Lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic change 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. A neurologist should be consulted for the treatment of lumbosacral osteochondrosis.

Symptoms of lumbar osteochondrosis

• severe pain syndrome that can radiate to the legs and pelvic organs
• pain in kidney and sacrum
• numbness of limbs
• stiffness
• 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 changed 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, reflected lumbosacral pain syndrome can be associated with simultaneous diseases of internal organs. Diseases of the urogenital sphere are more common in women, and disorders of the gastrointestinal tract in men.

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 (clarification of complaints and medical history) and a clinical examination are performed. The neurologist examines the dynamic and static function of the spine, assesses posture and parameters of paravertebral muscle tone, and determines the degree of mobility of various parts of the spine and limbs. The usual treatment regimen for osteochondrosis includes:

• exclusion of harmful loads
• immobilization (use of corset, orthosis, orthopedic shaping)
• drug therapy
• physiotherapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud therapy
• traction techniques (traction)

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

Physiotherapy of lumbar osteochondrosis

Physiotherapy procedures are used to eliminate pain, reduce swelling, normalize the tone of back muscles, activate recovery processes, dissolve fibrous foci and increase the mobility of damaged segments:

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

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

Physiotherapy

Recreational physical education plays a special role in the conservative treatment of degenerative pathologies of the locomotor system. The trainers and rehabilitators of the rehabilitation center develop individual complexes of dynamic and stretching exercises for osteochondrosis of the spine. This takes into account the patient's gender, age and physical abilities.

The optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdomen, pelvic region and lower limbs. Thanks to exercise therapy, abnormal muscle tension is eliminated, pressure on the intervertebral discs is reduced, swelling and pain are eliminated, the spine is stabilized, and posture is improved.

Surgical intervention

The absolute indication for decompression surgery is the disability of radiculomyeloischemia. This dangerous pathological condition is caused by hernial compression of nerve roots and impaired blood flow in the sacrococcygeal zone. It results in intermittent excruciating pain, pelvic organ dysfunction, intermittent claudication and other motor, reflex or sensory disturbances. A relative indication of functional stabilization is the lack of effect of long-term (longer than 1. 5-2 months) conservative therapy.

Endoscopic methods of osteoplasty are considered the most optimal: installation of interbody implants and fixation cages made of biocompatible materials. Minimally invasive interventions quickly restore 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, abnormal muscle tension, ligament damage, biomechanical causes, and dysfunction of the pain perception system. Therefore, the treatment must be carried out in a complex manner. In order to have a faster pharmacological effect and to reduce the risk of stomach and heart diseases, injectable therapeutic drugs are prescribed:

• anti-inflammatory (NSAIDs)
• pain relievers (pain relievers)
• muscle relaxants (relaxing, relieving muscle tone)
• vasodilator (improves blood microcirculation)
• chondroprotectors (stimulate the regeneration of intervertebral discs, slow down the destruction of cartilage tissue).

On medical advice, homeopathic injections and vitamins can be used to treat osteochondrosis. Paravertebral therapeutic blockades (injections into the lumbosacral nerve plexus) are prescribed for quick and effective removal of severe pain syndrome.

Medical therapy

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

• NSAIDs (non-steroidal anti-inflammatory drugs)
• pain relievers
• myotropic antispasmodics (medicines to relieve muscle spasms)
• 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
• tranquilizers 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).

How does this disease manifest itself clinically?

Osteochondrosis of the lumbar spine in the initial stage 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 discomforts only in the second stage.

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 weight or even simple movement of the limbs or trunk. After a while, the pains are painful and annoying, but they can worsen periodically.

Another common complaint of patients visiting a vertebrologist is stiffness and limited movement in the lumbosacral joint. It will be difficult for patients to bend and turn. It should also be noted that the pain can often radiate to the back surface of the lower limbs.

Due to the compression of the nerve roots by the enlarged intervertebral discs, disorders of skin pain and temperature sensitivity occur. It must be said that these violations can mean both a weakening and an increase in the threshold of sensitivity. In the case of early 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 effect on the human body with the help of drugs, which include non-steroidal anti-inflammatory drugs, pain relievers, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any group of these drugs, be sure to see your doctor, who will make a thorough diagnosis and create an individual treatment plan. This is very important because the drugs described above can have serious side effects that can be avoided by taking the drugs correctly.

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

The methods of manual therapy, physiotherapy and acupuncture have been proven in the treatment of osteochondrosis, which improve local blood supply and 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 experienced the manifestations of lumbar osteochondrosis of varying severity at least once in their life: from discomfort in the lumbar region to severe pain with limited movement.

The lumbar skeleton is exposed to maximum load, so the high percentage of osteochondrosis in this area of the spine is no accident.

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

After confirming the diagnosis, treatment of lumbar osteochondrosis should be started immediately, without waiting for complications to appear.

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 firmly attach the disc to the vertebral body.

The intervertebral discs act as shock absorbers that relieve pressure on the spine during stress. As age progresses, the cartilaginous tissue of the discs undergoes dystrophic processes as a result of malnutrition. The core dries out, loses its shock-absorbing properties, and then the fibrous ring breaks down. Microcracks and fiber breaks appear in its structure. Due to the increased load, the disc core moves outside the spinal column - the initial stage of hernia formation - protrusion. This leads to irritation of the nerve roots and the appearance of pain in the patient.

