Back pain is the most frequent complaint of patients in general medical practice. They rank second (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, the symptoms and treatment of which we will consider in this material.
Relatively recently, medicine considered this condition as age-related changes in the spine, which it associated with the natural aging processes of the human body.
Today, lumbar osteochondrosis is considered a fairly serious disease that occurs in people of all ages. Currently, the incidence has a constant trend towards rejuvenation, more and more often the disease is diagnosed in people under 30 years of age.
Causes of 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 assume who is more prone to the disease, is at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead a predominantly sedentary lifestyle. In a sitting position, the corset muscles relax, which increases the load on the lumbar spine.
- Hormone metabolism disorders and endocrine diseases can adversely affect the metabolism of the tissues of the spine and contribute to the development of osteochondrosis.
- Various congenital and acquired anomalies in the structure of the musculoskeletal system: curvature of the legs and spine, flat feet.
- The presence of constant heavy physical strain on the spine, in particular heavy lifting. In this case, we can speak of an occupational disease of categories such as weightlifters and people whose professional tasks are associated with constant lifting of heavy objects.
- 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 by irritation of the nerve endings located in the fibrous ring 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), constant dull pain (lumbodynia).
- Period of destruction of the fibrous ring. It is characterized by the appearance of instability and an increase in the mobility of the vertebrae, which causes a prolonged and persistent muscular tension. The patient feels symptoms such as constant fatigue of the lower back muscles, discomfort,
- The period of rupture of the annulus fibrosus and the exit of the nucleus pulposus beyond its limits with the formation of a herniated disc. The so-called radicular syndromes are observed, which are associated with compression of the nerve roots by fallen fragments.
- The spine is severely deformed. Human motor function is difficult. The main problem to be addressed is the disability of the patient. However, it should be emphasized that at this stage of the disease there is practically no pain. But this is not a signal to suspend the disease, quite the opposite.
- There is a pathological proliferation of bone tissue, which will further worsen the condition.
The way to treat osteochondrosis of the lumbar spine will depend directly on the degree of the injury, for this, drug, non-drug and surgical exposure methods are used.
Lumbar spine osteochondrosis symptoms
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 spread depend on which receptors are irritated, that is, how severe are the changes in the disc and surrounding tissues, is there a bulge or already a hernia, inwhich direction the bulge has formed, etc.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, painful in nature, aggravated by sudden movements, change of body position, prolonged stay in one 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 trunk and legs, as well as loss of tendon reflexes in the lower extremities;
- 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 (curvature forward) and kyphosis (smoothing of the lumbar curvature);
- If osteochondrosis has resulted in spinal cord impingement and dysfunction, the patient may have uncontrolled urine and stool.
Additional functions:
- coldness of the skin and numbness in the lumbar region, buttocks;
- dry, scaly, blue skin on lower back and buttocks;
- violation of sweating on the buttocks;
- urination disorder;
- 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.
Diagnosis
The diagnosis of osteochondrosis involves the use of several methods, mainly palpation of the lumbar spine.
To confirm the diagnosis, the patient is sent for examination with a diagnostic kit:
- Radiography helps to assess the condition of the spine and each vertebra separately. The integrity of the intervertebral discs and the spinal canal is also indirectly judged.
- With the CT scan, the degree of damage to the 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.
A correct diagnosis will help to understand how to treat lumbar osteochondrosis and what drugs and procedures will be required for this.
Complications
Osteochondrosis of the lumbar spine can cause bulges and hernias due to significant loads on this spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner.
Also, osteochondrosis can be tricky:
- inflammation of the sciatic nerve;
- spondyloarthrosis;
- Schmorl's hernia;
- osteophytosis, spondylosis;
- spinal canal stenosis with compression and dysfunction of the spinal cord;
- compression of the cauda equina with dysfunction of the 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 osteochondrosis of the lumbar spine
When lumbar osteochondrosis is diagnosed, treatment requires extensive and complex therapy, including:
- moderate physical activity;
- use of medications;
- spinal traction;
- manual therapy;
- physiotherapy;
- massage.
The treatment scheme for osteochondrosis is aimed at:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthen the muscles of the lower back, buttocks, legs;
- elimination of pathological muscle tension;
- improve the functioning of the 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 sensation of the lower extremities.
Surgical intervention is only used in some cases.
Medications
This treatment for osteochondrosis of the lumbar spine includes taking pills, injections and external medications (ointments and gels). Medications used to combat this disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for lumbar osteochondrosis:
- painkillers (pain relievers);
- 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.
Very often in the treatment of osteochondrosis, pills that calm the nervous system are prescribed, as well as antidepressants that combat stressful situations and depression.
Physiotherapy for lumbar osteochondrosis
As a general rule, medications alone are not enough to treat osteochondrosis. Physiotherapy procedures are used to eliminate pain, relieve muscle spasms, and stimulate recovery and metabolic processes:
- amplipulse;
- phonophoresis;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main symptom of pain is eliminated or during remission in a chronic pathology. It serves to relax tense muscles. Most often combined with warm-up procedures or a visit to the sauna. This will help increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is performed only by a specialist in this treatment area, increases blood circulation in the spinal cord and replaces displaced discs in the spine.
Recovery gymnastics
The full range of physical exercises used in the diagnosis of lumbar osteochondrosis should help to increase the mobility of the lumbar spine.
Recovery gymnastics will not be effective if exercises are performed from time to time. The main principle of exercise therapy is regularity. The constant implementation of a certain set of exercises will help to eliminate destructive processes in the intervertebral joints.
Surgery
Typically, a doctor will only order surgery if serious complications develop. 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 prescribed only if other treatment methods do not give results within six months. In addition, the microsurgical and endoscopic method of treatment of the spine is widespread.