Back pain or lower back pain is the most common complaint of patients in general practice. They rank second (after respiratory illnesses) in terms of the frequency of requests for medical care. There are many diseases that cause pain. But the most common cause is osteochondrosis of the lumbar spine, the symptoms and treatment of which we'll look at in this document.
Relatively recently, medicine has regarded this condition as age-related changes in the spine, which it has associated with the natural aging processes of the human body.
Today, lumbar osteochondrosis is considered to be quite a serious condition that affects people of all ages. Currently the incidence has a constant trend towards rejuvenation, more and more often the disease is diagnosed in people under 30 years of age.
Causes of occurrence
The reason for the development of lumbar osteochondrosis has not yet been established. But when faced with this pathology, it is quite often possible to assume that the one who is most prone to the disease is at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead predominantly sedentary lives. When sitting, the corset muscles relax, which increases the load on the lumbar spine.
- Hormonal metabolic disorders and endocrine diseases can interfere with 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 and intense physical exertion on the spine, especially when lifting heavy objects. In this case, we can speak of an occupational disease of such categories as weightlifters and people whose professional tasks are associated with the constant lifting of heavy objects.
- Constant unhealthy diet and daily routine, regular stress, insufficient sleep time, 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 nucleus pulposus inside the disc. The pain appears due to irritation of the nerve endings located in the fibrous annulus and longitudinal ligaments. The patient experiences local discomfort in the part of the spine where the affected disc is located: sharp pain or lumbago in the lower back (lumbago), dull pain of a constant nature (lumbodynia).
- Period of destruction of the fibrosus ring. It is characterized by the appearance of instability and increased mobility of the vertebrae, which causes prolonged and persistent muscle tension. The patient experiences symptoms such as constant fatigue of the muscles of the lower back, discomfort,
- The period of rupture of the fibrous ring and the release of the nucleus pulposus beyond its limits with the formation of a herniated discWe observe the so-called radicular syndromes associated with the compression of the nerve roots by fallen fragments.
- The spine is severely deformed. Human motor function is difficult. The main problem to be solved is the patient's disability. However, it should be emphasized that at this stage of the disease there is practically no pain. But this is not a signal to suspend the disease, quite the contrary.
- There is a pathological overgrowth of the bone tissue, which will further aggravate the situation.
How to treat osteochondrosis of the lumbar spine will directly depend on the degree of the lesion; for this, drug, non-drug and surgical exposure methods are used.
Symptoms of osteochondrosis of the lumbar spine
In osteochondrosis of the lumbar spine, the main symptom is pain. The nature of the pain sensations, the place of origin and the direction of spread depend on the receptors that receive the irritation, that is, on how important changes in the disc and surrounding tissues are, itthere is a protrusion or already a hernia, in which direction the protrusion formed, and so on.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, painful in nature, aggravated by sudden movements, change in body position, prolonged stay in one position. Pain reduction occurs by taking a horizontal position;
- In addition to pain in the lumbar spine, osteochondrosis may cause a feeling of weakness in the lower trunk and legs, as well as loss of tendon reflexes in the lower limbs;
- Curvature of the lumbar spine is common. Depending on where the curvature is observed, scoliosis (curvature of the spine to the right or left), lordosis (forward flexion) and kyphosis (smoothing of lumbar flexion) are distinguished;
- If osteochondrosis has resulted in clamping and dysfunction of the spinal cord, the patient may have uncontrolled urine and stools.
Additional features:
- cold skin and numbness in the lumbar region, buttocks;
- dryness, peeling, blue skin on lower back and buttocks;
- violation of sweating in the buttocks;
- urination disorder;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical intervention. Treatment for osteochondrosis can be done in hospital and at home.
Diagnostics
The 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:
- The
- X-ray allows you to assess the condition of the spine and each vertebra separately. The integrity of the intervertebral discs and the spinal canal is also judged indirectly.
- With tomography, the degree of damage to the nerve endings and the lining of the spinal cord is determined. And also assess the condition of the intervertebral discs.
- MRI - used to make a definitive diagnosis.
Correct diagnosis will help to understand how to treat lumbar osteochondrosis and what drugs and procedures will be needed for it.
Complications
Osteochondrosis of the lumbar spine can cause protrusions and hernias due to heavy loads on this spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner.
In addition, osteochondrosis can be complicated:
- inflammation of the sciatic nerve;
- spondylarthrosis;
- Schmorl's hernia;
- osteophytosis, spondylosis;
- spinal stenosis with compression and dysfunction of the spinal cord;
- cauda equina compression with pelvic organ dysfunction; lame
- ;
- paresis of the lower limbs.
The progression of complications can be prevented with prompt diagnosis and complex 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 medication;
- traction of the spine; Manual therapy
- ; physiotherapy
- ; Massage
- .
The treatment regimen for osteochondrosis aims to:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthening the muscles of 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.
Surgical intervention is only used in a few cases.
Drugs
Such treatment for osteochondrosis of the lumbar spine includes taking pills, injections and external drugs (ointments and gels). The drugs 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:
- pain relievers (pain relievers);
- nonsteroidal anti-inflammatory drugs;
- muscle relaxants, to relieve muscle spasms caused by pain;
- chondroprotectors that restore cartilage tissue;
- corticosteroids (prescribed if all other treatments have failed);
- vitamin preparations.
Very often in the treatment of osteochondrosis, pills are prescribed that calm the nervous system, as well as antidepressants that combat stressful situations and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, drugs alone are not sufficient to treat osteochondrosis. Physiotherapeutic procedures are used to eliminate pain, relieve muscle spasms, and stimulate metabolic and recovery processes:
- amplipulse;
- phonophoresis;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy; Laser therapy
- .
Massage is prescribed when the main painful symptom is removed or during remission in chronic pathology. It is used to relax tense muscles. Very often combined with warm-up procedures or a visit to the sauna. This will help to increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is performed only by a specialist in this area of treatment, increases blood circulation in the spinal cord, replaces displaced discs of the spine.
Catch-up gymnastics
The set of physical exercises used in the diagnosis of lumbar osteochondrosis should help increase the mobility of the lumbar spine.
Remedial gymnastics will not be effective if the exercises are performed occasionally. The main principle of exercise therapy is regularity. The constant implementation of a certain set of exercises will help to eliminate destructive processes in the intervertebral joints.
Surgery
Usually, a doctor will only prescribe surgery if there are serious complications. For example, an intervertebral hernia. The most common type of surgery is to remove the damaged disc (discectomy).
This operation is considered the most productive method in this case, but at the same time it is prescribed 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 widespread.