Lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. Pain syndrome is caused by damage to the intervertebral discs, spinal roots, nerve fibers and cartilage tissues. For the treatment of lumbosacral osteochondrosis, it is necessary to contact a neurologist.

Lumbar Osteochondrosis Symptoms

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

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

In addition, the reflex lumbosacral pain syndrome can be associated with concomitant diseases of the internal organs. In females, diseases of the genitourinary sphere prevail, for 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 gradual. At the first medical appointment, a clinical and functional examination (clarification of complaints and anamnesis) and a clinical examination are carried out. A neurologist examines the dynamic and static function of the spine, assesses posture and parameters of paravertebral muscle tone, determines the degree of mobility of the various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• exclusion of adverse loads
• immobilization (use of corsets, orthoses, orthopedic styling)
• pharmacological therapy
• physiotherapy procedures
• gentle acupressure massage
• physical therapy
• acupuncture
• mud therapy
• traction techniques (traction)

If conservative methods do not give the desired effect, surgery 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 number of physiotherapy procedures are used:

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

Thanks to physiotherapy combined 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 physical therapy and stretching exercises for osteochondrosis of the spine. This takes into account the patient's gender, age and physical capabilities.

The optimized therapeutic exercises aim to strengthen the muscles of the back, abdominals, pelvic region and lower limbs. Thanks to training therapy, pathological muscular tensions are eliminated, pressure on the intervertebral discs is reduced, swelling and pain are eliminated, the spine is stabilized and posture is improved.

Surgical intervention

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

Endoscopic methods of osteoplasty are recognized as the most optimal: installation of intercorporeal implants and fixation cages made of biocompatible materials. Minimally invasive interventions quickly restore the ability to support the operated ward and allow early rehabilitation to begin.

Injection therapy (injections for lumbar osteochondrosis)

The main manifestation of osteochondrosis of the lumbosacral region is pain. This multi-component symptom complex 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 cardio risks, drugs for injection therapy are prescribed:

• anti-inflammatories (NSAIDs)
• pain relievers (analgesics)
• muscle relaxants (relaxants, 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 can be used for the treatment of osteochondrosis and vitamins. For the quick and effective removal of severe pain syndrome, paravertebral therapeutic blocks (injections into the lumbosacral nerve plexus) are prescribed.

Medical therapy

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

• NSAIDs (non-steroidal anti-inflammatory drugs)
• analgesics
• myotropic antispasmodics (drugs to relieve muscle spasm)
• vegetative correctors (stabilizers of the tone of the autonomic nervous system)
• vasodilators (to improve blood flow and tissue trophism)
• dosage forms of chondroitin and glucosamine
• 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 itself 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 begin complaining of pain and other discomfort only 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 limb or torso movements. After a while, the pains become aching, annoying, but can periodically get worse.

Another common complaint of patients at a vertebrologist's appointment is stiffness, restriction of movement in the lumbosacral joint. It becomes difficult for patients to bend over, turn around. It should also be noted that pain can often radiate to the posterior surface of the lower limbs.

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

How to 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 non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants and drugs that relax peripheral muscles. Before taking any of the groups of these drugs, you should definitely visit your doctor, who will conduct a thorough diagnosis and work out your individual treatment plan. This is very important because the drugs described above can have some serious side effects which can be avoided if the drugs are taken correctly.

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

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

Treatment of osteochondrosis of the lumbar spine

According to statistics, one in two people aged 25 to 55 has experienced at least once in their life manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lumbar region to intense 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 the degeneration of the disc with gradual involvement of the adjacent vertebrae, intervertebral joints and the ligament apparatus in the pathological process.

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

The mechanism of development of osteochondrosis

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

The intervertebral discs act as shock absorbers that soften the pressure on the spine during stress. With age, due to malnutrition, the cartilage tissue of the discs undergoes dystrophic processes. The core dries up, loses its shock absorbing properties, followed by the destruction of the fibrous ring. In its structure, microcracks appear, fiber breaks. Due to the increased load, the core of the disc is displaced outside the spine - the initial stage of the formation of the 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 is formed.

