Causes, symptoms of lumbar osteochondrosis, how to treat an ailment
Most people over 30 years old even felt pain in the lower back. By the age of 60, about 80% of the population complain of this symptom. The main and most common cause of these pains is the osteochondrosis of the lumbar region. The first signs of this disease can be diagnosed already in adolescents aged 15-19 years, and by the age of 30, pain in the back is already troubling one person out of a hundred. Among all cases of osteochondrosis, the lesion of the lumbar region occurs in almost 90% of cases.
Essence of osteochondrosis
Osteochondrosis of lumbar spine develops as a result of destruction of connective tissue of intervertebral discs, bodies of adjacent vertebrae, articular surfaces of intervertebral joints and ligaments. All this occurs due to metabolic disturbance under the influence of loads.
The onset of the disease is the breakdown of glycoproteins - complex substances, which are a combination of proteins with polysaccharides. These substances determine the elasticity and elasticity of the connective tissue. Further, the process extends to the bony structures of the spine adjacent to the cartilage. Such processes are called degenerative-dystrophic.
The intervertebral disc suffers first in the development of pathology. It consists of a pulpous gel-like nucleus and a fibrous ring. With the development of osteochondrosis, the gel-like substance of the core dries out, losing its elastic cushioning properties. Then the fibrous ring is broken: cracks or tears are formed through which the core substance can go beyond it. The vertebrae begin to experience great mechanical stresses, which leads to increased formation of bone and fibrous tissues in places of increased stress on the spine and the appearance of bone growths - osteophytes.
Causes of development of the disease in the lumbar department of the
A degenerative process is triggered in the spine under the influence of several factors. In various situations, usually one of them prevails, while others create favorable conditions for the progression of the disease. Therefore today, osteochondrosis of the lumbar region is considered a multifactorial disease.
The most important reasons:
- Static load in unfavorable conditions: long retention of the working tool in one position, pressing something;long standing, when the spine experiences the greatest load due to gravitational forces( osteochondrosis first appeared in a person erect).
- Flat feet.
- Wearing heavy bags and cargo.
- Physical overload in sports or hard physical work. Injuries and microtrauma.
- Long stay in forced half-bent position, for example, during school, university, work in the office and at home at the computer, driving in the car. At this moment, the external pressure on the disk can be increased up to 20 times, as it turns out to be a compressed vertebra.
- Hereditary predisposition. Hereditary factors are of a different nature and can be associated with congenital disorders of the structure of the skeleton( contributing to an incorrect distribution of the load on the spine) or metabolic peculiarities( in which the synthesis of glycoproteins can be slowed or broken).
Osteochondrosis of the lumbar spine is an irreversible process. Manifestations of the disease depend on the degree of development of pathology. There are four degrees:
- 1st degree - the period of change and movement of the gelatinous nucleus inside the disk.
- 2nd degree - the period of destruction of the fibrous disc ring.
- 3rd degree - the period of ruptures of the fibrous ring and the release of the substance of the gelatinous nucleus beyond its limits with the formation of a herniated disc.
- 4-th degree - the period of the degenerative process on the vertebrae with the involvement of intervertebral joints and ligaments. There is development of arthrosis of the intervertebral joints( spondyloarthrosis).
Some authors distinguish three degrees, but in all cases their designation is conditional and given for a better understanding of ongoing processes, their connection with the symptoms and the prognosis of the disease.
At the first degree of pathology, pain occurs due to irritation of nerve endings in the fibrous ring and longitudinal ligaments. The patient feels local discomfort in that part of the spine where the affected disc is located: acute pain or lumbago lumbago, dull pain of a permanent nature( lumbalgia).
Irritation of nerve endings leads to the development of reflex syndromes that characterize the first degree: impulses from irritated endings spread to the spinal cord and "transmit the problem" to other organs and tissues. It is for this reason that a person can experience pains far from the "problem" place: there may be a reflex spasm of muscles and blood vessels, a violation of blood supply in the limbs, ligaments, disruption of the internal organs. Violation of the blood supply and nutrition of ligaments and tendons leads to the appearance of painful changes and seals in places where they attach to bones( enthesopathies), which often become the main cause of suffering.
Other characteristic symptoms of lumbar spine osteochondrosis at this stage are pain in the lumbosacral segment, which gives up in the leg( lumboishialgia), or pain only in the leg( sciatica, is much less common).
Spasm of large hip vessels can cause blood flow disorders and feign diseases of arteries of lower limbs, such as obliterating atherosclerosis. In rare cases, there may be bladder and urinary incontinence.
The 2nd degree is characterized by the appearance of instability and increased mobility of the vertebrae, which causes a prolonged and persistent muscle strain. The patient feels such symptoms as a constant fatigue of the muscles of the waist, discomfort, a feeling of "uncertainty in his back."
On the third degree in connection with the prolapse of the disc fragments, the so-called radicular syndromes are observed, which are associated with the compression of the nerve roots by the fallen fragments.
Patients experience a sensitivity disorder in the innervation zone of the * compressed nerve. At first they feel an increased sensitivity in a certain area, burning, tingling, then numbness occurs, a complete loss of sensitivity may develop. Decreased sensitivity is accompanied by impaired motor function until the onset of paralysis, as well as thinning and decreasing muscle volume( atrophy).
* Innervation - the connection of organs and tissues with the central nervous system through nerves.
In the area where these changes develop, it is possible to judge the specific site of the lesion in the spine department. If the area of the upper part of the foot suffers( it is called the rear of the foot), there is weakness in the extension of the thumb, the process is associated with damage to the intervertebral disc between the 4th and 5th lumbar vertebrae. If such symptoms occur in the area of the heel and the outer edge of the foot, a weakness appears in the gastrocnemius muscle, the patient experiences difficulty in trying to walk on the heels - possibly a disc injury in the lumbosacral segment.
A characteristic sign of lesion of the lumbosacral department in the third degree is a symptom of Lasega. The doctor lifts a straight leg lying on the back of the patient, with severe pain in the lumbosacral segment spreading over the back of the foot. When bending the leg in the knee joint, the pain stops immediately.
When the fragments of intervertebral discs fall into the lumen of the spinal canal, there are signs of spinal cord injury.
There may be a "ponytail" syndrome, in which the bundle of spine nerves in the lumbar and sacral segments collapses. In this case, the sensitivity and motor functions of the legs, the functions of the pelvic organs( most often the bladder) are disturbed.
In the 4th degree, the intervertebral ligaments, joints are involved in the process, the fibrosis of the disc is involved - replacement of all its elements with a dense cicatrical connective tissue. This period can be characterized by the disappearance of the pain syndrome, the restoration of the supporting function of the spine, but simultaneously there is a significant limitation of the amplitude of movements in it. Different stages of the process can be observed in different affected discs, so the manifestations of the disease can be very diverse.
In the treatment of osteochondrosis of the lumbar spine, medicamentous, non-medicamentous and surgical methods are used. Since osteochondrosis of the spine is an irreversible process, the treatment is aimed at eliminating clinical syndromes and preventing the progression of the disease. Maximum forces should be applied for treatment with conservative methods.
In the first stage of therapy, the exclusion of provoking static and dynamic loads is of the utmost importance, with severe exacerbation it is necessary to observe bed rest. Sometimes this measure helps more than medications.
