Lumbar osteochondrosis

According to medical statistics, lower back pain in 80% of cases is caused by lumbar osteochondrosis. This occurs as a result of degenerative-dystrophic changes in this segment, when the intervertebral discs and adjacent vertebrae are affected. Osteochondrosis of the lumbar spine (OSOP) manifests itself in a variety of symptoms: pain of a different nature, limited mobility, reduced sensitivity of the lower body, etc. With a prolonged absence of treatment, degenerative processes spread to the vertebrae, reducing the ability to work, so the patient can become disabled.

To avoid dangerous complications of lumbar osteochondrosis (LP), it is necessary to begin complex treatment in 1-2 stages of the pathology. In advanced cases, when there are already irreversible changes in the disc or vertebrae, an operation is performed. To avoid osteochondrosis of the lower back and associated complications, it is necessary to carry out its prevention.

Development of lumbar osteochondrosis

To understand what osteochondrosis of the lumbar spine is, it is necessary to study the structure of the spine. It consists of vertebrae, between which cartilaginous pads (intervertebral disc) are placed. The disc is covered with a hard fibrous membrane (anulus fibrosus), inside which the nucleus pulposus is located. This structure has a cushioning function and makes the spine more flexible.

Help. The lumbar segment of the spine is under tremendous stress on a daily basis, as it can support the weight of the upper body. Therefore, osteochondrosis of the lower spine is diagnosed more often than cervical, thoracic.

With regular stress on the spine, the discs shrink, lose a lot of fluid, their height decreases and the distance between the vertebrae decreases. The cartilage coating becomes fragile, microcracks appear on its surface, through which the pulpy nucleus protrudes over time. With further compression of the intervertebral discs, the outer shell ruptures and the jelly-like body falls off, so a hernia is formed. Then there is pathological mobility of the vertebrae, the load on the adjacent segments of the spine increases.

Shortly thereafter, bone growths (osteophytes) begin to form at the edges of the vertebral bodies. Therefore, the body tries to stabilize the spine.

Doctors distinguish 4 stages of osteochondrosis of the lumbar spine:

• 1 degree - problems with discs begin, the central part dehydrates, flattens, cracks appear on the outer shell. It has a canceled current.
• Grade 2: The cartilage lining sags, the vertebrae move closer to each other, become more mobile, the muscles and ligaments around the spine sag. Pain appears.
• 3 degrees - protrusions, hernias and subluxations of the vertebrae are formed. The pain increases, the mobility is limited, the sensitivity of the lower body is disturbed.
• Grade 4 osteochondrosis is characterized by the appearance of osteophytes that can damage the spinal nerves and adjacent vertebrae. There is constant pain, severe neurological disorders, and other complications, and the risk of disability increases.

The easiest way to cure chondrosis of the lower back (stage 1), but identifying the disease at this stage is very difficult. 2nd degree intervertebral osteochondrosis is treated using conservative techniques. Surgery may be needed in stages 3-4.

Help. According to statistics, OBO is most often detected in patients after 30 years. There are frequent cases of the development of pathologies in people after 20 years. About 80% of patients aged 60 suffer from manifestations of this disease.

Reasons

To understand how to deal with PKOP osteochondrosis (lumbosacral spine), it is necessary to know its causes:

• Regular static or dynamic load on the lumbar segment. The risk group for developing osteochondrosis includes office workers, professional athletes (weightlifting), removals, builders, etc.
• Incorrect posture, prolonged inappropriate posture.
• Genetic predisposition, abnormalities in the formation of the vertebral bodies. This category includes juvenile software - curvature of the spine, caused by pathologies of the vertebral bodies.
• Injuries to the spine.
• Hormonal imbalance, metabolic disorders, diseases of the endocrine glands, which disrupt the metabolism in the lumbar segment.
• Age-related changes in the body cause disc wear.
• Bone tuberculosis, osteomyelitis (purulent inflammation of the bone tissue), ankylosing spondylitis (inflammation of the vertebrae and joints), rheumatoid arthritis, etc.

A disease is often caused by several causes.

