Lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic damage to 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 should contact a neurologist.

Symptoms of lumbar osteochondrosis

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

Lumbar osteochondrosis has gender characteristics of the course. Vertebrogenic pain, which occurs due to 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, the syndrome of reflected lumbosacral pain can be associated with concomitant diseases of the internal organs. Diseases of the genitourinary sphere predominate in women, disorders of the gastrointestinal tract are more typical for men.

Treatment of osteochondrosis of the lumbosacral region

Treatment of patients with neurological manifestations of lumbosacral osteochondrosis should be comprehensive and stepwise. At the first medical examination, a clinical and functional examination (clarification of complaints and history) and a clinical examination is performed. The neurologist examines the dynamic and static function of the spine, evaluates 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 adverse loads
• immobilization (use of corsets, orthoses, orthopedic style)
• drug therapy
• physiotherapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud treatment
• traction techniques

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

Physiotherapy for lumbar osteochondrosis

A set of physiotherapeutic procedures is used to eliminate pain, reduce swelling, normalize the tone of the back muscles, activate the recovery processes, resolve fibrotic foci and increase the mobility of the damaged segments:

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

Thanks to combined physiotherapy with the simultaneous use of several methods, the effectiveness of the treatment of 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. The rehabilitator instructors of the rehabilitation center develop individual complexes of dynamic and stretching exercises for the treatment of osteochondrosis of the spine. This takes into account the gender, age and physical capabilities of the patient.

The optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdomen, pelvic area and lower limbs. Thanks to exercise therapy, pathological 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

An absolute indication for decompressive surgery is debilitating radiculomyeloischemia. This dangerous pathological condition is caused by hernial compression of the nerve roots and impaired blood flow in the sacrococcygeal area. This results in intermittent excruciating pain, pelvic organ dysfunction, intermittent lameness, 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 interdepartmental implants and fixation cells made of biocompatible materials. Minimally invasive interventions quickly return the ability to maintain the operated department and allow early rehabilitation.

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, 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-inflammatory (NSAIDs)
• pain relievers (analgesics)
• muscle relaxants (relaxing, relieving muscle tone)
• vasodilator (improving blood microcirculation)
• chondroprotectors (stimulating the regeneration of intervertebral discs, delaying the destruction of cartilage tissue).

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

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 (medicines to relieve muscle spasms)
• autonomic 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 common symptoms that 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 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 torso. After some time, the pains become painful, annoying, but they can periodically worsen.

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

As a result of compression of the nerve roots by enlarged intervertebral discs, disorders of skin pain and temperature sensitivity appear. It must be said that these disorders can mean both a weakening and an increase in the threshold of sensitivity. In case of untimely treatment, the disease is further complicated by muscle hypotonia, 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 drugs, which include non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any of these groups of drugs, you should definitely visit your doctor, who will conduct a thorough diagnosis and prepare an 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 been proven 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 between the ages of 25 and 55 had at least once in their life manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lumbar region to severe pain with limited mobility.

The lumbar skeleton is subjected to the maximum load, so the high percentage of osteochondrosis in this particular area of the spine is not accidental.

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

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 pulpous nucleus surrounded by a dense fibrous ring, whose collagen fibers tightly fix the disc to the body of the vertebra.

The intervertebral discs act as shock absorbers that cushion the pressure on the spine during times of stress. With age, as a result of malnutrition, the cartilage tissue of the discs undergoes dystrophic processes. The nucleus dries out, loses its shock-absorbing properties, followed by destruction of the fibrous ring. Microcracks, fiber breaks appear in its structure. Due to the increased load, the disc nucleus 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.

