Despite the prevalence of opinion, spinal osteochondrosis is not considered part of the aging process. The elastic discs between the vertebrae are responsible for flexion and extension of the back, like shock absorbers. Over time, they wear out and no longer provide full range of motion. With age, daily stress on the spine and accidental injuries, including minor ones, can damage the discs in the back and lead to osteochondrosis of the lumbar spine.
Who is affected by this lower back disease?
In most cases, the first symptoms of osteochondrosis of the lumbar spine occur at the age of 11-12 years. The disease manifests itself vividly by the age of sixteen, but the most severe course and frequent complications occur between 15 and 20 years of age.
Children under 15 years old rarely have severe forms of osteochondrosis, which is somehow connected with the excellent condition of their musculoskeletal system in general, and the spinal column in particular. In addition, the disease takes time to develop, and on average it takes five years.
Fortunately, these diseases are much easier to treat in children than in adults.
Symptoms
Reflex syndromes
- Cervicalgia- differently manifested pain in the neck (pulling, tingling, shooting), a feeling of "creeping" in the cervical muscles, as well as decreased mobility and flexibility of the neck.
- Lumbagois a sharp, sharp pain in the lumbar region, which may be accompanied by numbness or swelling. Instead of the word "lumbago" the words "lumbodynia" or "lumboischialgia" can be used.
- Thoracalgia- pains of a different nature in the chest, shoulder blades and ribs, which are constantly present or occur during movements of the body.
Compression syndromes
The occurrence of pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Spinal cord compression (myelopathy).
- Spinal cord injury due to impaired blood supply.
- Narrowing (stenosis) of arteries and veins (vascular compression myeloischemia).
Methods for detecting disease
Differential Diagnostics
Not every disorder can be diagnosed with a simple laboratory test. Many conditions cause similar symptoms. For example, many infections cause fever, headaches, and fatigue.
Many mental disorders are caused by:
- sadness;
- concern;
- sleep problems.
Differential diagnosis identifies possible disorders that cause symptoms. Typically, this diagnosis is based on several tests. These tests can rule out conditions and / or determine if you need additional testing.
Differential diagnosis is used to diagnose physical or mental health problems that cause similar symptoms.
Differential diagnosis is also commonly used in the field of psychiatry / psychology, where two different diagnoses can be made to a patient who has symptoms of several diseases. For example, a patient diagnosed with bipolar disorder may also be differential diagnosed with borderline personality disorder given the similarity of symptoms of both conditions.
Who is diagnosed more often?
If earlier the disease was diagnosed in sick people after 45 years, today about 27% of adolescents suffer from osteochondrosis of one degree or another.
Such a huge spread of the disease is understandable - children began to spend a lot of time in a sitting position, including because of the computer and the Internet. Is it bad? Time will tell, but the fact remains - the payment for a sedentary lifestyle is high, and osteochondrosis is far from the worst disease that can occur with such a lifestyle, but it is the most common (after obesity).
How to define an illness and its degree?
First
In a normal state, the intervertebral discs are constantly regenerating, but it happens that the process slows down and a disease such as osteochondrosis of the 1st degree occurs.
There are many reasons for this:
- obese;
- metabolic disorders;
- immunocompromised and so on.
Unfortunately, instability of pain of a given degree of ailment is influenced by the fact that many people neglect diagnosis and treatment, and try to cure pain on their own. To do this, use ointments and various tinctures. But this is the biggest mistake.
Osteochondrosis of the lumbar spine of the first degree can be cured quite easily by contacting a good specialist and performing a number of simple actions.
Degree 1 osteochondrosis is a compaction of the intervertebral cartilage in the lumbar region. The main symptom at this stage is slight pain when turning or bending. Sometimes the symptoms are more acute and short-lived due to sudden movements or significant exertion.
Second
A pronounced symptom of the disease is soreness in the lumbar region, which increases with any movement. The pain can radiate higher up the spine.
With osteochondrosis, pain can radiate to the lower extremities.
The second stage of osteochondrosis is characterized by such severe pain that it manifests itself even when coughing.
Additional symptoms are associated with pinched nerve endings:
- Sensitivity in the lower limbs changes. The main signs are: pain, numbness of the legs, high or too low level of sensitivity of the skin of the lower extremities.
- Limited mobility. A person suffering from osteochondrosis (grade 2) notices that as the disease progresses, it becomes very difficult to move.
- Increased fatigue and constant sleepiness. The patient has chronic fatigue, accompanied by irritability. This symptom is explained by the pain syndrome that constantly bothers the person.
- Problematic urination and pain in the kidney area.
