Lumbar osteochondrosis

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

Symptoms of lumbar osteochondrosis

• severe pain syndrome that can spread to the leg and pelvic organs
• pain in kidneys and sacrum
• numbness of limbs
• hardness
• tension in the lumbar region
• fatigue, weakness
• dizziness

Lumbar osteochondrosis has gender characteristics of the course. Vertebrogenic pain caused by the compression of nerve roots by the changed cartilage of the intervertebral discs is more difficult for women than for men. The intensity of pain directly depends on the level of estrogen. The lower their indicators, the more pronounced the pain.

In addition, reflected lumbosacral pain syndrome may be associated with accompanying diseases of internal organs. Diseases of the genitourinary system predominate in women, and disorders of the gastrointestinal tract are more typical for men.

Treatment of osteochondrosis of the lumbar-sacral region

Treatment of patients with neurological manifestations of lumbosacral osteochondrosis should be comprehensive and gradual. At the first medical appointment, a clinical and functional examination (clarification of complaints and anamnesis) and a clinical examination are performed. A neurologist examines the dynamic and static function of the spine, evaluates the parameters of posture and paravertebral muscle tone, and determines the degree of mobility of various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:

• exclusion of negative charges
• immobilization (use of corsets, orthoses, orthopedic style)
• drug treatment
• physiotherapy procedures
• gentle acupressure massage
• exercise therapy
• acupuncture
• mud therapy
• traction technique (traction)

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

Physiotherapy for lumbar osteochondrosis

A number of physiotherapy procedures are used to relieve pain, reduce swelling, normalize the tone of the back muscles, activate recovery processes, dissolve fibrous foci and increase the mobility of damaged segments:

• pulsed diadynamic currents
• darsonvalization
• magnetotherapy (exposure to a static or alternating magnetic field)
• laser treatment
• drug electrophoresis
• UV radiation
• local cryotherapy
• ultrasound
• transcutaneous electrical nerve stimulation

Due to combined physiotherapy with the simultaneous use of several methods, the effectiveness of therapy for lumbar osteochondrosis increases by 30%.

Physiotherapy

In the conservative treatment of degenerative pathologies of the musculoskeletal system, a special role is given to recreational physical education. Instructor-rehabilitators of the rehabilitation center prepare individual complexes of dynamic and stretching exercise therapy exercises for osteochondrosis of the spine. Here, the gender, age and physical capabilities of the patient are taken into account.

Optimized therapeutic exercises are aimed at strengthening the muscles of the back, abdomen, pelvis and lower limbs. Thanks to exercise therapy, pathological muscle tension is eliminated, pressure on the intervertebral discs is reduced, swelling and pain are eliminated, the spine is stabilized, and posture is improved.

Surgical intervention

The absolute indication for decompressive surgery is elimination of radiculomyeloischemia. This dangerous pathological condition is caused by hernia compression of the nerve roots and disruption of blood flow in the sacrococcygeal zone. Intermittent excruciating pain results in pelvic organ dysfunction, intermittent claudication, and other motor, reflex, or sensory disturbances. A relative indicator for operative stabilization is the lack of effect of long-term conservative therapy (more than 1. 5-2 months).

Endoscopic methods of osteoplasty are considered the most optimal: installation of interbody implants and fixation cages made of biocompatible materials. Minimally invasive interventions quickly return the ability to support the operated department and allow early rehabilitation.

Injection treatment (injections for lumbar osteochondrosis)

The main manifestation of osteochondrosis of the lumbar-sacral region is pain. This complex multicomponent symptom is associated with local inflammation, pathological muscle tension, ligament damage, biomechanical causes, and dysfunction of the pain perception system. Therefore, the treatment should be carried out comprehensively. Injection therapy drugs are prescribed for a faster pharmacological effect and reduction of gastrointestinal and cardio-risks:

• anti-inflammatory (NSAID)
• painkillers (analgesics)
• muscle relaxants (relaxing, reducing muscle tone)
• vasodilator (improving blood microcirculation)
• chondroprotectors (stimulates the regeneration of intervertebral discs, slows down the destruction of cartilage tissue).