Factors provoking the development and exacerbation of lumbar osteochondrosis

• Risks at work - intense dynamic loads, work associated with frequent changes in body position: flexion, extension, turns, heavy lifting, vibration.
• A genetic predisposition in which the tissues of the spinal column show structural alterations that accelerate their degeneration.
• Incorrect posture, in which there is an uneven distribution of the load on the axial skeleton.
• Orthopedic disorders: flat feet, curvature of the spine.
• Hypodynamy, sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of injury to the structures of the spinal column (falling from a height, transport accidents and more).
• Professions in sports with a large physical load on the spine: skiing, tennis, horseback riding, weight lifting.
• Irrational nutrition, imbalance of the diet for the main nutrients: proteins, fats, carbohydrates, vitamins, microelements.
• Hormonal imbalance in women during pregnancy and menopause.
• Bad habits: alcohol, smoking.
• 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 stage. There is a gradual decrease in the elasticity of the intervertebral discs. Microcracks appear in the fibrous ring. 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 stages. The destruction of the fibrous ring continues, the disc flattens, which leads to a decrease in the distance between 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 stages. The semi-destroyed fibrous ring can no longer contain the pulpy nucleus, a protrusion (protrusion) appears - the beginning of the formation of a hernia. The pain gets worse and becomes constant. There is a deformity of the spine.

4 stages. The intervertebral discs are replaced by 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 to replace the destroyed vertebrae with artificial implants.

Diagnostics

• Collection of anamnesis.
• Neurological examination of reflexes, sensitivity.
• functional tests.
• Radiography, MRI, CT.

Methods of treatment

Traditional treatment of lumbar osteochondrosis includes the following methods:

Drug therapy: non-steroidal anti-inflammatory drugs, glucocorticoids, muscle relaxants, sedatives and a complex of vitamins with trace elements.

Physiotherapy procedures: electro-, phonophoresis, exposure to magnetic fields, hydrotherapy.

Surgical treatment of lumbar osteochondrosis is carried out according to strict medical indications in severe cases, if the patient cannot stop intense pain with conservative methods or if he is threatened with a complication in the form of paralysis of the lower extremities or dysfunction of the internal organs .

Lumbar spine osteochondrosis: diagnosis and treatment

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

With lumbar osteochondrosis, degenerative changes occur in the lumbosacral spine. If the disease is not treated for a long time, the patient's general well-being worsens: constant back pain, numbness of the limbs, muscle spasms and cramps, general weakness and loss of strength.

How does the disease 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 joint elements of the spine change. The lumbar spine of a person takes on the main load in the form of the weight of the upper body of a person, loads when moving, exercising or performing any physical activity. As a result of all of the above, the following changes occur:

• the axis of the spine is distorted;
• posture changes;
• bones press on 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;
• cartilage thins;
• the structure of the synovial fluid is filled with third-party components;
• the vertebrae are worn out, due to which the distance between them is reduced;
• when the vertebrae come into contact, the nerves are pinched - this leads to sharp pain.

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

Lumbar Osteochondrosis Symptoms

• sharp pain in the lower back after a night's sleep;
• pain during sharp bends 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 the 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 the same position for a long time;
• congenital curvature of the spine;
• too frequent physical training;
• excess body weight;
• violation of blood flow in the spine;
• injuries, bruises, fractures of limbs or vertebrae;
• infections of the internal organs.

Stages of development of lumbar osteochondrosis

Stage 1: All degenerative disorders are just starting to develop in the patient's skeleton. But at the same time, the roots of the nerve endings are already affected. Blood flow worsens and the inflammatory process begins. It manifests itself with back pain after increased exertion, which often radiates to the legs.

Stage 2: The fibrous ring in the spine is destroyed, the cartilage becomes thinner, and the distance between the vertebrae is reduced. The pain in the second stage is more acute and more acute.

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 proper 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 orthopedic traumatologist. If you find it difficult to choose a doctor, you should initially consult a therapist. Depending on the symptoms and the alleged 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, it is necessary to provide the specialist with a complete 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, because it 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 - magnetic resonance imaging of the lumbar spine. During an MRI for osteochondrosis, the patient lies on a special retractable table with his back. The rollers are placed on the patient's head to remove muscle tension and the limbs are secured with belts. Any slight movement during the procedure can affect the quality of the result. Next, the table drives into the tomograph area. The procedure does not cause pain. The tomograph makes a lot of noise when scanning, so you can use headphones to avoid discomfort.

If MRI is contraindicated, there are other diagnostic methods such as computed tomography and radiography. 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 cheapest, since it allows you to examine the patient's body in several projections. Due to the body's high radiation exposure, x-rays cannot be performed frequently.

Treatment of lumbar osteochondrosis

Depending on the stage of lumbosacral osteochondrosis, different methods of treatment may be prescribed. One such method is physical therapy. It is carried out in a specially equipped room under the strict supervision of a doctor. Classes are held when the patient does not feel pain. But if during physical education the patient begins to feel worse, the doctor corrects or cancels the exercise altogether.

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 intensity.
• Hirudotherapy - treatment with leeches. Their impact improves microcirculation, the exchange of nutrients in the tissues of the back.
• Kinesio Taping is a treatment that uses a cotton patch.

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