Medications( painkillers and various derivatives of non-steroidal anti-inflammatory drugs) are prescribed for the removal of pain and inflammation: ibuprofen, ketoprofen, lornoxicam, meloxicam, etorikoksib, celecoxib, nimesulide, etc. Medications can be in tablets or injections depending on the specific situation. When they are not effective, glucocorticoid hormones are used: dexamethasone, prednisolone, betamethasone, triamcinolone, etc. The doctor can do injections with these drugs directly to the location of the disease site. Obligatory in the treatment of osteochondrosis is the intake of vitamins of group B: B1, B6 and B12.
Sedation medications( relanium, diazepam, zopiclone), anticonvulsants( topiramate, gabapentin, pregabalin, etc.) and antidepressants in tablets( amitriptyline, clomipramine, fluoxetine, trazodone, etc.) can be prescribed to eliminate reflexogenic and accompanying psychogenic disorders. With signs of radicular syndrome, diuretics are prescribed, and for paralysis - anticholinesterase drugs( galantamine, proserin, ipidacrin).
Currently, in the treatment of osteochondrosis, chondroprotectors( chondroxide, structum, rumalone, arteparone, etc.) are widely used. However, reviews about them are ambiguous, at the moment their effectiveness has not been reliably proven.
In an acute period for pain relief, novocain blockades can be applied - the introduction of local anesthetic drugs directly into the affected area.
On the photo - ibuprofen from different manufacturers
How to treat an ailment after eliminating acute pain? It is necessary to begin therapy immediately with non-drug methods. Applied therapeutic gymnastics, massage, physiotherapy procedures, acupuncture. It is quite popular electrophoresis and phonophoresis with caripazime on the affected area of the spine. Caripazim is an enzyme preparation that promotes resorption of the discarded areas of the disc.
If the conservative methods are not effective, an operation can be performed.
Surgical treatment is performed in the following cases:
- If it is not possible to stop pain by other methods for 3-4 months. With very intense pain, surgical treatment can be performed after 2 weeks.
- "Ponytail" syndrome.
- Signs of acute compression of the roots of the spinal cord( weakness and numbness in the extremities).
Contraindications to the operation - some severe diseases, old age.
Today for the treatment of osteochondrosis high-tech methods of surgical intervention are used: microsurgical, percutaneous endoscopic. Thanks to new technologies, it was possible to significantly improve the prognosis, rehabilitation in the postoperative period and shorten the period of temporary incapacity for work.
What can the patient do at home?
At home, especially with chronic pain of a permanent nature, you can treat osteochondrosis, using dry heat, compresses, applicators Kuznetsova and Lyapko.
It is important to take care of rational physical activity, to exclude postures in which the body is in a forced unnatural position, to organize a comfortable place for work, sleep and rest.
Sufficient attention should be paid to physical activity, gymnastics, to ensure maximum unloading of all parts of the spine. Often these measures can completely eliminate pain and help better the most modern tablets and injections.
Self-treatment of osteochondrosis prior to diagnosis is dangerous, since similar symptoms can be observed, for example, in tumor processes, and improper procedures can aggravate the situation.
It is important to read: the symptoms of osteochondrosis.
Osteochondrosis of the lumbosacral spine
What is osteochondrosis of the lumbar spine?
Osteochondrosis of the lumbar spine is a disease that is a special form of spine injury. Patients with such ailment complain of rapid fatigue, pain in the back, legs, which causes the limitation of motor activity. With osteochondrosis, deformation of the intervertebral discs occurs, a decrease in their height, a dystrophy and a beak-like growth of the vertebrae are observed. When diagnosed on an X-ray, displacements of the disks are clearly visible.
Deformation of the cartilaginous tissue during the development of osteochondrosis is a complex process, including including biochemical and vascular changes. First of all, there is a destruction of the fibrous ring, as a result of which pulpous is introduced into it. As a result, the fibrous ring ruptures and a disc herniation is formed. The greatest strain is exerted on the lower lumbar and lower lumbar segments. Herniated disc, squeezing the spinal cord or its roots, causes back pain, which respond in the leg.
The most powerful sciatic nerve in the human body is formed by the sacral roots of the spinal cord. They, as well as the lower lumbar roots are irritated with osteochondrosis. From the Latin name of the sciatic nerve in connection with this was formed the second name of the disease-sciatica.
Due to the disruption of the structure of the cartilaginous tissue, the intervertebral discs, which are special cartilaginous structures, can no longer perform all their functions in full. This leads to loss of flexibility and mobility of the spine. The processes that affect only the intervertebral discs at the initial stages of the disease gradually spread to the vertebrae themselves.
Discogenic radiculitis, which is considered one of the most common symptoms of osteochondrosis, occurs in almost every fifth person over 30 in the world. In the risk group, most often people of working age are. Osteochondrosis deprives the ability to engage in active activities and often becomes the cause of disability.
Symptoms of lumbar osteochondrosis
The main symptoms of lumbar osteochondrosis are severe back pain. However, in addition to this feature, there are a number of others. Thus, patients suffering from this disease quickly become tired, complain of headaches, fatigue and irritability. Discomfort in the back area does not allow choosing a comfortable position for sleep, so the body can not fully rest and recover after the end of the day. The decline in strength forces the patient to minimize physical activity and avoid pain. This leads to the fact that over time it becomes unable to perform even simple actions, for example, to ensure their own domestic needs.
Problems in the work of the genitourinary system can also be one of the symptoms of lumbar osteochondrosis. They manifest themselves in the form of pain in the kidney area. In patients with osteochondrosis, urination is impaired, possibly an unexpected occurrence of causeless discomfort. This leads to instability of the vertebrae, which, due to deformation, are not fixed by intervertebral discs. The load on the spine provokes the displacement of the lumbar region from the sacrum when the force of gravity is applied to it. Such a process leads to damage to internal organs, problems in their work. Women often suffer from ovaries, epididymis and uterus, and in men the potency is impaired.
For osteochondrosis is characterized by an increase in the sensitivity of the legs, including the feet, hips and legs. They cause spasms, which can lead to a complete loss of heart rate. The skin of the patient with osteochondrosis on his legs is very dry, scaly and covered with goose bumps in the area of discomfort. During sweating, sweating is disturbed.
All symptoms of osteochondrosis can be classified into the following groups:
Thinning of intervertebral disks leads to loss of vertebral stability. Having become mobile, they with sharp movements and heavy physical exertion begin to irritate and squeeze blood vessels and nerve roots. This process minimizes pain in the lumbar region, but they renew with renewed force where the nerve is squeezed. The pain is acute and has a drilling character. The most severe discomfort is expressed in the lower leg, thigh, foot and buttock. Unpleasant sensations cause the patient to change the gait, bending in the opposite direction from the squeezed nerve.
When the nerve roots are irritated for a long time, their inflammation, swelling, venous congestion and intoxication occur. The pain extends to the muscles, ligaments. The most acute it happens in moments of physical exertion, especially if you hold it without warm-up immediately after sleep or rest. Pain is often accompanied by excessive sweating, which is replaced by a feeling of chill.
To the manifestations of radicular syndrome also include tingling, numbness and loss of sensitivity. Muscles lose their tone, so patients become unable to endure prolonged physical exertion, for example, to go down and climb the stairs, quickly get tired. The functions of the small pelvis are violated in especially severe cases. It is even possible that paralysis and paresis occur.
Near the nerve roots are located blood vessels, which are deformed when deformed. At the first stages of the development of osteochondrosis, the arteries are compressed periodically, but then the spasm acquires a permanent character. In this case, there is "intermittent claudication", the patient with a long walk should often stop and rest.
