People with lumbar spine osteochondrosis always avoid sudden movements, carefully lean and turn to the sides, sit slowly, rise.Then they try to avoid sharp and penetrating lower back pain, forcing them to freeze in a body position.Osteochondrosis also manifests itself by crispness, clicks, limitation of mobility.Its treatment is more often conservative, but with serious damage to discs and vertebrae, surgical intervention is required.
What is osteochondrosis of the lumbar spine
Lumbar osteochondrosis is a degenerative-distribution pathology that initially affects intervertebral discs.Due to insufficient nutrient intake, they lose the ability to retain moisture.Regeneration processes decrease, discs become flat, fragile.The distance between adjacent vertebrae is reduced;Therefore, bone tissues grow to stabilize the lumbar segment affected by osteochondrosis.Osteophytes are formed - bone growth, with the displacement of which soft tissue structures, nerve roots and blood vessels are injured.
Pathology stages
The stage of osteochondrosis is the stage of disease development, characterized by certain destructive changes in the albums and bodies of the vertebrae.It is established using an x -ray exam.In resulting images, specific signs of destruction of vertebral structures are clearly visible.Each stage corresponds to the severity of osteochondrosis, a set of symptoms.The higher, the more difficult the disease lends itself to conservative treatment.
| Lumbar osteochondrosis stage | X -ray and clinical manifestations |
| First (pre -clinical) | There are no signs of radiographs osteochondrosis.Occasionally, there are uncomfortable sensations on the lower back after physical or long term effort, legs |
| Second | There is a rectification of lordosis, less often - the scenes of vertebral bodies, the deformation of semi -lua processes.The height of the discs is slightly reduced.Painful sensations appear more often, their duration increases |
| The third | Subcondral sclerosis of closing plates, damage to a large number of semi -lua processes and a moderate decrease at the disc height are observed.Besides pain in the lower back, the clinic contains a crisis, stiffness of movements |
| Room | Semi -lua processes are rejected out and later.There is compensatory growth of bone tissues, the formation of multiple osteophytes.The pain occurs when moving and at rest |
Causes of the disease
The causes of osteochondrosis development are often increased loads in the lumbar spine.The discs are constantly microtrauma, with no time to recover in a timely manner.A significant part is gradually damaged, launching the deformation of the bone bodies of the vertebrae.Such pathological conditions are also capable of provoking the destruction of the lumbar segment:
- Congenital or acquired anomalies - flat feet, scoliosis, kyphosis, deformation of the foot valgus, tbs dysplasia;
- Systemic pathologies - rheumatoid arthritis, scleroderma, red lupus;
- Endocrine and metabolic diseases, diabetes mellitus, hypo and hyperthyroidism, obesity;
- Anterior lesions - subluxation of vertebrae and their fractures, damage to the spinal cord;
- Circulatory disorders, even at the bottom of a sedentary lifestyle.
One of the main causes of osteochondrosis is the natural aging of the body.After 50 years, recovery processes decrease, collagen production decreases, the state of ligaments worsens.
Characteristic signs and symptoms of the disease
At the early stage of development, osteochondrosis does not appear clinically.A person takes weak pain from the lower back to muscle overvoltage after a business day and does not consult a doctor.But the severity of symptoms is increasing slowly - therefore a crisis with slope and turning to the case, sensitivity disorders and stiffness are united in pain.
Rook Syndrome
This is the name of the defeat of the roots of the spine, which leads to motor, vegetative and severe disorders.Rotor syndrome develops with 3-4 gravity osteochondrosis.In these stages, an intervertebral hernia is formed, compressing the roots of the spine.The pathology continues according to the type of lumbago, lumbalgia and lower back.In addition to intense pain, root syndrome is characterized by numbness, tingling, chills, decreased or complete absence of sensitivity.
Ischemic syndrome
In the late stages of the course of lumbar osteochondrosis, it is possible to compress herniacating large blood vessels.The pelvic organs no longer receive a sufficient amount of nutrients, which leads to a violation of their operation.The cerebral brain trophy is also upset, a neurological deficiency develops - intermittent lameness appears, temperature, pain sensitivity falls.
