Lumbar osteochondrosis is a degenerative-dystrophic lesion of the spine in the lumbar region. The pain syndrome is caused by damage to the intervertebral discs, spinal roots, nerve fibers and cartilage tissue. For the treatment of lumbosacral osteochondrosis, you need to contact a neurologist.
Symptoms of lumbar osteochondrosis
- severe pain syndrome that can radiate to the legs and pelvic organs
- pain in the kidneys and sacrum
- limb numbness
- stiffness
- tension in the lumbar region
- fatigue, weakness
- dizziness
Lumbar osteochondrosis has a gender-specific course. Vertebrogenic pain, which occurs as a result of nerve root compression by the altered cartilage of the intervertebral disc, is more difficult for women than for men. Pain intensity is directly related to estrogen levels. The lower their indicator, the more pronounced the pain.
In addition, reflected lumbosacral pain syndrome may be associated with concomitant diseases of internal organs. In women, diseases of the genitourinary sphere occur, in men, disorders of the gastrointestinal tract are more characteristic.
Treatment of osteochondrosis of the lumbosacral region
Treatment of patients with neurological manifestations of lumbosacral osteochondrosis should be comprehensive and gradual. At the first medical appointment, a clinical and functional examination is carried out (clarification of complaints and anamnesis) and a clinical examination. A neurologist examines the dynamic and static function of the spine, assesses posture and paravertebral muscle tone parameters, determines the degree of mobility of various parts of the spine and limbs. The standard treatment regimen for osteochondrosis includes:
- bad load exception
- immobilization (use of corset, orthosis, orthopedic styling)
- drug therapy
- physiotherapy procedures
- gentle acupressure massage
- exercise therapy
- acupuncture
- mud therapy
- traction technique
If conservative methods do not give the desired effect, surgical intervention may be necessary.
Physiotherapy for lumbar osteochondrosis
To eliminate pain, reduce swelling, normalize the tone of the back muscles, activate the recovery process, resolve the fibrous focus and increase the mobility of the damaged segment, a set of physiotherapy procedures is used:
- pulsating diadynamic current
- darsonvalization
- magnetotherapy (exposure to static or alternating magnetic fields)
- laser treatment
- medical electrophoresis
- UV radiation
- local cryotherapy
- ultrasound
- transcutaneous electrical nerve stimulation
Thanks to the combination of physiotherapy with the simultaneous use of several methods, the effectiveness of therapy for lumbar osteochondrosis increases by 30%.
Physiotherapy
A special role in the conservative treatment of degenerative pathologies of the musculoskeletal system is given to recreational physical education. Rehabilitation center instructors develop an individual complex of dynamic exercise therapy exercises and stretching for spinal osteochondrosis. This takes into account the gender, age and physical ability of the patient.
Optimized therapeutic exercises aimed at strengthening the muscles of the back, abdomen, pelvic area and lower legs. Thanks to exercise therapy, pathological muscle tension is eliminated, pressure on the intervertebral disc is reduced, swelling and pain are eliminated, the spine is stabilized, and posture is improved.
Surgical intervention
The absolute indication for decompressive surgery is disabling radiculomeloishemia. This dangerous pathological condition is caused by compression of the hernia on the nerve roots and impaired blood flow in the sacrococcygeal zone. It results in unbearable intermittent pain, pelvic organ dysfunction, intermittent claudication, and other motor, reflex or sensory disturbances. A relative indication for operational stabilization is the lack of effect from long-term conservative therapy (more than 1. 5-2 months).
The endoscopic method of osteoplasty is recognized as the most optimal: the installation of interbody implants and the fixation of cages made of biocompatible materials. Minimally invasive intervention quickly restores the ability to support the operated department and allows early recovery to begin.
Injection treatment (injection for lumbar osteochondrosis)
The main manifestation of osteochondrosis of the lumbosacral region is pain. These complex multicomponent symptoms are associated with local inflammation, pathological muscle tension, ligament damage, biomechanical causes, and dysfunction of the pain perception system. Therefore, treatment should be carried out in a complex. For faster pharmacological action and reduction of gastro and cardio risk, injection therapy drugs are prescribed:
- anti-inflammatories (NSAIDs)
- painkillers (analgesics)
- muscle relaxant
- vasodilation (improving blood microcirculation)
- chondroprotectors (stimulate the regeneration of intervertebral discs, delay the destruction of cartilage tissue).