Third
By the time the patient reaches Stage 3, his posture has changed markedly. In more advanced cases, bone deformation occurs. At this stage of osteochondrosis of the lumbar spine, there is also an obvious deterioration in the general physical and / or mental state of the patient and a deep loss of energy.
The third stage is characterized by the appearance of narrowing of the intervertebral foramen against the background of previous changes. Hernias of intervertebral discs are formed, the vessels of the neck and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
The terminal stage occurs when the intervertebral disc degenerates and the disc space is destroyed. At this stage, discal thinning reaches its maximum or, even worse, completely disappears. The postural imbalance is acute, and movement and flexibility are extremely limited.
Stage 4 osteochondrosis of the lumbar spine is often characterized by severe pain and a higher degree of deterioration in physical and / or mental condition. There is also a permanent loss of growth and energy levels. Stage 4 is usually considered irreversible.
Doctor's consultation
Which doctor should I contact?
When independent methods of treatment cease to bring an analgesic effect, the patient begins to ask himself the question: which doctor treats osteochondrosis? The first person you can turn to to treat osteochondria of the lumbar spine is your local therapist. But in this situation, he plays the role of a dispatcher, since he will not be able to prescribe full treatment - this is not his specialization.
Most likely, he will send you to a neurologist. It is this specialist who will conduct the necessary research and help build a treatment program. The therapist may also refer you to a vertebrologist. This doctor deals directly with diseases of the spine.
Scales and tests
Quality of Life Assessment
Such a generalized characteristic as quality of life is especially important for a group of patients with comorbid conditions, as they can influence the effectiveness of treatment. This is especially important for comparing the results of several studies, economic analysis and for understanding the problem as a whole.
Methods for assessing quality of life include:
- Oswestry quality of life questionnaire.
- Roland-Morris questionnaire.
- Stratford Scale.
- Quebec Back Pain Scale - a questionnaire on how back pain affects your daily life).
Pain Scales
Pain is an unpleasant sensation and emotional experience associated with tissue damage. Its purpose is to enable the body to respond and prevent further tissue damage.
Methods for assessing pain syndrome include:
- Won Korf Chronic Pain Assessment Scale.
- McGill Pain Questionnaire.
- Verbal Pain Scale.
Evaluation of treatment outcome
- McNab's Subjective Rating Scale.
- Patient satisfaction scale.
- Prolo functional and economic outcome scale.
- Lumbosacral Outcome Scale.
- Nurik Scale.
Hardware test
X-ray
X-rays provide detailed bone structures in the spine, and are used to rule out back pain resulting from:
- Spondylolisthesis.
- Tumors.
- Cracks.
Calcium in the bone blocks the penetration of the X-ray, and the image of the bones is perceived as a shadow on the film. X-rays provide excellent visibility of all details because bone is made up mostly of calcium. However, discs and nerve roots do not contain calcium, so X-rays do not capture images of these structures. X-rays, therefore, cannot be used to diagnose a herniated lumbar disc or other causes of a pinched nerve.
X-rays should not be taken on pregnant women.
Complications and possible consequences
Complications and possible consequences of osteochondrosis of the lumbar spine include:
- Radiculopathy is a condition characterized by a disease of the nerve roots.
- Muscle weakness - Common symptoms include fever, fatigue, flu-like symptoms, paresthesias, weight loss, and changes in consciousness.
- Neurogenic bladder - problems with the nerves that control the bladder and urination
- Damage to the lower motor neurons.
- Raynaud's phenomenon is a condition in which spasms occur, narrowing of the capillaries of the fingers and toes.
- Pain in the neck, back, leg.
Treatment
Treatment may vary depending on the severity of your symptoms and how much they limit your daily activities.
Here are some of the treatments your doctor may prescribe based on your pain level:
- Non-surgical treatment- not all patients suffering from osteochondrosis require surgery. For mild to moderate pain, more conservative treatments.
- Spondylodesis- surgical intervention in the treatment of osteochondrosis.
Prevention
Prevention of osteochondrosis of the lumbar segment is to eliminate the risk factors leading to this disease. Elimination of factors is the main preventive measure.
Physical activity is normalized, the muscles of the back are strengthened, the maximum load on the lower back is prevented, the development of diseases leading to lower back pain is prevented, all this is a prophylaxis for the prevention of symptoms of lumbar osteochondrosis.
Moderate exercise, lifestyle changes, and good nutrition can help prevent painful and disabling symptoms.
If you notice symptoms of osteochondrosis of the lumbar spine, do not tighten and immediately consult a doctor. A timely detected disease is easier to treat and proceeds without consequences.