Lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. Pain syndrome is caused by damage to intervertebral discs, spinal 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, which can radiate to the leg and pelvic organs
• Pain in kidneys and sacrum
• limb numbness
• stiffness
• Tension in the lumbar region
• fatigue, weakness
• dizziness

Lumbar osteochondrosis has sex characteristics of the course. Vertebral pain, which is caused by the compression of the nerve roots by the changed cartilage of the intervertebral discs, is significantly more severe for women than for men. Pain intensity is directly related to estrogen levels. The lower their indicators, the more pronounced the pain.

In addition, the reflected lumbosacral pain syndrome can be associated with concomitant diseases of the internal organs. In women, diseases of the genitourinary tract predominate, in men, diseases 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 doctor's appointment, a clinical and functional examination (clarification of symptoms and anamnesis) as well as a clinical examination are carried out. A neurologist examines the dynamic and static functioning of the spine, assesses the posture and paravertebral muscle tone parameters, determines the degree of mobility of various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• Exclusion of unfavorable loads
• Immobilization (use of corsets, orthoses, orthopedic styling)
• drug therapy
• physiotherapeutic procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud therapy
• Traction Techniques (Traction)

If conservative methods do not achieve the desired effect, surgical intervention may be necessary.

Physiotherapy for lumbar osteochondrosis

To eliminate pain, reduce swelling, normalize the tone of the back muscles, activate recovery processes, loosen fibrous foci and increase mobility of damaged segments, a number of physiotherapeutic procedures are used:

• pulsed diadynamic currents
• Darsonvalization
• Magnetic field therapy (exposure to a static or alternating magnetic field)
• laser treatment
• medical electrophoresis
• UV irradiation
• local cryotherapy
• Ultrasonic
• 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%.

physical therapy

Recreational sports play a special role in the conservative treatment of degenerative diseases of the musculoskeletal system. Instructors-rehabilitators of the rehabilitation center develop individual complexes of dynamic and stretching physical therapy exercises for osteochondrosis of the spine. Gender, age and physical abilities of the patient are taken into account.

Optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdominal muscles, pelvic area and lower extremities. Exercise therapy eliminates pathological muscle tension, reduces pressure on the intervertebral discs, eliminates swelling and pain, stabilizes the spine, and improves posture.

Surgical intervention

An absolute indication for decompression surgery is the deactivation of radiculomyeloischemia. This dangerous pathological condition is caused by hernia compression of nerve roots and impaired blood flow in the sacrococcygeal zone. It results in intermittent excruciating pain, dysfunction of the pelvic organs, intermittent claudication, and other motor, reflex, or sensory disorders. A relative indication for surgical stabilization is the ineffectiveness of conservative long-term therapy (longer than 1. 5–2 months).

Endoscopic methods of osteoplasty are considered the most optimal: installation of interbody implants and attachment cages made of biocompatible materials. Minimally invasive interventions quickly restore the support capability of the operated department and enable 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 disorders of the pain perception system. Therefore, treatment should be carried out in a complex. For faster pharmacological action and reducing gastric and cardio risks, drugs for injection therapy are prescribed:

• anti-inflammatory (NSAIDs)
• painkillers (analgesics)
• Muscle relaxants (relaxing, muscle toning)
• vasodilating (improving blood microcirculation)
• Chondroprotectors (stimulation of regeneration of intervertebral discs, slowing down the destruction of cartilage tissue).

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

Medical therapy

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

• NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
• analgesics
• myotropic antispasmodics (medicines used to relieve muscle spasms)
• Autonomic correctors (stabilizers of the autonomic nervous system tone)
• Vasodilators (to improve blood flow and tissue trophy)
• 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?

At the initial stage, osteochondrosis of the lumbar spine is characterized by very general symptoms that are very difficult to detect without the intervention of an experienced specialist. Usually, patients do not complain of pain and other discomfort until the second stage.

The main clinical symptom of this disease, as probably everyone 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 trunk. After a while, the pain becomes painful, annoying, but can periodically worsen.

Another common complaint of patients at a vertebrologist appointment is stiffness, restricted movement in the lumbosacral joint. It becomes difficult for patients to bend down, turn around. It should also be noted that the pain can often radiate to the back of the lower extremities.

As a result of the compression of the nerve roots by enlarged intervertebral discs, skin pain and temperature sensitivity are disturbed. It should be said that these injuries can mean both a weakening and an increase in the threshold of sensitivity. With untimely treatment, the disease is further complicated by muscle hypotonia, as well as 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 effect on the human body with the help of drugs, which include nonsteroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any of these drug groups, you should definitely consult your doctor, who will carry out a thorough diagnosis and draw up your individual treatment plan. This is very important as the drugs discussed above can have some serious side effects that can be avoided if the drugs are taken properly.

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

In the treatment of osteochondrosis, methods of manual therapy, physiotherapy and acupuncture have proven themselves, which help to improve local blood circulation, relax the back muscles.

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 the highest loads, so a high percentage of osteochondrosis in this particular area of the spine is not accidental.

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

If the diagnosis is confirmed, treatment of lumbar osteochondrosis should be started immediately, without waiting for complications to appear.

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 whose collagen fibers firmly fix the intervertebral disc to the vertebral body.

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

When the fibrous ring is completely torn, an intervertebral hernia occurs.

