Osteochondrosis of the lumbar spine - treatment and symptoms

17 September 2020

In the medical literature, the term "osteochondrosis of the spine" refers to degenerative processes in the centers of ossification in children. A disease accustomed to medicine, considered the most common among all problems of the musculoskeletal system, is hidden behind the words sciatica, herniated disc, back pain (back pain). The lower back, according to official statistics, suffers more often than other parts, which leads to serious complications for the whole body. Why does this happen and how to treat osteochondrosis?

What is osteochondrosis of the lumbar spine

Degenerative neuro-orthopedic disease affecting the intervertebral discs and leading to compensatory and reactive secondary changes in the osteo-ligamentous apparatus and nervous system - this is the medical definition of osteochondrosis. It mainly affects the lumbar region, which is located between the thoracic and the sacral and consists of five vertebrae. Between them are discs - fibro-cartilaginous formations, formed from the following:

cartilaginous tissue (the membrane involved in the nutrition of the discs of the vessels of the vertebral body);
nucleus pulposus (a gelatinous mass in the center with a nucleus pulposus);
annulus fibrosus (protects the fluid part).

Against the background of problems with blood circulation, changes in the composition of cartilage tissue, dehydration of the nucleus pulposus, the elasticity and elasticity of the intervertebral disc deteriorates, its fixing properties suffer. Under the influence of unfavorable factors, muscle fixation weakens, and the vertebrae acquire excessive mobility. Then degenerative and destructive processes affect the bone surfaces of the adjacent vertebrae, there is dystrophy (tissue malnutrition) of the spine.

The rest of the process looks like this:

Microcracks appear in the loose ring. The nucleus pulposus begins to enter it, gradually passes through the fibrous ring and is damaged, resulting in a herniated disc or a protrusion (initial stage).
A hernia compresses the spinal canal, can pinch nerve roots and blood vessels, causing pain and movement problems.
Due to the increased pressure on the vertebrae (due to the thinning of the disc), an accelerated production of bone tissue begins and spinous processes (osteophytes) are formed.

Reasons

Some experts tend to call intervertebral osteochondrosis of the lumbar spine and others a "disease of civilization", mainly caused by the upright posture, which has increased the load on the back of a modern person. The disease begins mainly in people over 30 years old, in men it is diagnosed more often than in women.

Lumbar osteochondrosis can develop:

excessive loads on the spine (housewife, professional, athletic);
weak back muscles;
incorrect distribution of household load on the spine (for the lumbar spine - the most common reason);
frequent tension of back muscles;
being overweight, especially in the context of diabetes mellitus;
injuries to the spine;
violation of metabolic processes;
ill-fitting shoes, flat feet;
postural problems, resulting in uneven load distribution along the spine;
hypothermia of the lumbar spine;
sedentary lifestyle, long-term driving;
hormonal disorders (mainly in women);
congenital pathologies of the musculoskeletal system;
age (natural changes in fibrocartilaginous tissue occur in people over 50 years old);
frequent stress, emotional tension.

Degrees of development

The disease progresses slowly and gradually, with most patients not recognizing a serious problem until stage 2 or later. In the absence of adequate treatment, osteochondrosis progresses and can lead to disability.

Main medical classification:

The initial phase is characterized by the initiation of the process of destruction of intervertebral discs, a decrease in their elasticity, elasticity. The disease is felt mainly with a load on the spine.
Destructive processes affect the fibrous ring, the distance between the vertebrae decreases (the disc becomes thinner), depreciation suffers, protrusions appear (protrusion of the intervertebral disc without breaking the ring). Pinching of the nerve roots and inflammation of the tissues occurs, which increases the pain syndrome.
Annulus rupture occurs, hernia occurs. The vessels, the nerve endings are compressed. Changes in the lumbar spine lead to a general deformity of the spine.
In the last stage, the muscles of the affected section atrophy, motor activity and the ability to work suffer. The spine is visibly bent - there is a pronounced scoliosis (3-plane deformity), lordosis (enlarged deformity of the lower back to the front).

