Lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. The pain syndrome is caused by damage to the intervertebral discs, vertebral roots, nerve fibers and cartilage tissue. For the treatment of lumbosacral osteochondrosis, you need to contact a neurologist.

Symptoms of lumbar osteochondrosis

• severe pain syndrome that can radiate to the organs of the leg and pelvis
• pain in the kidneys and sacrum
• numbness of limbs
• stiffness
• tension in the lumbar region
• fatigue, weakness
• dizziness

Lumbar osteochondrosis has gender features of the course. Vertebrogenic pain, which occurs due to compression of the nerve roots by the damaged cartilage of the intervertebral discs, is much more difficult for women than for men. The intensity of pain is directly related to the level of estrogen. The lower their indicators, the more pronounced the pain.

In addition, the syndrome of reflected lumbosacral pain can be associated with concomitant diseases of internal organs. In women, diseases of the genitourinary sphere predominate, in men, disorders of the gastrointestinal tract are more characteristic.

Treatment of osteochondrosis of the lumbosacral region

Treatment of patients with neurological manifestations of lumbosacral osteochondrosis should be comprehensive and staged. During the first medical appointment, a clinical and functional examination is carried out (clarification of complaints and anamnesis) and a clinical examination. A neurologist examines the dynamic and static function of the spine, assesses the posture and parameters of paravertebral muscle tone, determines the degree of mobility of different parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• exclusion of adverse charges
• immobilization (use of corsets, braces, orthopedic hairdressing)
• pharmacotherapy
• physiotherapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud therapy
• pulling (pulling) techniques

If conservative methods do not give the desired effect, surgical intervention may be required.

Physiotherapy for lumbar osteochondrosis

To eliminate pain, reduce swelling, normalize the tone of the back muscles, activate recovery processes, resolve fibrous foci and increase the mobility of damaged segments, a complex of physiotherapy procedures is used:

• pulsed diadynamic currents
• darsonvalisation
• magnetic therapy (exposure to a static or alternating magnetic field)
• laser treatment
• medicinal electrophoresis
• UV radiation
• local cryotherapy
• ultrasound
• Transcutaneous electrical nerve stimulation

Thanks to combined physiotherapy with the simultaneous use of several methods, the effectiveness of therapy for lumbar osteochondrosis increases by 30%.

Physiotherapy

A special role in the conservative treatment of degenerative pathologies of the musculoskeletal system is assigned to recreational physical education. Instructors-rehabilitators of the rehabilitation center develop individual complexes of exercises of dynamic exercise therapy and stretching for osteochondrosis of the spine. This takes into account the sex, age and physical abilities of the patient.

Optimized therapeutic exercises aim to strengthen the muscles of the back, abdominals, pelvic region and lower limbs. Thanks to training therapy, pathological muscle tension is eliminated, pressure on the intervertebral discs is reduced, swelling and pain are eliminated, the spine is stabilized and posture improves.

Surgical intervention

An absolute indication for decompressive surgery is disabling radiculomyeloishemia. This dangerous pathological condition is caused by hernial compression of the nerve roots and impaired blood flow in the sacrococcygeal area. This results in intermittent unbearable pain, dysfunction of the pelvic organs, intermittent claudication and other motor, reflex or sensory disturbances. A relative indication of operational stabilization is the lack of effect of long-term (more than 1. 5-2 months) conservative therapy.

Endoscopic methods of osteoplasty are recognized as the most optimal: placement of intersomatic implants and fixation cages made of biocompatible materials. Minimally invasive procedures quickly restore the ability to support the operated service and allow early rehabilitation to begin.

Injection treatment (injections for lumbar osteochondrosis)

The main manifestation of osteochondrosis of the lumbosacral region is pain. This complex, multi-component symptom is associated with local inflammation, pathological muscle tension, ligament damage, biomechanical causes, and dysfunction of the pain perception system. Therefore, the treatment should be carried out in a complex. For faster pharmacological action and reduction of gastro- and cardiovascular risks, injection therapy drugs are prescribed:

• anti-inflammatory (NSAIDs)
• analgesics (analgesics)
• muscle relaxants (relaxing, relieving muscle tone)
• vasodilator (improving blood microcirculation)
• chondroprotectors (stimulating the regeneration of intervertebral discs, slowing down the destruction of cartilage tissue).

