Despite the prevalence of opinions, spinal osteochondrosis is not considered part of the aging process. The elastic discs between the vertebrae are responsible for the flexion and extension of the back, as shock absorbers. Over time, they wear out and no longer offer 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 between the ages of 11 and 12. The disease is clearly manifested by the age of sixteen, but the most serious course and frequent complications occur between 15 and 20 years.
Children under the age of 15 rarely have severe forms of osteochondrosis, which in some way is related to the excellent state of their musculoskeletal system in general and of the spine in particular. In addition, the disease takes time to develop and, on average, takes five years.
Fortunately, these diseases are much easier to treat in children than in adults.
Symptoms
Reflex syndromes
- Cervicalgia: pain in the neck that manifests differently (pulling, tingling, shooting), a "dragging" sensation in the cervical muscles, as well as decreased mobilityand neck flexibility.
- Lumbagois a sharp, sharp pain in the lower back, 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 body movements.
Compression syndromes
The appearance of pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Compression of the spinal cord (myelopathy).
- Spinal cord injury due to poor blood supply.
- Narrowing (stenosis) of arteries and veins (compression vascular myeloischemia).
Methods for detecting diseases
Differential diagnosis
Not all disorders 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;
- trouble sleeping.
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 various diseases. For example, a patient diagnosed with bipolar disorder may also receive a differential diagnosis of borderline personality disorder, given the similarity of the symptoms of both conditions.
Who is diagnosed most often?
If before 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 large spread of the disease is understandable: children began to spend a lot of time sitting, including due to the computer and the Internet. Is it bad? Time will tell, but the fact is that 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 a disease and its degree?
First
In normal state, intervertebral discs constantly regenerate, but it happens that the process slows down and a disease such as 1st degree osteochondrosis occurs.
There are many reasons for this:
- obese;
- metabolic disorders;
- immunosuppressed and so on.
Unfortunately, the 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 the pain themselves. To do this, use ointments and various tinctures. But this is the biggest mistake.
First degree lumbar spine osteochondrosis can be cured quite easily by contacting a good specialist and taking a number of simple actions.
Grade 1 osteochondrosis is compaction of the intervertebral cartilage in the lumbar region. The main symptom at this stage is slight pain when turning or bending over. Sometimes the symptoms are more acute and of short duration due to sudden movements or significant exertion.
Second
A pronounced symptom of the disease is pain 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 pain so severe that it manifests itself even when coughing.
There are additional symptoms 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 drowsiness. The patient has chronic fatigue, accompanied by irritability. This symptom is explained by the pain syndrome that constantly bothers the person.
- Urination problems and pain in the kidney area.
Third Party
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 profound loss of energy.
The third stage is characterized by the appearance of a narrowing of the intervertebral foramen in the context of previous changes. Herniated intervertebral discs form, neck vessels and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
End-stage occurs when the intervertebral disc degenerates and the disc space is destroyed. In this stage, disc thinning reaches its maximum or, worse, disappears completely. 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 greater degree of physical and / or mental impairment. There is also a permanent loss of growth and energy levels. Stage 4 is generally considered irreversible.
Consult the doctor
Which doctor should I contact?
When independent treatment methods cease to produce an analgesic effect, the patient begins to ask the question: which doctor treats osteochondrosis? The first person you can contact 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 a complete treatment; this is not your specialization.
Most likely he will send you to a neurologist. It is this specialist who will carry out the necessary research and help build a treatment program. The therapist can also refer you to a vertebrologist. This doctor deals directly with diseases of the spine.
Scales and tests
Assessment of quality of life
A characteristic as widespread as quality of life is especially important for a group of patients with comorbid conditions, as it can influence the effectiveness of treatment. This is especially important for comparing the results of various studies, economic analyzes, 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 allow 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 the treatment result
- McNab Subjective Rating Scale.
- Patient satisfaction scale.
- Prolo's Functional and Economic Results Scale.
- Lumbosacral result scale.
- Nurik scale.
Hardware test
X-rays
X-rays provide detailed bone structures in the spine and are used to rule out back pain resulting from:
- Spondylolisthesis.
- Tumors.
- Cracks.
Calcium in bone blocks X-ray penetration and the image of bones appears as a shadow on film. X-rays provide excellent visibility of all details because bone is composed primarily of calcium. However, the discs and nerve roots do not contain calcium, so X-rays do not capture images of these structures. Therefore, X-rays cannot be used to diagnose a lumbar disc herniation or other causes of a pinched nerve.
X-rays should not be taken in 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 lower motor neurons.
- Raynaud's phenomenon is a condition in which spasms occur, narrowing of the capillaries in 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 with osteochondrosis require surgical intervention. For mild to moderate pain, more conservative treatments.
- Spondylodesis: surgical intervention in the treatment of osteochondrosis.
Prevention
Prevention of osteochondrosis of the lumbar segment consists of eliminating the risk factors that lead to this disease. Factor elimination is the main preventive measure.
Physical activity is normalized, the back muscles are strengthened, the maximum load on the lower back is prevented, the development of diseases that lead to lower back pain is prevented, all this is a prophylaxis to prevent the symptoms of thelumbar 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 in yourself, do not squeeze and immediately consult a doctor. A disease detected early is easier to treat and progresses without consequences.