In addition, there are factors that provoke the development of lumbar osteochondrosis:

• Overweight.
• Passive lifestyle, prolonged sitting.
• Regular use of unhealthy foods (fatty foods, fried foods, confectionery, semi-finished products, etc. ).
• Lack of fluids, dehydration.
• Congenital disorders of the structure of the spine, for example an additional vertebra.
• Regularly wearing uncomfortable heels.
• The gestation period, so the load on the spine increases.
• Sudden refusal to train professional athletes or excessive sports in people who previously led a passive lifestyle.
• Smoking, frequent and excessive consumption.

There are many other factors that can trigger degenerative-dystrophic processes in the lumbar spine. For example, flat feet, frequent hypothermia of the back, frequent stress, sleep disturbances, etc.

Symptoms

Symptoms of osteochondrosis of the lumbar spine are different, they depend on the stage of the pathology and the location of the affected area.

Doctors distinguish reflex and compression syndromes (a symptom complex) in OBOR. The first arise when the receptors of the outer membrane of the discs, ligaments, joint capsules are irritated, and the second, when the nerve bundles, blood vessels and spinal cord are compressed.

There are such reflex syndromes of lumbar osteochondrosis:

• Low back pain. Shooting pain in the lower back with sudden movement or effort. At the slightest attempt to move, the pain syndrome intensifies, so the patient freezes in one position. The muscles in the damaged area are very tense, with palpation the painful sensations become more pronounced. These manifestations are associated with the movement of the nucleus pulposus within the outer shell.
• Lombodynia. Aching pain develops over several hours or days. Discomfort increases with movement, change in the position of the body. It is weakened when the person assumes a horizontal posture with a roller under the lower back. When raising a straight leg in this position, the pain increases (Lassegh symptom). The degree of muscle tension is less than that of low back pain. The mobility of the lower back is limited.
• Lumboischialgia. Painful sensations (sharp or aching) spread from the lower back to the lower body. There is an increase in this sign during the movements. The pain is relieved by resting on the back. The muscles in the affected area are tense, the pain syndrome becomes pronounced on palpation.

Symptoms of compression syndromes depend on which parts of the lumbar segment are damaged. Characteristic signs are associated with compression of the spinal nerves by hernias, osteophytes, displaced vertebrae. This condition is called radiculopathy, in which pain increases with the slightest movement, the muscles of the lower back are tense, and mobility is limited.

Clinical manifestations of compression syndromes depending on the damaged vertebrae of the lumbar segment:

• L1 - L3 - pain and numbness in the lumbar region, front and inner thigh, the patient has difficulty bending / infusing the leg at the knee.
• L4 - pain syndrome extends to the front of the thigh, goes down to the knee (behind). In the same area, the sensitivity is disturbed.
• L5 - painful sensations radiate to the buttocks, outer thigh, go down the front of the lower leg to the inside of the foot and big toe. In the same area, numbness is felt, it is difficult for the patient to bend the big toe.
• S1 - pain spreads from the lower back to the buttock, the outside and back of the thigh, goes down to the outside of the lower leg, the foot. Numbness is felt in the same areas, the muscles of the lower leg are weakened, so it is difficult for the patient to stand on tiptoe.

There is a risk of damaging several nerve bundles at the same time, for example L5, S1. If the hernia moves backwards, it can compress the spinal cord.

Compression of blood vessels in the lower back increases the likelihood of weakening of the leg muscles, numbness of the lower limbs, impaired control over the urination and defecation process. In men with OBO, erections are impaired and in women the main symptoms can be complemented by inflammation of the ovaries or uterus.

Diagnostic measures

To diagnose OBO, the doctor examines the patient, palpates the patient to determine the condition of the muscles and to identify the curvature of the spine. It is important to inform the specialist in detail about your symptoms to facilitate the diagnosis.

Instrumental examinations will help detect intervertebral osteochondrosis:

• X-ray of the lower back (front and lateral view).
• Magnetic and computerized resonance.

