Treatment of joints

Lumbar osteochondrosis: symptoms and treatment methods

Lumbar osteochondrosis is one of the most common types of osteochondrosis, in which dystrophic changes occur in the ligamentous apparatus, intervertebral discs and the bodies of the vertebrae of the lumbar spine.

This wide spread of the disease is explained by the fact that the main load of body weight falls just on the lumbar spine. The intervertebral discs of this part of the spine are especially loaded with inclinations, lifting of weights and in a sitting position.

Therefore, the treatment of the disease should be taken very seriously. Moreover, complications such as protrusion, herniation of the intervertebral disc, which can cause paralysis of the lower extremities, can occur.

Causes of the disease

The main causes of lumbar osteochondrosis are injuries and sedentary lifestyle.

In addition, a great role is played by heredity, in particular, individual characteristics of the body, its hormonal, biochemical and psychogenic constitution.
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If parents were ill with osteochondrosis, most likely children will also face this problem, inheriting predisposing features of the structure of the body.

The risk group for lumbar osteochondrosis belongs to everyone whose activity is related to the back strain. These are loaders, builders, waiters, etc. In addition, they are more likely to develop lumbar osteochondrosis and people with "sedentary" work - office staff, drivers.

In addition, the development of osteochondrosis can contribute to some diseases of other organs and body systems. These are:

  • diseases of the gastrointestinal tract and liver;
  • metabolic disorders;
  • diseases of the pelvic organs;
  • diseases of the nervous system.

Factors contributing to the onset of the disease also include:

  • decreased motor activity;
  • stress;
  • long stay in uncomfortable poses;
  • supercooling;
  • incorrect posture;
  • congenital changes of the spine;
  • hormonal disorders.

Stages of the disease

  • In the first stage of the disease, low back pain is expressed. The patient feels discomfort and soreness, which are intensified by physical exertion. The rest of the time there is no pain. At this stage, the intervertebral discs begin to break down.
  • In the second stage of the disease, the fibrous ring breaks down and the distance between the vertebrae decreases, which leads to jamming of the nerve endings. This leads to severe pain that spreads not only in the lumbar region, but also covers the outer surface of the thighs, buttocks, and sometimes the shins.
  • In the third stage of osteochondrosis of the lumbar spine, the destruction of fibrous rings begins and the formation of intervertebral hernias. There is a noticeable deformation of the spine. The patient at this stage is disturbed by persistent severe pain.
  • In 4 stages of the disease, there are such changes in the spine that it becomes difficult for the patient to move around. This can lead to disability.

Symptoms of lumbar osteochondrosis

All the symptoms of lumbar osteochondrosis are divided into 4 groups:

  • pain;
  • ischemic syndrome;
  • radicular syndrome;
  • vertebral syndrome.

Lumbar osteochondrosis can have pain of varying degrees of severity, localization, origin, nature and intensity. Allocate:

  • Lumbalia is a constant aching pain in the lower back, which is intensified after physical exertion, weight lifting, supercooling, and tilting. It decreases significantly in the prone position.
  • Lumbago - a sudden pain, like a lumbago. It is acute intense and gives to the pelvic organs, anterior abdominal wall, to the sacral region. With the slightest movement or even a cough, the pain is greatly increased, which forces the patient to lie in bed. Often the cause of such pain is a sharp turn, lifting of gravity, trauma.
  • Lumboeishalgia is pain that spreads to the buttocks, one or both legs, which may lose sensitivity.

Radicular syndrome

If the osteochondrosis of the lumbar spine does not start to heal, it progresses. In this case, the vertebrae lose their real estate and become mobile.

This leads to the fact that when lifting weights and sharp movements, vertebrae squeeze and irritate the nerve endings and blood vessels. In such cases, the pain in the lower back subside, but appears in the area of ​​innervation of the damaged nerve.

Pain may appear in the thigh, lower leg, buttock, or foot and has a one-sided, strong, boring character. The body at the same time tries to protect the damaged root, which causes muscle tension and gait change. She becomes sparing with a bias in the healthy side.

If at this stage do not carry out the necessary treatment, then after the irritation of the roots appears and their inflammation. It is accompanied by puffiness, stagnation of blood, intoxication. At the same time after rest, there are pains in the joints and muscles, which disappear after the warm-up. Pain can be accompanied by a feeling of heat, chills and sweating.

In addition, due to radicular syndrome, tingling, numbness, a feeling of "goosebumps" in the lumbar region may occur. Also, there is a decrease in muscle tone, their atrophy and thinning.

It becomes difficult for patients to walk, climb and descend the stairs. In particularly difficult cases, when the spinal cord is squeezed, paralysis may develop.

Ischemic syndrome

This group of symptoms is associated with impaired blood circulation due to the squeezing of blood vessels. At first, narrowing of the arteries is not permanent, but over time a constant spasm occurs. In this case, there are pains during walking, which pass after stopping the movement and short-term rest.

As a result of the lack of treatment and prolonged spasm of blood vessels, there is a disruption in the nutrition of the pelvic organs and, as a result, their activity is disrupted.

There are also pains in the buttocks and inner thighs. In advanced cases, paralysis of buttocks may occur.

Vertebral Syndrome

Because of the above syndromes, the skeleton gradually changes. Due to severe pain and weakness of the muscles, the spine and pelvis warp, stoop appears, posture changes, gait becomes uncertain and tense.

Treatment of lumbar osteochondrosis

Treatment of the disease should be comprehensive and timely. Very rarely, the osteochondrosis of the lumbar spine ends only with an acute period. Much more often it passes into a chronic form, which requires treatment to prevent the occurrence of relapses.

The main goals of the treatment:

  • Elimination of the causes that caused compression and irritation of the nerve roots and blood vessels in the spine.
  • Suppression of pathological processes and pain relief.
  • Stimulation of regenerative reactions of the body.
  • Strengthening of the motor apparatus.