The compression of the blood vessels leads to the fact that the organs of the small pelvis do not receive the necessary nutrients. This causes pain on the inner side of the thighs, perineum, in the buttocks until their paralysis.
Under the influence of pain, ischemia and radicular syndrome, the skeleton of a patient with osteochondrosis deforms. The person begins to stoop, his pelvis and spine buckle, the muscles weaken, atrophy. All these changes affect the gait, which is adjusted depending on the area of pain, becomes tense and insecure. Gradually, the whole musculoskeletal system is exposed to osteochondrosis, and the intervertebral discs continue to collapse.
Pain syndrome( pain in lumbar osteochondrosis)
Unpleasant sensations and discomfort in the back are the main symptoms in osteochondrosis. The nature and strength of pain varies depending on the stage of development of the disease.
First time it is felt only in the lumbar region at the time of increased tension of the joints, muscles and ligaments, that is, when performing physical exertion. Can also wear a constant aching character. But with the development of osteochondrosis, acute pain or lumbago occurs even when sneezing, coughing.
Conduction of palpation, as a rule, allows you to determine the compaction in the muscles. The attack of pain can last several days, and all this time the patient has to comply with bed rest to minimize discomfort in the back. Any sharp movements, lifting of weights provoke occurrence of a dyscomfort.
Causes of lumbar osteochondrosis
The following are the main causes of lumbar osteochondrosis:
Uneven load on the spine. According to experts, osteochondrosis is typical for humans as a biological species, because it is largely due to its lifestyle and upright walking. The need to maintain the position of the body in a certain position requires constant stress of the musculoskeletal system. The optimal load on the spine will be in the standing position. In the supine position on the back, it is minimal, on the side - a little more. But in a sitting position, the load on the lumbar spine increases several times. The inclination of the body forward creates additional stress for the front edge of the vertebrae and spine. Therefore, it is recommended to periodically change the position of the body, letting the muscles relax and shifting the load on the spine, and keep your back straight.
Hypodynamia. Sedentary lifestyle, use of a car and public transport, spending a lot of time at the computer and TV - all this contributes to the development of problems with the spine, including osteochondrosis. A significant part of the population lacks motor activity. Passive way of life leads to the fact that the musculoskeletal system weakens. In the sitting position, the spine undergoes maximum load, this causes the deformation of the cartilaginous tissue, and as a consequence, the osteochondrosis of the lumbar region. Therefore, it is so important to periodically get up and perform a set of exercises. When a significant amount of time a person spends in a bent position, flexor muscles stretch and lose their tone.
Too much physical activity. Increased motor activity, as well as its lack, can also cause osteochondrosis. Back pain often disturbs sportsmen who are engaged in weightlifting. This sport requires lifting weights, which creates additional stress for the muscles of the back and provokes the formation of intervertebral hernias.
Incorrect posture. With a curved position of the spine, the load on it is distributed unevenly, and this leads to deformation of the intervertebral discs. The same influence is made by wrong walking. People at the senior and elderly age are at risk, since with time the intervertebral discs become less elastic, lose their mobility and are more easily damaged.
Defects in the osseous system and genetic predisposition, trauma and infectious diseases. As a rule, osteochondrosis causes congenital problems with the musculoskeletal system. In addition, the cause of the disease can be the natural fragility of cartilage tissue. Osteochondrosis develops as a complication after various injuries of the spine, osteomyelitis, tuberculosis.
Flat feet. In patients suffering from flatfoot, the arch of the foot does not perform damping functions, as it does in the normal state. Thus, when moving the entire load on themselves take intervertebral disks, resulting in their rapid wear.
Overweight. Extra pounds are a source of additional stress on the heart and the musculoskeletal system, including the spine. According to statistics, people with excess weight are more susceptible to various diseases.
Inflammatory processes in the body. The development of osteochondrosis is promoted by such factors as hormonal changes, problems with the joints of the spine, for example, rheumatoid arthritis, disruption of the endocrine, digestive and cardiovascular system.
Lifestyle. Many patients do not pay enough attention to their health: they do not move much, they do not get enough sleep, they do not eat right. This leads to increased fatigue, impaired psychoemotional state, stress. All this makes the body very vulnerable and contributes to the development of lumbar osteochondrosis.
Degrees of lumbar spine osteochondrosis
There are 4 degrees of lumbar osteochondrosis:
Inside the fibrous ring, cracks appear, which are filled with substance from the gelatinous nucleus, which causes irritation. At this stage, the deformation of the intervertebral discs is poorly expressed and manifests itself in the form of reflex-pain symptoms. The patient may complain of pain in the heart, lower back. In the back area, the cause of discomfort is sudden movements, lifting weights. Depending on the nature, 2 types of pain are distinguished: lumbulgia and lumbago. In the first case, it is stable, and in the second it arises suddenly;
Fracture of the fibrous ring continues. However, the gap between the vertebrae is narrowed, the nerve endings are jammed. At this stage, a phenomenon such as pseudo-spondylolisthesis of the lumbar region is characteristic. This is the process of displacement of the vertebrae relative to each other, which leads to pinching of the nerve endings and causes pain. The spine is characterized by uncharacteristic mobility. With osteochondrosis of 2 degrees, patients complain of pronounced discomfort in the back, alternating heat and cold in the lumbar region. Pain is manifested by attacks, during which a person on the skin appears crawling and sweating is intensified;
The fibrous ring is finally ruptured, and the gelatinous nucleus is extruded. Appears intervertebral hernia. Extrusion of the nucleus into the region of the vertebral canal leads to compression of the vessels and roots of the spinal nerves.
The deformation of the spine is in the form of lordosis, kyphosis or scoliosis. With lordosis, the spine faces a convexity forward. Such a violation of his normal position significantly complicates the work of internal organs and their systems. With the kyphosis the upper part of the spine warps, and there is a sensation of stoop or hunchback in neglected cases. Lateral curvature is manifested in the form of scoliosis. When a patient suffering from osteochondrosis with such a curvature of the spine leans forward, asymmetry becomes evident due to a protruding scapula or rib;
The last stage of osteochondrosis is the most dangerous, since the spine is completely deformed, which makes full motor activity impossible. On the roentgenogram, bony growths become noticeable. Although the pain for a while does not bother the patient, this does not indicate improvement.4 degree of osteochondrosis often ends in disability.
What is the risk of lumbar osteochondrosis?
Osteochondrosis leads to a weakening of the musculoskeletal system, atrophy. In addition, the disease contributes to the occurrence of problems with various organs in the body. The most common of these are disorders of the genitourinary system. For women, osteochondrosis creates the risk of deformation of the intervertebral discs during pregnancy, when the spine experiences a significant load. Men have problems with potency. Deformation of intervertebral discs due to osteochondrosis leads to the appearance of hernias. They require long and complex treatment, in some cases, surgical intervention is necessary.
In osteochondrosis, blood vessels are squeezed and the intervertebral openings through which they pass are reduced. As a result, there is a danger of developing compression-vascular ischemia. It implies an additional compression during the movement of the damaged spine and clamping of the vessels. With compression-vascular ischemia, the phenomenon of a "narrow bed" is associated. Clamping of the vessel thus occurs reflexively through the opening of the spinal canal.
