People with osteochondrosis in the lumbar column always avoid sudden movements, lean carefully and turn to the sides, sit slowly, get up.They therefore try to prevent acute and piercing pain from the lower back, forcing them to freeze in a position of the body.Osteochondrosis also manifests itself in the crisis, clicks, limitation of mobility.Its treatment is more often conservative, but with serious damage to discs and vertebrae, surgery is necessary.
What is osteochondrosis of the lumbar column
Lumbar osteochondosis is a dystrophic degenerative pathology, which initially affects intervertebral discs.Due to the insufficient nutrient intake, they lose the ability to keep humidity.The regeneration processes slow down, the discs become flat and fragile.The distance between the adjacent vertebrae is reduced, therefore, the bone tissues develop to stabilize the lumbar segment affected by osteochondrosis.Osteophytes are formed - bone growth, with the displacement of the structures of soft tissue, nerve roots, blood vessels are injured.
Pathology stages
The stage of osteochondosis is the stage of development of the disease, which is characterized by certain destructive changes in the discs and bodies of the vertebrae.It is established using an X-Ray examination.On the resulting images, specific signs of destruction of vertebral structures are clearly visible.Each step corresponds to the severity of osteochondrosis, a set of symptoms.The higher it is, the more difficult the disease lends itself to conservative treatment.
| Lumbar osteochondosis stage | Characteristics of X -rays and clinical manifestations |
| First (preclinical) | There is no sign of osteochondrosis on radiographs.Sometimes there are uncomfortable sensations in the lower back after physical effort or a long -term stay on the legs |
| The second | There is a rectification of lordosis, less often - the scenes of vertebral bodies, the deformation of the semi -moon processes.The height of the discs is slightly reduced.Painful sensations appear more often, their duration increases |
| The third | The subchondral sclerosis of the fence plates, the damage to a large number of semi-moon processes and a moderate decrease in the height of the disc are observed.In addition to pain in the lumbar region, the clinic contains a crunch, a stiffness of the movements |
| Fourth | The semi-moon processes are rejected outside and behind.There is compensatory growth in bone tissue, the formation of multiple osteophytes.The pain occurs when it moves and at rest |
Causes of the disease
The causes of the development of osteochondrosis are often increased loads on the lumbar column.The discs are constantly microtraumatic, not having time to recover in a timely manner.An important part is gradually damaged, launching the deformation of the bone bodies of the vertebrae.These pathological conditions are also able to cause the destruction of the lumbar segment:
- Congenital or acquired anomalies - Flat feet, scoliosis, cyphosis, deformation valgus of the foot, TBS dysplasia;
- Systemic pathologies - rheumatoid arthritis, scleroderma, red lupus;
- Endocrine and metabolic diseases - drop, diabetes mellitus, hypo- and hyperthyroidism, obesity;
- Anterior injuries - Subluxation of the vertebrae and their fractures, damage to the spinal cord;
- circulatory disorders, including in the context of a sedentary lifestyle.
One of the main causes of osteochondrosis is the natural aging of the body.After 50 years, the recovery processes slow down, the production of collagen decreases, the state of the ligaments worsens.
Characteristic signs and symptoms of the disease
At the initial stage of development, osteochondrosis does not appear clinically.A person takes low back pain for muscle overvoltage after a working day and does not consult a doctor.But the severity of the symptoms increases slowly - soon a crunch with inclinations and towers of the case, sensitivity disorders and stiffness are attached in pain.
Rook syndrome
It is the name of the defeat of vertebral roots, which leads to motor, vegetative and serious disorders.Rotor syndrome is developing with osteochondrosis of gravity 3-4.At these steps, an intervertebral hernia forms, compressing the vertebral roots.The pathology takes place according to the type of lumbago, low back pain and lumbar.In addition to intense pain, radicular syndrome is characterized by feelings of numbness, tingling, crawling carts, a decrease or a complete absence of sensitivity.
Ischemic syndrome
In the late stages of the lumbar osteochondosis course, it is possible to compress the hernias of large blood vessels.The pelvic organs cease to receive a sufficient amount of nutrients, which leads to a violation of their functioning.The brain brain trophy is also upset, a neurological deficiency develops - intermittent lameness appears, temperature, sensitivity to pain falls.
