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 (OBOP) is manifested in various symptoms: pain of various natures, limited mobility, impaired 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 may become disabled.
To avoid dangerous complications of lumbar osteochondrosis (LP), you need to start complex treatment in 1-2 stages of pathology. In advanced cases, when irreversible changes to the disc or vertebrae have already been performed, surgery is performed. To avoid osteochondrosis of the lower back and related complications, it is necessary to carry out its prevention.
Development of lumbar osteochondrosis
To understand what is lumbar spine osteochondrosis, you need 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 (annulus fibrosus), inside which is the nucleus pulposus. This structure has the function of absorbing shock and makes the spine more flexible.
Help. The lumbar segment of the spine is subjected to great stress on a daily basis, because it can bear the weight of the upper part of the body. Therefore, osteochondrosis of the lower part of the spine is diagnosed more often than cervical, thoracic.
With regular loading of the spine, the discs shrink, lose a lot of fluid, their height decreases, and the distance between the vertebrae decreases. The cartilaginous lining becomes brittle, microcracks appear on its surface through which the nucleus pulposus protrudes over time. By further compressing the intervertebral discs, the outer shell ruptures and the gelatinous body falls out, thus creating a hernia. Then there is a pathological mobility of the spine, the load on the adjacent segments of the spine increases.
Somewhat later, bone growths (osteophytes) begin to form at the edges of the vertebral body. So the body is trying to stabilize the spine.
Doctors distinguish 4 stages of lumbar osteochondrosis:
- 1st degree - problems with the discs begin, the central part becomes dehydrated, flattens out, cracks appear on the outer shell. It has deleted power.
- 2nd degree - the cartilaginous mucosa relaxes, the vertebrae get closer to each other, they become more mobile, the muscles and ligaments around the spine relax. Pain appears.
- Grade 3 - bulges, hernias and subluxations of the vertebrae form. The pain increases, mobility is limited, the sensitivity of the lower part of the 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 lower back chondrosis (stage 1), however, is very difficult to recognize the disease at this stage. Grade 2 intervertebral osteochondrosis is treated with conservative techniques. Surgery may be needed in stages 3-4.
Help. According to statistics, OBO is more often detected in patients after the age of 30. There are frequent cases of pathology development in people after the age of 20. Approximately 80% of patients aged 60 years suffer from the manifestation of this disease.
To understand how to deal with osteochondrosis PKOP (lumbosacral spine), you need to know its causes:
- Regular static or dynamic loading of the lumbar segment. The risk group for the development of osteochondrosis includes office workers, professional athletes (weightlifting), starters, builders, etc.
- Poor posture, prolonged inappropriate posture.
- Genetic predisposition, abnormalities in the formation of the vertebral body. This category includes juvenile software - curvature of the spine caused by pathologies of the vertebral body.
- Spinal cord injuries.
- Hormonal imbalance, metabolic disorders, diseases of the endocrine glands, which disrupt metabolism in the lumbar segment.
- Age-related changes in the body cause the disc to wear out.
- bone tuberculosis, osteomyelitis (purulent inflammation of bone tissue), ankylosing spondylitis (inflammation of the vertebrae and joints), rheumatoid arthritis, etc.
The disease is often caused by multiple causes.
In addition, there are factors that cause the development of lumbar osteochondrosis:
- Passive lifestyle, prolonged sitting.
- Regular consumption of unhealthy foods (fatty, fried foods, sweets, semi-finished products, etc. ).
- Lack of fluid, dehydration.
- Congenital disorders of the structure of the spine, for example, the extra vertebra.
- Wearing uncomfortable heels regularly.
- The period of pregnancy, and then the load on the spine increases.
- Sudden refusal to train professional athletes or excessive sports in people who have previously led a passive lifestyle.
- Smoking, frequent and excessive drinking.
There are many more factors that can trigger degenerative-dystrophic processes in the lumbar spine. For example, flat feet, frequent hypothermia of the back, frequent stress, sleep disorders, etc.
The symptoms of osteochondrosis of the lumbar spine are different, they depend on the stage of pathology and the localization of the affected area.
Doctors differentiate between reflex and compression syndromes (symptom complex) in OBOR. The first occurs when the receptors of the outer shell 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:
- Lumbago. Shooting pains in the lower back with sudden movements or exertion. 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, by palpation the painful feelings become more pronounced. These manifestations are associated with the movement of the nucleus pulposus within the outer shell.
