The health of the spine is the basis for the normal functioning of the musculoskeletal system.There are many diseases that destroy the structure of the vertebrae and surrounding tissues.This article describes the symptoms and treatment of osteochondrosis of the lumbar spine.
column structure
Before talking about osteochondrosis, it is necessary to understand how the spine works.I will say a few words about this.
The spine is made up of vertebrae, among which are the cartilaginous intervertebral discs.Thanks to them, a person can bend and twist.The entire spine is S-shaped, which provides elasticity.
Intervertebral discs consist of a nucleus pulposus surrounded by an annulus fibrosus.It is the destruction of the intervertebral disc that causes osteochondrosis.
Clinical picture of lumbar osteochondrosis.
Lumbar osteochondrosis is an injury to the vertebrae, intervertebral discs and surrounding tissues, which has a long course and often becomes chronic.The disease is often complicated by intervertebral hernias, inflammation of the nerves and other unpleasant pathologies.
The clinical manifestations of the disease vary in different stages.There are 4 main periods of development of lumbar osteochondrosis:
- Stage I. Symptoms clear.In most cases, mild pain in the lower back or buttocks is a cause for concern and increases with physical activity.Patients tend to attribute symptoms to fatigue.
- Stage II.The destruction of the annulus fibrosus begins, the distances between the vertebrae decrease.During this period, nerve endings may be pinched, which is characterized by a sharp "stabbing pain."At this stage, the symptoms are pronounced, so patients go to a medical center.
- III.At this stage, the fibrous rings undergo significant destruction and intervertebral hernias may form.The pain is constant.
- IV.The spine is severely deformed.Patients have difficulty moving.Irreversible disorders lead to disability.Lumbar osteochondrosis develops under unfavorable conditions: physical activity, hypothermia, forced professional posture.
Symptoms and signs
The description of the clinical picture talks a little about the symptoms, but not all of them.The signs of lumbar osteochondrosis are very diverse:
- Pain.The most common symptom of the disease.In the initial stages, the pain is mild and increases with exercise.In later stages, the pain becomes stronger and does not go away without taking pain relievers.It is characterized by sharp, painful "shots" - short attacks of unbearable pain.
- Temperature.When lumbar osteochondrosis is accompanied by inflammation of the nerves or surrounding tissues, an elevated temperature appears.Generally it does not exceed 38°C.
- Trophic ulcers.They occur when there is an alteration in the nutrition of the tissues around the spine, due to pinching of blood vessels.
- Characteristic pose.The person adopts a position in which he or she feels the least pain and remains in that position almost all the time.
- Changes in the position of the spine: scoliosis, kyphosis, etc.
- Limited movement.It occurs in the last two stages of lumbar osteochondrosis.Numbness of the extremities.As osteochondrosis progresses, numbness of the extremities may occur.This is due to pinching of some nerves in the lumbar region.The symptom appears from stage 2 of the disease.
Osteochondrosis of the lumbar region is characterized by an increase in symptoms, depending on the progression of the disease.
Reasons
Many patients believe that the only cause of lumbar osteochondrosis is inadequate physical activity.This opinion is fundamentally wrong.In fact, there are more than a dozen factors that can cause the development of the disease:
- Genetic predisposition.This factor comes first, because if it is present nothing can be done.All that remains is therapy and supportive treatment.
- Poor posture during periods of active growth.This may be due to incorrect posture at a desk or carrying a briefcase on your shoulder.
- Excess weight is a constant companion of osteochondrosis.Under the weight of extra pounds, the intervertebral discs are destroyed, which leads to the appearance of the disease.
- Injuries.They can be domestic, professional, sports.
- Endocrine diseases.Metabolic insufficiency is a common cause of destruction of intervertebral discs.
- Sedentary lifestyle.An insufficient amount of movement and physical activity leads to muscular dystrophy, which places increased stress on the spine.
- Hard work that puts strain on the back.
- Congenital anomalies of the spine.
- When several provoking factors are combined, the disease will develop faster.
Diagnosis
Diagnosing lumbar osteochondrosis is quite simple, especially in clinics equipped with modern equipment.Diagnostics is carried out in the following order: survey, examination, request for tests and hardware tests.
