Back or lower back pain is the most common complaint of patients in general medical practice. They rank second (after respiratory diseases) in the frequency of requests for medical care. There are many diseases that lead to pain. But the most common cause is osteochondrosis of the lumbar spine, the symptoms and treatment of which we will discuss in this article.
Relatively recently, medicine has considered this condition to be age-related changes in the spine that are associated with the natural aging processes of the human body.
Today, lumbar osteochondrosis is considered a very serious disease that occurs in people of all ages. Currently, the frequency has a steady tendency to rejuvenate, more and more often the disease is diagnosed in people under 30 years of age.
Causes
The cause of lumbar osteochondrosis has not yet been identified. But when faced with this pathology, it is often possible to guess who is more prone to the disease and at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead mostly sedentary lifestyles. In a sitting position, the muscles of the corset relax, which increases the load on the lumbar spine.
- Hormonal metabolic disorders and endocrine diseases can adversely affect the metabolism in the tissues of the spine and contribute to the development of osteochondrosis.
- Various congenital and acquired anomalies in the structure of the musculoskeletal system - curvature of the legs and spine, flat feet.
- The presence of constant heavy physical exertion of the spine, in particular lifting heavy objects. In this case we can talk about an occupational disease of such categories as weightlifters and people whose professional duties are related to the constant lifting of heavy objects.
- Constant unhealthy diet and daily routine, regular stress, insufficient time for sleep, metabolic disorders.
The points listed above are the most common factors that create the preconditions for the development of the disease.
Degrees of lumbar osteochondrosis
The manifestations of the disease depend on the degree of development of the pathology.
There are four degrees of osteochondrosis:
- Period of change and movement of the pulpal nucleus in the disc. The pain occurs due to irritation of the nerve endings located in the fibrous ring and longitudinal ligaments. The patient experiences local discomfort in the part of the spine where the affected disc is located: acute pain or lumbago in the lower back (lumbago), dull pain of a permanent nature (lumbodia).
- Period of destruction of annular fibrosis. It is characterized by the appearance of instability and increased mobility of the vertebrae, which causes prolonged and constant muscle tension. The patient feels symptoms such as constant fatigue of the lumbar muscles, discomfort,
- The period of rupture of the annular fibrosis and the exit of the nucleus pulposus beyond its boundaries with the formation of a herniated disc. The so-called radicular syndromes are observed, which are associated with compression of the nerve roots by dropped fragments.
- The spine is severely deformed. Human motor function is difficult. The main issue to be addressed is the disability of the patient. However, it should be emphasized that at this stage of the disease there is virtually no pain. But this is not a signal to stop the disease, quite the opposite.
- There is a pathological spread of bone tissue, which will further aggravate the condition.
How to treat osteochondrosis of the lumbar spine will depend directly on the extent of the lesion; for this, medical, non-drug and surgical methods of exposure are used.
Symptoms of osteochondrosis of the lumbar spine
When osteochondrosis of the lumbar spine occurs, the main symptom is pain. The nature of the sensations of pain, the place of origin and the direction of spread depend on which receptors are irritated, ie how rough the changes in the disc and surrounding tissues are, whether there is a bulge or already a hernia, in which direction the bulge has formed, etc. . n.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, pain in nature, worsening with sudden movements, change in body position, prolonged stay in one position. The reduction of pain occurs when occupying a horizontal position;
- Along with lumbar pain, osteochondrosis can give a feeling of weakness in the lower trunk and legs, as well as loss of tendon reflexes in the lower extremities;
- It is often the curvature of the lumbar spine. Depending on the place where the distortion is observed, we distinguish scoliosis (curvature of the spine to the right or left), lordosis (bending forward) and kyphosis (smoothing of the lumbar bend);
- If osteochondrosis has resulted in spinal cord compression and dysfunction, the patient may have uncontrolled urine and stools.
