lumbar osteochondrosis

Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. Pain syndrome is caused by damage to the intervertebral discs, spinal roots, nerve fibers, and cartilaginous tissues. For the treatment of lumbosacral osteochondrosis, you need to contact a neurologist.

Symptoms of lumbar osteochondrosis

• severe pain syndrome that can radiate to the leg and pelvic organs
• kidney and sacrum pain
• limb numbness
• stiffness
• tension in the lower back
• fatigue, weakness
• dizziness

Lumbar osteochondrosis has gender features of course. Vertebrogenic pain, which occurs due to compression of the nerve roots by the altered cartilage of the intervertebral discs, is much more difficult for women than it is for men. Pain intensity is directly related to estrogen level. The lower your indicators, the more pronounced the pain.

In addition, reflected lumbosacral pain syndrome may be associated with concomitant diseases of internal organs. In females, genitourinary diseases prevail, for men, gastrointestinal tract disorders 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 consultation, a clinical and functional examination is performed (clarification of complaints and anamnesis) and a clinical examination. A neurologist examines the dynamic and static function of the spine, assesses posture and paravertebral muscle tone parameters, determines the degree of mobility of various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• exclusion of adverse loads
• immobilization (use of corsets, orthotics, orthopedic style)
• drug therapy
• physical therapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud therapy
• traction techniques (traction)

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

Physiotherapy for lumbar osteochondrosis

To eliminate pain, reduce swelling, normalize the tone of the back muscles, activate recovery processes, resolve fibrous 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 irradiation
• 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 attributed to recreational physical education. Instructors-rehabilitators at the rehabilitation center develop individual complexes of dynamic exercise therapy and stretching exercises for osteochondrosis of the spine. This takes into account the patient's gender, age and physical capabilities.

Optimized therapeutic exercises aim to strengthen the muscles of the back, abdominals, 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 improves.

Surgical intervention

An absolute indication for decompressive surgery is disabling radiculomyeloishemia. This dangerous pathological condition is caused by hernial compression of the nerve roots and impaired blood flow in the sacrococcygeal zone. This results in intermittent unbearable pain, pelvic organ dysfunction, intermittent claudication, and other motor, reflex, or sensory disturbances. A relative indication for operational 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 ideal: installation of interbody implants and fixation cages made of biocompatible materials. Minimally invasive interventions quickly restore 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 multicomponent symptom complex is associated with local inflammation, pathological muscle tension, ligament damage, biomechanical causes and dysfunction of the pain perception system. Therefore, treatment must be carried out in a complex. For faster pharmacological action and reduction of gastro and cardio risks, injectable therapy drugs are prescribed:

• anti-inflammatory drugs (NSAIDs)
• pain relievers (analgesics)
• muscle relaxants (relaxing, relieving muscle tone)
• vasodilator (improve blood microcirculation)
• chondroprotective (stimulating the regeneration of intervertebral discs, delaying the destruction of cartilage tissue).

On the recommendation of a doctor, homeopathic injections can be used for the treatment of osteochondrosis and vitamins. For rapid and effective removal of severe pain syndrome, therapeutic paravertebral blocks (injections into the lumbosacral nerve plexus) are prescribed.

medical therapy

Traditionally, complex therapy for degenerative diseases of the spine includes treatment with pills and capsules, similar to the injection method:

• NSAIDs (non-steroidal anti-inflammatory drugs)
• painkillers
• myotropic antispasmodics (drugs to relieve muscle spasm)
• vegetative correctors (autonomic nervous system tone stabilizers)
• vasodilators (to improve blood flow and tissue trophism)
• Chondroitin and Glucosamine dosage forms
• sedatives 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 manifest clinically?

Osteochondrosis of the lumbar spine in the early stages is characterized by very general symptoms, which are very difficult to recognize without the intervention of an experienced specialist. Typically, 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 pain in the lower back. 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, irritating, but may periodically get worse.

Another common complaint of patients in the consultation of a vertebrologist is stiffness, limitation of movement in the lumbosacral joint. It becomes difficult for patients to bend over, turn around. It should also be noted that the 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, disturbances in skin pain and temperature sensitivity 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 illness?

The 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 non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any of the groups of these drugs, you should definitely visit your doctor, who will make a full diagnosis and work out your individual treatment plan. This is very important because the medications described above can have some serious side effects that can be avoided if the medications are taken correctly.

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

Manual therapy, physical therapy and acupuncture methods have proven themselves 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 years experienced at least once in their lifetime manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lower back to severe pain with limited mobility.

The lumbar skeleton is subject to maximum loads, so a high percentage of osteochondrosis in this specific area of the spine is not accidental.

The disease is based on disc degeneration with gradual involvement of adjacent vertebrae, intervertebral joints and ligamentous apparatus in the pathological process.

When the diagnosis is confirmed, treatment of lumbar osteochondrosis should be started immediately, without waiting for complications to appear.

The 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 fix the disc to the vertebral body.

Intervertebral discs act as shock absorbers that ease pressure on the spine during stress. With age, as a result of malnutrition, the cartilaginous tissue of the discs undergoes dystrophic processes. The core dries out, loses its shock-absorbing properties, followed by the destruction of the annulus fibrosus. Microcracks, fiber breaks appear in its structure. Due to the increased load, the disc core is shifted out of the spine - the initial stage of hernia formation develops - protrusion. This leads to irritation of the nerve roots and the appearance of pain in the patient.

If the annulus fibrosus is completely torn, an intervertebral hernia forms.