Another complication that can cause osteochondrosis is protrusion of intervertebral discs. In the future, it leads to the development of such a serious disease as the intervertebral hernia. With protrusion, the intervertebral discs protrude beyond the fibrous ring without causing a rupture. This process is accompanied by aching pains, which are permanent in nature. Protrusions are indicated by tingling in the feet, numbness, pain in the feet and fingers, with urination.
As a complication of osteochondrosis, spondyloarthrosis is possible. Sometimes it stands out as a special form of the disease. Spondyloarthrosis manifests itself in the form of bone spike-like growths. The pain is localized in this case. Unlike unpleasant sensations in such complications of osteochondrosis, as hernia, protrusion, it does not extend to the legs, does not cause numbness and tingling. The pain is aggravated by sharp turns and some other movements of the spine.
Patients with osteochondrosis are more susceptible to paresis of the foot. In this case, they have pain in the back, which gradually spreads to the popliteal region, and then causes a disruption in the functions of the foot. She does not rise and hang. During walking, the patient has to raise his leg high. In most cases, paresis requires an operation to restore the function of the foot.
Deformation of intervertebral discs with osteochondrosis causes spondylosis. It implies the appearance of beak-shaped protrusions or spurs on the spine above the protruding intervertebral discs. Such bone growths are a kind of protective mechanism that works in response to changes in the cartilaginous tissue. With osteochondrosis, the spine becomes unstable, so the body tries to correct it by increasing the area of the vertebral body. So spondylosis develops.
All complications caused by osteochondrosis are treated with difficulty and significantly complicate the life of the patient, limiting his ability to work and the ability to move. Therefore, it is important to start the fight against the disease in time, preventing serious consequences and disability.
Diagnosis of osteochondrosis involves the use of various methods, primarily, palpation of the lumbar spine.
During the course of this disease, the following signs are found:
kyphosis, that is, wedge-shaped deformation of the vertebrae;
scoliosis, which is the asymmetry of the body or the curvature of the spine. At a scoliosis at the patient ribs or a scapula act, that should not be at the healthy person;
change in flexure of the spine - flatulence of lordosis;
pain in the lumbar region;
offset one of the buttocks.
Patients, as a rule, have difficulty in performing active movements with a load on the spine.
The most modern diagnostic methods are:
Radiography of the lumbar spine. It is executed in a straight posterior and lateral projection, which are mutually perpendicular. According to the picture, the specialist determines the shape, structure and contours of the vertebrae, deformities of the spine and bone growths on it. When osteochondrosis on the roentgenogram it is noticeable that the intervertebral cleft is narrowed, in the tissues of the disk there are deposits of salts, there are observed marginal sprouting of the vertebral bodies;
Computerized tomography of the lumbar spine. The use of this method has a lower radiation load on the body compared to radiography. The patient does not experience pain during examination. As a result of tomography, it is possible to obtain more informative pictures than with radiography.
Magnetic resonance imaging of the lumbar region. MRI, like the other two methods, does not give the patient unpleasant sensations and does not harm the body. According to the images created with the help of electromagnetic radiation, it is possible to diagnose not only osteochondrosis, but also many other diseases of the spine.
Treatment of osteochondrosis of lumbar spine
Treatment of osteochondrosis requires extensive complex therapy, which implies moderate physical exertion, use of medicines, massage, physical therapy, traction of the spine, manual therapy. Only a few cases are resorted to surgical intervention.
As a rule, the operation of the operation is indicated by ponytail syndrome, as well as loss of control by the patient over urination and defecation. To confirm the diagnosis, an MRI should be performed. Before performing the operation, it is recommended to consult several specialists, since often it is possible to manage conservative methods of treatment.
Lfk with lumbar osteochondrosis
Physiotherapy is one of the most effective ways to get rid of osteochondrosis. Often it is compared with a massage that provides a short-lived effect. After all, the masseur can stretch the spine, but if the muscles do not support the vertebrae in the right position, soon the pain and deformity will reappear.
To engage in exercise therapy for osteochondrosis should be led by an instructor. Important is the correctness of the exercises, so make them better in front of the mirror. To achieve the best result, training should be regular. This allows you to return the spine flexibility, mobility, normalize the metabolism in the body, to form a muscle corset.
Gymnastics for lumbar spine osteochondrosis
Gymnastics for osteochondrosis should include only those exercises that do not cause the patient discomfort. If the performance of some is accompanied by pain, you should return to them later, when the improvement of the health of the spine becomes noticeable. It is also necessary not to allow too much tension for the muscles, to increase the load gradually.
As part of the gymnastics for osteochondrosis, you can perform the following exercises:
from the standing position, tilt the whole body back and forth, left to right;
get on all fours and take a few steps forward, then return to the starting position, repeat the exercise several times;
lie on a flat surface and strain the muscles of the press, pressing your back into the floor;
stretch out his hands behind his head and reach for them with his whole body.
Massage for lumbar osteochondrosis
Massage for osteochondrosis is also effective, as is therapeutic exercise. But there are a number of contraindications, including acute pain in the patient, presence of open wounds on the body, skin and blood diseases. More effective will be manual massage, which in large measure surpasses in its positive effect on the nervous system hardware.
This method of treatment allows you to remove muscle tension and pain, stimulates blood circulation and strengthens blood vessels. Among the positive effects that massage has on the body, also strengthening immunity and improving metabolism.
Nyxes in osteochondrosis of the lumbar department of the
During the attacks of osteochondrosis patients are concerned about severe pain. In the first stages, they are cared for by means of tablets and ointments, but as the disease progresses, they no longer produce the desired effect. Therefore, injections are often used as an anesthetic. The injections have a number of advantages, among which speed of action.
Before the tablet drug stops pain, it should take at least half an hour. With injection, you can cope with discomfort much faster. In addition, the injection is placed in the area of the onset of pain, which allows to avoid the negative effect of the drug on other organs. At injection the dose is more precisely calculated.
The following groups of drugs are used for osteochondrosis of the lumbar spine:
Analgesic. The most famous means are Analgin and Baralgin. Drugs of this group are used only for severe pain.
Non-steroidal anti-inflammatory drugs. A specific drug is prescribed depending on the intensity of pain and their nature, the degree of development of osteochondrosis. The most effective means of this group, such as Ibuprofen, Diclofenac sodium. They eliminate inflammation, pain and puffiness, prevent the squeezing of nerve endings.
Myotropic antispasmodics. Miolcam is a drug that eliminates spasm of skeletal muscles in the spine and gets rid of pain. The injection is performed 2 times a day. After the administration of the drug pain receptors are blocked and stop sending signals to the spinal cord.
Glucocorticosteroids. Ambene is widely known from the preparations of this group. This combined agent produces a multi-faceted effect, eliminating inflammation and positively affecting the nervous system. On the day, 2 to 3 Ambien injections are performed.
Article author: PhD Volkov Dmitry, surgeon
acute and chronic low back pain lumbar department
People leading a sedentary lifestyle, as well as those who injured his back, are more susceptible to such diseases as osteochondrosis of the lumbar. Among the professions that are at risk - work as a loader, driver, builder, waiter. At risk are all those who have sedentary work.
Separate several types of osteochondrosis: cervical, thoracic and lumbar. But it can be combined if the changes have touched several parts of the spine at once.
Causes of the disease
Poor heredity causes diseases of the lumbar region in most cases. And only in 40% of patients the disease was provoked by external adverse factors. Osteochondrosis of the lumbar region is characterized by sharp and aching pains. Aching pain in the lumbar region occurs with prolonged lying or sitting. The sharp ones are caught at the most inopportune moment. They prevent a person from unrolling and have an impulsive character. The culprits of all this are the nerve endings, which turn out to be jammed. Nerves of the spine can also be irritated. Swollen ligaments and muscles of the lumbar spine.