- Lumbodynia. Painful pain develops over hours or days. The discomfort increases with movement, changing body position. It is weakened when a person assumes a horizontal holding of the roller under the lower back. When lifting a straight leg in this position, the pain intensifies (Lassegh's symptom). The degree of muscle tension is lower than with lumbago. Lower back mobility is limited. Lumboischialgia. Painful sensations (sharp or painful) spread from the lower back to the lower body. This sign increases during movement. The pain is relieved by resting on the back. The muscles in the affected area are tense, the pain syndrome becomes pronounced by palpation.
The 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 the pain intensifies with the slightest movement, the muscles of the lower back are tense, and mobility is limited.
Clinical manifestations of compression syndrome depending on the damaged vertebrae of the lumbar segment:
- L1 - L3 - pain and numbness in the lumbar region, front and inner thighs, the patient has difficulty bending / bending the leg at the knee.
- L4 - pain syndrome extends to the front of the thigh, down to the knee (back). In the same area, sensitivity is impaired.
- L5 - painful sensations radiate to the buttocks, outer part of the thigh, descend along the front of the lower leg to the inner part of the foot and toe. Numbness is felt in the same area, it is difficult for the patient to bend the big toe.
- S1 - the pain spreads from the lower back to the buttocks, outer and back of the thighs, descends to the outer part of the lower leg, feet. Numbness is felt in the same areas, the calf muscles are weakened, and the patient finds it difficult to stand on his toes.
There is a risk of damage to several nerve bundles at once, 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 extremities, impaired control over the process of urination and defecation. In men with OBO, erection is impaired, and in women the main symptoms may be supplemented by inflammation of the ovaries or uterus.
To diagnose OBO, the doctor examines the patient, palpates the patient to determine the condition of the muscles, and determines the curvature of the spine. It is important to tell the specialist in detail about your symptoms in order to facilitate his diagnosis.
Instrumental examinations will help detect intervertebral osteochondrosis:
- X-ray of the lower back (frontal and lateral projection).
- Computer and magnetic resonance imaging.
X-rays allow you to estimate the structure of the EPP. To detect abnormal mobility of the vertebrae, X-rays are taken in positions of flexion and extension. This study allows us to notice that the intervertebral fissure narrowed, the vertebral bodies shifted, and osteophytes appeared at 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 allow the assessment of the condition of the vertebrae, discs, intervertebral foramen and spinal cord. With their help, protrusions, the direction of the hernia, the degree of compression of the nerve bundles, the spinal cord and blood vessels are detected.
MEDICINAL OSTEOCHONDROS MEDICINES
Treatment of osteochondrosis EPP lasts from 1-3 months to 1 year. The success of therapy depends on the patient himself who must strictly adhere to the doctor's recommendations. With self-medication, the patient's condition usually worsens.
- Stop or alleviate the symptoms of the software.
- Determine the cause of the disease, try to exclude it from life.
- Eliminate the inflammatory process.
- They restore blood circulation, metabolic processes in the lumbar spine.
- Try to improve the condition of the damaged cartilage lining to stop further degenerative changes.
In order to achieve such goals, it is recommended to carry out complex therapy. It usually starts with medication:
- Muscle relaxants. They relax the muscles and relieve pain and inflammation.
- NSAIL. They have anti-inflammatory, analgesic, antipyretic effect.
- Antispasmodics. They help stop smooth muscle cramps and relieve pain.
- Anesthetics. They are used for severe pain syndrome in the form of therapeutic blockade.
- Glucocorticosteroids. They also help cope with pain. However, these drugs are capable of destroying bones, so they are taken briefly and only after a doctor’s approval.
- Sedatives. They relieve neuromuscular tension, improve sleep.
- Vitamins (group B, E, C, A). Restores the condition of the affected nerves, relieves pain.
Careful. NSAIDs are forbidden to take with gastritis or gastric ulcer, because they further damage the mucous membrane of the gastrointestinal tract.
In case of worsening, the patient is given injections, and after the main symptoms are alleviated, he takes oral medications.
In addition, external agents (gels, ointments, creams, rubbing) are used.
The question of what to do in case of chronic osteochondrosis of the lower back is quite relevant. If OBOP has become chronic, then after relieving the main symptoms the patient is prescribed chondroprotectors, drugs that restore blood circulation, drugs based on vitamin B. They help restore innervation, normalize blood supply to the affected area and prevent further development of pathology.
Treatment of lumbar spine chondrosis (stage 1) is carried out with the use of chondroprotectors, which slow down the development of degenerative processes, accelerate cartilage regeneration. In addition, the patient is prescribed vitamin and mineral complexes. This form of osteochondrosis is the easiest to cure.