Vertebrate syndrome
As a result of reducing the distance between the adjacent bodies of the vertebrae, the growth of bone tissues, the lumbar vertebral segments are gradually deformed.The situation is aggravated by constant compensatory stress of the back muscles with their subsequent atrophy.Pathologically alters the march and posture of a person, including due to inadequate redistribution of cargo.The probability of involving other parts of the spine and leg joints in the depressive destructive process is significantly increased.
Pain syndrome
At the bottom of the back, there is a large sciatic nerve formed by the roots of the sacral spine.When it is violated with hernal protrusion, bone growth, spasmodic muscles, ishias occurs - a typical symptom of lumbar osteochondrosis.There is a sharp pain that spreads along the sciatic nerve to the hips, knees, side legs (lumbar -theilgia).Another specific feature of the pathology - Lumbago, or "shots" in the lower back after a sharp or turned slope, hypothermia.
Diagnostic methods
When making a diagnosis, the radiographic images taken in two projections are more informative.To study in more detail the affected lumbar segment, an magnetic resonance imaging is performed.The study allows to evaluate the condition of the spinal cord, soft tissue structures, blood vessels, nerve roots.It is possible to determine the degree of damage to nerve trunks using the potential caused, electronography, electromyography.To target the examination of the affected discs, the discography is used.
How the treatment is performed
A comprehensive approach to therapy for lumbar osteochondrosis is practiced.Treatment aims to eliminate pain, restoring the volume of movements, preventing the spread of pathology to healthy discs and vertebrae.
Drug
The use of non -inflammatory drugs non -esteroids, glucocosteroids, muscle relaxing allows you to get rid of lumbar pain.In therapy, medications are used to improve blood circulation.Patients should receive prescribed group B vitamins, chondroprotectors.
Medical Physical Education
This is the most effective and accessible treatment for osteochondrosis.After 1-2 months of daily treatment of physical therapy exercises, the muscles not only of the lumbar region, but from all the back, improves posture, accelerates the blood supply for damaged connective tissue structures.LFK doctors recommend that patients recommend slow and smooth turns and trunk inclinations, shallow and stored squats.
Massage
Patients with lumbar osteochondrosis show all types of massage - vacuum, acupuncture, conjunctive, segmental.But the most sought after is classic.During the session, the massage therapist performs the main massage movements: caressing, rubbing, kneading, vibration.The objectives of the procedures are to eliminate muscle cramps, improve blood circulation in the affected segment and strengthen skeletal muscles.
Physiotherapy
In an acute and subacute period, patients are prescribed by electrophoresis or ultraphonophoresis with glycocorticosteroids, anesthetic, group B vitamins. In the remission phase, laser therapy, magnetotherapy, stressed wave therapy and UHF therapy are often performed.Ozoceritoling, paraffin applications, hirudotherapy, mud, radon, hydrogen sulfide baths are also used.
Surgical intervention
The main indication of surgical intervention is the violation of the spinal cord with hernal protrusion.During the operation, the intervertebral hernia is removed, the decompression of the spinal canal is performed.The most commonly used surgical intervention methods for lumbar osteochondrosis are microdyscectomy, disk laser puncture, or reconstruction, implant installation, stabilization of the vertebral segment.
Traditional medicine
After the main therapy, stable remission in treatment, home ointment, herbal teas, compresses, oil and alcohol are used.Folk remedies do not affect the cause of osteochondrosis;Therefore, they are used to eliminate poor and painful pain, severity in the lower back after hypothermia, a marked change in climate or increased physical activity.
The consequences of lack of treatment
The development of almost all complications of lumbar osteochondrosis is caused by formed intervertebral hernia.Discogenic myelopathy is especially dangerous, which does not always produce surgical treatment.It is manifested by pelvic disorders, including defecation disorders, urination.Osteochondrosis complications also include Rooser syndrome - a common cause of acute and penetrating lumbar pain.
Prevention and forecast measures
The prognosis is favorable in the diagnosis of pathology of 1-2 degrees of gravity.It lends itself well to conservative treatment and, in young patients, it is even possible to partially restore intervertebral discs.With the development of complications, the forecast for full recovery is less favorable.
Prevention of lumbar spine osteochondrosis is to control body weight, exclusion of surplus loads, timely treatment of endocrine and metabolic diseases.Neurologists and vertebologists recommend visiting the pool, engaging in Aquaerobics, Pilates, Scandinava Walk.