Vertebrate syndrome
Due to the reduction in the distance between the adjacent bodies of the vertebrae, the growth of the bone tissue, the lumbar vertebral segments are gradually deformed.The situation is aggravated by constant compensatory stress of the back muscles with their subsequent atrophy.Pathologically luck the approach and posture of a person, especially due to poor redistribution of charges.The probability of involving other parts of the spine and leg joints in the destructive-depressive process is considerably increased.
Pain syndrome
At the bottom of the back is a large sciatic nerve made up of sacred vertebral roots.When it is violated with hernial projection, bone growth, spasmodic muscles, Ishias occur - a typical symptom of lumbar osteochondosis.There is acute pain spreads along the sciatic nerve to the hips, knees, bottom of the legs (lumbar -ilgia).Another specific characteristic of pathology - lumbago or "shots" in the lower back after a strong inclination or a turn, hypothermia.
Diagnostic methods
During the diagnosis, the radiographic photos taken in two projections are the most informative.To study the affected lumbar segment in more detail, an MRI is made.The study allows you to assess the state of the spinal cord, soft tissue structures, blood vessels, nerve roots.It is possible to determine the degree of damage to the nervous trunks using the potentials caused, electromyography.To aim at the examination of the assigned discs, discography is used.
How the treatment is carried out
A complete approach to therapy for lumbar osteochondosis is practiced.The treatment aims to eliminate pain, restore the volume of movements, prevent the spread of pathology to healthy and vertebrae.
Drug
The use of non-steroidal anti-inflammatory drugs, glucocorticosteroids, muscle relaxants allows you to get rid of lower back pain.In therapy, drugs are used to improve blood circulation.Patients should be prescribed by group B vitamins, chondroprotectors.
Medical physical education
It is the most effective and affordable treatment of osteochondrosis.After 1 to 2 months of daily treatment of physiotherapy exercises, the lower back muscles, but the entire back improves posture, accelerate blood supply to damaged connective tissue structures.LFK doctors recommend that patients recommend slowly gentle turns and torso inclinations, shallow squats and slots.
Massage
Patients with lumbar osteochondosis have all types of massage - empty, acupunctural, connective, segmental.But the most in demand is classic.During the session, the massage therapist performs the main massage movements: frames, friction, kneading, vibrations.The objectives of the procedures are to eliminate muscle cramps, improve blood circulation in the affected segment and strengthen skeletal muscles.
Physiotherapy
In an acute and subabiger period, patients are prescribed by electrophoresis or ultrafonophoresis with glucocorticosteroids, anesthetics, group B vitamins. At the stage of remission, laser therapy, magnetherapy, stressed waves and UHF therapy are often carried out.Ozokeritole, paraffin applications, hiaudotherapy, mud, radon, hydrogen sulfide baths are also used.
Surgery
The main indication of the surgical intervention is the violation of the spinal cord with hernial projection.During the operation, the intervertebral hernia is removed, the decompression of the vertebral canal is carried out.The most frequently used surgical intervention methods for lumbar osteochondosis are microdiscectomy, puncture vaporization or laser reconstruction of the disc, implant installation, stabilization of the vertebral segment.
Traditional medicine
After the main therapy, the achievements of stable remission in the treatment, the ointment made at home, plants based on plants, compresses, oil and alcohol friction are used.Popular remedies do not affect the cause of osteochondrosis, so they are used to eliminate weak and painful pain, the severity of the lower back after hypothermia, a clear change of time or increased physical activity.
The consequences of lack of treatment
The development of almost all complications of lumbar osteochondosis is caused by the intervertebral hernia.Disgogenic myelopathy is particularly dangerous, which does not always take place even surgical treatment.It manifests itself in pelvic disorders, including defecation disorders, urination.The complications of osteochondosis also include rooker syndrome - a common cause of acute and piercing lower back pain.
Prevention and forecast measures
The prognosis is favorable in the diagnosis of pathology from 1 to 2 degrees of gravity.It lends itself well to conservative treatment and in young patients, it is even possible to partially restore the tissues of the intervertebral discs.With the development of complications, full recovery forecasts are less favorable.
The prevention of osteochondrosis of the lumbar column is to control body weight, the exclusion of excessive loads, the appropriate treatment of endocrine metabolic diseases.Neurologists and vertebrologists recommend visiting the swimming pool, participating in aquaerobics, pilates, Scandinavian walking.