Elderly people, professional athletes, as well as those whose work involves long motionless sitting or standing on their feet, are often exposed to various diseases of the musculo-articular frame. Irrational daily menu, physical inactivity lead to wear and tear, destruction of bone and cartilaginous matter. As a result, osteochondrosis of the lumbar spine develops, the symptoms and treatment of which depend on the personal characteristics of the organism, as well as on the severity of the lesion.
According to the international classification of diseases of the 10th revision, this ailment was assigned the code M42. Sometimes patients are given cumbersome diagnoses, the coding simplifies the work of doctors. This short alphanumeric designation can be recorded in the medical history, outpatient card. So what is osteochondrosis of the lumbar spine? What are the reasons for its occurrence? What are the manifestations of the disease? This publication tells about everything.
Causes of lumbar osteochondrosis
Osteochondrosis of the lumbar spine often causes trauma and a slow-moving lifestyle. Among other things, one of the main roles is played by burdened heredity, just like the hormonal, chemical, psychogenic background of the body.
If parents have suffered from lumbar osteochondrosis, symptoms and treatment are likely to manifest and be passed on to their children. Having inherited the predisposing factors, the offspring also risks facing this disease.
The factors provocateurs also include the following reasons for the occurrence:
- Other diseases, such as the digestive tract, liver, pelvis, nervous system;
- Leap towards slowing metabolism;
- Shift of acid-base balance towards oxidation (acidosis);
- Decreased motor energy;
- Stress, nervous situations;
- Long awkward postures, incorrect posture.
Often, sacral osteochondrosis occurs as a result of hypothermia, hormonal disruptions, or as a result of pathological congenital defects of the spinal column.
Symptoms of lumbar osteochondrosis
Signs of lumbar osteochondrosis are associated with the fact that spinal nerve fibers pass in the back area inside the spinal canal. Depending on the localization, the severity of the defeat of some roots, the manifestations of the disease differ.
With osteochondrosis of the lumbar spine, the symptoms are the following:
- Pain syndrome- most patients complain of lower back pain in osteochondrosis. The pain is local directly in the zone of violation or it radiates to the gluteal region, the sacrum of the leg from the side of the lesion;
- Sign of tension- soreness increases with a certain posture, but when the position of the body changes, the pain disappears abruptly. The most common test used is named after the discoverer - Lasegue syndrome - the pain increases when the straight limb is lifted up, and disappears when the leg is bent at the knee;
- Decrease or increase in sensitivity- this symptom is directly related to damage to the radicular nerves, sensitivity is disturbed not at the site of the pathology, but at some distance. The patient has hypoesthesia, hyperesthesia or paresthesia, which is characterized by unusual projection sensations such as goosebumps, tingling, and so on.
Often, with lumbar osteochondrosis, motor activity decreases, this is associated with muscle atrophy of varying degrees. Under some circumstances, there is a limitation of functions, in other situations paralysis and paresis occur.
Also, lumbar chondrosis is associated with damage to the spinal vessels, with their irritation and spasm, vegetative changes appear. Blood circulation in the legs slows down, the lower extremities are constantly freezing, there is a pallor of the skin. Other organs in the lumbar region are often affected. So, with damage to the bladder, urinary incontinence develops or, on the contrary, delay.
Disease stages
- Lumbar osteochondrosis of the 1st degree is the initial type of pathology. It is characterized by a low density of intervertebral discs. Pain syndrome appears with a sharp turn of the body, after physical exertion or prolonged sitting.
This type of illness is common in drivers, office workers, athletes, and people who work in harsh climates. The pain is not characterized by acute attacks, but develops as a debilitating dull or aching.
At this stage, people are in no hurry to go to doctors, but use traditional methods of treatment, such as ointments, compresses. The situation leads to the fact that osteochondrosis of the lumbar or sacral spine passes into the second stage;
- Lumbar osteochondrosis of the 2nd degree - degenerative and dystrophic disorders of the vertebral joints occur. The fibrous vertebral ring is compressed, as the nucleus pulposus grows and protrusion (protrusion) of the intervertebral disc occurs.