Homeopathic injections and vitamins can be used for the treatment of osteochondrosis with the doctor's recommendation. Paravertebral therapeutic blockades (injections into the lumbosacral nerve plexus) are prescribed for quick and effective relief of severe pain syndrome.

Medical therapy

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

• NSAIDs (non-steroidal anti-inflammatory drugs)
• analgesics
• myotropic antispasmodics (medicines that relieve muscle spasms)
• vegetative correctors (stabilizers of the tone of the autonomic nervous system)
• vasodilators (to improve blood flow and tissue trophism)
• dosage forms of chondroitin and glucosamine
• sedatives and antidepressants (to relieve emotional tension and chronic stress)
• vitamin and mineral complexes

For the treatment of osteochondrosis of the lumbar-sacral spine, tablet preparations are prescribed for a long time (up to 2 months or more).

How does this disease manifest itself clinically?

In the initial stages, osteochondrosis of the back is characterized by very common symptoms, it is very difficult to recognize without the intervention of an experienced specialist. Usually, patients begin to complain of pain and other discomforts only when the second stage occurs.

The main clinical symptom of this disease, as probably everyone knows, is pain in the lower back. The severity of this symptom increases significantly after lifting and carrying weight, even after simple movements of the limbs or trunk. After a while, the pain becomes painful, annoying, but it can worsen from time to time.

Another common complaint of patients at the appointment of a vertebrologist is stiffness in the lumbosacral joint, limitation of movement. It becomes difficult for patients to bend and turn. It should also be noted that often the pain can spread to the back surface of the lower extremities.

As a result of compression of nerve roots by enlarged intervertebral discs, disturbances in pain and temperature sensitivity occur in the skin. It should be said that these violations can mean both weakening and an increase in sensitivity. If not treated in time, the disease is aggravated by muscle hypotension, as well as hyporeflexia.

How to get rid of this serious disease?

Osteochondrosis treatment is divided into two main groups of methods: conservative and surgical. The basis of the first method affects the human body with the help of drugs, which are non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any group of these drugs, you must consult your doctor, who will conduct a comprehensive diagnosis and draw up your individual treatment plan. This is very important because the drugs described above can cause some serious side effects that can be avoided if the drugs are taken correctly.

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

Manual therapy, physiotherapy and acupuncture methods have proven themselves in the treatment of osteochondrosis, which help to improve local blood supply and relax back muscles.

Treatment of osteochondrosis of the lumbar spine

According to statistics, every second person from 25 to 55 years of age has experienced the manifestations of lumbar osteochondrosis at least once in their life of varying severity: from discomfort in the lumbar region to severe pain with limited mobility.

The lumbar skeleton is exposed to maximum loads, so the high percentage of osteochondrosis in this particular region of the spine is not accidental.

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

When the diagnosis is confirmed, treatment of lumbar osteochondrosis should begin immediately, without waiting for the appearance of complications.

Mechanism of development of osteochondrosis

The cartilaginous structure of the intervertebral disc has a nucleus pulposus surrounded by a dense fibrous ring, the collagen fibers of which firmly anchor the disc to the vertebral body.

Intervertebral discs act as shock absorbers that relieve pressure on the spine during stress. With age, as a result of malnutrition, the cartilage tissue of the discs undergoes dystrophic processes. The core dries out, loses its shock absorption properties, followed by the destruction of the fibrous ring. Micro cracks, fiber breaks appear in its structure. Due to the increased load, the disc core is displaced outside the spinal column - the initial stage of hernia formation develops - protrusion. This causes irritation of the nerve roots and the appearance of pain in the patient.

If the fibrous ring is completely torn, then an intervertebral hernia is formed.