On the recommendation of the doctor, homeopathic injections for the treatment of osteochondrosis and vitamins can be used. For quick and effective removal of severe pain syndrome, paravertebral therapeutic blockade is prescribed (injection into the lumbosacral nerve plexus).
Medical therapy
Traditionally, complex therapy for degenerative diseases of the spine includes treatment with tablets and capsules, similar to the injection method:
- NSAIDs (nonsteroidal anti-inflammatory drugs)
- analgesics
- myotropic antispasmodics (medicines to relieve muscle spasms)
- autonomic correction (autonomic nervous system tone stabilizer)
- vasodilator (to increase blood flow and tissue trophism)
- dosage forms of chondroitin and glucosamine
- sedatives and antidepressants (to relieve emotional tension and chronic stress)
- vitamin and mineral complex
Tablet preparations for the treatment of osteochondrosis of the lumbosacral spine are prescribed for a long period (up to 2 months or more).
How does this disease manifest itself clinically?
osteochondrosis of the lumbar spine in the early stages is characterized by very general symptoms, which are very difficult to recognize without the intervention of an experienced specialist. Usually, the patient begins to complain of pain and other discomfort only when the second stage occurs.
The main clinical symptom of this disease, as everyone probably knows, is pain in the lower back. The severity of these symptoms increases significantly after lifting and carrying loads, or even after simple movements of the limbs or body. After a while, the pain becomes painful, annoying, but can get worse periodically.
Another common complaint of patients during the appointment of a vertebrologist is stiffness, limitation of movement in the lumbosacral joint. It becomes difficult for the patient to bend, turn. It should also be noted that often the pain can radiate to the back surface of the lower leg.
As a result of nerve root compression by the enlarged intervertebral disc, disturbances in skin pain and temperature sensitivity occur. It should be said that this violation can mean both a weakness and an increase in the sensitivity threshold. With untimely treatment, the disease is further complicated by muscle hypotension, as well as hyporeflexia.
How can you get rid of this serious disease?
Treatment of osteochondrosis problems is divided into two main groups of methods: conservative and surgical. The basis of the first method is the effect on the human body with the help of drugs, which include non-steroidal anti-inflammatory drugs, analgesics, biogenic immunostimulants, as well as drugs that relax peripheral muscles. Before taking any of these drug groups, you should definitely visit your doctor, who will carry out a comprehensive diagnosis and draw up your individual treatment plan. This is very important because the medicines described above can have some serious side effects that can be avoided if the medicine is taken correctly.
Chondroprotective and anti-inflammatory ointment, B vitamins are also widely used.
Methods of manual therapy, physiotherapy and acupuncture have proven themselves in the treatment of osteochondrosis, which help to increase local blood supply, relax the back muscles.
Treatment of osteochondrosis of the lumbar spine
According to statistics, every second person from 25 to 55 years has experienced at least once in his life manifestations of lumbar osteochondrosis of varying severity: from discomfort in the lumbar region to severe pain with limited movement.
The lumbar spine is subjected to the maximum load, so the high percentage of osteochondrosis in this particular area of the spine is not accidental.
This disease is based on disc degeneration with gradual involvement of adjacent vertebrae, intervertebral joints and ligamentous apparatus in the pathological process.
When the diagnosis is confirmed, the treatment of lumbar osteochondrosis should be started immediately, without waiting for the appearance of complications.
Mechanisms of development of osteochondrosis
In the cartilaginous structure of the intervertebral disc there is a nucleus pulposus surrounded by a dense fibrous ring, collagen fibers that bind the disc tightly to the vertebral body.
Intervertebral discs act as shock absorbers that soften the pressure on the spine during stress. With age, as a result of malnutrition, the cartilaginous tissue of the disc undergoes a dystrophic process. The core dries, loses its shock-absorbing properties, followed by the destruction of the fibrous ring. Microcracks, fiber breaks appear in the structure. Due to the increased load, the core of the disc is displaced outside the spinal column - the initial stage of hernia formation develops - protrusion. This leads to nerve root irritation and the appearance of pain in the patient.
If the fibrous ring is completely torn, then an intervertebral hernia is formed.
Factors that provoke the development and worsening of lumbar osteochondrosis
- Occupational hazards - intense dynamic loads, work related to frequent changes in body position: bending, extension, turning, lifting heavy loads, vibration.
- A genetic predisposition in which the spinal tissue has structural changes that accelerate its degeneration.
- Incorrect posture, where there is an uneven distribution of load on the axial frame.
- Orthopedic pathology: flat feet, curvature of the spine.
