Low back pain is the most common complaint of patients in general medical practice. They are in second place in terms of the frequency of medical care requirements (after respiratory diseases). There are many diseases that cause pain. However, the most common cause is lumbar osteochondrosis, the symptoms and treatment of which we will discuss in this material.
More recently, medicine has recognized this condition as an age-related change in the spine 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 incidence shows a persistent trend towards rejuvenation, with more of the disease being diagnosed in people under 30 years of age.
Causes
The cause of lumbar osteochondrosis has not yet been determined. However, when faced with this pathology, it is often possible to think about who is more prone to the disease and who is at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead a sedentary lifestyle. The sitting position relaxes the muscles of the corset, which increases the load on the lower back.
- Hormonal metabolic disorders and endocrine diseases can adversely affect metabolism in spinal tissues and contribute to the development of osteochondrosis.
- Various congenital and acquired abnormalities in the structure of the musculoskeletal system - curvature of the legs and spine, straight legs.
- Continuous heavy physical force on the spine, especially lifting heavy objects. In this case, we can talk about the occupational disease of categories such as weightlifters and people whose professional duties are associated with the constant lifting of heavy objects.
- Regular unhealthy diet and daily routine, regular stress, sleep time, metabolic disorders.
The above points are the most common factors that create the initial conditions for the development of the disease.
Degrees of lumbar osteochondrosis
Manifestations of the disease depend on the degree of pathology.
There are four degrees of osteochondrosis:
- The cycle of change and movement of the nuclear pulp inside the disk. The pain is caused by irritation of the nerve endings located in the ring fibrosis and longitudinal ligaments. The patient feels local discomfort in the area where the affected disc is located: sharp pain or lumbago in the waist (lumbago), dull pain of a constant nature (lumbodinia).
- Anulus fibrosis destruction time. It is characterized by the appearance of instability, which causes long-term and persistent muscle tension, and an increase in vertebral mobility. The patient has persistent fatigue of the lumbar muscles, restlessness,
- Hernulus fibrosus with a rupture period and the pulposus nucleus extending beyond the boundaries of the substance, with the formation of a herniated disc. Radical syndromes are associated with compression of nerve roots with fallen fragments.
- The spine is severely deformed. Human motor function is difficult. The main issue to be addressed is the patient's disability. However, it should be noted that there is practically no pain at this stage of the disease. However, this is not a signal to stop the disease, on the contrary.
- There is a pathological spread of bone tissue that will worsen the condition.
How to treat lumbar osteochondrosis will directly depend on the extent of the lesion; For this purpose, drug, non-drug and surgical exposure methods are used.
Symptoms of lumbar osteochondrosis
The main symptom of lumbar osteochondrosis is pain. The nature, location, and direction of pain sensations depend on which receptors are irritated, that is, how rough the changes in the disc and surrounding tissues are, whether there is a bulge or a hernia, in which direction the bulge originates, and so on.
Here are the main symptoms of lumbar osteochondrosis:
- Pain in the lower back, painful in nature, aggravated by sudden movements, change in body position, prolonged stay in one position. The reduction in pain occurs when holding a horizontal position;
- In addition to low back pain, osteochondrosis can cause weakness in the lower body and legs, as well as loss of tendon reflexes of the lower extremities;
- Curvature of the lumbar spine is common. Depending on where the curve is observed, we distinguish between scoliosis (lumbar curvature to the right or left), lordosis (forward curvature) and kyphosis (smooth curvature of the lumbar spine);
- If osteochondrosis results in spinal cord compression and dysfunction, the patient may have uncontrolled urination and stool.
Additional Features:
- coldness of the skin and numbness in the lumbar region;
- dryness, peeling, lower back and buddha blue skin;
- Buddha sweating disorder;
- urinary excretion;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical intervention. Osteochondrosis can be treated in a hospital or at home.
Diagnostics
The diagnosis of osteochondrosis involves the use of various methods, primarily 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 separately. The integrity of the intervertebral discs and spinal canal is also indirectly assessed.
- Tomography determines the degree of damage to nerve endings and spinal cord. Also assess the condition of the intervertebral discs.
- MRI - used to make a definitive diagnosis.
The correct diagnosis will help you understand how to treat osteochondrosis of the spine and what medications and procedures will be required for this.
Complications
Osteochondrosis of the lumbar spine can cause protrusions and tears due to significant loads on this spine. These are complications that develop very quickly, so it is very important to treat them in a timely manner.
In addition, osteochondrosis can be aggravated:
- sciatic nerve inflammation;
- spondyloarthritis;
- Schmorl hernia;
- osteophytosis, spondylosis;
- narrowing of the spinal canal with compression and dysfunction of the spinal cord;
- compression of the cauda equina with pelvic dysfunction;
- topal;
- Paresis of the lower extremities.
It is possible to prevent the development of complications with timely diagnosis and complex treatment.
Treatment of lumbar osteochondrosis
When lumbar osteochondrosis is diagnosed, treatment requires a wide range of complex therapies, including:
- moderate physical activity;
- drug use;
- spinal traction;
- manual treatment;
- physiotherapy;
- massage.
The treatment regimen for osteochondrosis is as follows:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- Strengthen muscles in the lower back, thighs, 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 extremities.
Surgery is used only in a few cases.
Medication
This type of treatment for lumbar osteochondrosis includes pills, injections, and topical medications (ointments and gels). Medications used to fight this disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for lumbar osteochondrosis:
- painkillers (analgesics);
- non-steroidal anti-inflammatory drugs;
- muscle relaxant, to relieve muscle spasms caused by pain;
- chondroprotectors that restore cartilage tissue;
- corticosteroids (prescribed when all other treatments fail);
- vitamin preparations.
Very often in the treatment of osteochondrosis are prescribed pills that calm the nervous system, as well as antidepressants to combat stress and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, drugs alone are not enough to treat osteochondrosis. Physiotherapeutic procedures are used to relieve pain, relieve muscle spasms and stimulate metabolic and recovery processes:
- amplipuls;
- phonophoresis;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main pain symptom is removed or in remission in chronic pathology. Serves to relax tense musclesVery 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 treatment performed only by a specialist in this field increases the blood circulation to the spinal cord, replaces the displaced discs of the spine.
Healing gymnastics
All physical exercises used in the diagnosis of lumbar osteochondrosis should help increase lumbar mobility.
Therapeutic gymnastics will not be effective if the exercises are performed from time to time. The main principle of exercise therapy is regularity. Continuous application of a certain training complex will help to eliminate destructive processes in the intervertebral joints.
Surgery
Generally, a doctor will only prescribe surgery if severe complications develop. For example, an intervertebral hernia. The most common type of surgery is the removal of a damaged disc (discectomy).
This operation is the most effective method in this situation, and is prescribed only if other treatments do not work within six months. In addition, microsurgical and endoscopic treatment of the spine is widespread.