Non-pharmacological treatment of

If you have pain in the spine, you should always contact the doctor. At home, the patient should ensure peace with bed rest. In this case, the bed must have a rigid or orthopedic mattress.

Medical treatment

Treatment with pharmaceuticals will differ slightly in the acute phase and the period of remission.

In the acute phase, it is very important to relieve the pain syndrome, reduce the inflammatory process and release the roots of the clamped nerves. For these purposes, NSAIDs, muscle relaxants, glucocorticoids, blockades are used.


This group of drugs has an analgesic, anti-inflammatory and antipyretic effect. Drugs remove puffiness in the tissues, which causes inflammation and reduces soreness. Medications for internal use, rectal agents and injections may be used.

The most widely used:

  • Diclofenac( Diclac, Diclobarle, Voltaren, Diclobene, Feloran, Diclonate P, Orthofen, Diklovit);
  • Ibuprofen( Nurofen, Pedee, Brufen, Advil, Cefekon, Ibufen);
  • Piroxicam( Revmadore, Sanikam);
  • Naproxen( Apranax, Nalgezin, Sanaprox, Naprobene, Aliv);
  • Aceclofenac( Aertal, Asinak);
  • Nimesulid( Naiz, Aulin, Nimesil, Sulaidin);
  • Dexketoprofen( Dexalgin, Flamadex);
  • Meloksikam( Movalis, Mataren, Oxicamox, Meloks, Meoflam).

Muscle relaxants

The funds of this group are designed to relieve muscle spasms, while eliminating the pain and relieving the stiffness of the vertebrae and joints. Appoint preparations Midokalm and Sirdalut.


These drugs are prescribed only in cases of ineffectiveness of other groups of pharmaceuticals, as they have serious contraindications and adverse reactions. Treatment with these drugs is strictly controlled by a doctor.


Most often do novocaine blockade, or novocaine with a glucocorticoid( eg hydrocortisone).The essence of the blockade - the medicine is injected directly into the area of ​​pain and quickly eliminates it.

Blockades are used only for temporary elimination of soreness, as they do not show any healing properties. It is often impossible to take such measures, because the body gets used to it and reacts much less. In addition, muscle atrophy can be observed at the injection site.

When an acute attack of lumbar osteochondrosis is removed, funds are allocated for the restoration of damaged tissues of the body, to improve blood circulation and conduction of nerve fibers and restore muscle work.

To this end, the following applies:

  • Chondroprotectors. Appointed to strengthen bone tissue and normalize metabolic processes in the cartilage. They are applied: Alflutop, Mukosat, Teraflex, Dona, Rumalon, Structum, etc.
  • Vitamin preparations, in particular group B, which improves nervous patency. Milgama, Neurobex, Neuromultivitis and others can be prescribed.
  • Vascular tools that are designed to improve microcirculation and nutrition of tissues( Cavinton, Euphilin, Pentoxifylin, Trental).
  • Biogenic preparations that stimulate the recovery processes in the body.
In addition, and during the period of exacerbation of the osteochondrosis of the lumbar spine and during remission, local remedies can be used in the form of ointments, gels and creams that have an anesthetic, warming, anti-inflammatory or distracting effect.

Widely used: Deep Relief, Fastum gel, Dolobene, Capsicum, Apizarthron, Traumel S, Chondroxide, Voltaren gel, Finalgon, Nikoflex, Dolobene, etc.


Lumbar osteochondrosis is treated with a massage. Thanks to its competent implementation, the nutrition of damaged tissues is improved, muscle spasm is removed, soreness is reduced and the muscular skeleton is strengthened. It is very important that the massage is performed by a qualified specialist, especially in the acute phase of the disease, since any incorrect movements can aggravate the patient's condition.

Therapeutic physical training

Exercises of curative physical training are selected individually in each case and are performed only when the osteochondrosis of the lumbar spine is in the period of remission.


The osteochondrosis of the lumbar spine is also treated with physiotherapy methods both in the acute period and in the period of remission. The most frequently used are electrophoresis, UV irradiation, phonophoresis, darsonvalization, acupuncture, etc.

Traditional medicine

There are many traditional medicine to relieve the condition with lumbar osteochondrosis, but it is not recommended to use them alone. You need to consult a doctor.

To reduce pain and relax the muscles take coniferous baths. Widely used and compresses from decoction of burdock leaves.

What are the symptoms of lumbar osteochondrosis? What treatment will help?

This disease is characterized by degeneration in the intervertebral discs. As you know, drives are designed to provide flexibility and mobility to our spine. When the disc becomes flat, exhausted, the vertebrae come together, compressing the vessels and nerve roots. Hence the pain and swelling. The most common problem with the musculoskeletal system is the osteochondrosis of the lumbar spine, the symptoms of which are the appearance of regular pain in the lumbar region and limited mobility of the patient.

Pain in osteochondrosis of the lumbar region is the main manifestation of this disease, but other symptoms are also common.

Symptoms of lumbar spine osteochondrosis and the main complications of

The most common signs of lumbar osteochondrosis are the following symptoms:
  • decreased mobility in the lumbar spine
  • loss of back flexibility( inability to bend or turn the body)
  • general fatigue
  • sleep disturbance
  • irritability
  • difficulty in exercisinghousehold needs because of the pain
  • violation in the sweating system
  • chills, and tingling in the ngah varying degree of intensity
  • syndrome "cold feet»
  • spasms in the arteries stop
  • instability in sexual function( common men)
  • menstrual irregularities in women
  • varices

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Lumbosacral osteochondrosis, the symptoms of the most common complications.

