Older people, professional athletes, as well as those whose job involves spending a long time without moving or standing, are often exposed to various diseases of the musculoskeletal framework. Irrational daily menu, physical inactivity leads to wear, 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 the severity of the injury.
According to the International Classification of Diseases of the 10th revision, this ailment is assigned the code M42. Sometimes patients are given cumbersome diagnoses, coding simplifies the work of doctors. This short alphanumeric designation can be recorded in the medical record, outpatient card. So what is osteochondrosis of the lumbar spine? What are the reasons for its appearance? What are the manifestations of the disease? This publication tells of everything.
Causes of lumbar osteochondrosis
Osteochondrosis of the lumbar spine often causes trauma and a slow lifestyle. Among other things, one of the main roles is played by burdened heredity, as well as the hormonal, chemical and psychogenic background of the body.
If the parents have suffered from lumbar osteochondrosis, it is likely that the symptoms and the treatment will manifest themselves and are transmitted to their children. Having accepted the predisposing factors by inheritance, the offspring are also at risk of facing this disease.
Triggering factors also include the following reasons for the occurrence:
- Other diseases, such as the digestive tract, liver, pelvis, nervous system;
- Leap towards slowing down metabolism;
- Shift from acid-base balance towards oxidation (acidosis);
- Decrease in motor power;
- Stress, nervous situations;
- Long and uncomfortable postures, wrong posture.
Sacral osteochondrosis often occurs as a result of hypothermia, hormonal disturbances, or as a result of pathological birth defects of the spine.
Symptoms of lumbar osteochondrosis
The signs of lumbar osteochondrosis are associated with the fact that the spinal nerve fibers pass posteriorly into the spinal canal. Depending on the localization, the severity of the damage to some roots, the manifestations of the disease differ.
With osteochondrosis of the lumbar spine, the following symptoms stand out:
- Pain syndrome: Most patients complain of low back pain in osteochondrosis. The pain is local directly in the area of violation or radiates to the gluteal region, the sacrum of the leg from the side of the injury;
- Sign of tension: The pain increases with a certain position, but when the position of the body changes, the pain disappears abruptly. The most widely used test bears the name of the discoverer - Lasegue syndrome - the pain increases when the straight limb is raised and disappears when the leg is bent at the knee;
- Decreased or increased sensitivity- this symptom is directly related to damage to the root nerves, sensitivity is disturbed not at the site of the pathology, but at a certain distance. The patient has hyperesthesia, hyperesthesia or paresthesia, which is characterized by unusual projection sensations, such as goose bumps, tingling, etc.
Often with lumbar osteochondrosis, motor activity decreases, this is associated with muscle atrophy of varying degrees. In some circumstances, there is a limitation of functions, in other situations paralysis and paresis occur.
In addition, 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 constantly freeze, there is a pallor of the skin. Other organs in the lower back are often affected. So, with damage to the bladder, urinary incontinence develops or, conversely, is delayed.
Stages of the disease
- First degree lumbar osteochondrosis is the initial type of pathology. It is characterized by a low density of intervertebral discs. The pain syndrome appears with a sharp turn of the body, after physical exertion or a prolonged session.
This type of illness is common among drivers, office workers, athletes, and people who work in harsh climates. The pain is not characterized by acute attacks, but develops as a dull or debilitating ache.
At this stage, people are not in a 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 to the second stage;
- Second-degree lumbar osteochondrosis: degenerative and dystrophic disorders of the vertebral joints occur. The fibrous vertebral annulus becomes compressed as the nucleus pulposus grows and the intervertebral disc protrudes (protrusion).
Neuropathologists define the second stage of osteochondrosis as lumbago. In other words, a lumbago occurs in the lower back when a heavy object is lifted suddenly or with other loads. This period lasts for many years, the stages of remission alternate with acute attacks of exacerbations;
- Third-degree lumbar osteochondrosis - the protrusion of the pulp gradually increases, an intervertebral hernia is formed. The patient develops the entire palette of the neurological state: constant pain, radiation to the buttocks, abdomen, coccyx, legs, urethra, limited mobility.
The legend is used to locate the hernia. The diagnosis of L5 S1 osteochondrosis means that the nucleus pulposus bulge occurred between the 5th lumbar vertebra and the 1st cruciform vertebra;
- When therapeutic measures are not taken on time, all stages of development flow smoothly to the next stage. Lumbar osteochondrosis in stage 4 is characterized by the development of complications.
As a general rule, drug treatment for severely developed pathology is not very effective. The neuropathologist is obliged to offer a method of radical action, that is, hernia surgery.
