Lumbar osteochondrosis - treatment and symptoms

17 September 2020

In the medical literature, the term "osteochondrosis of the spine" refers to degenerative processes in the ossification centers in children. Among all the problems of the musculoskeletal system, the most common medical habit is hidden behind the words sciatica, disc herniation, dorsalgia (back pain). According to official statistics, the lower back suffers more often than other parts, which leads to serious complications for the whole body. Why does this happen and how is osteochondrosis treated?

What is osteochondrosis of the lumbar spine

Degenerative neuro-orthopedic disease affecting the intervertebral discs and causing secondary compensatory and reactive changes in the osteo-connective apparatus and nervous system - this is the definition given by osteochondrosis doctors. It mainly affects the lumbar region, which is located between the chest and sacrum and consists of five vertebrae. There are discs between them - fibro-cartilaginous formations formed from the following elements:

cartilage tissue (membrane involved in feeding the discs from the vessels of the spinal cord);
nuclear pulp (gelatinous mass with a nuclear pulp in the center);
annulus fibrosus (protects the fluid part).

Blood circulation, changes in the composition of cartilage tissue, dehydration of the pulposus nucleus, deterioration of the elasticity and resilience of the intervertebral disc, suffer from fixation features. Under the influence of adverse factors, muscle fixation weakens and the vertebrae gain excessive mobility. After that, degenerative and destructive processes affect the bone surfaces of adjacent vertebrae, there is dystrophy of the spine (tissue nutrition).

The additional process looks like this:

Micro cracks appear in the loose ring. The nucleus of the pulposus begins to penetrate it, gradually breaking and damaging the annular fibrosis, causing a herniated disc or protrusion (initial stage).
A hernia compresses the spinal canal, squeezing nerve roots and blood vessels, causing pain and movement problems.
Due to the increased pressure on the vertebrae (from the thinning of the disc), the rapid production of bone tissue begins and spinous processes (osteophytes) are formed.

Reasons

Some experts tend to call intervertebral osteochondrosis of the spine and others a "disease of civilization", primarily due to the upright posture that increases the load on the back of a modern man. The disease mainly begins in people over the age of 30, and is diagnosed more often in men than in women.

Lumbar osteochondrosis can develop:

Excessive loads on the spine (home, profession, sports);
weak back muscles;
improper distribution of household load on the spine (for the spine - the most common cause);
frequent tension of the lumbar muscles;
overweight, especially against the background of diabetes mellitus;
spinal injuries;
disorders of metabolic processes;
incorrectly fitted shoes, flat feet;
posture problems, uneven distribution of load along the waist;
lumbar hypothermia;
sedentary lifestyle, long-term driving;
hormonal diseases (mainly in women);
congenital pathologies of the musculoskeletal system;
age (natural changes in fibrocartilaginous tissue occur in people over 50 years);
frequent stress, emotional stress.

Development rates

The course of the disease is slow and gradual, most patients recognize a serious problem only in stage 2 or later. Without proper treatment, osteochondrosis develops and can lead to disability.

Basic Medical Classification:

The initial stage is characterized by the destruction of the intervertebral discs, the beginning of the process of loss of elasticity, elasticity. The disease feels like a burden on the spine.
Destructive processes affect the ring fibrosis, the distance between the vertebrae is reduced (the disc is thinned), amortization suffers, protrusions are formed (intervertebral disc protrusion without breaking the ring). Compression of nerve roots and tissue inflammation occur, which increases the pain syndrome.
Anulus tears the fibrosus, forming a hernia. Vessels, nerve endings are compressed. Changes in the lumbar spine cause general deformation of the spine.
In the final stage, the muscles of the affected area suffer from atrophy, motor activity and inability to work. The vertebral column is significantly curved - there is a clear scoliosis (3-plane deformity), lordosis (hypertrophic forward curvature of the lumbar spine).

Symptoms of lumbar osteochondrosis

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, heavy lifting, lumbar hypothermia, prolonged maintenance of an anxious posture (in the sitting position, the load is higher than in the upright position). It is caused by irritation of the sinuvertebral nerve.

The stages of lumbar osteochondrosis look like this:

In the initial stage, there is discomfort in the lower back, pain is rare, especially in the high back. They pass quickly.
In the second stage, the mobility of the lumbar spine deteriorates, there is pain after physical exertion, and without it (with a strong cough, change in posture) gradually intensifies, lasts a long time. Malfunctions of internal organs are possible.
With the development of osteochondrosis, the pain becomes permanent (permanent) and the vertebrae are deformed. Nerve endings are compressed, so the pain can be transmitted to the sacrum, legs, become sharp, shoot. Loss of sensation in the limbs, thighs, thighs, tenderness, paresthesia (burning, tingling, "gas bubbles"). The functions of the pelvic organs are impaired.
In the final stage, motor function is impaired or completely impossible, spinal curvature occurs. The pain is permanent, the person unconsciously takes an unnatural position to reduce it.