  • disorders in the functioning of the genitourinary system
  • discomfort and pain in the kidney area
  • urination disorders
  • irritation of the sciatic nerve

And more serious complications:

  • protrusion of the intervertebral discs
  • hernia( intervertebral or herniated spine)
  • radiculitis

In addition, the syndrome of lumbalgia is common - regularvarious pain in the lower back. There are several types of lumbulgia: acute, subacute and chronic.

Acute lumbargia - sudden painful lumbago, can last for several hours. The pain is stitching, cold sensations or, conversely, burning in the lower back are also possible.

Subacute lumbargia( as well as chronic lumbargia) occurs a few days after a strong strain of the waist or its supercooling. Pain often appears on one side, it becomes stronger because of long sitting or standing.

Treatment of lumbar syndrome is often performed with the help of leeches( hirudotherapy), as well as acupuncture.

What are the methods of examination for the detection of osteochondrosis of the lumbar spine?

  1. X-ray. Gives precise information about the condition of the lumbar spine and each vertebra separately. In addition, indirectly one can judge the state of the intervertebral discs, as well as the bone channels.
  2. Tomography. It allows to reveal the rupture of the contour of the disk, compression of the nerve root, deformation of the meninges.
  3. MRI is assigned in particularly difficult cases.

What causes osteochondrosis of the lumbar region?

The lumbar spine is the most important area in the connects the sacrum and thoracic region, the lumbar region includes five vertebrae. It is the lower back that takes the most serious strain, regardless of the person's lifestyle. Not surprisingly, that the lumbar spine osteochondrosis of the cause of which has long been identified and studied is one of the most common diseases of the spine.
  1. Osteochondrosis usually occurs due to serious physical exertion. Among the people at risk of risk are those who are overweight and work a lot physically( for example, lifting weights).The problem can be aggravated by the fact that, in general, the way of life of such people is not very active. Also, osteochondrosis can cause problems with posture and inability to move properly or sit flat. It becomes clear that any excessive and regular strain on the spine often causes the development of osteochondrosis.
  2. The appearance of this disease is a different back injury.
  3. Incorrect mode of the day and poor nutrition. Increased predisposition can be regular stress, lack of sleep, metabolic disorders in the body.
  4. Genetic predisposition. There are cases when the intervertebral disc has a porous-loose structure, because of what it is more prone to deformities.

Intervertebral osteochondrosis of the lumbar region can also develop as a result of flat feet, stoop, lack of vitamins and microelements, poor ecology, regular wearing of uncomfortable shoes, etc.

Problems in the sacral department of the spine

Osteochondrosis can spread to the coccyx and provoke acute periodic pains in the coccygeal region. The most susceptible to this disease women( from 40 to 60 years) because of the anatomical features of the female body.

The osteochondrosis of the sacral spine, the symptoms of which differ somewhat from the symptoms with problems in the lumbar region, are difficult to identify.

The pain syndrome for this type of osteochondrosis is supplemented by frequent urination, incontinence, exacerbations of inflammation in the genitourinary system, as well as in the rectum. In spite of the fact that the osteochondrosis of the sacrum is characterized by acute, bursting, sometimes burning pain, patients often find it difficult to indicate the specific place of localization of the pain syndrome.

Pain most often occurs with prolonged sitting, especially on a hard surface, during coughing, severe physical exertion. Patients "transplanted" to one half of the pelvis, move very carefully.

Risk groups

Once osteochondrosis was considered a disease to which mainly elderly people are exposed, they were most often diagnosed with them. This is understandable, because over time, the intervertebral discs actually lose elasticity, become less mobile and, accordingly, are prone to injury and deformation. Today, the disease is "very much younger", most of the patients are from 30 years old.

Also in the risk group are professional athletes, but you can buy osteochondrosis at home, incorrectly performing complex physical exercises. Osteochondrosis is common in people with joint inflammation( Bechterew's disease) or some forms of arthritis( for example, rheumatoid).

The attack of an osteochondrosis can:

  • sudden overload
  • sudden lifting of weights
  • supercooling

The patient immediately takes a forced posture, the muscles in the lower back and upper back are reflexively spasmodic( this protects the spine from the position in which the pain intensifies).

How to treat osteochondrosis in the lower back?

It is important to understand that the lumbar osteochondrosis symptoms and treatment of which has long been well studied is not a verdict. Recovery is possible. To successfully get rid of the disease, the patient will have to change many habits and work on his recovery daily. And after recovery, it will be necessary to prevent the disease, becauseThis ailment can come back after a while.

Often, intervertebral disc degeneration occurs because of problems with the muscular skeleton of the lumbar spine. It is known that it provides reliable support of the spine, and also maintains the correct posture necessary for the health of the spine.

Conservative treatment of

This disease requires the use of complex treatment, which combines:

  • massage
  • many varieties of stretch marks
  • practice of manual therapy
  • exercise therapy
  • diets, etc.

The main task of conservative treatment is to stop the progression of the disease and return the spine to the correct anatomical position.

Usually, conservative treatment is usually performed within 2-3 months, in a situation where this type of treatment does not give positive results, surgical treatment can be prescribed.

Surgical intervention

Usually, the doctor prescribes surgery only in the event that serious complications develop. For example, intervertebral hernia. The most common type of surgical intervention is the removal of a damaged disc( discectomy).

This operation is considered the most productive method in this case, but at the same time is assigned only if other methods of treatment do not bring results within six months. In addition, the method of microsurgical and endoscopic treatment of the spine is common.

How to start treatment?

Adjust lifestyle

Revise your lifestyle and habits. It is necessary to give up excessive physical exertion or, conversely, to introduce regular exercises by simple physical exercises to those who are accustomed to lead a sedentary lifestyle. Then, to evenly distribute the load, pick up an orthopedic mattress and other bedding.

Take medicines

Often after the first visit to the doctor, medication is prescribed. Usually these drugs not only relieve pain, but also fight the inflammatory process in the body. Medication programs include non-steroid drugs, analgesics, muscle relaxants, a drug of chondroitin, biogenic stimulants. In especially neglected cases, hormones are prescribed.

