Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. The pain syndrome is caused by damage to intervertebral discs, spinal roots, nerve fibers and cartilage tissue. For the treatment of lumbosacral osteochondrosis, it is necessary to contact a neurologist.
Symptoms of lumbar osteochondrosis
- severe pain syndrome that can radiate to the leg and pelvic organs
- pain in kidneys and sacrum
- numbness of limbs
- stiffness
- tension in the lumbar region
- fatigue, weakness
- dizziness
Lumbar osteochondrosis has sexual characteristics of the course. Vertebrogenic pain, which is caused by compression of the nerve roots by the changed cartilage of the intervertebral discs, is much more severe for women than for men. The intensity of 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 internal organs. In women, diseases of the genitourinary sphere predominate, 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 phased. During the first medical examination, a clinical and functional examination (clarification of complaints and medical history) and a clinical examination is performed. The neurologist examines the dynamic and static function of the spine, evaluates the posture and tone parameters of the paravertebral muscles, determines the degree of mobility of different parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:
- exclusion of harmful loads
- immobilization (use of corset, orthosis, orthopedic styling)
- drug therapy
- physiotherapy procedures
- gentle acupressure massage
- exercise therapy
- acupuncture
- mud therapy
- traction techniques
If conservative methods do not give the desired effect, surgical intervention may be required.
Physiotherapy for lumbar osteochondrosis
To remove pain, reduce swelling, normalize the tone of the back muscles, activate the recovery process, resolve fibrotic 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
- medical electrophoresis
- UV radiation
- local cryotherapy
- ultrasound
- transcutaneous electrical nerve stimulation
Thanks to combined physiotherapy with the simultaneous use of several methods, the effectiveness of lumbar osteochondrosis therapy increases by 30%.
Physiotherapy
A special role in the conservative treatment of degenerative pathologies of the musculoskeletal system is given to recreational physical education. Instructors-rehabilitators of the rehabilitation center develop individual complexes of dynamic and therapeutic stretching 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, abdomen, 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 is improved.
Surgical intervention
The absolute indication for decompressive surgery is the prevention of radiculomyeloischemia. This dangerous pathological condition is caused by hernial compression of nerve roots and disturbed blood flow in the sacrococcygeal zone. This leads to occasional excruciating pain, pelvic organ dysfunction, occasional 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 interbody implants and fixing cages made of biocompatible materials. Minimally invasive interventions quickly restore the ability to support the operated department and enable the start of 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 risk, drugs for injection therapy are prescribed:
- anti-inflammatory (NSAID)
- painkillers (analgesics)
- muscle relaxants (relaxation, relaxation of muscle tone)
- vasodilating (improves blood microcirculation)
- chondroprotectors (stimulate the regeneration of intervertebral discs, slow down the destruction of cartilage tissue).
Homeopathic injections for the treatment of osteochondrosis and vitamins can be used according to the doctor's recommendation. Paravertebral therapeutic blockades (injections into the lumbosacral nerve plexus) are prescribed for quick and effective removal of 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 spasm)
- vegetative correctors (autonomic nervous system tone stabilizers)
- 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-mineral complexes
Tablets 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 discomforts only when the second stage occurs.
The main clinical symptom of this disease, as everyone probably knows, is lower back pain. 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 pains become painful, annoying, but occasionally they can get worse.
Another common complaint of patients during an examination with a vertebrologist is stiffness, limitation of movement in the lumbosacral joint. It becomes difficult for patients to bend down, turn. It should also be noted that pain can often radiate to the back surface of the lower extremities.
As a result of compression of the nerve roots by enlarged intervertebral discs, there is a disorder of skin pain and temperature sensitivity. 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 additionally complicated by muscle hypotension, as well as hyporeflexia.
How can you get rid of this serious disease?
Treatment of osteochondrosis problems is divided into two main groups of methods: conservative and surgical. The basis of the first method is the action 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 group of these drugs, be sure to visit your doctor, who will conduct a detailed diagnosis and create 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 properly.
Chondroprotective and anti-inflammatory fats, B vitamins are also widely used.
Methods of manual therapy, physiotherapy and acupuncture have been proven in the treatment of osteochondrosis, which help to improve local blood supply, relax back muscles.
Treatment of osteochondrosis of the lumbar spine
According to statistics, every second person aged 25 to 55 has at least once in their life experienced 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 the high percentage of osteochondrosis in this part of the spine is no accident.
The disease is based on the degeneration of the disc with the gradual involvement of adjacent vertebrae, intervertebral joints and the ligamentous apparatus in the pathological process.
Once the diagnosis is confirmed, the treatment of lumbar osteochondrosis should be started immediately, without waiting for the appearance of complications.
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 attach the disc to the vertebral body.