On the recommendation of a doctor, homeopathic injections for the treatment of osteochondrosis and vitamins can be used. For a quick and effective elimination of severe pain syndrome, therapeutic paravertebral blockades are prescribed (injections into the lumbosacral nerve plexus).

medical therapy

Traditionally, the complex therapy of degenerative diseases of the spine includes treatment with tablets and capsules, similar to the injection method:

• NSAIDs (nonsteroidal anti-inflammatory drugs)
• painkillers
• myotropic antispasmodics (drugs to relieve muscle spasms)
• vegetative correctors (stabilizing the tone of the autonomic nervous system)
• vasodilators (to improve blood flow and tissue trophism)
• chondroitin and glucosamine dosage forms
• sedatives and antidepressants (to relieve emotional tension and chronic stress)
• vitamin and mineral complexes

Tablet preparations for the treatment of osteochondrosis of the lumbosacral spine are prescribed for a long time (up to 2 months or more).

How does this disease manifest clinically?

osteochondrosis of the lumbar spine in the initial stages is characterized by very general symptoms, which are very difficult to recognize without the intervention of an experienced specialist. Usually, patients only begin to complain of pain and other discomfort when the second stage occurs.

The main clinical symptom of this disease, as everyone probably knows, is pain in the lower back. The severity of this symptom increases dramatically after lifting and carrying weights, or even after simple movements of the limbs or torso. After a while, the pains become aching, bothersome, but can periodically worsen.

Another common complaint of patients during an appointment with a vertebrologist is stiffness, limitation of movement of the lumbosacral joint. It becomes difficult for patients to bend over, turn around. It should also be noted that often the pain can radiate to the back surface of the lower extremities.

As a result of compression of the nerve roots by enlarged intervertebral discs, disorders of skin pain and temperature sensitivity occur. It must be said that such violations can mean both a weakening and an increase in the threshold of sensitivity. With untimely treatment, the disease is further complicated by muscle hypotension, as well as hyporeflexia.

How can you get rid of this serious disease?

Treatment of the problem of osteochondrosis is divided into two main groups of methods: conservative and surgical. The basis of the first method is the impact on the human body with the help of drugs, which include nonsteroidal anti-inflammatory drugs, painkillers, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any of the groups of these drugs, you should definitely consult with your doctor, who will conduct a thorough diagnosis and draw up your individual treatment plan. This is very important because the drugs described above can have serious side effects which can be avoided if the drugs are taken correctly.

Chondroprotective and anti-inflammatory ointments, B vitamins are also widely used.

Methods of manual therapy, physiotherapy and acupuncture have proven themselves in the treatment of osteochondrosis, which help to improve local blood supply, relax the muscles of the back.

Treatment of osteochondrosis of the lumbar spine

According to statistics, every second person between the ages of 25 and 55 has at least once in his life experienced manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lumbar region to severe pain with reduced mobility.

The lumbar skeleton is subjected to maximum loads, so a high percentage of osteochondrosis in this particular area of the spine is not accidental.

The disease is based on disc degeneration with progressive involvement of adjacent vertebrae, intervertebral joints and ligament apparatus in the pathological process.

When the diagnosis is confirmed, treatment for lumbar osteochondrosis should be started immediately, without waiting for the appearance of complications.

The mechanism of development of osteochondrosis

In the cartilaginous structure of the intervertebral disc there is a pulpy nucleus surrounded by a dense fibrous ring, the collagen fibers of which tightly attach the disc to the vertebral body.

The intervertebral discs act as shock absorbers that reduce the pressure exerted on the spine during efforts. With age, as a result of malnutrition, the cartilaginous tissue of the discs undergoes dystrophic processes. The nucleus dries up, loses its shock-absorbing properties, followed by the destruction of the fibrous ring. Microcracks, fiber breaks appear in its structure. Due to the increased load, the core of the disc is displaced outside the spine - the initial stage of the formation of a hernia develops - protrusion. This leads to irritation of the nerve roots and the appearance of pain in the patient.

If the fibrous ring is completely torn, an intervertebral hernia forms.