Factors leading to the development and exacerbation of lumbar osteochondrosis

• Occupational hazards - intense dynamic loads, work associated with frequent changes in body position: bending, stretching, turning, lifting heavy loads, vibration.
• A genetic predisposition with structural changes in the tissues of the spinal column that accelerates their degeneration.
• Incorrect posture, in which there is an uneven distribution of the load on the axial skeleton.
• Orthopedic pathologies: flat feet, curvature of the spine.
• Hypodynamia, sedentary lifestyle.
• Obesity.
• Congenital and acquired pathologies of the spine.
• Consequences of damage to the structures of the spine (fall from a height, traffic accidents, etc. ).
• Sports with a large physical load on the spine: skiing, tennis, horse riding, weightlifting.
• Irrational nutrition, dietary imbalance for the main nutrients: proteins, fats, carbohydrates, vitamins, trace elements.
• Hormonal imbalance in women during pregnancy and menopause.
• Bad habits: alcohol, smoking.
• Age changes.
• Inflammatory processes of the spine (Bekhterev's disease).
• Pathologies associated with disturbed metabolic processes in the body (diabetes, hypothyroidism).

Stages of lumbar osteochondrosis

Depending on the degree of damage to the intervertebral discs and the clinical picture, four stages of osteochondrosis of the spine are distinguished:

1 stage. There is a gradual decrease in the elasticity of the intervertebral discs. Microcracks appear in the fibrous ring. There is stiffness and discomfort in the back in the morning due to reflex spasm of the muscles surrounding the affected segment of the spine.

2 stages. The destruction of the fibrous ring continues, the disc flattens, which leads to a decrease in the distance between adjacent vertebrae. Pathological mobility develops when the vertebrae can move relative to each other. Nutrition of spinal tissues is disturbed. The pain is now regular.

3 stages. The semi-destroyed fibrous ring can no longer support the nucleus pulposus, a protrusion (protrusion) appears - the beginning of the formation of a hernia. The pain becomes intense and constant. There is a deformation of the spine.

4 stages. Intervertebral discs are replaced by scar tissue. There are many complications up to the complete loss of motor activity. This stage of lumbar osteochondrosis can only be treated with the help of a complex operation to replace the destroyed vertebrae with artificial implants.

Diagnostics

• Anamnesis collection.
• Neurological examination of reflexes, sensitivity.
• functional tests.
• X-ray, MRI, CT.

Treatment methods

Traditional treatment of lumbar osteochondrosis includes the following methods:

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

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

Surgical treatment of lumbar osteochondrosis is carried out in severe cases according to strict medical instructions, if the patient cannot stop severe pain with conservative methods or is threatened with a complication in the form of paralysis of the lower extremities or dysfunction of internal organs.

Osteochondrosis of the lumbar spine: diagnosis and treatment

Back pain often occurs in a person due to the formation of the wrong posture while walking and sitting at the desk. However, it is also one of the consequences of damage to intervertebral discs, cartilage tissues and nerve fibers, resulting in the development of lumbar osteochondrosis.

With lumbar osteochondrosis, degenerative changes occur in the lumbosacral spine. If the disease is not treated for a long time, the general well-being of the patient deteriorates: constant back pain, numbness of the limbs, spasms and cramps in the muscles, general weakness and loss of strength.

How does pathology develop?

During the development of the disease, degenerative-dystrophic and destructive disorders occur in the skeleton of the patient's spine. As a result, the anatomy and physiology of the articular elements of the spine changes. A person's lower back receives the main load in the form of the weight of the person's upper body, during movement, exercise or any physical activity. As a result of all of the above, the following changes occur:

• the axis of the spine is disturbed;
• posture changes;
• bones exert pressure on internal organs. This leads to the development of diseases of the cardiovascular system;
• coordination is impaired due to disruption of nerve endings;
• the structure of the spine changes;
• cartilage becomes thinner;
• the structure of the synovial fluid is filled with third-party components;
• spines wear out, so the distance between them decreases;
• when the vertebrae come into contact, the nerves are compressed - this causes sharp pain.

The risk of developing lumbar osteochondrosis is athletes who lead an extremely active lifestyle, people who lead a sedentary lifestyle (those who are in one unchanged position for a long time, creating an increased load on the spine), representatives of manual occupations. heavy equipment, the elderly, pregnant women, hyperactive children.