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

Factors provoking the development and exacerbation of lumbar osteochondrosis

• Occupational risks - intensive dynamic loads, work associated with frequent changes in body position: flexion, extension, turns, lifting heavy loads, vibrations.
• A genetic predisposition in which the tissues of the spine 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, horse riding, weight lifting.
• Irrational nutrition, imbalance of the diet 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 (Bechterev's disease).
• Pathologies associated with disturbed 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. A gradual decrease in the elasticity of the intervertebral discs is observed. Microcracks appear in the fibrous ring. Due to the reflex spasm of the muscles around 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 spinal tissues is disturbed. The pain is now 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 intensifies and becomes constant. He has a spinal deformity.

4 stage. Intervertebral discs are replaced by scars. There are many complications up to the complete loss of motor activity. Treatment at this stage of lumbar osteochondrosis is possible only with the help of a complex operation to replace the destroyed vertebrae with artificial implants.

Diagnosis

• History taking.
• Neurological examination of reflexes, sensitivity.
• functional tests.
• X-ray, 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, impact with a magnetic field, 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 with conservative methods or is at risk of complications 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 a person due to the formation of an incorrect posture when walking and sitting at a desk. But this is also one of the consequences of damage to the intervertebral discs, cartilaginous tissues and nerve fibers, which leads to the development of osteochondrosis of the lumbar spine.

In 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 of the limbs, spasms and cramps in the muscles, general weakness and loss of strength.

How does the pathology develop?

During the development of the disease, degenerative-dystrophic and destructive disorders appear in the skeleton of the patient's spine. As a result, the anatomy and physiology of the articular elements of the spine changes. The lumbar part of a person's spine takes the main load in the form of the weight of a person's upper body, 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 spine is distorted;
• changes in posture;
• the bones press against the internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is impaired due to a disorder of the nerve endings;
• the structure of the spine changes;
• the cartilage thins;
• the structure of the synovial fluid is full of third-party components;
• the vertebrae are worn, due to which the distance between them is reduced;
• when the vertebrae come into contact, the nerves are compressed - this leads to sharp pain.

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

Symptoms of lumbar osteochondrosis

• sharp pain in the lower back after a night's sleep;
• pain during sharp turns of the body or lifting heavy objects;
• the first signs of scoliosis appear;
• frequent urination;
• the 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 light exercise;
• numbness of the limbs;
• muscle spasms and cramps;
• vertigo;
• decreased muscle tone and sensitivity.

Causes of osteochondrosis of the lumbosacral spine

• improperly distributed load on the back;
• sedentary way of life;
• 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;
• infections of internal organs.

Stages of development of lumbar osteochondrosis

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 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 annulus fibrosus in the spine breaks down, the cartilage thins and the distance between the vertebrae decreases. The pain in the second stage is sharper and sharper.

Stage 3 - there is 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 of the spine and joints appears. The back becomes inactive, and in the absence of proper treatment - completely immobile.

How is osteochondrosis of the lumbar spine diagnosed?

Diagnosis of the 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 suspected 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 must provide the specialist with a complete medical history and the results of early tests (if any). The specialist will perform 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 determine the degree of development of the disease. If you have questions, a specialist will advise you and conduct an examination.
3. He will refer you for research, because this 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 state of the muscles, ligaments, blood vessels, to detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the lumbar spine. During 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 belts. Any slight movement during the procedure can affect the quality of the result. The mass is then driven into the scanner 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. Radiography is only suitable for primary diagnosis and does not provide a layer-by-layer image of the affected tissues. However, this study is the simplest and most economical, which 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 often.

Treatment of lumbar osteochondrosis

Depending on the stage of lumbosacral osteochondrosis, different treatment methods can be prescribed. One of these methods is exercise therapy. It is performed 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 adjusts or cancels the exercise completely.

Another method of treating lumbar osteochondrosis is physiotherapy. Improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy procedures include:

• Electrophoresis - analgesic, 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 impact on the affected areas is carried out using currents of different intensity.
• Hirudotherapy - treatment with leeches. Their effect improves microcirculation, the exchange of nutrients in the tissues of the back.
• Kinesio taping is a treatment using a cotton patch.

Drug treatment - 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).