OTHER CONSERVATIVE TECHNIQUES
In the case of acute chronic disease (osteochondrosis) of 1 - 2 degrees, the following treatment procedures will help stop its development:
- Ultrasound therapy relieves pain and inflammation, and normalizes blood flow in the damaged area.
- Detensor therapy is a safe pulling of the spine due to the weight of your own body, after which muscle tone normalizes and mobility improves.
- Magnetotherapy reduces pain and inflammation of the muscles around the spine.
- Reflexology massage (inserting needles into bioactive points on the body) speeds up blood circulation, relieves inflammation and edema.
- Manual therapy (doctor's influence on the affected area) and massage normalize muscle tone, reduce the compression of nerve bundles, improve the nutrition of intervertebral discs and restore the structure of the spine.
- Electrophoresis enables the delivery of medicinal solutions through the skin to bone and cartilage tissues.
- Drasonvalization 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 you do them.
HOME TREATMENT WITH SOFTWARE
If you are wondering if it is possible to treat OBO at home, talk to your doctor. If the specialist has given permission, start therapy which usually consists of the following points:
- Diet. If lumbar osteochondrosis is caused by impaired blood flow or metabolism, then exclude fatty, fried, spicy foods, eggs, etc. from the menu. Fill the menu with fresh vegetables, fruits, lean meats, fish, dairy products. Give up alcohol, tonic drinks (tea, coffee). Drink filtered water, compotes, herbal teas.
- To restore blood circulation, practice or apply rubs and compresses.
- Sleep on an orthopedic mattress, low pillow. If you have a sedentary job, buy a chair with a backrest that will support your spine. Occasionally wear special corsets or belts.
- Exercise therapy will help strengthen the muscular corset, relieve some of the burden from the diseased spine. The complex for each patient is compiled individually by a doctor or instructor.
- Self-massage the lumbar region. However, ask an expert how to do it properly.
- Use folk remedies in the form of rubs, compresses, baths, etc.
- The needle applicator is a plastic plate with many thorns, which improves blood circulation, metabolic processes in the damaged area, reduces muscle pain and relaxes.
And at home you can use lotions with herbal decoctions, plasters.
Help. A novelty in the treatment of osteochondrosis is a massage bed that is suitable for even the most disorganized patients.
However, keep in mind that home treatment can only be done with the permission of your doctor.
Lumbar osteochondrosis surgery is prescribed if conservative techniques have long been shown to be ineffective. And surgery is also indicated for involuntary urination, defecation and cauda equina syndrome (contraction of the nerves of the lower spinal cord).
The following surgical methods are used to treat OBO:
- Spondylodesis - fusion of adjacent vertebrae.
- Facetextomy - removal of intervertebral joints that pinch the spinal nerve.
- Laminectomy is the removal of the lamina that covers the spinal canal that compresses the spinal cord.
- Discectomy is the complete or partial removal of the 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 spinal segments grow together.
Help. After the operation, there is a risk of complications: spinal cord injuries, nerve bundles, broken grafts, infections, etc.
After treatment, you must undergo rehabilitation to speed up your recovery.
In the absence of appropriate 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 (inflammation of the sciatic nerve), in which there is severe pain and numbness in the lower limb.
- In case of damage to the blood circulation in the spinal cord, the probability of compression myelopathy increases (compression of the spinal cord by various formations: bone fragments, hernias, tumors, hematomas).
- Cauda equina syndrome - compression of the roots of the lower spinal cord, which leads to damage to the functionality of the intestines, pelvic organs and lower limbs.
To avoid such complications, you must start treatment as early as possible.
To avoid lumbar osteochondrosis, follow these rules:
- Lead a moderately active lifestyle (walk more often, exercise regularly, sign up for the pool).
- For inactive work, warm up every 1. 5 hours.
- Sleep on an orthopedic mattress.
- Avoid excessive physical exertion, lift weights only from a semi-squat position, before that put 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 hypothermia.
- Treat diseases that can cause OBO in a timely manner.
- Give up bad habits.
Following these recommendations, you can avoid degenerative changes in your spine and improve your health.
If you notice symptoms of lumbar osteochondrosis, contact your doctor immediately. Self-medication can worsen your condition and cause complications. Lumbar chondrosis (stage 1) is treated with exercise, physiotherapy, and chondroprotectors. In the later stages, medications, massage, manual therapy, etc. are used. In the absence of positive dynamics for a long time or the appearance of neurological symptoms, the doctor may prescribe surgery. The patient must strictly follow the doctor’s recommendations to speed recovery.