Isolated osteochondrosis of the lumbar region is very rarely observed, most often it is accompanied by cervical osteochondrosis. This disease is characterized by the destruction of the connective tissue of the intervertebral discs, ligaments and joints. The fact that the load provokes a metabolic disorder, and this, in turn, is a direct way to osteochondrosis of the lumbar region. At the very beginning of the disease, glycoproteins disintegrate. They help the connective tissue to be supple and elastic. Then this process affects the bony tissues of the spine, which are in contact with the cartilage. First of all, with degenerative and dystrophic lesions, intervertebral disks fall under attack. With the development of the disease, the vertebrae can not cope with their function of depreciation, so the load on the spine increases, which subsequently leads to bone changes.
Lumbar disease causes several factors. Sometimes only one of them affects, and the rest allows the osteochondrosis to progress. Here are some of them:
- excess weight;
- strong physical load without a change of position, when the most active is gravity( standing and sitting);
- heavy weights;
- flat feet;
- heavy physical labor;
- excessive exercise;
- a sitting semi-bent position for a long time when working in the office, driving a motor vehicle, when the intervertebral pressure grows tens of times.
- heredity( congenital disorders of the spine and low level of metabolism).
Symptoms of lumbar spine osteochondrosis
The first symptom of lumbar disease is pain in the lower back. They can even give to your feet. Degenerative dystrophic processes have a number of problems, which are associated with joints, discs and osteophytes. The latter are bony expansions that appear in the area of a strong load on the vertebrae. Discogenic pain and protrusion of the disc are the main problems of the lumbar spine.
In the lower back there are sharp pains that do not allow to straighten up, or aching, appearing in the morning after a long sleep and with prolonged sitting. This is due to pinching of nerves. Irritation and swelling of the muscles can also be the cause.
Pain in the lumbar region increases during coughing and sneezing, when the body tilts forward. In the osteochondrosis of the lumbar region, the lower back may ache, Some areas of the skin and muscles of the buttocks, thighs and lower legs become insensitive. There is a curvature of the lumbar spine.
There are several types of osteochondrosis:
- scoliosis( the spine is curved in the right or left side);
- lordosis( bending forward is observed);
- kyphosis( the spine is bent backwards).
If the nerve endings are trapped in the lumbar region, then urination and defecation may be impaired. Insensitivity of the genitals and perineum is also possible.
As a rule, acute osteochondrosis appears after prolonged physical exertion, even for some time after their termination. Very often patients are talking about aching dull pain in the lumbar region, which can give in the leg. Sometimes complain of pain, which increases the ride, coughing, heavy loads. If you keep a single pose for a long time, it is also possible to increase pain.
Symptoms of lumbar disease include:
- loss of sensitivity in the lower part of the trunk;
- sensation of cold feet;
- artery spasms on the feet;
- tingling in the muscles of the legs;
- overdried skin where there is pain and sensitivity disappears;
- increased sweating.
The most terrible manifestation of osteochondrosis of the lumbar spine is the instability of the vertebral discs. Under the influence of physical exertion, the vertebra not fixed by the disk tends to creep. Therefore, with osteochondrosis, the lumbar region can move from the sacrum, which can damage internal organs.
Degree of disease
Osteochondrosis of the spine is considered an irreversible disease. Allocate 4 degrees of the disease.
- The kernel changes and moves in the spinal disk. As a consequence, the spinal disc is torn. This can happen with sudden movements or overexertion.
- The fibrous ring breaks down. Loads increase chronic pain. Remission and exacerbation alternate with each other. The cervical region is characterized by pain in the neck, head, upper limbs. Fingers of hands periodically grow numb, discomfort appears. For the lumbar region, a distinctive feature will be pain in the lower half of the trunk and a feeling of fatigue in the legs.
- Spinal hernia is formed. Fibrous ring is broken. The core goes beyond it. In patients with osteochondrosis, limbs become numb, gait changes, pains in the head and in the place where the nerve is affected. With the intervertebral hernia in the cervical region, patients suffer from frequent headaches, dizziness, loss of vision and hearing, and weakness in the upper limbs. With osteochondrosis of the thoracic part, the rhythm of the heart is broken, it becomes difficult to breathe. When the lumbar region is affected, kidneys, the gastrointestinal tract, and the genitourinary system are affected. Neme lower limbs.
- The degeneration of the vertebrae increases, it seizes the ligaments and joints between the vertebrae. At this degree of disease, symptoms become weaker. The vertebral hernia does not make itself felt, but the vertebrae continue to slip and twist. The vertebral bodies expand and cover the spinal cord in the canal and can squeeze it, clamp the nerves. If the vertebral hernia is removed by surgery, then all the disorders that arise in connection with this, also refer to the 4th degree of osteochondrosis.
Chronic and acute course of the disease
Degenerative processes of the lumbar osteochondrosis narrow the channel through which the spinal cord and blood vessels pass, and with physical activity or unsuccessful movement, compression may occur. In chronic osteochondrosis of the lumbar region, compression can occur without a provoking factor, since the channel gradually narrows and the time begins when the contents begin to squeeze. If we are talking about blood vessels, the artery narrows or clogs and stops passing the right amount of blood. The organ that she nourishes, dies.
In chronic conditions, the osteochondrosis of the lumbar region provokes paresis of the lower extremities and makes the genital area of the insensitive.
In the acute phase, the symptom that dominates is pain. It has a local character and occupies the lumbar region. Painful sensations are very strong, cutting. Such pain does not allow a person to actively move. At its aggravation the patient is forced to spend all the time in bed and takes a forced pose. If a diagnosis is made that it is lumbar, lumbar or crural osteochondrosis, the patient is assigned a bed rest. If for some time he will comply with the injunction, the affected vertebral disc will recover much faster. The disease will not have a chance to progress.
Osteochondrosis at a young age
It used to be that osteochondrosis is a disease of adults, they are sick with people who are already over 40. However, recently this diagnosis is increasingly put to children and adolescents. They complain of back pain, and studies show that they have degenerative dystrophic changes. Very often the disease progresses rapidly and at such a young age, an intervertebral hernia can develop.
Juvenile osteochondrosis has a number of differences from the course of the disease in adults. With changes in the cervical and lumbar region, pain is less pronounced. Disorder of motor function is very rare.
If a child has cervical osteochondrosis, he complains of dizziness and headache, quickly becomes tired of physical activity. At the same time, the neck and shoulders of pain are not affected.
When diagnosing the disease of the thoracic region, the child is difficult to breathe, there is pain in the upper part of the trunk.
In juvenile osteochondrosis of the lumbar region, the clinical picture is the same as in adults.
To prevent the onset of the disease, children and adolescents need to exercise, paying special attention to the muscles of the back.
Symptoms of osteochondrosis of the lumbosacral spineOsteochondrosis of the lumbosacral spine is a common cause of the appearance of pain with restriction of mobility in the lower back and legs. Primarily formed in middle-aged people due to changes in the structure of intervertebral discs and vertebrae.
What is osteochondrosis?