In official medicine, the reflex syndromes of the disease are divided into 3 groups: muscular-tonic, neurodynstrophic, vegetative-vascular. The last 2 categories manifest themselves in stage 3 and later of the disease.

The clinical picture may include:

Weakened or missing reflexes of the Achilles tendon, flexion of the fingers (if osteochondrosis of the sacral region is added);
dry skin, blue discoloration;
urinary excretion (urinary retention or retention), pain in the bladder;
cramps and pain in the thigh against the background of eating and circulatory disorders;
tense, unstable gait, lameness;
fever with increased sweating, increased back pain;
pain syndrome that spreads to the heart (if the chest and lower back are affected).

Complications

If osteochondrosis of the lumbar spine is diagnosed, treatment should be started immediately, as the patient may be completely disabled at the last stage. Paralysis of the lower extremities may develop against the background of compression (compression) by the vertebrae, where there is no space between the spinal cord.

In addition, osteochondrosis can be caused by:

pelvic disorders (men suffer from erectile function, women - ovarian function);
lumbago (acute low back pain), sciatica (compression and inflammation of the sciatic nerve);
intervertebral disc prolapse, stenosis (narrowing of the spinal canal);
Fatal spinal cord injury.

Diagnostics

To make a correct diagnosis and assess the severity of the disease, the doctor collects anamnestic data (study of patients' complaints, lifestyle, hereditary factors). Thereafter, a physiological examination is performed to assess the patient's motor capabilities, posture, sensitivity level, muscle tone, and size and spasm. Hitting with a hammer marks the radiation zones (where it gives) in lumbar osteochondrosis.

After the patient is assigned:

Radiographyis the most accessible way to study the anatomical parameters of the vertebrae, assess the tendency of the holes in the bottom to narrow, and determine bone growth.
MRI(magnetic resonance imaging) - helps to assess the condition of the blood vessels that supply the spine, nerve processes, discs.
CT(computed tomography) - is prescribed only to examine changes in blood vessels, spinal cord covering and study of extraneous growths.

Treatment of lumbar osteochondrosis

Surgery is the last resort for patients with significant neurological disease and high risk of disability. These problems are characterized by advanced osteochondrosis of the spine - doctors try to treat stage 1 and 2 in a conservative way.

Therapeutic measures are as follows:

elimination of pain syndrome;
elimination of muscle spasm, hypertension;
elimination of the inflammatory process;
improving blood circulation and metabolic processes in the affected areas;
normalization of spinal mobility;
Restoration of lumbar sensitivity.

There is no universal treatment: each specific case of osteochondrosis requires an individual scheme. It is especially important to consider the form of the disease: acute or chronic. Therapy is necessarily combined, involves the use of drugs (internal and external) in combination with physical manipulation - massage, gymnastics, physiotherapy. The treatment regimen for lumbar osteochondrosis can be supplemented with acupuncture, hirudotherapy.

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

To reduce the stress on the spine, a special belt or corset should be worn during treatment.
Physical activity is excluded to avoid the addition of irritants (only those recommended by a doctor remain).
It is important to follow the diet closely: cartilage tissue needs sources of collagen (gelatin, aspic, aspic) and the whole body needs plant foods, fish, nuts. It is advisable to avoid salty, smoked, salty products, as well as sharp cheeses and fatty meats.
The regimen prescribed by your doctor should be followed until the end: do not stop treatment when the main symptoms subside, do not change the set of medications and procedures yourself.
It is worth choosing an orthopedic mattress and special shoes with your doctor to help relax your back during sleep. It is strictly forbidden for women to wear heels.

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

Drug treatment

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

Most doctors prescribe medication for osteochondrosis at home:

Chondroprotectors- protects cartilage tissue and promotes regeneration, indicated for long-term use (six months or longer).
Means that improve blood circulation and metabolic processes in tissues- tablets taken for several months due to the cumulative effect.
Muscle relaxant- relieves muscle spasms, used orally for a short time.
Non-steroidal anti-inflammatory- 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 early stages, external forms can be discarded, after which it is repeated with tablets.
Corticosteroids- Painkiller injections are prescribed only when there is no significant effect from non-steroidal drugs.
Warming ointments- help reduce pain and improve blood circulation in the tissues, are safer than non-steroidal drugs, but are prohibited in the inflammatory process.
B vitaminsand multivitamin complexes are prescribed for a long time to increase the overall effectiveness of treatment.