Factors provoking the development and exacerbation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work associated with frequent changes in body position: bending, extension, bends, heavy lifting, vibration.
• A genetic predisposition in which the tissues of the spine have structural changes that accelerate their degeneration.
• Incorrect posture, in which there is an uneven distribution of the load on the axial skeleton.
• Orthopedic pathologies: flat feet, curvature of the spine.
• Hypodynamia, sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of damage to the structures of the spine (fall from a height, transport accidents, etc. ).
• Professions in sports with a large physical load on the spine: skiing, tennis, horseback riding, weightlifting.
• Irrational nutrition, imbalance in the diet for the main nutrients: proteins, fats, carbohydrates, vitamins, microelements.
• Hormonal imbalance in women during pregnancy and menopause.
• Bad habits: alcohol, tobacco.
• The age changes.
• Inflammatory processes of the spine (Bekhterev's disease).
• Pathologies associated with impaired metabolic processes in the body (diabetes, hypothyroidism).

Stages of lumbar osteochondrosis

Depending on the degree of damage to the intervertebral discs and the clinical picture, there are four stages of osteochondrosis of the lumbar spine:

1 step. There is a gradual decrease in the elasticity of the intervertebral discs. Microfissures appear in the fibrous annulus. Due to the reflex spasm of the muscles surrounding the affected segment of the spine, there is stiffness and discomfort in the back in the morning.

2 step. The destruction of the fibrous ring continues, the disc flattens, which leads to a decrease in the distance between the adjacent vertebrae. Pathological mobility develops when the vertebrae can move relative to each other. The nutrition of the vertebral tissues is disturbed. The pain is already regular.

3 step. The semi-destroyed fibrous ring can no longer hold the nucleus pulposus, a protrusion (protrusion) appears - the beginning of the formation of a hernia. The pain gets worse and becomes constant. There is a spinal deformity.

4 floor. Intervertebral discs are replaced with scar tissue. There are many complications up to the complete loss of motor activity. It is possible to treat this stage of lumbar osteochondrosis only with the help of a complex operation aimed at replacing the destroyed vertebrae with artificial implants.

Diagnostic

• History taking.
• Neurological examination of reflexes, sensitivity.
• functional tests.
• X-ray, MRI, CT.

Treatment methods

Traditional treatment of lumbar osteochondrosis includes the following methods:

Drug therapy: nonsteroidal anti-inflammatory drugs, glucocorticoids, muscle relaxants, sedatives and vitamin complex with trace elements.

Physiotherapy procedures: electro-, phonophoresis, magnetic field exposure, hydrotherapy.

Surgical treatment of lumbar osteochondrosis is carried out according to strict medical indications in severe cases, if the patient fails to stop severe pain by conservative methods or is threatened with a complication in the form of paralysis of thelower limbs or dysfunction of internal organs.

Osteochondrosis of the lumbar spine: diagnosis and treatment

Back pain often occurs in a person due to the formation of an incorrect posture when walking and sitting at a desk. But this is also one of the consequences of damage to the intervertebral discs, cartilage tissues and nerve fibers, leading to the development of osteochondrosis of the lumbar spine.

With lumbar osteochondrosis, degenerative changes occur in the lumbosacral spine. If the disease is left untreated for a long time, the general state of health of the patient worsens: constant back pain, numbness in the limbs, spasms and cramps in the muscles, general weakness and loss of strength.

How does pathology develop?

During the development of the disease, degenerative-dystrophic and destructive disorders occur in the skeleton of the patient's spine. As a result, the anatomy and physiology of the articular elements of the spine change. A person's lumbar spine bears the main load in the form of the weight of a person's upper body, loads during movement, training or performing any physical activity. As a result of all of the above, the following changes occur:

• the axis of the spine is deformed;
• posture changes;
• the bones press against the internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is disturbed due to the violation of nerve endings;
• the structure of the spine changes;
• the cartilage thins;
• the synovial fluid structure is filled with third-party components;
• the vertebrae are worn down, which reduces the distance between them;
• when the vertebrae come into contact, the nerves are pinched - this leads to sharp pain.

At the risk of developing lumbar osteochondrosis, there are athletes who lead an overly active lifestyle, sedentary people (being in an unchanged state for a long time, they create an increased load on the spine), representatives of manual professions who workwith heavy tools, elderly people, pregnant women, hyperactive children.

Symptoms of lumbar osteochondrosis

• sharp pain in the lower back after a night's sleep;
• pain when making sharp turns of the body or lifting heavy objects;
• the first signs of scoliosis appear;
• frequent urination;
• pain radiates to the legs, internal organs of the abdomen and pelvis;
• sharp pain in the kidneys and sacrum;
• difficulty moving, walking, tilting and turning the body;
• fatigue after a light load;
• numbness of limbs;
• spasms and cramps in the muscles;
• dizziness;
• decreased muscle tone and sensitivity.