Use folk remedies for

Do not forget about folk remedies for osteochondrosis. Many herbs and other gifts of nature are taken in order to get rid of this disease both external and internal. Folk remedies help relieve pain and reduce inflammation.

Are there any other treatments?

Traditional medicine offers a variety of ways to stretch the spine. These procedures deal with a number of medical and preventive institutions, which has special equipment. Excellent results give massage, it removes muscle tension, eliminates spasms, reduces pain. Massage can replace some pain medications, which is why it is quite popular.

Wearing a fixing corset is not approved by all specialists. This accessory keeps the back in anatomically correct position, which means, it neutralizes the signs of osteochondrosis of the lumbar spine. But with excessive prolonged wear can provoke muscle atrophy. The best option for using a corset with a hernia is to wear it during exacerbations( bouts of pain), several hours a day.

The corset should be selected by a trauma doctor or vertebrologist. We must understand that not every model of the corset is universal. More precisely, universal does not exist at all.

Physiotherapy for this disease is used in almost all cases. Exercises strengthen the muscles of the back. The productivity of the practice of physiotherapy exercises increases if the classes are held regularly. Systematicity is a sign that the patient really wants to recover. It is impossible to overstrain, exercises that are difficult for you to perform, it is best to remove from the program of classes. At occurrence of a dyscomfort it is better to stop employment or occupation.

Acupuncture, leeches, vacuum massage and other similar procedures are best performed in clinics with a good reputation. These procedures are aimed at stimulating blood circulation.

Another common method of treatment is to visit specialized sanatoriums and dispensaries. Especially useful in osteochondrosis water procedures - one of the most common types of treatment in specialized sanatoria.

The phenomena of osteochondrosis of the lumbar spine, the symptoms of which are difficult to confuse with any other disease, require treatment under the supervision of an experienced doctor. Self-treatment, as well as ignoring the disease is unacceptable, becausethis can lead to more serious problems with the spine. Take care of your health!

It should be noted that in practice it is very rare to find isolated lumbar osteochondrosis, more often it is observed simultaneously with cervical osteochondrosis.

Symptoms of lumbar osteochondrosis

In lumbar osteochondrosis, the onset or pain of pain is usually preceded by physical overload, and a painful reaction to them can occur both after the load and the day after it. Most often, patients experience dull, aching pain in the lower back( lumbalgia), sometimes giving up in the leg. There are complaints of pain in the leg, which is amplified when trying to lift the weight, with jerking, sneezing, coughing, changing the position of the trunk, and also if you are in one position for a long time.

With exacerbation of lumbar osteochondrosis, patients complain of the inability to straighten or move - as any movement increases pain, on a strong and constant tension of the muscles of the back. Even after a short stay in the cold, acute pain in the lower back( "lumbago") can occur.

Symptoms of lumbar osteochondrosis are also:

  • sensory disturbance in buttocks, thighs and lower leg, sometimes - stop,
  • chills and tingling in the legs,
  • chills in feet, spasm of the arteries of the feet - sometimes even the pulse disappears,
  • sweating,
  • dryness and peeling of the skinin places of pain or loss of sensitivity.

In the event that a spinal cord becomes entrapped in lumbar osteochondrosis, there is a violation of urination or defecation, as well as a violation of the sensitivity of the bladder or genitals.

The most unpleasant complication of of lumbar osteochondrosis is vertebral instability. The disc no longer fixes the vertebra, and under the load under the action of gravity the lumbar region "slides" from the sacrum. And this already provokes dangerous violations in internal organs, especially in the genitourinary system: women have problems with appendages, uterus, ovaries;in men - with potency.

Diseases contributing to the development of lumbar osteochondrosis

Many diseases of the internal organs contribute to the appearance of lumbar osteochondrosis and the appearance of pain. Thus, more than 28% of patients with clinical manifestations of lumbar osteochondrosis suffer from diseases of the gastrointestinal tract and liver. The reason is that with diseases of the gastrointestinal tract, liver, pancreas, etc., the flow of painful impulses causes tension and spasm of muscles and vessels. This leads to oxygen starvation and development of the dystrophic process in the corresponding areas of the body. The process aggravates the metabolic disturbance observed in these diseases. Lumbar pelvic organs can also provoke lumbar pain: in women, inflammation of the appendages of the uterus( adnexitis), in men - inflammation of the prostate gland( prostatitis). Phenomena in the pelvic cavity observed in these diseases, as well as hemorrhoids, chronic colitis, constipation, also contribute to the manifestation of lumbar osteochondrosis.

What is osteochondrosis of the lumbosacral spine? What are its symptoms? How to treat lumbar osteochondrosis?

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.

Species of lumbar osteochondrosis manifestations

The most complete and systematized classification of vertebrogenic( spine related) diseases of the peripheral nervous system was proposed by IP Antonov. According to this classification, the following clinical syndromes of lumbar osteochondrosis can be distinguished:

  1. Reflex - lumbago, lumbalgia, lumboschialgia.
  2. Radicular - vertebrogenic( discogenic) sciatica with damage more often than the fifth lumbar or first sacral root.
  3. Radicular vascular syndromes - radiculo-ischemia, or compression along with the root of the vessels( radicular artery, vein).

Lumbago - acute, type of lumbago, lumbar pain. It usually occurs after lifting the heaviness, awkward movement, sometimes - coughing, sneezing.

Lumbalia - subacute or chronic pain. Occurs gradually after physical exertion, prolonged stay in uncomfortable position, in sitting position.

Lumbosciagia is a back pain extending into one or both legs. It can occur with muscle-tonic, vegetative-vascular and neurotrophic manifestations.