Radiography allows evaluation of the structure of the EPP. To detect abnormal mobility of the vertebrae, x-rays are taken in the flexion and extension positions. This study allows us to note that the intervertebral cleft has narrowed, the vertebral bodies have shifted and osteophytes have appeared on their edges. However, this diagnostic method is considered obsolete.

Today, CT and MRI are increasingly used to detect degenerative-dystrophic changes in the spine. These highly informative studies make it possible to assess the condition of the vertebrae, discs, intervertebral foramen and spinal cord. With their help, the protrusions, the direction of the hernia, the degree of compression of the nerve bundles, spinal cord and blood vessels are detected.

Treatment

DRUGS FOR LUMBAR OSTEOCONDROSIS

Treatment of osteochondrosis EPP lasts from 1-3 months to 1 year. The success of therapy depends on the patient himself, who must strictly follow the doctor's recommendations. With self-medication, the patient's condition usually worsens.

Treatment goals:

• Stops or mitigates software symptoms.
• Identify the cause of the disease, try to exclude it from life.
• Eliminates the inflammatory process.
• Restores blood circulation, metabolic processes in the lumbar spine.
• Try to improve the condition of the damaged cartilage lining, stop further degenerative changes.

To achieve these goals, complex therapy is recommended. It usually starts with taking medications:

• Muscle relaxants. They relax the muscles, relieve pain and inflammation.
• NSAIDs. They have anti-inflammatory, analgesic, antipyretic effects.
• Antispasmodics. They help stop smooth muscle spasm, relieve pain.
• Anesthetics. They are used for severe pain syndrome in the form of a therapeutic block.
• Glucocorticosteroids. They also help cope with pain. However, these drugs are capable of destroying bones, so they are taken for a short time and only after a doctor's approval.
• Sedatives. Relieves neuromuscular tension, improves sleep.
• Vitamins (group B, E, C, A). Restores the condition of the affected nerves, relieves pain.

Watch out. NSAIDs should not be taken for gastritis or gastric ulcers, as they further damage the mucous membranes of the gastrointestinal tract.

In case of exacerbation, the patient is given injections and, having resolved the main symptoms, takes medications orally.

In addition, external agents are used (gels, ointments, creams, rubs).

The question of what to do in case of chronic lumbar osteochondrosis is quite relevant. If the OBOP has become chronic, after the relief of the main symptoms, the patient is prescribed chondroprotectors, drugs that restore blood circulation, drugs based on vitamins B. They help restore innervation, normalize the blood supply in theaffected area and prevent further development of the pathology.

Treatment of chondrosis of the lumbar spine (stage 1) is carried out with the use of chondroprotectors, which slow down the development of degenerative processes, accelerate the regeneration of cartilage. Also, the patient is prescribed vitamin and mineral complexes. This form of osteochondrosis is the easiest to cure.

OTHER CONSERVATIVE TECHNIQUES

In case of 1 - 2 degree acute chronic disease (osteochondrosis), the following treatment procedures will help to stop its development:

• Ultrasound therapy relieves pain and inflammation and normalizes blood flow to the damaged area.
• Detensor therapy is a safe traction of the spine due to the weight of your body, after which the muscle tone is normalized and the mobility improves.
• Magnetic therapy reduces pain and inflammation in the muscles around the spine.
• Reflexology (insertion of needles in bioactive points of the body) accelerates blood circulation, relieves inflammation and edema.
• Manual therapy (impact on the affected area with the hands of a doctor) and massage normalize muscle tone, reduce compression of nerve bundles, improve nutrition of the intervertebral discs and restore the structure of the spine.
• Electrophoresis enables the administration of medicinal solutions through the skin to bone and cartilage tissues.
• Drasonalization improves blood circulation, metabolic processes, reduces pain, restores skin sensitivity.

There are many more effective procedures that will help improve the patient's condition in 5-15 sessions. The main thing is to get a doctor's approval before performing them.

