People suffering from lumbar spine osteochondrosis always avoid sudden movements, bending and twisting to the side gently, sitting and standing slowly. Therefore, they try to prevent sharp and piercing pain in the lower back, forcing them to freeze in one position of the body. Osteochondrosis is also manifested by disturbances, clicks, movement limitations. The treatment is often conservative, but if the disc and spine are severely damaged, surgical intervention is required.
What is lumbar spine osteochondrosis
Lumbar osteochondrosis is a degenerative-dystrophic pathology that initially affects the intervertebral disc. Due to insufficient supply of nutrients, they lose the ability to retain moisture. The regeneration process is slowed down, the disc becomes flat and brittle. The distance between adjacent vertebrae is reduced, therefore, to stabilize the lumbar segment affected by osteochondrosis, bone tissue grows. Osteophytes are formed - bone growth, when displaced, soft tissue structures, nerve roots, and injured blood vessels.
The stage of osteochondrosis is the stage of development of the disease, which is characterized by certain destructive changes in the disc and body of the vertebrae. It is installed using X-ray examination. The obtained images clearly show signs of destruction of specific vertebral structures. Each stage corresponds to the severity of osteochondrosis, a set of symptoms. The higher the disease, the more difficult the disease is for conservative treatment.
|Stages of lumbar osteochondrosis||Radiographic signs and clinical manifestations|
|First (preclinical)||There are no signs of osteochondrosis on radiography. Sometimes, there is discomfort in the lower back after physical exercise or being on the legs for a long time|
|Second||There is an adjustment of lordosis, more rarely - degeneration of the vertebral body, deformation of the lunar process. The height of the disc is slightly reduced. Painful sensations appear more frequently, their duration increases|
|Third||There is subclondral sclerosis of the end plate, defeat of a large number of delayed processes, decreased disc height. In addition to pain in the lumbar spine, this clinic has cramps, stiffness of movement|
|Fourth||The process of the moon deviating outwards and backwards. There is compensatory growth of bone tissue, the formation of several osteophytes. Pain occurs while moving and resting|
Causes of disease
Increased load on the lumbar spine is often the cause of osteochondrosis. The disk is always micro-injured, does not have time to recover on time. Most of it is gradually damaged, triggering deformities of the vertebral body. Such pathological conditions can also provoke destruction of the lumbar segment:
- congenital or acquired anomalies - flat feet, scoliosis, kyphosis, hallux valgus, hip dysplasia;
- systemic pathology - rheumatoid arthritis, scleroderma, lupus erythematosus;
- endocrine and metabolic diseases - gout, diabetes mellitus, hypo and hyperthyroidism, obesity;
- previous injuries - subluxation of the spine and fractures, spinal cord injuries;
- circulatory disorders, including with an inactive lifestyle background.
One of the main causes of the development of osteochondrosis is the natural aging of the body. After 50 years, the recovery process slows down, collagen production decreases, and ligament conditions worsen.
Characteristics and symptoms of the disease
In the early stages of development, osteochondrosis is not clinically expressed. A person experiences a slight pain in the lower back for muscle tension after a day of work and does not go to the doctor. But the severity of symptoms slowly increases - soon the pain increases as the body bends and turns, sensory disturbances, stiffness.
This is the name of a spinal cord lesion, which leads to motor disturbances, autonomy and pain. Radicular syndrome develops with 3-4 degrees of osteochondrosis severity. At this stage, an intervertebral hernia is formed, compressing the roots of the spine. Pathology runs according to the types of lumbago, lumbodynia and lumboischialgia. In addition to severe pain, radicular syndrome is characterized by numb sensations, tingling, creeping crawling, decreased or complete absence of sensitivity.
In the later stages of lumbar osteochondrosis, compression of large blood vessels by hernial protrusion is possible. The pelvic organs stop receiving adequate nutrients, which causes disruption of their function. Spinal cord trophism is also disturbed, neurological deficits develop - intermittent claudication appears, temperature, pain sensitivity drops.