Radiculitis ( radicular syndromes) show signs of compression of one or two roots. Along with root pains, they are characterized by motor pains( weakness of flexors or extensors of the big toe or entire foot) and sensitive disorders associated with loss of function of the damaged rootlet.

Radiculoheischemia occurs as a result of compression of the radicular-spinal arteries. The clinical picture is dominated by gross motor( paresis, paralysis) and sensitive disorders in the presence of mild pains, and often their absence.

Treatment of lumbar osteochondrosis

Lumbar osteochondrosis requires compulsory treatment, this disease can not be ignored. Treatment of lumbar osteochondrosis is described in the general section "Osteochondrosis, treatment".

A therapeutic anesthetic anti-inflammatory plaster NANOPLAST forte can be of great help in treating lumbar osteochondrosis.

Lumbar osteochondrosis: treatment with a medical plaster NANOPLAST forte

In the therapeutic treatment of lumbar osteochondrosis , various drugs such as NSAIDs, muscle relaxants and other drugs are used. All these drugs are effective, but with prolonged use can harm the body. Therefore, it is very important to minimize side effects and increase the effectiveness of the treatment of lumbar osteochondrosis. This can help the drug of a new generation - an anesthetic anti-inflammatory medical plaster NANOPLAST forte.

In the treatment of lumbar osteochondrosis, the medical plaster NANOPLAST forte is very effective, it allows you to relieve pain and inflammation, improve blood circulation in the lumbar osteochondrosis area, and reduce the dose of analgesic and anti-inflammatory drugs.

For lumbar osteochondrosis, the NANOPLAST forte patch is applied to the lumbar region. To achieve maximum effect, the adhesive need to be glued transversely to the spine. It is usually recommended to use a patch in the morning for 12 hours, but it is possible to apply it for the night. The course of treatment is from 9 days.

High efficiency, uniqueness of the composition, long-term( up to 12 hours!) Therapeutic effect, ease of use and affordable price make NANOPLAST forte a means of choice in the treatment of lumbar osteochondrosis.

Lumbar osteochondrosis and its treatment: Medical blog of an ambulance doctor

Lumbar osteochondrosis and its treatment

Written: 6 May, 2009 in category Medicine

Has the spine stuck? Manifestations of osteochondrosis are even at a young age, and in old age, almost every person. About the reasons, the clinical picture, prevention and treatment of lumbar osteochondrosis, read the article of the doctor honey. Sciences of George Nedzvedya. My notes at the end.

Hardly there is an adult who did not feel at least once in a life lumbar pain .He bent to brush his teeth or put on socks and suddenly - stopped in an uncomfortable position. The slightest attempt to straighten causes pain. Scientific and technological progress freed or severely restricted a person in their movements. He sits or stands when he goes to work, stays in a monotonous pose for a long time at the bench or at his desk.

In all cases, the is marked by an overload of some and underload of other muscle groups and joints. Some - unfortunately, not all!- helps with morning exercises, swimming in the pool, homework , if it is diverse in movements. Great opportunities for motor activity are available on the plot of land, dacha, but you have to prepare yourself for this work. Our experience shows that the increase in the incidence of lumbosacral radiculitis is observed exactly in the spring and autumn , and mainly due to the persons of "sedentary professions", which for a short time are literally likened to tractors, forgetting that tractors are overloaded from excessive load.

Any pain, as you know, is an alarm signal indicating a "breakdown," a weak spot in the body. In most cases( but I emphasize - not in all!) Acute lower back pain is the sign of the development of osteochondrosis in the corresponding department of the spine.

Our spine is the support of the skeleton; this is a kind of spring-shock absorber , which protects the internal organs from injuries when walking, running, jumping;inside the spinal canal passes spinal cord - a kind of "command post", which controls many functions of the body. Therefore, nature provided the spine with high flexibility and at the same time took care to limit it to reasonable limits by a powerful ligament apparatus and muscle corset. It is important to know that in the intervertebral foramen leaves spinal cord roots , from which, like the tree crown, the peripheral nervous system branches. Therefore, when osteochondrosis progresses, the osteochondral structure of the spine is affected, but develops edema and inflammation in the nerve roots of the spinal cord . This explains the long and stubborn course of the disease, which delivers exhausting pain to the person, limiting his vital activity.

Anatomy of the spine

In order to understand how osteochondrosis develops, let's remember the anatomy. Our spine consists of 26 vertebrae, interconnected by intervertebral disc, fibrous ring, ligaments, intervertebral joints, muscles. This structure provides a stable and mobile function of the spine. From the point of view of biomechanics, the spine should be considered as a set of functional motor units - of the vertebral-motor segments( PDS).The latter is formed by by two adjacent semi-vertebrae connected by the disc, between the transverse and interarticular ligamentous and muscular formations.

Spinal-motor segment

The intervertebral disc is a great hard worker. It can withstand very heavy stresses on the spine in the course of our life. The magnitude of the load compressing the two vertebrae is largely determined by the position of the body. The smallest load when a person lies , the greatest static load - in the sitting position. In the standing position, it increases by a factor of 2.5.When the body tilts forward( from the standing position) - 10 times compared with the load in the prone position. And , when the weight is lifted on outstretched arms, it increases to a great extent .In this case, the spine is a lever of the first kind. One shoulder is the length of the spine and arms, the other is the transverse diameter of the vertebra. It is estimated that if a person raises 40 kg, then the force in 360 kg of acts on the spine. Deformation of the intervertebral disc occurs when compression is approximately 950 kg.

Huge load on the lumbar spine

How does the intervertebral disc withstand such large loads? The disk is a cartilaginous ring that holds the so-called elastic gelatinous nucleus inside it. It contains special substances glycosaminoglycans that can quickly absorb and give off water. When pressure on the spine increases, these substances "capture" water. The core of the disc becomes elastic and compensates for the load on the spine. When the load on the spine decreases, glycosaminoglycans give up water, the elasticity of the nucleus decreases and again a dynamic equilibrium sets in.