Symptoms of lumbar osteochondrosis

The clinical manifestations of the disease depend on the stage of severity. The main symptom is a local pain syndrome that occurs in response to physical activity, lifting heavy objects, hypothermia of the lower back, prolonged preservation of an uncomfortable posture (when sitting down, the load is higherin vertical position). It is caused by irritation of the sinuvertebral (recurrent) nerve.

The stages of osteochondrosis of the lumbar spine look like this:

At the initial stage there is discomfort in the lumbar region, pain is rare, mainly with a high load on the back. They pass quickly.
In stage 2, the mobility of the lumbar spine deteriorates, the pain occurs after physical exertion and without it (with a strong cough, change in posture) gradually intensifies, persists for a long time. Malfunctions in the work of internal organs are possible.
With the development of osteochondrosis, the pain becomes permanent (permanent) and the vertebrae become deformed. Nerve endings are pinched, so the pain can be transmitted to the sacrum, leg, become sharp and pull. Loss of sensitivity of the limbs, buttocks, thighs, numbness, paresthesias (burning, tingling, "goosebumps") occur. Pelvic organ dysfunctions appear.
At the last stage, the motor function is impaired or becomes completely impossible, the curvature of the spine occurs. The pain is permanent, the person unconsciously takes an unnatural position to reduce it.

The reflex syndromes of the disease in official medicine are divided into 3 groups: musculo-tonic, neurodystrophic, vegetative-vascular. The last 2 categories manifest themselves strongly at 3 stages of the disease and later.

The clinical picture may include:

weakened or missing reflexes of the Achilles tendon, flexion of the fingers (in case of osteochondrosis of the sacral region);
dry skin, blue discoloration;
urinary disorders (urinary retention or incontinence), pain in the bladder;
cramps and pain in the thigh region on the background of nutritional and circulatory disorders;
tense, unsteady gait, lameness;
increased sweating, fever with increased back pain;
radiating to the region of the heart (if the thoracic-lumbar region is affected).

Complications

If osteochondrosis of the lumbar spine has been diagnosed, treatment should be started immediately, because at the last stage the patient can be completely disabled. Against the background of squeezing (compression) of the spinal cord by the vertebrae, between which there is no space left, paralysis of the lower extremities may develop.

In addition, osteochondrosis can cause:

disorders of the pelvic organs (men suffer from erectile function, women - ovarian activity);
lumbago (sharp pain in the lower back), sciatica (pinching and inflammation of the sciatic nerve);
intervertebral disc prolapse, stenosis (narrowing of the spinal canal);
damage to the lining of the spinal cord, which is fatal

Diagnostics

In order to make the correct diagnosis and assess the severity of the disease, the doctor collects data from anamnesis (study of patient complaints, lifestyle, hereditary factors). After that, a physiological examination is carried out, where the motor skills, posture, level of sensitivity, tone and size of muscles, as well as their spasm are evaluated. By tapping with a hammer, areas of irradiation (where it gives) pain in osteochondrosis of the lumbar spine are marked.

After patient assignment:

X-rayis the most accessible way to examine the anatomical parameters of the vertebrae, assess the tendency of the holes between their bases to narrow and identify bony growths.
MRI(magnetic resonance imaging) - helps to assess the condition of the vessels that supply the spine, nervous processes, discs.
CT(computed tomography) - is prescribed only to check for changes in the vessels, the lining of the spinal cord and to study marginal growths.

Treatment of osteochondrosis of the lumbar spine

Surgery is considered a last resort, mainly prescribed for patients with significant neurological conditions and a high risk of disability. These problems are characterized by advanced osteochondrosis of the lumbar spine - doctors try to treat stages 1 and 2 conservatively.

The therapeutic measures aim to:

elimination of pain syndrome;
elimination of muscle spasms, hypertonicity;
elimination of the inflammatory process;
improvement of blood circulation in affected areas and metabolic processes;
normalization of the mobility of the lumbar vertebrae;
restoration of lumbar sensitivity.

exercises for osteochondrosis of the lumbar spine

There is no universal method of treatment: each specific case of osteochondrosis requires an individual scheme. It is especially important to take into account the form of the disease: acute or chronic. Therapy is necessarily of a combined nature, involving the use of drugs (internal and external) with physical manipulations - massage, gymnastics, physiotherapy. The treatment regimen of osteochondrosis of the lumbar spine can be supplemented with acupuncture, hirudotherapy.