Additional features:
- cold skin and tingling in the lumbar region, buttocks;
- dryness, peeling, bruising of the skin in the lower back and buttocks;
- sweating disorder in the buttocks;
- urinary incontinence;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical intervention. Treatment of osteochondrosis can be performed in a hospital and at home.
Diagnostics
Diagnosis of osteochondrosis involves the use of various methods, mainly palpation of the lumbar spine.
To confirm the diagnosis, the patient is sent for examination using diagnostic equipment:
- Radiography helps to assess the condition of the spine and each vertebra individually. The integrity of the intervertebral discs and spinal canal is also assessed indirectly.
- Tomography determines the degree of damage to the nerve endings and the lining of the spinal cord. And also to assess the condition of the intervertebral discs.
- MRI - used to make a definitive diagnosis.
The correct diagnosis will help to understand how to treat lumbar osteochondrosis and what medications and procedures will be needed for it.
Complications
Osteochondrosis of the lumbar spine can cause bulges and hernias due to significant loads on this spine. These complications develop very quickly, so it is very important to treat yourself in a timely manner.
In addition, osteochondrosis can be complex:
- inflammation of the sciatic nerve;
- spondyloarthritis; Schmorl's hernia;
- osteophytosis, spondylosis;
- spinal canal stenosis with compression and dysfunction of the spinal cord;
- compression of the ponytail with pelvic organ dysfunction;
- куц;
- paresis of the lower limbs.
It is possible to prevent the progression of complications with timely diagnosis and comprehensive treatment.
Treatment of osteochondrosis of the lumbar spine
When lumbar osteochondrosis is diagnosed, treatment requires extensive complex therapy, which includes:
- moderate physical activity;
- use of drugs;
- spinal traction;
- manual therapy;
- physiotherapy;
- massage.
The osteochondrosis treatment regimen is aimed at:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthening the muscles in the lumbar region, buttocks, legs;
- elimination of pathological muscle tension;
- improving the functioning of the pelvic organs;
- regulation of blood circulation and metabolic processes in the affected area;
- restoration of normal range of motion in the lower back and increased sensitivity of the lower limbs.
Surgery is used in only a few cases.
Medicine
Such treatment of lumbar spine osteochondrosis involves taking pills, injections and external (ointments and gels) drugs. Medications used to fight this disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for osteochondrosis of the lower back:
- painkillers (analgesics);
- non-steroidal anti-inflammatory drugs;
- muscle relaxants, to relieve muscle spasm that occurs due to pain;
- chondroprotectors that repair cartilage tissue;
- corticosteroids (prescribed if all other treatments fail);
- vitamin preparations.
Very often in the treatment of osteochondrosis pills are prescribed that calm the nervous system, as well as antidepressants that fight stressful situations and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, drugs alone are not enough to treat osteochondrosis. Physiotherapy procedures are used to relieve pain, relieve muscle spasm and stimulate metabolic and recovery processes:
- amplipulse;
- phonophoresis;
- diadynamic currents;
- darsonvalization; magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main symptom of pain is removed or during remission in chronic pathology. It serves to relax tense muscles. It is often combined with warm-up procedures or a visit to the sauna. This will help increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is performed only by a specialist in this field of treatment, increases blood circulation in the spinal cord, replaces the displaced discs of the spine.
Therapeutic gymnastics
The whole set of exercises used to diagnose lumbar osteochondrosis should help increase the mobility of the lumbar spine.
Therapeutic gymnastics will not be effective if the exercises are performed from time to time. The main principle of exercise therapy is regularity. Constant performance of a certain set of exercises will help to eliminate the destructive processes in the intervertebral joints.
Surgery
Usually the doctor will prescribe surgery only if serious complications develop. For example, an intervertebral hernia. The most common type of surgery is the removal of the damaged disc (discectomy).
This operation is considered the most productive method in this case, but at the same time is prescribed only if other methods of treatment do not work within six months. In addition, the method of microsurgical and endoscopic treatment of the spine is widespread.