- Hypodynamia, sedentary lifestyle.
- Obesity.
- Congenital and acquired pathology of the spine.
- As a result of injury to the spinal structure (fall from a height, transport accident, etc. ).
- Occupations in sports with a large physical load on the spine: skiing, tennis, horse riding, weight lifting.
- Irrational nutrition, dietary imbalance for the main nutrients: protein, fat, carbohydrates, vitamins, microelements.
- Hormonal imbalance in women during pregnancy and menopause.
- Bad habits: alcohol, smoking.
- Age changes.
- Inflammatory process of the spine (Bekhterev's disease).
- Pathologies related to impaired metabolic processes in the body (diabetes, hypothyroidism).
Stages of lumbar osteochondrosis
Depending on the degree of damage to the intervertebral disc and the clinical picture, there are four stages of osteochondrosis of the lumbar spine:
1 level. There is a gradual decrease in the elasticity of the intervertebral disc. Microcracks appear in the fibrous ring. Due to the reflex spasm of the muscles surrounding the affected spinal segment, there is stiffness and discomfort in the back in the morning.
2 levels. The destruction of the fibrous ring continues, the disc becomes flat, which leads to a decrease in the distance between adjacent vertebrae. Pathological mobility develops when the vertebrae can move relative to each other. The nutrition of the vertebral tissue is disturbed. Pain is normal.
3 levels. The semi-destroyed fibrous ring can no longer hold the nucleus pulposus, a protrusion appears - the beginning of hernia formation. The pain gets worse and becomes constant. There is a defect in the spine.
4 levels. The intervertebral disc is replaced by scar tissue. There are many complications up to the complete loss of motor activity. It is possible to treat this stage of lumbar osteochondrosis only with the help of a complex operation to replace the destroyed vertebra with an artificial implant.
Diagnostics
- Collection of anamnesis.
- Neurological examination of reflexes, sensitivity.
- functional test.
- Radiography, MRI, CT.
Treatment Methods
Traditional treatment of lumbar osteochondrosis includes the following methods:
Drug therapy: non-steroidal anti-inflammatory drugs, glucocorticoids, muscle relaxants, sedatives and vitamin complexes with trace elements.
Physiotherapy procedures: electro-, phonophoresis, magnetic field exposure, hydrotherapy.
Surgical treatment of lumbar osteochondrosis is carried out according to strict medical indications in severe cases, if the patient fails to stop severe pain with conservative methods or he is threatened with complications in the form of paralysis of the lower legs or dysfunction of internal organs.
Osteochondrosis of the lumbar spine: diagnosis and treatment
Back pain often occurs in a person due to improper posture formation while walking and sitting at the table. But it is also one of the consequences of damage to the intervertebral disc, cartilaginous tissue and nerve fibers, resulting in the development of osteochondrosis of the lumbar spine.
With lumbar osteochondrosis, degenerative changes occur in the lumbosacral spine. If the disease is not treated for a long time, the general well-being of the patient worsens: constant back pain, numbness of the limbs, spasms and spasms in the muscles, general weakness and loss of strength.
How does pathology develop?
During the progression of the disease, degenerative-dystrophic and destructive disorders occur in the patient's spinal skeleton. As a result, the anatomy and physiology of the articular elements of the spine changes. A person's lumbar spine takes the main load in the form of the weight of the person's upper body, the load during movement, training or performing any physical activity. As a result of all the above, the following changes occur:
- the axis of the spinal column is distorted;
- changes in posture;
- bones press on internal organs. This leads to the development of diseases of the cardiovascular system;
- coordination is disturbed due to violation of nerve endings;
- the structure of the spine changes;
- thinning cartilage;
- the synovial fluid structure is filled with third-party components;
- worn vertebrae, because the distance between them is reduced;
- when the vertebrae touch, the nerves are pinched - this leads to acute pain.
At the risk of developing lumbar osteochondrosis are athletes who lead an overly active lifestyle, people with a sedentary lifestyle (being in one position that does not change for a long time, they make an increased load on the spine), representatives of the labor professionmanuals that work with heavy equipment, the elderly, pregnant women, hyperactive children.
Symptoms of lumbar osteochondrosis
- acute pain in the lower back after a night's sleep;
- pain during sharp turns of the body or lifting heavy objects;
- the first signs of scoliosis appear;
- frequent urination;
- pain radiating to the legs, internal organs of the abdomen and pelvis;
- acute pain in the kidneys and sacrum;
- difficulty moving, walking, tilting and turning the body;
- fatigue after a slight load;
- numbness of limbs;
- cramps and spasms in the muscles;
- dizziness;
- reduce muscle tone and sensitivity.