Factors provoking the development and exacerbation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work associated with frequent changes in body position: bending, stretching, twists, lifting heavy loads, vibration.
• A genetic predisposition in which the tissues of the spine exhibit structural changes that accelerate their degeneration.
• Wrong posture in which the load on the axial skeleton is unevenly distributed.
• Orthopedic pathologies: flat feet, curvature of the spine.
• Hypodynamia, sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of injuries to the structures of the spine (fall from a height, transport accidents and others).
• Sports professions with great physical strain on the spine: skiing, tennis, horseback riding, weightlifting.
• Irrational nutrition, nutritional imbalance for the main nutrients: proteins, fats, carbohydrates, vitamins, trace elements.
• Hormonal imbalance in women during pregnancy and menopause.
• Bad habits: alcohol, smoking.
• age changes.
• Inflammatory processes of the spine (Bechterew's disease).
• Pathologies associated with disrupted 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:

1st stage. The elasticity of the intervertebral discs gradually decreases. Microcracks appear in the fiber ring. Due to the reflex spasm of the muscles surrounding the affected spinal segment, there is stiffness and discomfort in the back in the morning.

2 level. The destruction of the fibrous ring continues, the disc flattens, which leads to a decrease in the distance between adjacent vertebrae. Pathologic mobility occurs when the vertebrae are able to move relative to each other. The nutrition of the vertebral tissues is disturbed. The pain is regular.

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

4 levels. Intervertebral discs are replaced by scar tissue. There are many complications, up to the complete loss of motor skills. Treatment of this stage of lumbar osteochondrosis is only possible with the help of a complex operation in which destroyed vertebrae are replaced with artificial implants.

diagnosis

• Collection of anamnesis.
• 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 a vitamin complex with trace elements.

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

Surgical treatment of lumbar osteochondrosis is carried out according to strict medical indications in severe cases, when the patient cannot stop severe pain with 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 incorrect posture when walking and sitting at a desk. But it is also one of the consequences of damage to intervertebral discs, cartilage tissue 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 not treated for a long time, the general condition of the patient worsens: constant back pain, numbness in the limbs, spasms and spasms in the muscles, general weakness and loss of strength.

How does pathology arise?

During the development of the disease, degenerative-dystrophic and destructive disorders appear in the skeleton of the patient's spine. This changes the anatomy and physiology of the joint elements of the spine. A person's lumbar spine takes most of the load in the form of the weight of a person's torso, loads during movement, exercise, or engaging in any physical activity. From all of the above, the changes are as follows:

• the axis of the spine is distorted;
• postural changes;
• Bones press on the internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is disturbed due to injury of nerve endings;
• the structure of the spine changes;
• cartilage thinned;
• the structure of the synovial fluid is filled with third-party components;
• the vertebrae are worn out, reducing the distance between them;
• When the vertebrae touch, the nerves are pinched - this leads to acute pain.

The risk of developing lumbar osteochondrosis is for athletes who lead an overly active lifestyle, people with a sedentary lifestyle (if they are in an unchanged state for a long time, they cause an increased load on the spine), representatives of manual trades whoworking with heavy tools, the elderly, pregnant women, hyperactive children.

Symptoms of osteochondrosis of the lumbar spine

• acute low back pain after a night's rest;
• pain with sharp body movements or lifting heavy objects;
• 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 moving, walking, tilting, and rotating the body;
• fatigue after light exertion;
• numbness of the limbs;
• spasms and spasms in the muscles;
• Dizziness;
• decreased muscle tone and sensitivity.

Causes of osteochondrosis of the lumbosacral spine

• improperly distributed load on the back;
• sedentary lifestyle;
• hunched posture;
• staying in the same position for a long time;
• congenital curvature of the spine;
• too frequent physical training;
• overweight;
• violation of blood flow in the spine;
• Injuries, bruises, fractures of limbs or vertebrae;
• Internal organ infections.

Stages of development of osteochondrosis of the lumbar spine

Stage 1 - All degenerative diseases are just beginning to develop in the patient's skeleton. But at the same time, the roots of the nerve endings are already affected. Blood circulation deteriorates and the inflammatory process begins. It manifests itself in back pain after increased exertion, which often radiates into the legs.

Stage 2 - The fibrous ring in the spine is destroyed, the cartilage thins and the space between the vertebrae is reduced. The 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 cramps in the muscles, as well as frequent numbness.

Stage 4 - the growth phase of neoplasms (osteophytes) in the bone structure. Osteoarthritis occurs in the spine and joints. The back becomes inactive and completely immobile in the absence of proper treatment.

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 first consult a therapist. Depending on the symptoms and the supposed causes of the pathology, he will refer you to one of the highly specialized specialists.

1. The doctor will examine your medical history and the frequency of its manifestations. You must provide the specialist with a complete medical history and the results of previous studies (if any). The specialist conducts a visual examination 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 carry out an examination.
3. He will refer you for tests as 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 determine 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 his back on a special folding table. Rollers are placed on the patient's head to relieve 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 moves 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 be uncomfortable.

If MRI is contraindicated, then there are other diagnostic methods, such as computed tomography and radiography. X-rays are only suitable for primary diagnostics and do not provide a layered image of the affected tissue. However, this study is the simplest and most economical, since it allows you to examine the patient's body in several projections. Due to the high radiation exposure of the body, X-rays cannot be taken frequently.

Treatment of osteochondrosis of the lumbar spine

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 strict supervision of a doctor. Classes are held when the patient is not in pain. But if the patient feels worse during physical education class, the doctor will correct the exercise or stop it altogether.

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

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

Drug treatment - is prescribed in extreme cases with analgesics (having analgesic or additional anti-inflammatory effect), antispasmodics (relieve muscle spasms), vasodilators (improving blood microcirculation).