Causes of osteochondrosis of the lumbosacral spine

• poorly distributed load on the back;
• sedentary lifestyle;
• hunched posture;
• stay in one position for a long time;
• congenital curvature of the spine;
• too frequent physical training;
• excess body weight;
• violation of blood flow in the spine;
• wounds, bruises, fractures of limbs or vertebrae;
• infections of internal organs.

Stages of development of lumbar osteochondrosis

Stage 1 - all degenerative disorders are just beginning to develop in the patient's skeleton. But at the same time, the roots of the nerve endings are already affected. The blood flow worsens and the inflammatory process begins. It is manifested by back pain after increased exertion, which often radiates to the legs.

Stage 2 - the fibrous ring of the spine is destroyed, the cartilage becomes thinner and the distance between the vertebrae is reduced. The pain in the second stage is sharper and sharper.

Stage 3 - there is a strong compression of muscle fibers and nerve endings. There are burning pains and spasms in the muscles, as well as frequent numbness.

Stage 4 - the period of growth of neoplasms (osteophytes) in the bone structure. Osteoarthritis appears in the spine and joints. The back becomes inactive and, in the absence of correct treatment, completely immobile.

How is osteochondrosis of the lumbar spine diagnosed?

Diagnosis of pathology begins with a consultation with a specialist. At the first manifestations of osteochondrosis, consult a rheumatologist, neuropathologist, surgeon or traumatologist orthopedist. If you have trouble choosing a doctor, you should first consult a therapist. Depending on the symptoms and the presumed causes of the pathology, he will refer you to one of the highly specialized specialists.

1. The doctor will study your medical history and the frequency of their manifestations, you need to provide the specialist with a full medical history and the results of the first studies (if any). The specialist will perform a visual examination and palpation.
2. During the examination, the doctor pays particular attention to changes in posture, muscle tone, skin sensitivity and identifies the most painful areas. The purpose of the conversation is to find out the degree of development of the disease. If you have any questions, a specialist will advise you and conduct an examination.
3. He will refer you for tests, as this is a complete diagnosis that will allow you to make the correct diagnosis.
4. Based on the test results, the doctor will prescribe an individual treatment plan.

To identify the condition of muscles, ligaments, blood vessels, to detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the lumbar spine. During an MRI of osteochondrosis, the patient lies on a special retractable table with his back. Rollers are placed on the patient's head to eliminate muscle tension, and the limbs are fixed with belts. Any slight movement during the procedure may affect the quality of the result. Then the table enters the tomograph area. The procedure does not cause pain. The tomograph makes a lot of noise during the scan, so you can use headphones so you don't feel any discomfort.

If MRI is contraindicated, there are other diagnostic methods such as CT scan and X-ray. Radiography is only suitable for primary diagnosis and does not provide a layered image of the affected tissues. However, this study is the simplest and most economical, allowing you to examine the patient's body in several projections. Due to the body's high exposure to radiation, X-rays cannot be taken frequently.

Treatment of lumbar osteochondrosis

Depending on the stage of lumbosacral osteochondrosis, different treatment methods can be prescribed. One of these methods is exercise therapy. It is performed in a specially equipped room under the close supervision of a doctor. Classes are held when the patient does not feel pain. But if during physical education the patient began to feel worse, the doctor corrects or completely cancels the exercise.

Another method of treating lumbar osteochondrosis is physiotherapy. It improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy treatments include:

• Electrophoresis - painkillers, anti-inflammatory drugs are used, the procedure reduces the neurological manifestations of the disease.
• Magnetic therapy - an alternating magnetic field relieves inflammation.
• Ultrasound therapy - acts along the affected spine.
• Diadynamic therapy - the effect on the affected areas occurs with the help of currents of different intensities.
• Hirudotherapy - treatment with leeches. Their impact improves microcirculation, the exchange of nutrients in the tissues of the back.
• Kinesio taping is a treatment using a cotton patch.

Drug therapy - is prescribed in extreme cases with the use of painkillers (have an additional analgesic or anti-inflammatory effect), antispasmodics (relieve muscle spasms), vasodilators (improve blood microcirculation).