How osteochondrosis develops

And here with osteochondrosis this amazing mechanism of amortization is damaged. The disc, losing its properties of a full-bodied shock absorber, more and more bends, is torn, its body protrudes, presses on the nerves and vessels lying near it. Thus, the pathological process passes to the entire motor segment of the ;all the formations lying around the disc are affected: muscles, ligaments, vessels, nerves. Significant changes undergo the bone structure of the vertebrae. Appear so-called "thorns", the edges of the vertebrae change their shape, cease to be smooth, become sharp, ribbed, rough.

Vertebrae in norm and with osteochondrosis

Muscles due to constant irritation tense, contract and can even cause blockade of the motor segment: the mobility of this part of the spine is severely disrupted. The proximal vertebrae try to compensate for the deformed segment, but over time, because of fatigue, they also turn off, that is, osteochondrosis extends farther and farther .The spine gradually loses its flexibility, there are more and more frequent exacerbations of the disease. The compression of nerves and blood vessels, spastic and inflammatory changes in them lead to impairment of brain functions and neural regulation of internal organs. And from here - dizziness, headache, numbness of the hands of and other numerous clinical symptoms of osteochondrosis.

Usually the development of the disease is preceded by spine dysfunction. In the spinal-motor segment, the closure plates are first of all damaged, then the vertebral bodies, then the gelatinous nucleus and the fibrous ring. By the way, our muscular corset is a kind of tire that protects intervertebral discs from excessive loads. If the loads are prohibitive, for example, for athletes, weightlifters, they wear a special leather belt , which reduces the pressure in the disks by 24%.

One of the complications of osteochondrosis: prolapse of the gelatinous nucleus( hernia of the disk ).Operation is necessary.

It was found that the extensibility of discs subject to degenerative changes is 30% higher than the than normal. When compressed, they flatten by 1-2 mm, when stretched, they increase by 4-5 mm. Usually it is the lower lumbar intervertebral discs, which are a weak link in the complex biokinematic chain "spine - large joints of the legs".In these cases, even ordinary movements, coughing, sneezing can provoke the disease.

You were diagnosed with "lumbar osteochondrosis"

The reaction of people to the conclusion of the radiologist about the dystrophic process in the spine is ambiguous. Some are skeptical about these "finds" and refer them to the inevitable age changes. For others, the conclusion "osteochondrosis" is a great stress and mobilizes on the search for effective methods of treatment that would permanently rid them of this suffering. Still others fall into depression and put an end to their active life: "I have osteochondrosis - an incurable disease."Some resort to sophisticated methods of treatment( drinking urine, broths of herbs, mummies, fasting, etc.), turn to psychics, bone-doctors, healers.

But it would be much more accurate to take a critical view of X-ray findings and to analyze its locomotor activity in the past .After all, the human body is a complex self-organizing system that constantly adapts to the changing conditions of the external and internal environment. Its strength is largely determined by the genotype, i.e.hereditary apparatus, in which the program of the life of the individual is laid down. If it allows the body to adapt to physical stress, extreme climatic and other factors, then the person is not sick - his body mobilizes its reserves and adapts to these loads.

From these positions on the state of the spine can be judged on the nature of the motor activity of a person , about how he treats his body, and hence, health. An experienced specialist in posture, the posture of an incoming patient can immediately recognize his profession. Characteristic of the posture of drivers, machinists and persons of "sitting occupations" with a long record of service. At the same time, can maintain a normal posture, if you daily charge , load those muscles that are inactive while doing the basic work.

Causes of osteochondrosis

According to modern ideas, causes the development of osteochondrosis and its neurological manifestations: internal ( endogenous), or biomedical, and external ( exogenous), or socio-hygienic factors. The most significant of these are endogenous, especially , the unfavorable heredity of .According to our data, the relative contribution of hereditary factors to the development of neurological manifestations of lumbar osteochondrosis is approximately 68% , and environmental - 32%.Hereditary predisposition is in the individual characteristics of a person, in his psychogenic, hormonal, immunological, biochemical constitution. Parents can give us not the best for the spine "building material."Important mechanisms are the construction of the motor act, i.e. muscular dexterity .It can be assumed that the genetic constitution to some extent suggests which profession to choose a person. However, not everyone can assess their capabilities and make the right choice. It was noted that in asthenics( persons with an underdeveloped muscular system) previously damaged the lumbar intervertebral discs .Under the influence of static-dynamic loads, they not only wear "tired" disks, but also develops the compensatory stabilizing dystrophic processes of , known as deforming spondylosis, spondyloarthrosis, fibration of ligaments similar to calluses on the palms.

In athletes, normostenics , the functional stress of the musculoskeletal system is affected first of all by on the muscular system .At physical overloads they have muscular pain - myalgia, myositis, fibromyositis. At the same time, osteochondrosis develops later and is limited more often to one vertebral-motor segment. In hypersthenic and persons with a high body weight, the disease is heavier than , with frequent exacerbations and incomplete recovery.

Osteochondrosis is promoted by

Many diseases of internal organs contribute to the appearance of lumbar osteochondrosis and the appearance of pain. According to our data, for example, more than 28% of patients with clinical manifestations of lumbar osteochondrosis suffer from diseases of the gastrointestinal tract and liver .The reason for this relationship is as follows. The internal organs are controlled by the thoracic and lumbar segments of the spinal cord. In diseases of the gastrointestinal tract, liver, pancreas, etc., the flow of painful impulses causes tension and spasm of muscles, vessels .This leads to an oxygen starvation and the development of a dystrophic process in the area of ​​the corresponding PDS .