When osteochondrosis changes the normal structure of the cartilaginous tissue. The intervertebral disc consisting of a cartilaginous plate, a pulpous nucleus and a fibrous tissue loses water with age, it becomes flattened, loses its elasticity. Deformation and thinning of the intervertebral disc leads to a reduction in the spacing between adjacent vertebrae, deformation of the vertebral surface, compression of the vessels and nerve root ends.
Disease can occur in one department of the spine or simultaneously in several. The defeat of several segments of the spine - lumbar, thoracic and cervical - is called polysegmentary osteochondrosis. Most often, the lumbar segment is affected due to functional and anatomical features.
The maximum load falls on the lumbar spine when lifting any weight and keeping the upper half of the trunk in an upright position. The lumbar segment consists of large vertebrae and has relatively thin intervertebral discs. Physiological lordosis and the above factors lead to maximum vulnerability of this segment of the spine.
Causes of lumbar spine
There are several main factors provoking the formation of osteochondrosis:
- minimal physical activity, prolonged fixation of one posture, for example, with sedentary work;
- various congenital and acquired abnormalities in the structure of the musculoskeletal system - curvature of the legs and spine, flat feet;
- intensive physical work with lifting heavy objects;
- is overweight;
- back injury;
- autoimmune diseases with joint and spinal injuries;
- infectious diseases with a predominant lesion of the bone system - tuberculosis, osteomyelitis;
- age changes;
- various hormonal changes in metabolism( more often in women).
Signs and symptoms of osteochondrosis of the lumbosacral spine
The main signs of osteochondrosis are pain sensations of various intensity in the lumbar segment of the spine with the spread of pain on the buttocks and the back surface of the legs. More often the signs of osteochondrosis appear after a high load on the lumbar region or hypothermia. Symptoms of osteochondrosis grow gradually depending on the stages of the change of the cartilaginous plate, fibrous ring, as well as the compression of nerve endings and blood supply vessels. At the first stage, the disease can be asymptomatic.
The main symptoms of lumbar osteochondrosis:
- pain in the region of the lumbosacral segment of the spine. Painful sensations are permanent( lumbalgia) or shooting( lumbago).At the initial stage, pain occurs only after physical overstrain, then has a permanent character and can occur at the slightest stress( coughing, sneezing);
- decreased mobility in the lumbar segment, a compensated increase in muscle tone. Patients can not hold a single position for a long time, a change in the position of the body increases pain;
- spread of pain to lower limbs;
- decrease in the sensitivity of the skin of the legs, violation of blood supply;
- muscle weakness in the legs, lowering the threshold of tendon reflexes;
- malfunction of the urinary system and intestines;
- neurasthenia, characterized by increased irritability, mood swings, fast fatigue, depression.
Four degrees are distinguished during osteochondrosis:
- at 1 degree of change in the cartilaginous tissue lead to microfractures of the fibrous ring and redistribution of the gelatinous nucleus. During this period, there are minor, short pain, numbness in the lower back, which quickly pass after rest;
- at 2 degrees due to flattening and thinning of intervertebral discs, the distance between a number of located vertebrae decreases, irritation of nerve endings is observed. The pain in this period is of a persistent nature, extending to the buttocks, thighs, and thighs. Exacerbation of pain is accompanied by a feeling of heat or cold in the lumbar region, sweating, paresthesia in the lower back and legs;
- at 3 degrees develops deformity of the vertebrae, osteophytes( bone formations) proliferation, curvature of the spine in the form of scoliosis, lordosis or kyphosis, due to a decrease in its length. The intervertebral disc is significantly deformed, possibly the appearance of protrusion or herniation of the disc. At this stage the pains are more intense and more prolonged, disorders in the activity of internal organs are manifested;
- at 4 degrees there is a persistent deformation of the lumbar region, a change in the position of the pelvis and extremities. Movement in the lumbar region is as limited as possible, lame appears.
Lumbar osteochondrosis with prolonged flow leads to the appearance of protrusion, then to the herniation of the intervertebral disc. The protrusion of the disc is characterized by its bulging beyond the spine, with a volume of 1-5 mm, without rupturing the fibrous tissue. When the outer shell of the fibrous ring ruptures, an intervertebral hernia forms. In addition, osteochondrosis can be complicated:
- by sciatica;
- with spondylarthrosis;
- of Schmorl's hernia;
- osteophytosis, spondylosis;
- stenosis of the spinal canal with compression and impaired spinal cord activity;
- compression of the "horse tail" with a breakdown in the functioning of the pelvic organs;
- paresis of the lower extremities.
Prevent progression of complications with timely diagnosis and comprehensive treatment.
Osteochondrosis of the lumbar spine. Symptoms and treatment of lumbar osteochondrosis
- How to eat properly with osteochondrosis?
One of the most common forms of osteochondrosis is osteochondrosis of the lumbar region , or more precisely, the lumbosacral spine. Very many - both men and women - are familiar with back pain in the lumbar region, sacrum, lower limbs, caused by various types of lumbar osteochondrosis and its complications. Among the causes of temporary disability and disability, this disease is one of the first places.
The course of the disease is chronic, usually with periods of exacerbations. Most often provoke exacerbations of the lumbar osteochondrosis, lifting and carrying of weights, hypothermia, stress, trauma.
Osteochondrosis of the lumbar spine - causes, mechanism of occurrence and development of
There is no single-valued cause of osteochondrosis, the disease is considered to be multifactorial. The most popular theory is that the cause of osteochondrosis of the spine is the constant overstrain of muscles or hypotension of muscles, non-physiological muscle tension, which leads to an overload of the vertebral segments, a deterioration in their blood supply and, ultimately, degeneration of the intervertebral discs and joints, resulting in osteochondrosis.
The cause of premature aging of intervertebral disks can also be endocrine and metabolic disorders, a hereditary predisposition to the development of osteochondrosis, autoimmune disorders, microtrauma. The negative role of visceral, that is, associated with internal organs, pathologies in the development of osteochondrosis of the spine is also proved. A significant role in the development of the disease belongs to the adverse heredity. The contribution of hereditary factors to the appearance of lumbar osteochondrosis is about 60%, the rest is attributed to factors of adverse external impact on the spine.
Factors contributing to the development of osteochondrosis in both the lumbar and in other parts of the spine are very numerous. The main ones are: abnormal posture, hypodynamia, muscle strain in the lumbar region as a result of constant weight lifting or sudden overload, hormonal changes, endocrine and somatic diseases, disruption of normal blood supply to the spinal tissues, emotional stress, age changes, poor nutrition. Under the influence of these factors in the structures of the spine, the processes of dehydration and circulatory disturbances, arthrosis and subluxation in small joints, bone proliferation, and herniation of discs-hernia gradually increase.
The most obvious causes of lumbar osteochondrosis are most often considered sedentary life and back injuries. Therefore, the risk group is primarily those people whose profession is directly related to the burden on the back. This is a very wide range of professions - the sellers and waiters, surgeons and teachers - all who are forced to spend most of their working time standing up. The group of risk includes builders and loaders, as well as athletes who, due to the nature of their activities, have heavy loads on the spine. In addition, from osteochondrosis of the lumbar region, drivers, various office workers, programmers suffer - that is, those who work mostly sedentary, and who suffer from hypodynamia.
Symptoms of lumbar spine osteochondrosis
With lumbar osteochondrosis painful sensations of various character are possible. This can be like aching pain that occurs with prolonged sitting or after sleep, and sharp shooting, catching in the most uncomfortable position and not giving the opportunity to straighten. The pain is caused by pinching of the nerve roots, irritation of the spinal column nerves, edema and irritation of muscles and ligaments located in the zone of innervation of the lumbar spine.
