Back or lower back pain is the most frequent complaint of patients in general medical practice. They occupy the second place (after respiratory diseases) in terms of frequency of requests for medical care. There are many diseases that cause pain. But the most common cause is osteochondrosis of the lumbar spine, whose symptoms and treatment we will consider in this material.
Recently, medicine considered this condition as an age-related spinal disorder associated with the natural aging processes of the human body.
Today, lumbar osteochondrosis is considered a very serious disease that occurs in people of all ages. Currently, the incidence has a constant tendency to rejuvenation, more and more the disease is diagnosed in people under 30 years.
Causes of the occurrence
The reason for the development of lumbar osteochondrosis has not yet been established. But when faced with this pathology, it is often possible to presume who is most subject to the disease, is at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead a predominantly sedentary lifestyle. In the seated position, the corset muscles relax, which increases the load on the lumbar spine.
- Hormonal metabolic disorders and endocrine disorders can adversely affect metabolism in spinal tissues and contribute to the development of osteochondrosis.
- Various congenital and acquired abnormalities in the structure of the musculoskeletal system - curvature of the legs and spine, flat feet.
- The presence of constant and intense physical effort in the spine, in particular, lifting heavy objects. In this case, we can speak of an occupational disease of categories such as weightlifters and people whose professional functions are associated with the constant lifting of heavy objects.
- Constant unhealthy diet and daily routine, regular stress, insufficient sleep time, metabolic disorders.
The points listed above are the most common factors that create the prerequisites for the development of the disease.
Degrees of lumbar osteochondrosis
The manifestations of the disease depend on the degree of development of the pathology.
There are four degrees of osteochondrosis:
- Period of change and movement of the nucleus pulposus within the disc. The pain appears due to the irritation of the nerve endings located in the fibrous ring and in the longitudinal ligaments. The patient feels local discomfort in the part of the spine where the affected disc is located: acute pain or low back pain in the lower back (lumbago), deaf pain of a constant nature (lumbodynia).
- Period of destruction of the fibrous ring. It is characterized by the appearance of instability and increased mobility of the vertebrae, which causes prolonged and persistent muscle tension. The patient feels symptoms such as constant fatigue of the lower back muscles, discomfort,
- The period of rupture of the fibrous ring and the release of the nucleus pulposus beyond its limits with the formation of a herniated discThe so-called root syndromes are observed, which are associated with the compression of nerve roots by fallen fragments.
- The spine is severely deformed. Human motor function is difficult. The main issue that needs to be addressed is the patient's disability. However, it should be noted that at this stage of the disease there is practically no pain. But this is not a sign to stop the disease, quite the opposite.
- There is a pathological proliferation of bone tissue, which further worsens the condition.
The treatment of osteochondrosis of the lumbar spine will depend directly on the degree of the lesion, for which medicinal, non-medicated and surgical methods are used.
Symptoms of osteochondrosis of the lumbar spine
When osteochondrosis of the lumbar spine occurs, the main symptom is pain. The nature of the pain sensations, the place of origin and the direction of propagation depend on which receptors receive irritation, that is, as are the gross changes in the disc and in the surrounding tissues, there is a protrusion or already a hernia, in which direction theprotrusion was formed and so on.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, of a painful nature, aggravated by sudden movements, change of body position, prolonged stay in the same position. Pain reduction occurs when taking a horizontal position;
- Along with pain in the lumbar spine, osteochondrosis can cause a feeling of weakness in the lower torso and legs, as well as loss of tendon reflexes in the lower extremities;
- The curvature of the lumbar spine is common. Depending on where the curvature is observed, we distinguish between scoliosis (curvature of the spine to the right or left), lordosis (forward flexion) and kyphosis (smoothing of the lumbar curvature);
- If osteochondrosis resulted in spinal cord clamping and dysfunction, the patient may have uncontrolled urine and feces.
Additional resources:
- cold skin and numbness in the lower back, buttocks;
- dryness, flaking, bluish skin on the lower back and buttocks;
- violation of sweat on the buttocks;
- urinary disorder;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical intervention. Osteochondrosis treatment can be performed in the hospital and at home.
Diagnosis
The diagnosis of osteochondrosis involves the use of several methods, mainly palpation of the lumbar spine.
To confirm the diagnosis, the patient is referred for examination with diagnostic equipment:
- Radiography helps to assess the condition of the spine and each vertebra separately. The integrity of the intervertebral discs and the vertebral canal is also assessed indirectly.
- With tomography, the degree of damage to nerve endings and the lining of the spinal cord is determined. And also assess the condition of the intervertebral discs.
- MRI - used to make a definitive diagnosis.
Correct diagnosis will help you understand how to treat lumbar osteochondrosis and what medications and procedures will be needed for this.
Complications
Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this spine. These complications develop very quickly, so it is very important to treat them in a timely manner.
In addition, osteochondrosis can be complicated:
- inflammation of the sciatic nerve
- ;
- spondyloarthrosis;
- Schmorl's hernia; osteophytosis, spondylosis;
- spinal canal stenosis with compression and dysfunction of the spinal cord;
- cauda equina compression with dysfunction of Organs pelvic organs; lame;
- paresis of the lower extremities.
It is possible to prevent the progression of complications with timely diagnosis and complex treatment.
Treatment of lumbar spine osteochondrosis
When lumbar osteochondrosis is diagnosed, treatment requires extensive complex therapy, which includes:
- moderate physical activity;
- use of medicines;
- spine traction;
- manual therapy; physiotherapy; massage
- .
The osteochondrosis treatment regimen aims to:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthening of the muscles of the lower back, buttocks, legs;
- elimination of pathological muscle tension;
- improving the functioning of Organs pelvic organs;
- regulation of blood circulation and metabolic processes in the affected area;
- restoration of normal range of motion in the lower back and increased sensitivity of the lower extremities.
Surgical intervention is used only in some cases.
Medication
This treatment of osteochondrosis of the lumbar spine includes taking pills, injections and external medications (ointments and gels). The drugs used to fight the disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for lumbar osteochondrosis:
- analgesics (analgesics);
- non-steroidal anti-inflammatory drugs;
- muscle relaxants, to relieve muscle spasm that occurs due to pain;
- chondroprotectors that restore cartilage tissue;
- corticosteroids (prescribed if all other treatments have failed);
- vitamin preparations.
Often, in the treatment of osteochondrosis, pills are prescribed to calm the nervous system, as well as antidepressants that fight stress and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, medications alone are not enough to treat osteochondrosis. Physiotherapeutic procedures are used to eliminate pain, relieve muscle spasm and stimulate metabolic and recovery processes:
- amplipulse; phonophoresis
- ;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy; laser therapy
- .
Massage is prescribed when the main symptom of pain is removed or during remission in chronic pathology. It serves to relax tense muscles. Often combined with heating procedures or a visit to the sauna. This will help to increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is performed only by a specialist in this area of treatment, increases blood circulation in the spinal cord, replacing the disks displaced from the spine.
Corrective Gymnastics
The full range of physical exercises used in the diagnosis of lumbar osteochondrosis should help to increase the mobility of the lumbar spine.
Corrective gymnastics will not be effective if the exercises are performed from time to time. The main principle of exercise therapy is regularity. The constant execution of a certain set of exercises will help to eliminate destructive processes in the intervertebral joints.
Surgery
Usually, the doctor will only request surgery if there are serious complications. For example, an intervertebral hernia. The most common type of surgery is to remove the damaged disc (discectomy).
This operation is considered the most productive method in this case, but at the same time, it is only prescribed if the other treatment methods do not yield results in six months. In addition, the method of microsurgical and endoscopic treatment of the spine is widespread.