The effectiveness of the treatment will increase if you follow the following rules:

A special belt or corset should be worn during treatment to reduce stress on the spine.
Physical activity is excluded (only those recommended by the doctor remain), so as not to add provoking factors.
It is important to closely monitor the diet: cartilage needs sources of collagen (gelatin, asp, jelly meat), and the whole body needs plant foods, fish, nuts. It is advisable to refuse salty, smoked, pickled products, as well as sharp cheeses, fatty meats.
The scheme prescribed by the doctor should be followed to the end: do not interrupt treatment when the main symptoms have disappeared, do not change all of the drugs and procedures yourself.
Together with the doctor, it is worth choosing an orthopedic mattress that will help relax the lower back during sleep and special shoes. Women are totally prohibited from heels.

Acute osteochondrosis of the lumbar spine requires special attention - its treatment begins with the appointment of the patient to bed rest for several days. Pain sensations are reduced by injections of analgesics, blockage of novocaine and glucocorticoids are not excluded. Spinal traction (using a traction table or vertical device), walking with crutches, electrophoresis, and laser therapy help improve the condition.

Drug treatment

Drugs for the treatment of osteochondrosis of the lumbar spine are used internally and topically. Local gels and ointments are symptomatic treatment: relieve inflammation and pain, relieve muscle spasms and edema, improve blood circulation. In acute conditions, injections have an immediate anti-inflammatory, antipyretic, analgesic effect.

Most doctors prescribe home medication for osteochondrosis:

Chondroprotectors- protect cartilage tissue and promote its recovery, are indicated for long-term use (from six months or more).
Means that improve blood circulation and metabolic processes in the tissues- tablets to be taken for several months, since the effect is cumulative.
Muscle relaxants- relieve muscle spasms, are used orally in a short course.
Nonsteroidal anti-inflammatory drug- quickly blocks pain, suppresses the production of prostaglandins involved in the inflammatory process. Ointments and gels are applied to the affected area 1-2 times a day, unless otherwise specified in the instructions. In the initial stages, the external forms can be removed, after which they are duplicated with tablets.
Corticosteroids- painkiller injections are prescribed only in the absence of a significant effect of nonsteroidal drugs.
Ointments that have a warming effect- help relieve pain and improve blood circulation in tissues, are safer than non-steroidal drugs, but are prohibited in the inflammatory process.
B vitaminsand multivitamin complexes are prescribed as a long course to increase the overall effectiveness of the treatment.

Physiotherapy

In order to improve the effect of drug therapy and speed up recovery, the patient may be prescribed physiotherapy courses. You can alternate them or go through several options at the same time. The specific technique is chosen depending on the stage and form of the disease.

Osteochondrosis of the lumbar spine - treatment includes effective methods:

Electrotherapy (electrophoresis)- involves the effect of low-power electric currents to improve blood circulation in the affected areas.
Laser therapy- activates biological processes in nerve endings, relieves symptoms of neurodystrophic syndrome.
UHF- local impact on the lumbar region with a high frequency magnetic field to stop the inflammatory process, stimulate cell regeneration (restoration) of tissues and reduce pain.
Phonophoresis and electrophoresis- helps deliver medicine to the area in need, which increases the effectiveness of drug treatment. The result depends on the specific agent used during the procedure.
Darsonvalisation- a therapeutic effect of high-frequency alternating current in order to widen blood vessels, improve blood circulation and tissue nutrition. The procedure affects symptoms less than others.
Amplipulse- local effect of currents with sinusoidal modulation, due to which the severity of pain is reduced. The procedure has analgesic, vasodilator, neurostimulant effect, improves tissue trophism.

Catch-up gymnastics

Physical activity - especially when it comes to early (initial stage) osteochondrosis of the lumbar spine - should be included in the treatment: it helps relax and strengthen muscles, has abeneficial effect on tissue nutrition. For people with grade 2 disease and more severe exercise, the doctor chooses. With an exacerbation, gymnastics, swimming, yoga (the most effective directions) are prohibited.