Pain syndrome can be caused by compression of the radicular structures( radiculopathy), compression of the spinal cord( compression myelopathy), spinal cord injury due to blood supply disorders due to constriction, constriction of the supply arteries and veins( compression-vascular myelo-ischemia).
The cause of compression can be: protrusion and herniated intervertebral discs, spondylolisthesis( slipping of the vertebra forward in relation to the underlying), proliferation of osteophytes and cartilaginous tissue in the vertebral segment. As a result, osteochondrosis of the lumbar spine leads to a narrowing of the channel through which the spinal nerves or vascular structures pass, and under certain conditions( clumsiness, physical stress, unsuccessful torso rotation, etc.), compression( compression) may occur. Compression of the nervous structures leads to various pain syndromes, muscle spasms. Vessel compression causes a violation of blood supply - begins ischemia of the organ, which is fed from this vessel or artery.
Clinical syndromes of lumbar spine osteochondrosis
The clinical picture of lumbar osteochondrosis is defined by a complex of vertebral symptoms( changes in the statics and dynamics of the lumbar spine) and escapravertebral symptoms, which are understood as a violation of the function of neurological and vascular structures in the lumbosacral spine.
Vertebral lumbar osteochondrosis syndromes
In the lumbar osteochondrosis, the vertebral syndrome is characterized by the following complex of symptoms:
- disruption of the spinal functional anatomical segment configuration: flattening or( less often) strengthening of lordosis, scoliosis or lordoscoliosis;
- impairment of mobility in the lumbar region, a decrease in the volume of movements, a muscle-tonic imbalance caused by the stress of both deep and superficial multiarticular muscles.
- local pain and soreness in active and passive movements, which causes reflex tonic tension of the muscles
- disruption of the spring-motor functions of the intervertebral disc, and in general of the vertebral-motor segment.
- local soreness( hypersensitivity) of bone-ligamentous structures of the spine in the affected area( soreness in palpation, local( regional) vertebral and / or vertebrozonal pain syndrome).
It is important to note that with osteochondrosis of the lumbar spine of , vertebral pathologies are always observed. The presence of signs of myelopathy, radiculopathy and mieloradiculopathy, without obvious clinical and morphological signs of vertebral syndrome, requires, as a rule, a more in-depth examination of the patient for primary( "non-embryogenic") damage to the nervous system.
Extravertebral( reflex and compression) syndromes in osteochondrosis of the lumbar spine
Extravertebral syndromes are divided into two large groups: reflex and compression.
Reflex syndromes are preceded by compression and are caused by stimulation of the receptors of the roots of the nerves leaving the vertebral canal through the intervertebral foramen. Irritation can be caused by intervertebral hernia, bony proliferation, as well as vascular disorders( edema, worsening of blood circulation), inflammation. In some cases, this leads to intense pain, which arises not only locally but also along the nerve, at a distance from the site of irritation - the so-called "reflected pain". Reflected pain can be short and sharp( "lumbago") or dull prolonged. In the zone of innervation of the damaged nerve, vegetative disturbances( burning, chills, sensory disturbance) are possible. Possible myofascial pain - muscle spasm, which leads to restriction of movements.
Reflex syndromes include lumbago( "lumbago") with acute development of the disease and lumbargia in subacute or chronic course.
Compression syndromes are syndromes resulting from compression, infringement of nerves, vessels, spinal cord in the region of lumbar vertebral-motor segments. Compression syndromes in osteochondrosis of the lumbosacral canal are subdivided into radicular and vascular-radicular. A special case of compression syndrome is myelopathy - infringement of a spinal cord.
Radicular syndromes( radiculopathy) are caused usually by protrusions of the disk, causing infringement of spinal roots. The resulting radicular symptoms correspond to the level of the affected vertebral segment. Most often, the roots of L4-S1 are affected.
Vascular-radicular neurologic disorders are caused by the compression of the hernia on the spine and the radicular artery passing along with it. At the same time, a "paralytic sciatica" characterized by peripheral paresis or paralysis of the extensor muscles of the foot can develop catastrophically quickly. In such cases, the appearance of motor disorders is accompanied by the disappearance of the pain syndrome.
Even more severe neurologic manifestations cause a violation of the blood supply to the spinal cord due to damage to the radicular-spinal arteries. In this case, chronic discirculatory myelopathy develops, usually at the level of the lumbar spinal cord thickening.
The most unfavorable variant of lumbar vertebrogenic radicular syndromes is the compression of the "horse tail" - the so-called caudal syndrome. Most often it is caused by the fallen middle disc hernia, which squeezes all the roots at the level of the affected segment.
What is osteochondrosis of the lumbar spine? What are its symptoms? How to treat osteochondrosis of the lumbar region?
About the causes and symptoms of osteochondrosis of the lumbosacral spine and about new methods of treatment tells cms. E.L.Shahramanova, the doctor of the consultative and polyclinic department of the Scientific Research Institute of Rheumatology.
Clinical classification of lumbar osteochondrosis. Degrees of osteochondrosis
Classification of lumbar osteochondrosis in degrees is used to systematize the characteristics of clinical manifestations of the disease. This classification systematically describes the symptoms of the disease and begins with the moment when the patient has pain.
1 degree of osteochondrosis
Occurs when the intervertebral disc ruptures, caused by sudden movement or overexertion. It is manifested by sudden pain, a feeling of electric current flow arises in the spine, the musculature is reflexively tense.
2 degree of osteochondrosis
The second degree can manifest itself in the form of symptoms of intervertebral protrusions and instability of the spine. Chronic pain, worse with exertion. The intervals of remission and exacerbation are alternating. The cervical region is characterized by neck pain that increases after a long stay in one position, headaches, pain in the arm, shoulder pain, periodic discomfort or numbness in the fingers. For the lumbar region - pain in the lower back, pain in the gluteal region, periodic pain in the sacrum, frequent fatigue in the legs.
3 degree of osteochondrosis
manifests itself in the form of symptoms of a herniated disc( pain along the affected nerve, numbness of the hands or feet, changes in gait, headaches) or distant symptoms of intervertebral hernia( in the cervical region: frequent headaches, tinnitus, dizziness, decreased vision, hearing, muscular strength in the hands, in the thoracic part: a violation of the heart rhythm, difficulty breathing, in the lumbar part: kidney disease, gastrointestinal tract, disorders in the genital area, numbness or weakness in the legs).
4 degree of osteochondrosis
It is considered that the fourth degree of osteochondrosis starts from the moment when the hernia does not manifest itself, the manifestations of the disease may decrease, but the symptoms of spinal instability, slipping or twisting of the vertebrae, or their complete fixation relative to each other still remain. They can be joined by the manifestations of the growth of vertebral bodies( osteophytes), which can also pinch the spinal nerves or block the spinal canal( secondary stenosis of the spinal canal) and squeeze the spinal cord( spinal cord ischemia).In addition, the fourth degree can be attributed to the consequences of surgical intervention, if the hernia was removed promptly( various kinds of disorders of innervation, paresis, inflammation).
Treatment of lumbar spine osteochondrosis
With first acute pain in the lower back, you should always consult a doctor for a diagnosis to exclude a stroke of kidney colic, appendicitis or some other disease requiring emergency medical care.