Neuropathologists define the second stage of osteochondrosis as lumbago. In other words, a lumbago occurs in the lower back when a heavy object is suddenly lifted or with other loads. This period lasts for many years, the stages of remission alternate with acute attacks of exacerbations;
- Lumbar osteochondrosis of the 3rd degree - the protrusion of the pulp gradually increases, an intervertebral hernia forms. The patient develops the entire palette of neurological status: constant pain, irradiation to the buttocks, abdomen, tailbone, legs, urethra, limited mobility.
Legend is used to locate the hernia. The diagnosis of osteochondrosis L5 S1 means that the bulging of the nucleus pulposus occurred between the 5th lumbar and 1st cruciform vertebra;
- When therapeutic measures are not taken on time, all stages of development flow smoothly into the next stage. Stage 4 lumbar osteochondrosis is characterized by the development of complications.
As a rule, medication treatment for severely developed pathology is not very effective. The neuropathologist is obliged to offer a radical method of action, that is, hernia surgery.
Methods for the diagnosis of osteochondrosis
In order to identify osteochondrosis of the EPP, the neuropathologist first takes an anamnesis, because the patient's complaints are one of the decisive values for accurate diagnosis. During the conversation, the patient is asked questions about his health and condition - what and where it hurts, what is the duration of the pain, what intensifies the feeling when stiffness appeared, whether the treatment was carried out, what it was, and the like.
Instrumental diagnostic methods are necessarily used:
- General Rg-graphic image of the lumbar spine- the spine is taken as a whole or its individual segments are photographed. More often than others, an aiming Rg-gram is made on the basis of complaints, in which the doctor notices disc atrophy, a decrease in the intervertebral space, the appearance of osteophytes, a smoothing of the lumbar bend;
- Myelography- contrast fluid is injected into the canal, where the spinal cord passes, using a spinal tap. The technique is used to determine the internal structure of the channel. Ordinary people consider the procedure to be difficult and dangerous for diagnosis, but apart from allergy to contrast, the puncture of the spinal canal practically does not threaten the patient. The puncture is made in the place where the spinal cord is absent;
- Computed tomography- compression of the nerve roots, protrusion of the pulp is determined, it is easy to see vertebral bodies, ligaments, vessels, soft tissues at close range on the monitor;
Most accurately, sacral osteochondrosis is determined using electromagnetic waves; for this, the patient is assigned an examination on a magnetic resonance imaging scanner.
Each tissue has its own incoming signal, the computer processes the data and displays the image on the screen. The doctor examines the vessels, discs, bone processes, nerve fibers at a 1 mm cut. At the same time, the patient does not receive harmful ionizing effects.
Treatment of osteochondrosis of the lumbar spine
Many patients are interested in the question: what to do with osteochondrosis of the lumbar region? Osteochondrosis of the lumbar spine does not always have indications for surgery. The main thing is that after a thorough examination of the patient, the usual therapeutic measures are sufficient.
Conservative therapy is reduced:
- To drug treatment;
- Physiotherapy procedures;
- Gymnastic exercises from exercise therapy.
Also for the treatment of osteochondrosis of the lumbar spine, methods of manual therapy and methods from traditional medicine are used.
For the treatment regimen for osteochondrosis of the lumbar spine, the surgical method is offered to patients only in extremely severe cases, if conservative methods have not yielded the desired results.
Medication
Treatment of osteochondrosis of the lumbar spine is carried out by a neuropathologist or the most narrow specialist, a vertebrologist. Before treating the lumbar chondrosis of the spinous processes, the doctor determines the stage and severity of pathological disorders.
Muscle relaxants are used to relieve pain, reduce spasm, inflammation. These drugs quickly return mobility to the patient, relieve spasms, so the pain goes away.
In addition to the group of drugs for muscle relaxation, steroid hormones are sometimes used to remove swelling and inflammation.
Remedial gymnastics
Treatment of lumbar osteochondrosis should be carried out in conjunction with the methods of exercise therapy. Exercise and gymnastics should be given the same attention as the use of medications.
The therapeutic effect of osteochondrosis is those exercises that relieve pain, strengthen the muscular frame, reduce compression between the discs - this slows down the further progression of the disease.