Physiotherapy procedures

Physiotherapy courses can be prescribed to increase the effectiveness of medication and speed recovery. You can change them or go through several options at once. Special techniques are selected according to the stage and form of the disease.

Lumbar osteochondrosis - treatment consists of effective methods:

Electrotherapy (electrophoresis)- involves the application of low electric currents to improve blood circulation in the affected areas.
Laser therapy- activates biological processes in the nerve endings, eliminates the symptoms of neuro-dystrophic syndrome.
UHF- a local effect on the lumbar region with a high-frequency magnetic field to stop the inflammatory process, stimulate cell regeneration (regeneration) of tissues and reduce pain.
Phonophoresis and electrophoresis- helps to deliver drugs to the area of need, which increases the effectiveness of drug treatment. The result depends on the specific agent used during the procedure.
Darsonvalization- the therapeutic effect of high-frequency alternating current to dilate blood vessels, improve blood circulation and tissue nutrition. The symptoms of the procedure are less affected than others.
Amplipulseis a local effect of sinusoidally modulated currents that reduces the severity of pain. The procedure has a analgesic effect, vasodilator, neurostimulating, improves tissue trophism.

Healing gymnastics

Physical activity - especially in the early (early stages) of osteochondrosis of the spine - should be included in the treatment: it helps to relax and strengthen muscles, has a beneficial effect on tissue nutrition. For people with grade 2 disease and more strenuous exercise, the doctor will choose. Gymnastics, swimming, yoga (the most effective areas) are prohibited with exacerbation.

The following exercises show good results:

Pay attention to your knees and palms, keep your back straight (parallel to the ground). On exhalation, slowly bend your back and turn your head back slightly. Count to 5-8 (as you feel), breathe in and roll your back with the wheel. Count to 5-8 again and take the starting position. Training is performed 10-12 times at a slow pace. If necessary, they are divided into 2-3 approaches.
Lie on your stomach. On exhalation, slowly pull the chest off the ground, bend down and try to rise as high as possible. The arms stretch forward, the legs do not move. Hold this position for 5-10 seconds and gradually lower. Repeat the exercise 8-10 times, gradually increasing the delay time at the highest point.

Massage

Massage is an effective way to treat any stage of osteochondrosis, which helps to relieve unpleasant symptoms, relieve muscle spasms and normalize lymph flow and blood supply to the affected areas. In addition, this procedure stimulates the recovery of atrophic muscles and eliminates the restriction of mobility of the vertebrae, strengthens the ligament apparatus. Massage is performed by a specialist in courses of 10-12 sessions when the symptoms of the acute phase are reduced.

Surgery

If the patient is diagnosed with significant neurological diseases, loss of urinary control, a severe hernia, surgery is required. In addition, an indication is that conservative treatment does not have a positive effect (lasting more than a month). Before receiving an application for surgery, the doctor should assess all the risks, especially if the traditional technology on microdiscectomy is chosen.

During the procedure, the surgeon can do the following:

remove pathologically altered areas by placing local implants (discectomy) developed separately for each patient;
Aligning the spine with a special rod - this helps to properly distribute the load and prevent new deformation.

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

Treatment of lumbar osteochondrosis with folk remedies

Traditional medicine prescriptions are allowed after consultation with a physician who can competently assess the patient's condition. They do not have the same effect as drug treatment, do not replace physiotherapy, massage and gymnastics, but increase the likelihood of a positive result from the main treatment.

Some simple options:

Rub peeled black radish (350 g), mix with liquid honey (250 g) and vodka (100 ml). Use it to rub your back with light massage movements for 10 minutes in the morning and evening. After that, it is recommended to wrap this area with a woolen cloth and lie down under an blanket for an hour. The procedure is performed for 8-10 days, after which they take a break.
With severe back pain you can take 100 grams of medium-fat cottage cheese, add 1 tsp. Put apple cider vinegar on a cotton cloth or towel. The dressing is kept for 2 hours, if necessary, the procedure is repeated twice a day. The duration of treatment is not limited.
Collect fresh lilac flowers, fill a one-liter jar without crushing. Pour a liter of vodka, keep in a cool place for 3 weeks. Use to rub the affected area once a day for a month. It is not necessary to cover the waist with anything after processing.

Prevention of lumbar osteochondrosis

Doctors say that regular physical activity, which strengthens muscles, improves blood circulation and tissue nutrition, can prevent many back diseases. Lumbar osteochondrosis is no exception - it will not be treated if you regularly do gymnastics, yoga and swimming.

Additional Welcome Measures:

dietary control (more plant foods, less animal fat, acid, marinade: as in treatment);
limiting heavy loads on the spine;
monitor the state of the endocrine system;
elimination of bad habits (alcohol, smoking);
use of orthopedic mattress;
posture tracking;
Avoid high heels (7 cm) for women.