Symptoms of lumbar osteochondrosis

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

Causes of osteochondrosis of the lumbar-sacral spine

• improperly distributed load on the back;
• sedentary lifestyle;
• stooped posture;
• staying in the same position for a long time;
• congenital curvature of the spine;
• physical education too often;
• excess body weight;
• violation of blood flow in the spinal column;
• injuries, bruises, fractures of limbs or vertebrae;
• infections of internal organs.

Stages of development of lumbar osteochondrosis

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

Stage 2 - the fibrous ring in the spine is destroyed, the cartilage becomes thinner, the distance between the vertebrae decreases. In the second stage, the pain becomes sharper and sharper.

Stage 3 - there is a strong compression of muscle fibers and nerve endings. There are burning pains and spasms in the muscles, as well as frequent numbness.

Stage 4 - the period of growth of neoplasms (osteophytes) in the bone structure. Arthrosis appears in the spine and joints. The back becomes immobile, and in the absence of proper treatment - completely immobile.

How is lumbar osteochondrosis diagnosed?

Diagnosis of pathology begins with a consultation with a specialist. At the first manifestations of osteochondrosis, consult a rheumatologist, neuropathologist, surgeon or orthopedic traumatologist. If you have difficulty choosing a doctor, you should first consult with a therapist. Depending on the symptoms and the alleged causes of the pathology, he will send you to one of the highly qualified specialists.

1. The doctor will study your medical history and the frequency of their manifestations, you should provide the specialist with a complete medical history and the results of early studies (if any). The specialist will conduct a visual inspection and palpation.
2. During the examination, the doctor pays special attention to changes in posture, muscle tone, skin sensitivity and identifies the most painful places. The purpose of the conversation is to find out the degree of development of the disease. If you have any questions, the specialist will give you advice and conduct an examination.
3. He will direct you to tests, as this is a complete diagnosis that will allow you to make the correct diagnosis.
4. Based on the results of the examinations, the doctor will prescribe an individual treatment plan.

In order to determine the condition of muscles, ligaments, blood vessels, to detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the spine. During MRI of osteochondrosis, the patient lies on a special retractable table with his back. To relieve muscle tension, rolls are placed on the patient's head and the limbs are fixed with belts. Any small movement during the procedure can affect the quality of the result. Then the table enters the tomography area. The procedure does not cause pain. During the scan, the tomograph makes a lot of noise, so you can use headphones to avoid discomfort.

If MRI is contraindicated, other diagnostic methods such as computed tomography and radiography are available. X-ray is suitable only for initial diagnosis and does not provide a layered image of the affected tissues. However, this study is the simplest and most economical, allowing to check the patient's body in several projections. Due to the high radiation exposure of the body, X-rays cannot be taken often.

Treatment of lumbar osteochondrosis

Depending on the stage of lumbosacral osteochondrosis, different treatment methods can be prescribed. One of these methods is exercise therapy. It is carried out in a specially equipped room under the close supervision of a doctor. Classes are held when the patient does not feel pain. But if the patient starts to feel bad during physical training, the doctor adjusts the exercise or completely cancels it.

Another method of treatment of lumbar osteochondrosis is physiotherapy. It improves blood circulation and tissue nutrition, reduces inflammation and relieves pain. Physiotherapy procedures include:

• Electrophoresis - painkillers, anti-inflammatory drugs are used, the procedure reduces the neurological manifestations of the disease.
• Magnetic therapy - alternating magnetic field eliminates inflammation.
• Ultrasound therapy - moves along the affected spine.
• Diadynamic therapy - the effect on the affected areas occurs with the help of currents of different intensity.
• Hirudotherapy - treatment with leeches. Their effect improves microcirculation, nutrient exchange in back tissues.
• Kinesio taping is a treatment using a cotton patch.

Drug treatment - in extreme cases, analgesics (have an analgesic or additional anti-inflammatory effect), antispasmodics (eliminate muscle spasms), vasodilators (improve blood microcirculation) are prescribed.