Back or back pain is the most common patient complaint in general medical practice. They ranked second (after respiratory illness) in terms of frequency of medical treatment requests. There are many diseases that cause pain. But the most common cause is lumbar spine osteochondrosis, the symptoms and treatment of which we will consider in this material.
Recently, medicine has considered this condition as an age-related change in the spine, which is related to the natural aging process of the human body.
Today, lumbar osteochondrosis is considered a relatively serious disease that occurs in people of all ages. Currently, this phenomenon has a stable tendency to rejuvenation, the more often the disease is diagnosed in people under 30 years of age.
Cause
The cause of the development of lumbar osteochondrosis is not yet known. But when faced with this pathology, it is very possible to assume who is more susceptible to the disease, at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead a sedentary lifestyle. In a sitting position, the corset muscles relax, which increases the load on the lumbar spine.
- Hormonal metabolic disorders and endocrine diseases can adversely affect metabolism in spinal canal tissue 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 heavy physical exercise on the spine, in particular, lifts heavy objects. In this case, we can talk about occupational diseases from categories such as weightlifting and people whose professional duties are related to lifting heavy objects continuously.
- Unhealthy diet and daily routine, normal stress, insufficient sleep, metabolic disorders.
The items listed above are the most common factors that are a prerequisite for the development of this disease.
Degrees of lumbar osteochondrosis
Manifestation of the disease depends on the stage of pathological development.
There are four degrees of osteochondrosis:
- Period of change and movement of the nucleus pulposus in the disc. Pain appears due to irritation of nerve endings located in the fibrosus annulus and longitudinal ligaments. The patient feels local discomfort in the part of the spine where the affected disc is located: acute pain or lumbago in the lower back (lumbago), persistent dull pain (lumbodynia).
- Period of destruction of annulus fibrosus. It is characterized by the appearance of instability and increased mobility of the vertebrae, resulting in prolonged and persistent muscle tension. The patient feels symptoms such as constant lower back muscle fatigue, discomfort,
- The period of rupture of the fibrosus annulus and the release of the nucleus pulposus exceeds its limit with the formation of a herniated disc. The so-called radicular syndrome is observed, which is associated with compression of the nerve root by falling debris.
- Spinal cord severely deformed. Human motor function is difficult. The main problem that needs to be addressed is the disability of the patient. However, it must be emphasized that at this stage of the disease, the pain is almost non-existent. But this is not a signal to delay the disease, on the contrary.
- There is pathological proliferation of bone tissue, which will worsen the condition.
How to treat lumbar spine osteochondrosis directly depends on the degree of lesion; for this, drug, non-drug and surgical exposure methods are used.
Symptoms of lumbar spine osteochondrosis
When lumbar spine osteochondrosis occurs, the main symptom is pain. The nature of the sensation of pain, place of origin and direction of spread depends on which receptor receives the irritation, i. e. , how large the changes in the surrounding disc and tissue are, there is a protrusion or hernia, in which direction the protrusion is formed, and so on.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, pain in nature, exacerbated by sudden movements, changes in body position, prolonged stay in one position. Reduction of pain occurs while taking a horizontal position;
- Along with pain in the lumbar spine, osteochondrosis can cause weakness in the lower limbs and legs, as well as loss of tendon reflexes in the lower limbs;
- Lumbar spine curvature is common. Depending on where the curvature is observed, we distinguish between scoliosis (curvature of the spine to the right or left), lordosis (forward bend) and kyphosis (smoothing of the lumbar arch);
- If osteochondrosis results in clamping and dysfunction of the spinal cord, the patient may experience uncontrolled urination and stools.
Additional Features:
- skin cold and numbness in the lumbar region, buttocks;
- dryness, exfoliation, blue skin on lower back and buttocks;
- sweating violations in the back;
- urinary disorders;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical intervention. Treatment of osteochondrosis can be carried out in the hospital and at home.
Diagnostics
The diagnosis of osteochondrosis involves the use of a variety of methods, particularly lumbar spine palpation.
To confirm the diagnosis, the patient is sent for examination using diagnostic equipment:
- Radiography helps assess the condition of the spinal space and each vertebra separately. The integrity of the intervertebral disc and spinal canal is also indirectly assessed.
- With tomography, the degree of damage to the nerve endings and lining of the spinal cord is determined. And also assess the condition of the intervertebral disc.
- MRI - used to make an accurate diagnosis.
Proper diagnosis will help understand how to treat lumbar osteochondrosis, and what medications and procedures are needed for this.
Complications
Osteochondrosis of the lumbar spine can cause protrusion and hernias due to the large load on this spine. It is this complication that develops rapidly, so it is very important to address it in a timely manner.
Also, osteochondrosis can be complicated:
- inflammation of the sciatic nerve;
- spondyloarthrosis;
- Hernia Schmorl;
- osteophytosis, spondylosis;
- spinal canal stenosis with compression and spinal cord dysfunction;
- cauda equina compression with pelvic organ dysfunction;
- lame;
- paresis of the lower extremities.
It is possible to prevent the development 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;
- drug use;
- spine attraction;
- manual therapy;
- physiotherapy;
- massage.
The treatment scheme for osteochondrosis aims to:
- elimination of inflammatory processes;
- pain reduction in the lumbosacral region;
- strengthens muscles in the lumbar region, back, legs;
- removal of pathological muscle tension;
- improves pelvic organ function;
- regulation of blood circulation and metabolic processes in the affected area;
- restoration of normal movement of the lower back and increased sensitivity of the lower limbs.
Surgical intervention is only used in some cases.
Medicine
Such lumbar spine osteochondrosis treatment includes taking pills, injections and external medications (ointments and gels). Medications used to combat the disease relieve pain and stop inflammation.
Depending on the manifestation, the doctor may prescribe different pills for lower back osteochondrosis:- painkillers (analgesics);
- non-steroidal anti-inflammatory drugs;
- muscle relaxants, to relieve muscle cramps caused by pain;
- chondroprotectors that restore cartilage tissue;
- corticosteroids (prescribed if all other treatments fail);
- Vitamin preparations.
Very often in the treatment of osteochondrosis, pills are prescribed to calm the nervous system, as well as antidepressants that fight stressful situations and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, medication alone is not enough to treat osteochondrosis. Physiotherapeutic procedures are used to relieve pain, relieve muscle spasms, and stimulate metabolic and recovery processes:
- amplipulse;
- fonoforesis;
- diadynamic current;
- darsonvalization;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when symptoms of primary pain are removed or during remission in chronic pathology. It works to stretch tense muscles. Often combined with a warm-up procedure or a visit to the sauna. This will help increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, performed only by specialists in this field of treatment, improves blood circulation in the spinal cord, replacing lost discs from spinal space.
Recovery gymnastics
All physical exercises used in the diagnosis of lumbar osteochondrosis should help improve lumbar spine mobility.
Rehabilitation gymnastics will not be effective if training is carried out from time to time. The main principle of exercise therapy is regularity. Continuous implementation of a specific set of exercises will help eliminate destructive processes in the intervertebral joints.
Surgery
Usually, the doctor will only order surgery if serious complications arise. For example, an intervertebral hernia. The most common type of surgery is discectomy.
This operation is considered the most productive method in this case, but at the same time, it is only prescribed if other treatment methods do not bring results within six months. In addition, micro surgical treatment methods and spinal endoscopy are becoming more widespread.