If the cause of back pain is known, and this exacerbation of osteochondrosis of the lumbar spine, first of all, it is necessary to minimize the load on the spine as much as possible. It is necessary to comply with bed rest for 3 - 7 days - sometimes only this can significantly reduce the pain. But in order to accelerate recovery, you need the right, that is, effective, treatment. It should stimulate its own protective and healing processes in the human body. Treatment should take into account the localization of the lesion, the stage of the disease, the functional state of the organism and its individual systems. Surgical treatment of this disease is indicated only in very serious cases. Most often, various methods of conservative treatment of osteochondrosis are used.
Conservative treatment of lumbar osteochondrosis
Conservative treatment methods are, first of all, drug treatment. To reduce the pain syndrome, as well as to reduce inflammation, which is often the cause of vertebral syndrome, non-steroidal anti-inflammatory drugs( NSAIDs) are given in the form of tablets or - in acute cases - as injections. Sometimes after the injection of the analgesic, the pain subsides and does not resume even when the duration of the drug ends. This means that it was possible to break the vicious circle in which pain leads to muscle spasm, and muscle tension, in turn, increases pain. However, if the pain continues for a long time, it is important to remember that NSAIDs usually have various side effects and, if taken for a long time, can cause unwanted complications - a decrease in the number of white blood cells in the blood, complications from the gastrointestinal tract.
Often to improve the general condition of patients prescribe sedative( sedative) for 1-3 weeks, as well as small doses of antidepressants. When osteochondrosis of the lumbar spine, if necessary, produce novocaine blockades. Recently, preparations for the anticonvulsant series have been successfully used to relieve pain.
For the reduction of compression syndromes, manual therapy, traction treatment( spinal traction) and in special cases - surgical intervention.
With the weakening of fixation properties of the ligamentous-articular apparatus of the spine, it is recommended to use fixing devices - corsets, collars, bandages, etc. However, fixing devices can only be used for a limited period of time, since muscle relaxation is observed when they are used. And patients with osteochondrosis of the spine are extremely important in the future to strengthen their own muscular corset.
After removing acute symptoms, the task of creating a muscle fixation comes first, and then stimulating the processes of regeneration of damaged structures. For this, therapeutic gymnastics, reflexotherapy, and massage are used. For this, chondroprotectors( preparations for the restoration of cartilaginous tissue) are used. And also drugs that improve the condition of blood vessels( angioprotectors), vitamins, especially group B, calcium preparations that improve the bone tissue.
For the treatment of spinal osteochondrosis, physiotherapy procedures are widely used. They reduce pain and swelling of tissues, improve blood circulation, stimulate muscle fixation. Procedures can be combined, alternating. Such methods of physiotherapeutic treatment as
- darsonvalization of the affected area of the back and affected limbs can be used;
Osteochondrosis of the lumbar spine is a very common disease. Whichever way of life a person does, the load on his spine is very significant. Moreover, when sitting, the lumbar region can be subjected to large deformations.
Not only elderly people are affected by this disease, but young people often face spinal problems. Osteochondrosis of the lumbar spine is a dangerous disease that can cause an irreparable blow to human health, its ability to move freely.
Mechanism of the disease
Osteochondrosis is a disease of the bone tissues of the spine, when the intervertebral disc, the surfaces of the joints and the ligamentous elements of the spine are destroyed. The disease is degenerative and dystrophic, initiating pathologies in the bone and ligaments.
The osteochondrosis of the lumbar spine develops in several stages. In the initial period, the destruction of the pulpous nucleus starts, which leads to a decrease in the height of the discs. Microcracks begin to form in the fibrous ring. However, the pathology remains within the intervertebral disc.
In the next stage of osteochondrosis, the muscles and ligaments sag, which causes excessive mobility of the vertebrae in relation to each other. There is an unstable condition of the motor segment of the vertebrae. At this stage, it is possible to shift the vertebrae and create prerequisites for spondylolisthesis.
At the third stage, changes in the structure of the disks themselves begin. They show prolapses and protrusions. In the lumbar joint there are subluxations, arthrosis arises. At the final stage, the body produces protective reflexes, which are expressed in the appearance of bone growths on the contiguous surfaces - osteophytes. They, in turn, lead to microscopic damage to the nerve root. As a result of the development of osteochondrosis, the vertebral motor apparatus is immured in a peculiar envelope.Back to the table of contents
The main causes of the disease
The causes of osteochondrosis of the lumbar region are mainly associated with abnormal loads on the spine. The greatest probability of osteochondrosis of the spine is present in people with excess weight and in those who often lifts heavy objects.
For normal functioning of the spine, sufficient muscle elasticity and good blood supply to bone tissues and cartilage are necessary. This is achieved only with the intensification of muscle activity. In a person with a passive lifestyle, the working conditions of the spine are violated, which is further complicated by an incorrect posture and gait.
The risk of osteochondrosis of the lumbar spine significantly increases in athletes, especially weightlifters. They have the reasons for the development of the disease in the back injuries. If a person conceives himself to perform heavy physical exercises, then this too can lead to the onset of osteochondrosis of the spine in violation of the training technique.
Osteochondrosis of the lumbar spine may be the result of malnutrition, lack of contact with nature, systematic stress, insomnia, a violation in the metabolic system. Addiction to the disease can be a hereditary phenomenon and lies at the genetic level.
The manifestation of the osteochondrosis of the lumbar spine increases with the age of the person, which is caused by natural degenerative processes in the bone tissues. However, modern osteochondrosis of the lumbar region has significantly rejuvenated, and the most common among 30-year-old people.Back to the table of contents
Symptoms of the disease
Osteochondrosis of the loin has a specific feature - its symptoms can manifest itself in various areas of the body like pain in the extremities or pain in the internal organs. This somewhat complicates the formulation of the correct diagnosis.
The underlying signs of lumbar osteochondrosis are painful phenomena in the back or lumbar region that are transmitted to the sciatic nerve area of the leg. Signs of lumbar osteochondrosis clearly begin to appear only when osteochondrosis passes through the 2 stages of its development. The first pain in osteochondrosis occurs only with sudden movements in the joint or significant physical exertion. Gradually painful sensations turn into constant aching pains with periodic exacerbations.
Clamping of nerve fibers under the influence of lumbar osteochondrosis leads to severe pain in the lower back, loss of skin sensation on the legs, a constant sensation of coldness in the lower extremities, muscle weakness, changes in sweat secretion. Over time, pain with osteochondrosis appears with any change in the position of the back, as it loses its flexibility. The development of osteochondrosis of the lumbar region causes instability of the entire spine.
The lumbar region moves relative to the sacral bone, which can cause pain in the internal organs of a person.
Indirect signs of osteochondrosis of the spine becomes general fatigue of the body, weakness, irritability, insomnia. The disturbance of normal sleep is explained by the fact that a certain position of the body causes painful sensations in the lower back. Complications of lumbar osteochondrosis can cause disturbances in the system of urination, kidney work.Back to index
Diagnosis of the disease
Primary diagnostics of the osteochondrosis of the spine is performed by the method of palpation. Areas such as coccyx, iliac crest, a zone of spinous processes are examined. In this way, the presence of flattening, painful sensations at different points, displacement of elements, kyphosis, scoliosis, distortion of the sacrum is determined. A more accurate diagnosis and stage of the disease can be established using magnetic resonance imaging. To modern methods of diagnosis is computer tomography myelography.Back to index
Treatment methods for osteochondrosis
Treatment of osteochondrosis of the lumbar spine may be based on several techniques. The following methods of treatment are mainly used: