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 cartilage tissue. 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 the kidneys and sacrum
• numbness of limbs
• rigidity
• tension in the midsection
• 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, the reflected lumbosacral pain syndrome can be associated with concomitant diseases of the internal organs. In women, diseases of the genitourinary sphere predominate, in 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. At the first medical appointment, a clinical and functional examination (clarification of complaints and anamnesis) and a clinical examination is performed. A neurologist examines the dynamic and static function of the spine, assesses the posture and tone parameters of the paravertebral muscles, determines the degree of mobility of various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• exclusion of negative charges
• immobilization (use of corsets, orthoses, orthopedic styling)
• drug therapy
• physiotherapy procedures
• gentle massage with acupressure
• exercise therapy
• acupuncture
• mud therapy
• pulling techniques

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

Physiotherapy for lumbar osteochondrosis

To eliminate pain, reduce swelling, normalize back muscle tone, activate recovery processes, resolve fibrous foci and increase mobility of damaged segments, a set of physiotherapy procedures is used:

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

Thanks to physiotherapy combined 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 abilities of the patient.

Optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdomen, pelvic region and lower extremities. 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 the position is improved.

Surgical intervention

An absolute indication for decompressive surgery is disabling radiculomyelosemia. This dangerous pathological condition is caused by hernial compression of nerve roots and impaired blood flow in the sacrococcygeal area. It results in chronic excruciating pain, pelvic organ dysfunction, permanent claudication, and other motor, reflex, or sensory disturbances. A relative indicator 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 fixation 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 symptom with many components 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, injection therapy drugs are prescribed:

• anti-inflammatory (NSAIDs)
• sedative (analgesic)
• muscle relaxants (relaxants, eases muscle tone)
• vasodilator (improving blood microcirculation)
• chondroprotectors (stimulation of the regeneration of intervertebral discs, slowing down the destruction of cartilage tissue).

With the doctor's recommendation, homeopathic injections for the treatment of osteochondrosis and vitamins can be used. For quick and effective removal of severe pain syndrome, paravertebral therapeutic blockades (injections into the lumbosacral nerve plexus) are prescribed.

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 correctives (autonomic nervous system tone stabilizers)
• vasodilators (to improve blood flow and tissue trophism)
• chondroitin and glucosamine dosage forms
• 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 period (up to 2 months or more).

How does this disease appear 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 knows, is pain in the lower back. The severity of this symptom increases significantly after lifting and holding weights, or even after simple movements of the limbs or torso. After a while, the pains become painful, annoying, but may worsen periodically.

Another common complaint of patients when meeting with a vertebrologist is stiffness, limitation of movement in the lumbosacral joint. It becomes difficult for patients to bend, 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 nerve roots by enlarged intervertebral discs, disturbances in skin pain and sensitivity to temperature occur. It must be said that these violations can mean both a weakening and an increase in the sensitivity threshold. With premature 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 drugs, which include nonsteroidal anti-inflammatory drugs, analgesics, biogenic immunostimulators, as well as drugs that relax peripheral muscles. Before taking any of these groups of drugs, you should definitely visit your doctor, who will make a complete 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 medications are taken properly.

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

Methods of manual therapy, physiotherapy and acupuncture have proven themselves in the treatment of osteochondrosis, which help improve local blood supply, relax the back muscles.

Treatment of osteochondrosis of the lumbar spine

According to statistics, every second person between 25 and 55 years of age 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 spine is subjected to maximum loads, so a high percentage of osteochondrosis in this particular area of the spine is not accidental.

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.

When the diagnosis is confirmed, the 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 fix the disc to the vertebral body.

Intervertebral discs act as shock absorbers that relieve pressure on the spine during stress. With age, as a result of malnutrition, the cartilaginous tissue of the discs undergoes dystrophic processes. The nucleus dries out, 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 core of the disc is displaced outside the spine - the initial stage of hernia formation - elongation takes place. This leads to irritation of the nerve roots and the appearance of pain in the patient.

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

Factors that provoke the development and worsening of lumbar osteochondrosis

• Hazards at work - intense dynamic load, work accompanied by frequent changes in body position: bending, stretching, twisting, lifting heavy loads, vibration.
• A genetic predisposition in which the spinal tissues 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, a sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of damage to spinal structures (fall from a height, transport accidents and others).
• Professions in sports with a large physical load on the back: skiing, tennis, horse riding, weightlifting.
• Irrational eating, diet imbalance 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 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, four stages of osteochondrosis of the spine are distinguished:

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 stages. 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. Nutrition of vertebral tissue is disturbed. The pain is now regular.

3 stages. The half-destroyed fibrous ring can no longer support the nucleus pulposus, a protrusion appears - the beginning of the formation of a hernia. The pain worsens and becomes constant. There is a deformity of the spine.

4 stages. The 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 the destroyed vertebrae with artificial implants.

Diagnosing

• Collection of anamnesis.
• 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, 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 with conservative methods or 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 a wrong posture while walking and sitting at a table. 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 general well-being of the patient deteriorates: 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 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 receives 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;
• attitude changes;
• the bones crush the internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is disturbed due to the violation of nerve endings;
• the structure of the spine changes;
• the cartilage thins;
• the structure of the synovial fluid is filled with third-party components;
• the vertebrae are tired, due to which the distance between them decreases;
• when the vertebrae come into contact, the nerves are pressed - this leads to acute pain.

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

Symptoms of lumbar osteochondrosis

• acute pain in the lower back after night sleep;
• pain during sharp turns of the body or lifting heavy things;
• the first signs of scoliosis appear;
• frequent urination;
• the 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 light load;
• numbness of limbs;
• muscle spasms and cramps;
• 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;
• very frequent physical training;
• excess body weight;
• violation of blood flow in the spine;
• injuries, bruises, fractures of limbs or vertebrae;
• internal organ infections.

Stages of development of lumbar osteochondrosis

Stage 1 - all degenerative disorders have just begun 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 appears with 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 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 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?

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 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 studies (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 find out the degree of development of the disease. If you have any questions, a specialist will advise you and perform an examination.
3. He will refer you for analysis, because it 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 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 table drawn with his back. Rollers are placed on the patient's head to relieve muscle tension and the limbs are secured with straps. Any slight movement during the procedure can affect the quality of the result. The table is then inserted into the tomography area. The procedure does not cause pain. The scanner 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 suitable only for primary diagnosis and do not provide a stratified image of the affected tissues. However, this study is simpler and more economical, allowing you to examine the patient's body in several projections. Because of the high radiation exposure to 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 close supervision of a doctor. Classes are held when the patient does not feel 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. Improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy treatments include:

• Electrophoresis - sedatives, 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 intensity.
• Hirudotherapy – treatment with leeches. Their influence improves microcirculation, the exchange of nutrients in the tissues of the back.
• Kinesio Taping is a treatment using a cotton pad.

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).