TREATMENT WITH SOFTWARE AT HOME

If you are wondering if it is possible to treat OBO at home, talk to your doctor. If the specialist has given permission, therapy begins, which usually consists of the following points:

• Diet. If lumbar osteochondrosis is caused by impaired blood flow or metabolism, exclude fatty, fried, spicy foods, eggs, etc. from the menu. Stock the menu with fresh vegetables, fruits, lean meat, fish, dairy products. Give up alcohol, tonic drinks (tea, coffee). Drink filtered water, compotes, herbal teas.

• To restore blood circulation, exercise or apply rubs and compresses.
• Sleep on an orthopedic mattress, a low pillow. If you have a sedentary job, buy a chair with a back that will support your spine. Wear special corsets or belts from time to time.
• Physical therapy will help strengthen the muscle corset, relieving some of the load from the diseased spine. The complex for each patient is compiled individually by a doctor or instructor.
• Self-massage the lumbar region. However, ask a professional how to do it right.
• Use folk remedies in the form of rubs, compresses, baths, etc.
• The needle applicator is a plastic plate with many spines, which improves blood circulation, metabolic processes in the damaged area, reduces muscle pain and relaxes.

And even at home you can use lotions with herbal decoctions, plasters.

Help. A novelty in the treatment of osteochondrosis is a massage bed suitable for even the most disorganized patients.

However, remember that home treatment can only be done with your doctor's permission.

SURGICAL TREATMENT

An operation for lumbar osteochondrosis is prescribed if conservative techniques have proved ineffective for a long time. And surgery is also indicated for involuntary urination, defecation and cauda equina syndrome (pinching of the nerves of the lower spinal cord).

The following surgical methods are used in the treatment of OBO:

• Spondylodesis - fusion of adjacent vertebrae.
• Facetestomy: removal of the intervertebral joints that pinch the spinal nerve.
• Laminectomy is the removal of the lamina covering the spinal canal that compresses the spinal cord.
• Discectomy is the complete or partial removal of an intervertebral disc that causes compression of the nerve root or spinal cord.
• Corpectomy: removal of the vertebral body and adjacent cartilage pads. Then the empty space is filled with a bone graft and 3 vertebral segments are fused.

Help. After surgery, there is a risk of complications: spinal cord injuries, nerve bundles, broken grafts, infections, etc.

After treatment, you need to undergo rehabilitation to speed up your recovery.

Complications

In the absence of adequate therapy, the risk of such complications of lumbar osteochondrosis increases:

• Herniated disc, pinched nerve root or spinal cord.
• Prolonged inflammation increases the likelihood of developing radiculitis (inflammation of the nerve roots).
• Sciatica (sciatica), which causes severe pain and numbness in the lower limbs.
• If blood circulation in the spinal cord is impaired, the likelihood of compression myelopathy (compression of the spinal cord by various formations: bone fragments, hernia, tumors, hematoma) increases.
• Cauda equina syndrome - compression of the roots of the lower spinal cord, leading to disruption of the function of the intestine, pelvic organs and lower limbs.

To avoid such complications, treatment should be started as soon as possible.

Prevention

To avoid lumbar osteochondrosis, follow these rules:

• Lead a moderately active lifestyle (walk more often, exercise regularly, join a swimming pool).
• For sedentary work, warm up every 1. 5 hours.
• Sleep on an orthopedic mattress.
• Avoid excessive physical exertion, lift weights only from a half squat position, first wear a special belt on your lower back.
• Buy orthopedic shoes.
• Eat right, take vitamin and mineral complexes as prescribed by your doctor.
• Learn to relax.
• Try not to get hypothermia.
• Treats diseases that can cause OBO over time.
• Give up bad habits.

By following these tips, you can avoid degenerative changes in the spine and improve your health.

Most important

If you notice symptoms of lumbar osteochondrosis, consult a doctor urgently. Self-treatment can worsen your condition and cause complications. Lumbar chondrosis (stage 1) is treated with physical therapy, physiotherapy, and chondroprotectors. In the later stages, drugs, massage, manual therapy, etc. are used. In the absence of positive dynamics for a long time or the appearance of neurological symptoms, the doctor can prescribe an operation. The patient must strictly follow the doctor's recommendations to speed up recovery.