If the annulus fibrosus is completely torn, an intervertebral hernia is formed.

Factors provoking the development and aggravation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work involving frequent changes in body position: bending, stretching, turning, lifting heavy loads, vibration.
• A genetic predisposition in which there are structural changes in the tissues of the spinal column that accelerate their degeneration.
• Incorrect posture, in which the load is unevenly distributed on the axial frame.
• Orthopedic pathologies: flat feet, curvature of the spine.
• Hypodynamics, sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of damage to the structure of the spine (fall from a height, traffic accidents and others).
• Sports activities that put a lot of physical strain on the spine: skiing, tennis, horse riding, weight lifting.
• Irrational nutrition, imbalance in the diet of 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 related to 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 section. The elasticity of the intervertebral discs gradually decreases. Microcracks appear in the fibrous ring. The reflex spasm of the muscles surrounding the affected segment of the spine causes 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. Abnormal mobility occurs when the vertebrae can move relative to each other. The nutrition of the vertebral tissues causes confusion. The pain is now regular.

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

4 stages. The intervertebral discs are replaced by scar tissue. Many complications occur until the complete loss of motor activity. Treatment of this stage of lumbar osteochondrosis is only possible with complex surgery to replace the destroyed vertebrae with artificial implants.

Diagnostics

• Anamnesis collection.
• Neurological examination of reflexes and 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 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, when the patient cannot be eliminated by conservative methods, or is threatened by a complication in the form of paralysis of the lower limbs or dysfunction of internal organs.

Osteochondrosis of the lumbar spine: diagnosis and treatment

Back pain often occurs in people due to improper posture while walking and sitting at a desk. But this is one of the consequences of damage to the intervertebral discs, cartilaginous tissues and nerve fibers, which results in the development of osteochondrosis of the lumbar spine.

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

How does the 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 changes. A person's lumbar spine bears the main load when carrying the weight of the person's upper body, moving, exercising or doing any physical activity. As a result of the above, the following changes occur:

• the axis of the spine is distorted;
• changes in posture;
• bones press on internal organs. This leads to the development of cardiovascular diseases;
• coordination is disturbed due to damage to nerve endings;
• the structure of the spine changes;
• the cartilage becomes thinner;
• the structure of the synovial fluid is filled with third-party components;
• the vertebrae are worn out, due to which the distance between them decreases;
• when the vertebrae touch, the nerves are pinched - this leads to acute pain.

The risk of developing lumbar osteochondrosis is athletes who lead an excessively active lifestyle, people who lead a sedentary lifestyle (in an unchanged state for a long time, causing an increased load on the spine), representatives of professions that perform physical work. heavy tools, elderly, pregnant women, hyperactive children.

Symptoms of lumbar osteochondrosis

• acute pain in the lower back after a night's sleep;
• pain when turning the body sharply 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 turning 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;
• stooped posture;
• staying in the same position for a long time;
• congenital curvature of the spine;
• too frequent physical exercise;
• excessive body weight;
• violation of the blood flow of the spinal column;
• injuries, bruises, broken limbs or vertebrae;
• infections of internal organs.

Stages of development of lumbar osteochondrosis

Stage 1 - any 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. Blood flow deteriorates and the inflammatory process begins. It manifests itself in back pain after increased stress, which often radiates to the legs.

Stage 2 - the annulus fibrosus of the spine is destroyed, the cartilage thins and the distance between the vertebrae decreases. In the second stage, the pain is sharper and more acute.

Stage 3 - strong compression of muscle fibers and nerve endings occurs. 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 completely immobile without 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, consult a therapist first. Depending on the symptoms and the suspected causes of the pathology, you will be referred to one of the highly qualified specialists.

1. The doctor examines your medical history and the frequency of its manifestations, the specialist must give you a complete medical history and the results of early examinations (if any). The specialist performs 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 learn about the degree of development of the disease. If you have any questions, a specialist will give you advice and perform an examination.
3. He sends you for tests, because this is a complete diagnosis that allows you to make the correct diagnosis.
4. Based on the results of the tests, the doctor prescribes an individual treatment plan.

In order to identify the condition of muscles, ligaments and blood vessels, to detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the lumbar spine. During the 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 secured with belts. Any slight movement during the procedure can affect the quality of the result. The table then moves into the tomograph area. The procedure does not cause pain. The tomograph makes a lot of noise during the scan, so you can use headphones to avoid discomfort.

If MRI is contraindicated, there are other diagnostic methods, such as computed tomography and radiography. X-rays are only suitable for primary diagnosis and do not provide a stratified image of the affected tissues. However, this study is the simplest and most economical, which allows examining the patient's body in several views. Due to the high radiation exposure to the body, it is not possible to take X-rays often.

Treatment of lumbar osteochondrosis

Depending on the stage of lumbosacral osteochondrosis, different treatment methods may be prescribed. One such method is exercise therapy. It is performed in a specially equipped room under the close supervision of a doctor. The classes are held when the patient does not feel pain. But if the patient felt worse during physical education, the doctor will correct or completely stop the exercise.

Another way to treat lumbar osteochondrosis is physiotherapy. It improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy treatments are as follows:

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

Drug treatment - in extreme cases, painkillers (with pain-relieving or additional anti-inflammatory effect), antispasmodics (alleviation of muscle spasms), vasodilators (improves blood microcirculation) are prescribed.