In addition, the process worsens the metabolic disorder observed in these diseases. Provoke lumbar pain can also diseases of the pelvic organs: in women - inflammation of the appendages of the uterus( adnexitis).in men - inflammation of the prostate gland( prostatitis).These diseases increase the course of neurological manifestations of lumbar osteochondrosis. By the way, stagnation in the pelvic cavity, observed with the above diseases, as well as hemorrhoids, chronic colitis, constipation, lead to discomfort, heaviness in the lumbosacral region and promote the development of lumbar osteochondrosis.

In the development and course of neurological manifestations of lumbar osteochondrosis, the state of the higher nervous activity of a person is of great importance.regulating and coordinating apparatus of all human systems and organs. In persons with a labile, weak type of nervous system, the disease often takes a protracted character, a stereotype of the patient with lumbosacral radiculitis is quickly formed.

Body reaction to pain

The body itself reacts to the lumbar pain , turns off the damaged and adjacent spinal-motor segments from the movements, reflexively fixes them with contracted muscles, develops an analgesic pose. Externally, this is manifested curvature of the spine and a sharp restriction of movements in it .Moreover, in each patient the severity of these adaptive reactions is individual, relief is more often observed in a horizontal position in a certain posture. Therefore, one of the main therapeutic factors with severe lumbar pain is the strict bed rest regime .Therapeutic measures should be aimed at reducing edema, improving blood circulation, eliminating the factors that squeeze the nerve roots at the level of the damaged vertebral-motor segment.

Much depends on how all the organs and systems of a sick person respond to painful impulses, how they mobilize themselves to work in these conditions. It is understandable that if the body as a whole is healthy and trained, then compensatory, adaptive reactions will soon develop and the body will cope with the disease itself.

Classification of lumbar osteochondrosis

In our opinion, in the formation of the clinical diversity of lumbar osteochondrosis both pathological and recovery reactions in the organs and systems of the diseased person are involved, which are highly individual and largely genetically determined. From these standpoints, the working classification of vertebrogenic( spine-related) diseases of the peripheral nervous system ( IP Antonov, 1982), which distinguishes the following clinical syndromes of lumbar osteochondrosis:

  1. Reflexive - lumbago, lumbalgia, lumboscialgia.
  2. Lumbago - acute, type of lumbago, lumbar pain. It usually occurs after lifting the heaviness, awkward movement, sometimes - coughing, sneezing.
  3. Lumbalia - subacute or chronic pain. Occurs gradually after physical exertion, prolonged stay in uncomfortable position, in sitting position.
  4. Lumbosciagia is a back pain extending into one or both legs. It can occur with muscle-tonic, vegetative-vascular and neurotrophic manifestations.
  5. Radicular - vertebrogenic( discogenic) sciatica with damage more often than the fifth lumbar or first sacral root.
  6. Radicular-vascular syndromes - radiculo-ischemia, or compression along with the root of the vessels( radicular artery, vein).

Radicular syndromes( radiculitis) of show signs of compression of one, two roots. Along with root pains, they are characterized by motor pains( weakness of flexors or extensors of the big toe or entire foot) and sensitive disorders associated with loss of function of the damaged rootlet.

Radiculoheischemia occurs as a result of compression of the radicular-spinal arteries. The clinical picture is dominated by gross motor( paresis, paralysis) and sensitive disorders in the presence of mild pains, and often their absence.

The main tasks in the treatment of patients with neurological manifestations of lumbar osteochondrosis are:

  • elimination of factors squeezing, irritating nerve roots in the spine,
  • suppression of emerging pathological and
  • stimulation of restorative reactions,
  • formation of adaptive motor stereotype.

These tasks are successfully solved with the gradual treatment of lumbar osteochondrosis, which allows to order the medical care of this large category of patients.

At the first stage of treatment, care should be directed to treatment of pain syndrome and is provided in any medical institution or in self-help order - undifferentiated symptomatic treatment( analgesic cocktails, solux, amplipulse, compresses, rubbing).

In the second stage of treatment, after examination by a doctor,

appears symptomatic differentiated care for ( various kinds of analgesic blockade, the introduction of vasodilator drugs - a solution of nicotinic acid, baralgina, etc., dehydrating drugs - furosemide, lazix).

In the neurological department of the hospital( the third stage of ) is differentiated pathogenetic treatment of of lumbar osteochondrosis( epidural administration of prolonged action hormones, various types of traction and manual effects, various types of physiotherapeutic and reflex action).

Restorative treatment of osteochondrosis( the fourth stage of ) is performed by in the rehabilitation department of the polyclinic or hospital, in dispensaries or sanatoriums. It is aimed at restoring lost functions and forming an adaptive motor stereotype.

The success in treatment and rehabilitation largely depends on the active participation of the patients themselves, on the conscientious implementation of the recommendations for the propulsion mode, hygiene of the poses and movements.

Prevention of lumbar osteochondrosis

In this case it is necessary to remember the following rules :

  1. Often change the poses and positions of .If the work is sedentary, every 45-60 minutes it is necessary to stand up to "stretch" the lower back, making circular movements with the trunk and careful inclinations in all directions. And the chair or armchair should be comfortable, the back of the chair should correspond to the normal configuration of the spine.
  2. It is necessary to sleep on a rigid bed , so that the spine does not bend.
  3. In the mornings, needs special exercises to strengthen the muscular corset( abdominal and back muscles).To form a correct posture, it is necessary to deal with swimming .
  4. Walk in comfortable shoes, women can not walk in shoes with high heels , if there is discomfort in the lower back.
  5. Timely treat diseases of the internal organs and small pelvis , especially the intestines, make sure that there are no constipation.
  6. Watch your body, posture, avoid excess weight .
  7. If lumbar pain occurs, contact with .

Carrying out recommendations on motor conditions, maintaining the tonus of the musculoskeletal system, the nervous system - , is the key to your success in the prevention of lumbar pain and other manifestations of lumbar osteochondrosis.