Due to a decrease in the distance between adjacent vertebral bodies, the growth of bone tissue, the lumbar vertebral segment is gradually deformed. The condition is exacerbated by persistent dorsal muscle tension with subsequent atrophy. The way a person walks and postures changes pathologically, including due to improper load redistribution. The likelihood of involvement of other parts of the spine and foot joints in the degenerative-degenerative process increases significantly.
In the lower back there is a large sciatic nerve, formed by the roots of the sacral spine. When violated by hernial protrusion, bone growth, spasmodic muscle, sciatica occur - typical symptoms of lumbar osteochondrosis. Acute pain appears, spreading along the sciatic nerve to the thighs, knees, legs (lumboischialgia). Another typical sign of pathology is lumbago, or "lumbago" in the lower back after a tilt or sharp rotation, hypothermia.
When making a diagnosis, the most informative X-ray images are made in two projections. An MRI is performed to examine the affected lumbar segment in more detail. This study allows you to assess the condition of the spinal cord, soft tissue structure, blood vessels, nerve roots. It is possible to determine the degree of damage to the nerve trunk using the potential generated, electroneurography, electromyography. Discography is used to examine the target of the affected disc.
How treatment is done
An integrated approach to the treatment of lumbar osteochondrosis is practiced. Treatment aims to relieve pain, restore various movements, prevent the spread of pathology to healthy discs and spine.
The use of non-steroidal anti-inflammatory drugs, glucocorticosteroids, muscle relaxation makes it possible to relieve lower back pain. In therapy, drugs are used to improve blood circulation. Patients must be given B vitamins, chondroprotectors.
This is the most effective and affordable method to treat osteochondrosis. After 1-2 months of physical therapy daily, the muscles of not only the lower back, but also the entire back are strengthened, posture improves, and the blood supply to the damaged connective tissue structure is accelerated. Exercise therapists recommend patients to slow down, bend bends and torso, superficial squats and lungs.
Patients with lumbar osteochondrosis are shown all types of massage - vacuum, acupuncture, connective tissue, segment. But the most popular are the classics. During the session, the masseur performs basic massage movements: caressing, rubbing, kneading, vibrating. The purpose of the procedure is to relieve muscle spasms, improve blood circulation in the affected area, and strengthen skeletal muscle.
In the acute and subacute periods, patients are given electrophoresis or phonophoresis with glucocorticosteroids, anesthetics, B group vitamins. At the remission stage, laser therapy sessions, magnetotherapy, shock wave therapy, UHF therapy are frequently performed. Ozokerite therapy, applications with paraffin, hirudotherapy, mud therapy, radon baths and hydrogen sulfide are also used.
The main indication for surgical intervention is a violation of the spinal cord by hernial protrusion. During surgery, an intervertebral hernia is removed, and the spinal canal is decompressed. The most common surgical methods used for lumbar osteochondrosis are microdiscectomy, puncture vaporization or laser disc rearrangement, implant placement, and spinal segment stabilization.
After the main therapy, achieve a stable remission, homemade ointments, herbal teas, compresses, oils and alcohol are used in the treatment. Folk remedies do not affect the cause of osteochondrosis, so it is used to relieve weak pain, soreness, heaviness in the lower back after hypothermia, sharp weather changes or increased physical activity.
Consequences of not being served
The development of almost all complications of lumbar osteochondrosis is provoked by the resulting intervertebral hernia. Discogenic myelopathy is very dangerous, which cannot always be eliminated even with surgical treatment. It is indicated by pelvic disorders, including defecation and urinary incontinence. Complications of osteochondrosis also include radicular syndrome - a common cause of acute and stabbing pain in the lower back.
Precautions and prognosis
Prognosis is good when diagnosing pathology 1-2 severity. It responds well to conservative treatment, and in young patients it is even possible to restore part of the intervertebral disc. With the onset of complications, the prognosis for complete recovery is less encouraging.
Prevention of lumbar spine osteochondrosis is to control weight, exclude excess load, timely treatment of endocrine and metabolic diseases. Neurologists and vertebrologists recommend visiting the pool, doing aqua aerobics, Pilates, and Nordic walking.