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, spinal roots, nerve fibers and cartilaginous tissues. For the treatment of lumbosacral osteochondrosis, you need to contact a neurologist.

Symptoms of lumbar osteochondrosis

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

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

In addition, reflected lumbosacral pain syndrome may 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 typical.

Treatment of osteochondrosis of the lumbosacral region

Treatment of patients with neurological manifestations of lumbosacral osteochondrosis should be comprehensive and phased. At 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 posture and parameters of paravertebral muscle tone, determines the degree of mobility of 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)
• drug therapy
• physiotherapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud treatment
• traction techniques (traction)

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 set of physiotherapy procedures is used:

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

Thanks to the 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 dynamic and stretching exercise therapy exercises for osteochondrosis of the spine. This takes into account the gender, age and physical capabilities of the patient.

Optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdominals, pelvic region and lower extremities. 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 zone. It results in intermittent unbearable pain, pelvic organ dysfunction, intermittent claudication, and other motor, reflex, or sensory disturbances. A relative indication for operational stabilization is the lack of effect from long-term conservative therapy (more than 1. 5-2 months).

Endoscopic methods of osteoplasty are recognized as the most optimal: installation of interbody implants and fixing cages made of biocompatible materials. Minimally invasive interventions quickly return the ability to support the operated department 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 multicomponent symptom is associated with local inflammation, pathological muscle tension, ligament damage, biomechanical causes, and dysfunction of the pain perception system. Therefore, treatment should be carried out in a complex. For faster pharmacological action and reduction of gastro- and cardio-risks, injection therapy drugs are prescribed:

• anti-inflammatory (NSAIDs)
• painkillers (analgesics)
• muscle relaxants (relaxing, relieving muscle tone)
• vasodilating (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 quick and effective removal of severe pain syndrome, paravertebral therapeutic blockades are prescribed (injections into the lumbosacral nerve plexus).

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 period (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 to complain 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 significantly after lifting and carrying weights, or even after simple movements of the limbs or torso. After a while, the pains become aching, annoying, but can periodically worsen.

Another common complaint of patients at a vertebrologist's appointment is stiffness, limitation of movement in 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, disturbances in skin pain and temperature sensitivity occur. It should be said that these 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 medicines, which include non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax the peripheral muscles. Before taking any of the groups of these drugs, you should definitely visit 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 some serious side effects that can be avoided if the drugs are taken correctly.

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

The 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 from 25 to 55 years old has experienced at least once in his life manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lumbar region to severe pain with limited mobility.

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

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

When the diagnosis is confirmed, the treatment of 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 nucleus pulposus surrounded by a dense fibrous ring, the collagen fibers of which tightly 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, as a result of malnutrition, the cartilaginous tissue of the discs undergoes dystrophic processes. The core 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 disk core is displaced outside the spinal column - the initial stage of hernia formation develops - protrusion. This leads to irritation of the nerve roots and the appearance of pain in the patient.

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

Factors provoking the development and exacerbation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work associated with frequent changes in the position of the body: flexion, extension, turns, lifting heavy loads, vibration.
• A genetic predisposition in which the tissues of the spinal column 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 injury to the structures of the spine (fall from a height, transport accidents, and others).
• Occupations in sports with a large physical load on the spine: skiing, tennis, horseback riding, weightlifting.
• 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 stage. 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 stage. 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 deformity of the spinal column.

4 stage. 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 destroyed vertebrae with artificial implants.

Diagnostics

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

Treatment Methods

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, 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 he is threatened with a complication in the form of paralysis of the lower extremities 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 while walking and sitting at a desk. But it is also one of the consequences of damage to the intervertebral discs, cartilaginous 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, 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 spinal column. As a result, the anatomy and physiology of the articular elements of the spine changes. 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 during movement, training or performing any physical activity. As a result of all of the above, the following changes occur:

• the axis of the spinal column is distorted;
• posture changes;
• bones press on the internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is disturbed due to infringement of nerve endings;
• the structure of the spinal column 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 acute pain.

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

Symptoms of osteochondrosis of the lumbar

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

Causes of osteochondrosis of the lumbosacral spine

• improperly distributed load on the back;
• sedentary lifestyle;
• stooped posture;
• staying 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 spinal column;
• injuries, bruises, fractures of limbs or vertebrae;
• infections of the internal organs.

Stages of development of osteochondrosis of the lumbar

Stage 1 - all degenerative disorders are just beginning to develop in the patient's skeleton. But at the same time, the roots of 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 in the spine is destroyed, the cartilage becomes thinner, and the distance between the vertebrae is reduced. Pain in the second stage is sharper 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. Arthrosis 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 orthopedic traumatologist. If you find it difficult to choose a doctor, you should initially consult with 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, you need to provide the specialist with a complete medical history and the results of early studies (if any). The specialist will conduct a visual inspection and palpation.
2. During the examination, the doctor pays special 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 results of the tests, 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 remove muscle tension, and the limbs are fixed with straps. Any slight movement during the procedure can affect the quality of the result. Next, the table drives into the area of the tomograph. The procedure does not cause pain. The tomograph makes a lot of noise during the scan, so you can use headphones so as not to feel discomfort.

If MRI is contraindicated, there are other diagnostic methods such as computed tomography and radiography. X-ray 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 high radiation exposure to the body, x-rays cannot be taken frequently.

Treatment of osteochondrosis of the lumbar

Depending on the stage of lumbosacral osteochondrosis, different methods of treatment can be prescribed. One of these methods is exercise therapy. It is carried out in a specially equipped room under the close supervision of a doctor. Classes are held when the patient does not experience pain. But if during physical education the patient began 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 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 treatment - is prescribed in extreme cases with the use of analgesics (have an analgesic or additional anti-inflammatory effect), antispasmodics (relieve muscle spasms), vasodilators (improve blood microcirculation).