Methods for the diagnosis of osteochondrosis
To identify the osteochondrosis of PPE, the neuropathologist first takes an anamnesis, because the patient's complaints are one of the decisive values for an accurate diagnosis. During the conversation, the patient is asked questions about his health and condition: what and where does it hurt, what is the duration of the pain, what intensifies the sensation when the stiffness appeared, if the treatment was carried out, what was it 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, a targeted Rg-gram is performed on the basis of complaints, in which the doctor notes disc atrophy, a decrease in the intervertebral space, the appearance of osteophytes, a smoothing of the lumbar curve;
- Myelography: Contrast liquid is injected into the canal through which the spinal cord passes through a lumbar puncture. The technique is used to determine the internal structure of the canal. Common people consider the procedure difficult and dangerous for diagnosis, but apart from contrast allergy, puncture of the spinal canal practically does not threaten the patient. The puncture is done in the place where the spinal cord is missing;
- Computed tomography: nerve root compression is determined, pulp protrusion is determined, it is easy to see vertebral bodies, ligaments, vessels, soft tissues at close range on the monitor;
Sacral osteochondrosis is more accurately determined by electromagnetic waves; For this, the patient is assigned an examination in an MRI scan.
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 in 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, manual therapy methods and methods of traditional medicine are used.
For the treatment regimen of osteochondrosis of the lumbar spine, the surgical method is offered to patients only in extremely severe cases, if conservative methods have not given the desired results.
Medications
Treatment of osteochondrosis of the lumbar spine is carried out by a neuropathologist or the more limited specialist, a vertebrologist. Before treating lumbar chondrosis of spinous processes, the doctor determines the stage and severity of pathological disorders.
Muscle relaxants are used to relieve pain, reduce spasms, and inflammation. These drugs quickly restore mobility to the patient, relieve spasms, and pain disappears.
In addition to the group of drugs for muscle relaxation, steroid hormones are sometimes used to eliminate swelling and inflammation.
Recovery gymnastics
Treatment of lumbar osteochondrosis should be carried out in conjunction with exercise therapy methods. Exercise and gymnastics should receive the same attention as the use of medications.
The therapeutic effect of osteochondrosis are those exercises that relieve pain, strengthen the muscle structure, reduce compression between the discs, which slows the progression of the disease.
Physiotherapy
In lumbosacral osteochondrosis, treatment involves the use of the following procedures:
- Drug electrophoresis;
- Laser and magnetic therapy;
- Treatment with magnetic currents;
- Darsonval;
- UV irradiation;
- Treatment with diadin;
- Shock wave method.
Manipulations involve the use of means that use natural physical force: currents, light radiation, vibration, etc. The treatment regimen, the duration of the physiotherapy course is determined by the attending physician.
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 the muscle tissue, but also places thevertebrae.
In the case of lumbar chondrosis, this method normalizes blood and lymphatic circulation, eliminates muscle tone and deformation, and restores motor function. The chiropractor's hands reduce the purity of spasms, reduce back pain.
How is osteochondrosis of the lumbar region treated by manual techniques? Is it possible to recover it completely in this way? Manual therapy is prescribed only when degenerative processes have not altered the tissues of the spine, that is, no bone growths have formed. The need for procedures is determined by the physician after the Rg, CT, or MRI diagnoses.
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, the intervertebral discs are compressed and destroyed;
- Cauda equina syndrome develops: a massive bundle of nerves of the spinal cone is damaged, innervating the pelvic region, the legs;
- Loss of sensation progresses, there is a disorder of the ability to work of the 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 popular pharmacy offers many remedies to cure ailments:
- Medicinal herbs, essential oils, flower extracts, plant roots;
- Animal products, such as snake or bee, badger, dog, sheep fat, hard-boiled eggs and others;
- Iodine, turpentine and alcohol are used to produce irritating and warming effects.
Similarly to drugs, chondrosis of the lower back is treated with folk methods only in the initial stage of the disease, while the symptoms are only eliminated, but the pathological changes do not disappear. Among other things, such treatment often has side effects, which is why a consultation with a specialist is required before using any prescription of traditional medicine.
The dosage of any drug or medication must be prescribed by your doctor.
Complications
Lumbar chondrosis in the last stage can have unpleasant consequences, including disability.
In the context of dystrophy and degenerative disorders, a narrowing of the spinal canal forms and a 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 traction pains appear due to the altered structure of the vertebral joints. Complications are most often related to the crest of the lower spine, where bone growths are formed in the form of spines.
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 must be especially careful with your back. It is worth remembering that regular gymnastic exercises are the key to a healthy spine.
Weights should be lifted with great 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, adopt 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, twist the torso - this relieves the tension from the entire musculo-articular framework.
The trigger point massage is great. They are active or latent. Trigger points appear as a result of overexertion, heavy stretching, repetitive work, bending over, 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.