The intervertebral discs act as shock absorbers that relieve pressure on the spine during stress. Over the years, as a result of malnutrition, the cartilaginous tissue of the discs undergoes dystrophic processes. The core dries, loses its cushioning properties, which is followed by the destruction of the fibrous ring. Microcracks, fiber breaks appear in its structure. Due to the increased load, the core of the disc moves outside the spinal column - the initial stage of hernia formation develops - protrusion. This leads to irritation of the nerve roots and pain in the patient.
If the fibrous ring is completely torn, then an intervertebral hernia is formed.
Factors causing the development and worsening of lumbar osteochondrosis
- Occupational hazards - intense 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 spinal column have structural changes that accelerate their degeneration.
- Improper 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 injuries to spinal structures (fall from a height, traffic accidents, etc. ).
- Occupations in sports with a large physical load on the spine: skiing, tennis, horse riding, weight lifting.
- Irrational diet, nutritional imbalance for the main nutrients: proteins, fats, carbohydrates, vitamins, microelements.
- Hormonal imbalance in women during pregnancy and menopause.
- Bad habits: alcohol, smoking.
- Changes in the years.
- Inflammatory processes of the spine (Bekhter'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 phase. 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, stiffness and discomfort in the back appear in the morning.
2 stages. The destruction of the fibrous ring continues, the disc flattens, which leads to a reduction in the distance between adjacent vertebrae. Pathological mobility develops when the vertebrae can move relative to each other. The nutrition of the vertebral tissue is disturbed. The pain is already regular.
3 stages. The semi-destroyed fibrous ring can no longer hold the nucleus pulposus, a bulge (protrusion) appears - the beginning of the formation of a hernia. The pain worsens and becomes constant. There is a deformity of the spinal column.
4 stages. The intervertebral discs are replaced by scar tissue. There are many complications up to the complete loss of motor activity. This stage of lumbar osteochondrosis can only be treated 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.
Treatment methods
Traditional treatment of lumbar osteochondrosis includes the following methods:
Drug therapy: non-steroidal anti-inflammatory drugs, glucocorticoids, muscle relaxants, sedatives and 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, if the patient does not stop severe pain with conservative methods or is threatened with complications 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 improper posture while walking and sitting at the table. But it is also one of the consequences of damage to the intervertebral discs, cartilage tissue and nerve fibers, which results in 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 condition of the patient worsens: constant back pain, numbness of the limbs, spasms and spasms 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. A person's lumbar spine takes the main load in the form of the weight of the upper body, the load 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;
- changes in posture;
- the bones press on the internal organs. This leads to the development of diseases of the cardiovascular system;
- coordination is disturbed due to injury to nerve endings;
- the structure of the spinal column changes;
- the cartilage becomes thinner;
- the structure of the synovial fluid is filled with 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 acute pain.
At risk of developing lumbar osteochondrosis are athletes who lead an excessively active lifestyle, people with a sedentary lifestyle (a long time in one unchanged position creates an increased load on the spine), representatives of manual labor professions who work with heavy tools, the elderly, pregnant women, hyperactivekids.
Symptoms of lumbar osteochondrosis
- acute 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 spreads to the legs, internal organs of the abdomen and pelvis;
- acute pain in the kidneys and sacrum;
- difficulty moving, walking, leaning and turning the body;
- fatigue after light exercise;
- numbness of limbs;
- muscle spasms and cramps;
- dizziness;
- decreased muscle tone and sensitivity.
Causes of osteochondrosis of the lumbosacral spine
- irregularly distributed load on the back;
- sedentary lifestyle;
- stooped 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 internal organs.
Stages of development of lumbar osteochondrosis
Stage 1 - all 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 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 decreases. The pain in the second phase is sharper and more acute.
Stage 3 - there is strong compression of muscle fibers and nerve endings. Burning pains and muscle spasms occur, as well as frequent numbness.
Phase 4 - the period of growth of neoplasms (osteophytes) in the bone structure. Arthrosis occurs 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?
Pathology diagnosis begins with a consultation with a specialist. At the first manifestations of osteochondrosis, consult a rheumatologist, neuropathologist, surgeon or orthopedic traumatologist. If it is difficult for you to choose a doctor, you should first consult with a therapist. Depending on the symptoms and the alleged causes of the pathology, they will refer you to one of the highly specialized specialists.
- 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 examination and palpation.
- 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 any questions, an expert will advise you and perform an examination.
- He will refer you to tests, because it is a complete diagnosis that will allow you to make a correct diagnosis.
- Based on the test results, the doctor will prescribe an individual treatment plan.
To determine the state 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 MRI of osteochondrosis, the patient lies on a special table that can be retracted 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 results. Then the table enters 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 magnetic resonance imaging 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 picture 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 exposure of the body to radiation, X-rays cannot be taken very 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 the patient feels worse during physical education, the doctor corrects or completely cancels the exercise.
Another method of treating lumbar osteochondrosis is physiotherapy. Improves circulation and tissue nutrition, reduces inflammation and 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 - action on the affected areas occurs with the help of currents of different intensity.
- Hirudotherapy - treatment of leeches. Their influence 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).