The following exercises show good results:

Focus on your knees and palms, keep your back straight (parallel to the floor). On the exhale, slowly bend the lumbar region, tilt the head slightly back. Count to 5-8 (depending on how you feel), inhale and arch your back with a wheel. Again count to 5-8 and take the starting position. The exercise is performed 10 to 12 times at a slow pace. If necessary, they are divided into 2-3 approaches.
Lie on your stomach. As you exhale, slowly pull your chest off the floor, leaning into your lower back and trying to rise as high as you can. The arms are extended forward, the legs do not move. Hold this position for 5-10 seconds and gradually lower. Repeat the exercise 8 to 10 times, gradually increasing the duration of the delay at the highest point.

Massage

is an effective method of treating any stage of osteochondrosis, which helps to relieve unpleasant symptoms, eliminate muscle spasms, and normalize lymphatic flow and blood supply to affected areas. In addition, this procedure stimulates the restoration of atrophied muscles and removes the limitation of the mobility of the vertebrae, strengthens the ligament apparatus. The massage is performed by a specialist doctor over 10 to 12 sessions when the symptoms of the acute phase have subsided.

Surgery

If a patient is diagnosed with significant neurological disorders, loss of urination control, severe hernial protrusion, surgery is required. In addition, the indication is the absence of a positive effect of conservative treatment (lasting more than one month). Before receiving a referral for surgery, the physician should assess all risks, especially if traditional technology is chosen over microdiscectomy.

During the procedure, the surgeon can:

eliminate pathologically altered areas by placing local implants (discectomy) on them, which are developed individually for each patient;
to align the spine with a special rod - this helps to distribute the load correctly and prevent further deformation.

The discectomy is performed under general anesthesia, with posterior access for the surgeon. During the operation, the skin is cut to a length of 10 cm, the muscles are spread, and the affected disc is removed. At the end of the procedure, the wound is sutured in layers. The duration of surgery is about 2 hours, the next day the patient should lie on his back. The rehabilitation period is 2 months. With microdiscectomy, the procedure takes 1. 5 hours, an incision is made 3 cm, and you can stand up after leaving the anesthetic.

Treatment of osteochondrosis of the lumbar spine with folk remedies

treatment of lumbar osteochondrosis with folk remedies

After consulting with a doctor who can competently assess the patient's condition, it is allowed to use traditional medicine recipes. They do not give the same pronounced effect as drug therapy, do not replace physiotherapy, massage and gymnastics, but increase the likelihood of a positive result of the main treatment.

Some simple options:

Grate the peeled black radish (350 g), mix with liquid honey (250 g) and vodka (100 ml). Use to rub the lower back with light massaging movements for 10 minutes morning and night. After that, it is advisable to wrap this area with a woolen cloth and lie down for an hour under a blanket. The procedure is carried out for 8-10 days, after which they take a break.
With severe lower back pain, you can take 100 g of medium-fat cottage cheese, add 1 tbsp. Apple cider vinegar, place on a cotton cloth or cheesecloth. The bandage is kept for 2 hours, the procedure, if necessary, is repeated 2 times a day. The duration of treatment is not limited.
Collect fresh lilac flowers, fill a liter jar with them without crushing them. Pour a liter of vodka, leave in the fridge for 3 weeks. Use to rub the affected area once a day for a month. It is not necessary to cover the lower back with anything after the treatment.

Prevention of osteochondrosis of the lumbar spine

Doctors say that most back diseases can be prevented with regular physical activity, which strengthens muscles, improves blood circulation and nourishes tissues. Osteochondrosis of the lumbar spine is no exception - treatment won't have to be done if you consistently practice gymnastics, yoga, and swimming.

Additional preventive measures:

diet control (more plant foods, less animal fats, pickles, marinades: as in processing);
limit heavy loads on the spine;
monitoring the condition of the endocrine system;
elimination of bad habits (alcohol, tobacco);
use of an orthopedic mattress;
followed by posture;
avoiding high heels (from 7 cm) for women.