Causes of osteochondrosis of the lumbosacral spine
- improperly distributed load on the back;
- sedentary lifestyle;
- stooped posture;
- stay in the same position for a long time;
- congenital curvature of the spine;
- too frequent physical exercise;
- overweight;
- violation of blood flow in the spinal column;
- injuries, bruises, broken limbs or vertebrae;
- infection of internal organs.
Stages of development of lumbar osteochondrosis
Stage 1 - all degenerative disorders have just begun to develop in the patient's skeleton. But at the same time, the roots of the nerve endings are already affected. Blood flow worsens and the inflammatory process begins. It is indicated by back pain after increased energy, which often radiates to the legs.
Stage 2 - the fibrous ring in the spine is destroyed, the cartilage becomes thinner, and the distance between the vertebrae decreases. The pain in the second stage is sharper and more acute.
Stage 3 - there is strong compression of muscle fibers and nerve endings. There are burning pains and spasms in the muscles, as well as frequent numbness.
Stage 4 - the period of growth of neoplasms (osteophytes) in the bone structure. Arthrosis appears in the spine and joints. The back becomes inactive, and if there is no proper treatment - completely immobile.
How is osteochondrosis of the lumbar spine diagnosed?
Pathological diagnosis begins with a consultation with a specialist. At the first manifestation of osteochondrosis, consult a rheumatologist, neuropathologist, surgeon or orthopedic traumatologist. If you find it difficult to choose a doctor, you should consult a therapist first. Depending on the symptoms and the cause of the alleged pathology, he will refer you to one of the very specialized specialists.
- The doctor will study your medical history and the frequency of their manifestations, you need to provide the specialist with a complete medical history and the results of preliminary studies (if any). The specialist will conduct a visual examination and palpation.
- During the examination, the doctor pays special attention to changes in posture, muscle tone, skin sensitivity and identifies the most painful areas. The purpose of the conversation is to find out the progress of the disease. If you have any questions, a specialist will advise you and carry out an examination.
- He will refer you for a test, because it is a complete diagnosis that will allow you to make a correct diagnosis.
- Based on the test results, the doctor will prescribe an individual treatment plan.
To identify the condition of muscles, ligaments, blood vessels, to detect inflammatory processes or tumors, an informative and safe diagnostic method is prescribed - MRI of the lumbar spine. During MRI of osteochondrosis, the patient lies on a special retractable table with his back. A roller is placed on the patient's head to relieve muscle tension, and the limbs are attached with a belt. Any small movement during the procedure can affect the quality of the result. Next, schedule driving to the tomograph area. This procedure does not cause pain. The tomograph makes a lot of noise during the scan, so you can use headphones to avoid discomfort.
If MRI is contraindicated, there are other diagnostic methods such as computed tomography and radiography. X-rays are only suitable for primary diagnosis and do not provide a layered image of the affected tissue. However, this study is the easiest and most economical, allowing you to examine the patient's body in several projections. Due to the high radiation exposure to the body, x-rays cannot be taken frequently.
Treatment of lumbar osteochondrosis
Depending on the stage of lumbosacral osteochondrosis, different treatment methods can be prescribed. One of these methods is exercise therapy. It is carried out in a specially equipped room under the strict supervision of a doctor. Classes are held when the patient is not in pain. But if during physical education the patient begins to feel worse, the doctor corrects or cancels the exercise altogether.
Another method of treating lumbar osteochondrosis is physiotherapy. It improves blood circulation and tissue nutrition, reduces inflammation and reduces pain. Physiotherapy treatment includes:
- Electrophoresis - painkillers, anti-inflammatory drugs are used, the procedure reduces the neurological manifestations of the disease.
- Magnetic therapy - alternating magnetic fields relieve inflammation.
- Ultrasound therapy - acts along the affected spine.
- Diadynamic therapy - the effect on the affected area occurs with the help of currents of different intensity.
- Hirudotherapy - treatment with leeches. Their effect improves microcirculation, the exchange of nutrients in the back tissue.
- Kinesio taping is a treatment using a cotton patch.
Drug treatment - prescribed in extreme cases with the use of analgesics (have analgesic or additional anti-inflammatory effects), antispasmodics (relieves muscle spasms), vasodilators (improves blood microcirculation).