Diagnosis begins with the collection of anamnestic data.The doctor clarifies the patient's age (this is important), the time of the first symptoms and working conditions.From the information collected, the specialist can draw a conclusion about the cause of the disease.
Next, the doctor performs an examination.The doctor palpates the spine, asks the patient to perform some movements: flexion, flexion-extension, turns.Based on this, it is possible to determine how limited the patient's motor activity is.
Tests are performed to rule out bone tuberculosis and some other diseases.From the blood, a specialist can judge the presence of inflammation.
X-ray examination is an accessible and informative way to determine the presence of osteochondrosis.Most often, photographs are taken in two projections.But in some cases, it is possible to obtain an X-ray image in an additional projection or an overview of a specific area of the spine.
Magnetic resonance imaging.Examination of the spine with this device is the gold standard for diagnosing osteochondrosis.This procedure makes it possible to identify destruction of fibrous rings, spina bifida, displacement of individual vertebrae and much more.
Treatment
Osteochondrosis can be treated by an orthopedist, neurologist or vertebrologist.It depends on the cause of this disease.
Treatment varies drastically depending on the stage of the disease.
Chiropractors are called to improve the condition of the spine and correct misalignments (if possible).Proper massage will increase the blood supply to the spinal area.Physical therapy and bracing will correct signs of scoliosis (this is especially important for children).Medications are needed to replenish the supply of substances necessary for the construction of intervertebral disc tissue.
In the second stage of the disease, intensive drug therapy is indicated.Non-steroidal anti-inflammatory drugs should be taken in a cycle to relieve inflammation.For severe pain, strong pain relievers are prescribed.Muscle relaxers will help relieve muscle tension.
In rare cases, anticonvulsants and antidepressants may be prescribed.
Additional treatment consists of the use of physiotherapy, exercise therapy, massage (if this does not aggravate the patient's condition).
The third stage of the disease is characterized by destructive processes in the intervertebral disc.Surgical treatment is indicated for hernias.Drug therapy is the same as in the second stage of the disease.
With significant destruction of the disc in the fourth stage of the disease, it is possible to perform prosthetics with an artificial implant.In the postoperative period, drug therapy and additional treatment methods are carried out.
Treatment of symptoms and signs of osteochondrosis of the lumbar spine should be carried out only with the participation of a specialist.Self-medication is unacceptable.
Complications of lumbar osteochondrosis.
Complications of lumbar osteochondrosis are mainly associated with the formation of intervertebral hernias, which have a negative effect on the spinal cord and nearby tissues.
Below is a list of the most common complications:
- Numbness of the extremities or individual muscles of the back.It occurs due to compression of the spine.
- Disorders of urination and defecation (up to the complete disappearance of the urge).
- Trophic ulcers.
- Depression.It would seem that this cannot be a complication.But in fact, constant pain causes mood swings.There have even been cases of suicide for this reason.Complications of lumbar osteochondrosis arise due to improper treatment or non-compliance with the treatment regimen.As a rule, with timely treatment, complications do not arise.
at-risk group
There are people who have a higher probability of developing lumbar osteochondrosis.These people are at risk.
Those people whose relatives suffer from similar diseases should take care of their spine.
The risk group includes obese patients.Excess weight puts enormous pressure on the intervertebral discs.People who lead a sedentary lifestyle are also at high risk.
Without a doubt, athletes must take care of their spine.At the same time, it doesn't matter what sport they play.
Protecting the spine is necessary if the job involves lifting heavy objects or staying in an uncomfortable position for a long time.
Prevention of lumbar osteochondrosis.
Treatment of osteochondrosis is long-term, and often the disease takes on a chronic form.That is why the prevention of spinal pathologies is of great importance.
To avoid problems in the lumbar spine, it is necessary to follow a regimen of physical activity and rest.The load on the column must be uniform and not excessive.Rest should be regular and better in a lying position.
If you are overweight, you need to lose it.
Preventive measures include timely treatment of endocrine diseases and postural disorders (especially in children).
Problems with the spine significantly reduce the quality of life, so it is necessary to be attentive to even minor pain or discomfort in this area.