Physiotherapy
In lumbosacral osteochondrosis, treatment involves the use of the following procedures:
- Electrophoresis with drugs;
- Laser and magnetic therapy;
- Treatment with magnetic currents;
- Darsonval;
- UV irradiation;
- Diadine treatment;
- Shock wave method.
Manipulations involve the use of means using natural physical strength: currents, light radiation, vibration, and so on. The treatment regimen, the duration of the course for physiotherapy is determined by the attending doctor.
Manual therapy
When a sick person asks a neurologist how to cure osteochondrosis of the lumbar spine using a manual technique, he is usually advised by a qualified specialist who, with his hands, not only affects muscle tissue, but also puts the vertebrae in place.
In case of lumbar chondrosis, this method normalizes blood and lymph circulation, eliminates muscle tone and deformation, and restores motor function. The hands of the chiropractor reduce the purity of spasms, reduce back pain.
How is osteochondrosis of the lumbar region treated using manual techniques and is it possible to completely recover in this way? Manual therapy is prescribed only when degenerative processes have not disturbed the tissues of the spine, that is, no bone growths have formed. The need for procedures is determined by the doctor after Rg-diagnostics, CT or MRI.
Surgery
Treatment of lumbar chondrosis by surgery is carried out according to certain indications, when the pathology is characterized by the following changes in the spine:
- The spinal canal narrows, intervertebral discs are compressed and destroyed;
- Cauda equina syndrome develops - a massive bundle of nerves of the spinal cone, which innervates the pelvic region, legs, is damaged;
- Loss of sensitivity progresses, there is a disorder of the working capacity of internal organs;
- There is a risk of paralysis in the feet.
The operation is carried out according to emergency or planned indications. The goal of surgical treatment is to relieve pressure and improve the condition of the spine.
Traditional medicine
Treatment of osteochondrosis of the lumbar spine with folk methods is best done in consultation with your doctor.
The People's Pharmacy offers many remedies to cure ailments:
- Medicinal herbs, essential oils, extracts of flowers, plant roots;
- Animal products, such as snake or bee venom, badger, dog, sheep fat, boiled eggs and others;
- Iodine, turpentine, and alcohol are used for warming, irritating effects.
Similarly to medicines, chondrosis of the lower back is treated with folk methods only at the initial stage of the disease, while the symptoms are only eliminated, but pathological changes do not disappear. Among other things, such treatment often has side effects, because of this, a specialist consultation before using any recipe from traditional medicine is required.
The dosage of any folk or medication should be prescribed by your doctor.
Complications
Lumbar chondrosis in the last stage can lead to unpleasant consequences, including disability.
Against the background of dystrophy and degenerative disorders, a narrowing of the spinal canal is formed, stenosis develops. As a result of such changes, a chronic type of compression is formed, which interferes with normal blood flow, ischemia of the roots or cauda equina syndrome develops.
In addition, sometimes diseases such as spondylosis and spondyloarthrosis develop - the intervertebral discs age, lose strength, and pulling pains appear due to the disturbed structure of the vertebral joints. Complications most often relate to the ridge of the lower spine, spike-like bone growths are formed there.
In the third stage, as a complication of osteochondrosis, intervertebral hernias develop, diseases of the genitourinary system and other internal organs appear.
Preventive measures
Prevention of osteochondrosis of the lumbosacral spine is of no small importance. The lower back has the greatest load, so you need to be especially careful about your back. It is worth remembering that regular gymnastic exercises are the key to a healthy spine.
The weights should be lifted with the utmost care, avoiding sudden jerks. Men and women can carry loads that are within reason.
Sitting in the office, you need to keep track of your posture, take the correct posture, and sit in a chair with your back straight. It is good to get up every hour and walk around the room, do squats, turn the torso: this relieves the tension of the entire musculoskeletal frame.
Massage of trigger points is great. They are active or are in a latent form. Trigger points appear as a result of overexertion, strong stretching, repetitive work, stoop, hypothermia and other factors.
Knowing the reasons for the development of spasmodic areas, it is necessary to take measures to exclude their formation. Recently, a trigger point massager has gained popularity, it is better to prevent the appearance of painful foci with a special device than to treat them for a long and expensive time.