Author: George Nedzved , Doctor of Medical Sciences. Journal of Health and Success, June 1997.


A few words about the Latin terminology:

  • osteochondrosis - osteo- bone and chondrus- cartilage.
  • lumbalis - lumbar, hence the lumbago.
  • -ALGIA - pain, hence the lumbalgia.
  • radiculus - the spine( the spinal nerve coming out of the spine), hence the radiculitis.

In the end I give 2 references to gymnastics with lumbar osteochondrosis ( with pictures and without pictures).I recommend doing exercises with a preventive purpose.

Osteochondrosis of lumbar region - symptoms, treatment, gymnastics

Pain sensations in the back of different intensity are experienced by more than 80% of people. About 40% of them apply for help to a specialist.

It is known that 20% of people after 30 years suffer from radiculitis, which is one of the signs of lumbar osteochondrosis.

This type of osteochondrosis affects people of working age more often and in some cases can lead to disability.

Causes of lumbar osteochondrosis

The main reasons are:

  • Posture disorders. Wearing uncomfortable shoes, the habit of carrying bags on the same shoulder, improper posture at the table lead to the development of osteochondrosis.
  • Perinatal trauma, hereditary spinal cord anomalies. Excess weight. With obesity, there is an increased pressure on the spinal column, which leads to degenerative changes in bone tissue and promotes the development of lumbar osteochondrosis.
  • Disturbance of metabolic processes. The cause may be malnutrition or any infectious processes occurring in the body.
  • Sharp changes in lifestyle( another diet, changing physical exertion to increase or decrease).
  • Age-related degeneration of bone and cartilaginous tissue.
  • Pregnancy. In later terms, when pressure on the spine is particularly large, it is possible to develop lumbar osteochondrosis.
  • Consequences of injuries of the lower limbs or spine.
  • Low or too high activity. Disregard for physical education, sedentary work, physical inactivity, or, on the contrary, heavy physical labor associated with lifting weights and heavy load on the back, lead to lumbar osteochondrosis.
  • Congenital or acquired pathology of the musculoskeletal system( finger folding, flat feet, shortening of the foot, clubfoot).
  • Permanent overexcitation, frequent stress.

Symptoms of lumbar osteochondrosis

Symptoms of lumbosacral osteochondrosis include:

  • Back pain. This is the earliest and most characteristic symptom. Pain can be given to the legs, thighs, buttocks. The nature of low back pain may be different. When the torso is tilted, as well as when coughing and sneezing, low back pain intensifies.
  • Peeling and dry skin in places of loss of sensitivity and pain.
  • Impaired sensation of the muscles and skin of the lower half of the body.
  • Curvature of the spine. Depending on the type of curvature, osteochondrosis is divided into kyphosis( the spine is smoothed or slightly bent back), lordosis( the spinal column is bent forward) and scoliosis( the spine is curved to the left or right side).
  • Tingling and chills in the legs.
  • Spasm of the arteries of the feet, chills of the legs.
  • Violation of sensitivity in the genitals, violation of defecation and urination.

The most dangerous consequence of lumbar osteochondrosis is the development of vertebral instability. This is fraught with the appearance of dangerous violations in internal organs( men may have problems with potency, in women - with ovaries and uterus).

Treatment of lumbar osteochondrosis

Therapy of lumbar osteochondrosis is complex and includes:

Non-drug treatment .This type of therapy includes manual therapy, physiotherapy, spinal traction, massage, reflexology, physiotherapy. The purpose of exercise therapy is to perform the patient's specially designed for him a set of physical exercises. The program is aimed at preventing complications of osteochondrosis, strengthening the musculoskeletal system, correcting the posture, and removing the compression of the nerve endings. In addition, the exercise physiotherapy facilitates the normalization of metabolic processes in the lesion, improves blood supply and reduces the burden on the spine by strengthening muscles and ligaments. The method of physiotherapy is used for relief of pain and removal of inflammatory phenomena. Physiotherapeutic procedures include laser therapy, ultrasound, magnetotherapy, electrophoresis. Therapeutic massage with osteochondrosis of the lumbar region improves blood circulation, relieves tension in muscles and stops pain. With the help of manual therapy there is a correction of posture, the volume of movements in the spine is restored, the pain syndrome is stopped. The meaning of traction( traction) is to exert pressure on the vertebral column with the help of special equipment. It is believed that stretching promotes an increase in the intervertebral space and the removal of pain. But many experts consider this method to be dangerous, as it, in their opinion, leads to the development of intervertebral hernias.

With the help of reflexotherapy have a physical effect on the reflexogenic zones of a person.

Medication treatment .At this type of therapy of lumbar osteochondrosis are used:

  • NSAIDs. They are used to relieve pain and inflammation. Assign inside( tablets) and topically( ointment).To the NSAID include "Ibuprofen", "Diclofenac", "Meloksikam", "Finalgon", "Kapsikam", "Naiz", "Fastum Gel".
  • Novocain blockades( used for severe pain).
  • steroid preparations( in the form of intramuscular and epidural injections)
  • muscle relaxants( "Sirdalud", "Midokalm").They are used to relieve spasms and relax the muscles.
  • vitamins B12, B6, B1.Used to normalize metabolic processes.

To achieve a positive effect in the treatment of lumbar osteochondrosis, all the recommendations of the treating physician should be strictly followed.

Gymnastics for osteochondrosis of lumbar department

Exercises for lumbar osteochondrosis:

  • Feet on shoulder width, arms on waist. Slow inclination forward, back straight. Straightening. Tilt backwards. The number of repetitions is 10.
  • The starting position, lying on the back, the legs are bent at the knees. The elbow of the left hand touches the knee of the right leg, then vice versa. The number of repetitions is 10.
  • Lying on the back, you need to strain the abdominal muscles for 10 seconds, then relax. The number of repetitions is 10.
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