinary disorders. Complications of osteochondrosis include radicular syndrome - a common cause of sharp, piercing pain in the lower back.
Prevention measures and forecast
The prognosis is favorable when 1-2 severe pathologies are diagnosed. It responds well to conservative treatment, and in young patients it is also possible to partially restore the tissue of the intervertebral discs. With the development of complications, the prognosis for full recovery is less favorable.
Prevention of lumbar osteochondrosis is the management of body weight, elimination of overload, timely treatment of endocrine and metabolic diseases. Neurologists and vertebrologists recommend visiting the swimming pool, doing water aerobics, Pilates and Nordic walking.