Factors that provoke the development and exacerbation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work associated with frequent changes in body position: flexion, extension, turning, lifting heavy loads, vibration.
• A genetic predisposition in which spinal tissues show structural changes that accelerate their degeneration.
• Incorrect posture, in which there is an uneven distribution of 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 (falls from heights, transport accidents and others).
• Occupations in sports with a high physical load on the spine: skiing, tennis, horseback riding, weight lifting.
• Irrational nutrition, diet imbalance for key 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 associated with 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, there are four stages of osteochondrosis of the lumbar spine:

1 stage. There is a gradual decrease in the elasticity of the intervertebral discs. Microcracks appear in the annulus fibrosus. Due to the reflex spasm of the muscles around the affected segment of the spine, there is stiffness and discomfort in the back in the morning.

2 stage. Destruction of the annulus fibrosus continues, the disc flattens out, which leads to a decrease in the distance between adjacent vertebrae. Pathological mobility develops when the vertebrae can move relative to each other. The nutrition of vertebral tissues is disturbed. The pain is already regular.

3 stage. The semi-destroyed annulus fibrosus can no longer hold the nucleus pulposus, a bulge (bulge) appears - the beginning of the formation of a hernia. The pain gets worse and becomes constant. There is a spinal deformity.

4 stage. Intervertebral discs are replaced by scar tissue. There are many complications until 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 destroyed vertebrae with artificial implants.

Diagnosis

• Anamnesis collection.
• Neurological examination of reflexes, sensitivity.
• functional tests.
• Radiography, magnetic resonance, computed tomography.

treatment methods

Traditional treatment of lumbar osteochondrosis includes the following methods:

Drug therapy: non-steroidal anti-inflammatory drugs, glucocorticoids, muscle relaxants, sedatives and a vitamin complex with trace elements.

Physiotherapy procedures: electro-, phonophoresis, exposure to magnetic field, hydrotherapy.

Surgical treatment of lumbar osteochondrosis is carried out according to strict medical indications in severe cases, if the patient is unable to stop severe pain by conservative methods, or if he 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 usually occurs in a person due to the formation of an incorrect posture when walking and sitting at a table. But it is also one of the consequences of damage to 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 worsens: 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 patient's spinal skeleton. As a result, the anatomy and physiology of the articular elements of the spine change. A person's lumbar spine takes the main load in the form of a person's upper body weight, loads during movement, training, or performing any physical activity. As a result of all the above, the following changes occur:

• the spinal axis is distorted;
• postural changes;
• bones put pressure on 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;
• cartilage thins;
• the structure of synovial fluid is filled with third-party components;
• the vertebrae are worn out, due to which the distance between them is reduced;
• when the vertebrae come into contact, the nerves are compressed - this leads to sharp pain.

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

Symptoms of Osteochondrosis of the Lumbar

• sharp pain in the lower back after a night's sleep;
• pain during sharp turns of the body or lifting heavy things;
• the first signs of scoliosis appear;
• frequent urination;
• pain radiates to the legs, internal organs of the abdomen and pelvis;
• sharp pain in the kidneys and sacrum;
• difficulty moving, walking, bending and turning the body;
• fatigue after a light load;
• limb numbness;
• spasms and cramps in the muscles;
• dizziness;
• decreased muscle tone and sensitivity.

Causes of osteochondrosis of the lumbosacral spine

• poorly 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;
• infections of internal organs.

Developmental stages of osteochondrosis of the lumbar

Stage 1 - all degenerative disorders are just beginning to develop in the patient's skeleton. But at the same time, the roots of nerve endings are already affected. Blood flow worsens and the inflammatory process begins. It is manifested by back pain after increased exertion, which often radiates to the legs.

Stage 2 - the annulus fibrosus in the spine is destroyed, the cartilage becomes thinner and the distance between the vertebrae is reduced. The pain in the second stage is sharper and more acute.

Stage 3 - There is 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. Osteoarthritis appears in the spine and joints. The back becomes inactive, and in the absence of correct treatment - completely immobile.

How is osteochondrosis of the lumbar spine diagnosed?

The diagnosis of the 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 initially consult a therapist. Depending on the symptoms and the supposed 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 its manifestations, you will need to provide the specialist with a complete medical history and the results of initial studies (if any). The specialist will perform a visual examination 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 doubts, a specialist will advise you and carry out an examination.
3. He will refer you for examinations as 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, detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the lumbar spine. During an osteochondrosis MRI, the patient lies on a special retractable table with his back. Rollers are placed on the patient's head to remove muscle tension and the limbs are secured with belts. Any small movement during the procedure can affect the quality of the result. Then the table moves to the CT area. The procedure does not cause pain. The scanner makes a lot of noise during the exam, so you can wear headphones so you don't feel uncomfortable.

If MRI is contraindicated, there are other diagnostic methods, such as computed tomography and radiography. Radiography is only suitable for primary diagnosis and does not provide a layered image of the affected tissues. However, this study is the simplest and most economical, allowing to examine the patient's body in various projections. Due to the high radiation exposure of the body, x-rays cannot be taken frequently.

Treatment of osteochondrosis of the lumbar

Depending on the stage of lumbosacral osteochondrosis, different treatment methods may be prescribed. One such method is exercise therapy. It is carried out in a specially equipped room under the 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 physical therapy. It improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy treatments include:

• Electrophoresis - analgesics, anti-inflammatory drugs are used, the procedure reduces the neurological manifestations of the disease.
• Magnetic therapy - an alternating magnetic field relieves inflammation.
• Ultrasound therapy - works along the affected spine.
• Diadynamic therapy - the effect on the affected areas occurs with the help of currents of different intensities.
• Hirudotherapy - treatment with leeches. Its impact improves microcirculation, the exchange of nutrients in the tissues of the back.
• Kinesio taping is a treatment that uses a cotton patch.

Drug treatment - it is prescribed in extreme cases with the use of analgesics (they have an additional analgesic or anti-inflammatory effect), antispasmodics (relieve muscle spasms), vasodilators (improve blood microcirculation).