Back pain or lower back pain is the most frequent patient complaint in general medical practice. They are in second place (after respiratory diseases) in terms of frequency of requests for medical treatment. There are many diseases that lead to pain. But the most common cause is osteochondrosis of the lumbar spine, the symptoms and treatment of which we will consider in this material.
Relatively recently, medicine has considered this condition as age-related changes in the spine, associated with the natural aging processes of the human body.
Today, lumbar osteochondrosis is considered a rather serious disease that occurs in people of all ages. Currently, the incidence has a constant tendency to rejuvenate, more and more often the disease is diagnosed in individuals under the age of 30.
Causes of occurrence
The reason for the development of lumbar osteochondrosis has not yet been established. But when faced with this pathology, it is quite often possible to assume that those who are more prone to the disease, are at risk.
Predisposing factors:
- Passive lifestyle. This includes people who lead a predominantly sedentary lifestyle. In a sitting position, the muscles of the corset relax, which increases the load on the lumbar spine.
- Hormonal metabolic disorders and endocrine diseases can adversely affect the metabolism in the tissues of the spine and contribute to the development of osteochondrosis.
- Various congenital and acquired anomalies in the structure of the musculoskeletal system - curvature of the legs and spine, flat feet.
- The presence of intense and constant physical exertion on the spine, especially lifting heavy objects. In this case, we can talk about an occupational disease of such categories as weightlifters and people whose professional duties are associated with the constant lifting of heavy objects.
- Constant unhealthy diet and daily routine, regular stress, insufficient sleep time, metabolic disturbances.
The points listed above are the most common factors that create the prerequisites for the development of the disease.
Degrees of lumbar osteochondrosis
Manifestations of the disease depend on the degree of development of the pathology.
There are four degrees of osteochondrosis:
- Period of change and movement of the nucleus pulposus within the disc. Pain appears due to irritation of the nerve endings located in the fibrous annulus and longitudinal ligaments. The patient feels local discomfort in the part of the spinal column where the affected disc is located: acute pain or low back pain in the lower back (lumbago), dull pain of a constant nature (lumbodynia).
- Period of destruction of the fibrous ring. It is characterized by the appearance of instability and an increase in the mobility of the vertebrae, which causes prolonged and persistent muscle tension. The patient experiences symptoms such as constant fatigue of the lower back muscles, discomfort,
- The period of rupture of the fibrous ring and the exit of the nucleus pulposus beyond its limits with the formation of a herniated disc. So-called root syndromes are observed, which are associated with the compression of nerve roots by fallen fragments.
- The spine is severely deformed. Human motor function is difficult. The main issue that needs to be addressed is the patient's disability. However, it should be emphasized that at this stage of the disease there is practically no pain. But this is not a signal to stop the disease, on the contrary.
- There is a pathological proliferation of bone tissue, which will further worsen the condition.
Treatment of osteochondrosis of the lumbar spine will directly depend on the degree of injury; for this, drugs are used, not drugs and surgical methods of exposure.
Symptoms of osteochondrosis of the lumbar spine
When osteochondrosis of the lumbar spine occurs, the main symptom is pain. The nature of the painful sensations, the place of origin and the direction of propagation depend on which receptors receive the irritation, that is, how gross the changes in the disc and surrounding tissues are, is there a protrusion or already a hernia, in whichdirection the protrusion has formed and so on.
We list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, painful in nature, aggravated by sudden movements, change in body position, prolonged stay in one position. Pain relief occurs when assuming a horizontal position;
- Along with pain in the lumbar spine, osteochondrosis can cause a feeling of weakness in the lower trunk and legs, as well as loss of tendon reflexes in the lower limbs;
- Lumbar spine curvature is common. Depending on the place where the curvature is observed, we distinguish between scoliosis (curvature of the spine to the right or left), lordosis (forward bending) and kyphosis (smoothing of the lumbar curve);
- If osteochondrosis has resulted in blockage and dysfunction of the spinal cord, the patient may have uncontrolled urine and stool.
Additional features:
- cold skin and numbness in the lumbar region, buttocks;
- dryness, peeling, bluish skin in the lower back and buttocks;
- violation of sweating in the buttocks;
- urination disorder;
- erectile dysfunction.
These symptoms indicate the onset of the disease and require medical attention. Treatment of osteochondrosis can be carried out in the hospital and at home.
Diagnostics
Diagnosis of osteochondrosis involves the use of various methods, mainly palpation of the lumbar spine.
To confirm the diagnosis, the patient is sent for examination using diagnostic equipment:
- Radiography helps assess the condition of the spine and each vertebra separately. The integrity of the intervertebral discs and spinal canal is also indirectly assessed.
- With tomography, the degree of damage to the nerve endings and lining of the spinal cord is determined. It also evaluates the condition of the intervertebral discs.
- MRI - used to make a definitive diagnosis.
Correct diagnosis will help to understand how to treat lumbar osteochondrosis and what medications and procedures will be needed for this.
Complications
Osteochondrosis of the lumbar spine can cause protrusions and hernias due to significant loads on this spine. It is these complications that develop very quickly, so it is very important to treat them in a timely manner.
Furthermore, osteochondrosis can be complicated:
- inflammation of the sciatic nerve;
- spondyloarthrosis;
- Schmorl's hernia;
- osteophytosis, spondylosis;
- stenosis of the spinal canal with compression and dysfunction of the spinal cord;
- compression of the cauda equina with dysfunction of the pelvic organs;
- lame;
- paresis of the lower limbs.
It is possible to prevent the progression of complications with timely diagnosis and complex treatment.
Treatment of osteochondrosis of the lumbar spine
When lumbar osteochondrosis is diagnosed, treatment requires extensive complex therapy, which includes:
- moderate physical activity;
- use of medicines;
- traction of the spine;
- manual therapy;
- physiotherapy;
- massage.
The treatment scheme for osteochondrosis aims to:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthen the muscles of the lumbar region, buttocks, legs;
- elimination of pathological muscle tension;
- improve the functioning of the pelvic organs;
- regulation of blood circulation and metabolic processes in the affected area;
- restoration of normal range of motion in the lower back and increased sensitivity of the lower limbs.
Surgery is used only in a few cases.
Medication
Such treatment of osteochondrosis of the lumbar spine includes taking pills, injections and external drugs (ointments and gels). The drugs used to fight this disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for lumbar osteochondrosis:
- analgesics (analgesics);
- non-steroidal anti-inflammatory drugs;
- muscle relaxants, to relieve muscle spasm that occurs due to pain;
- chondroprotectors that restore cartilage tissue;
- corticosteroids (prescribed if all other treatments have failed);
- vitamin preparations.
Very often in the treatment of osteochondrosis, pills are prescribed that calm the nervous system, as well as antidepressants that fight stressful situations and depression.
Physiotherapy for lumbar osteochondrosis
As a rule, drugs alone are not enough to treat osteochondrosis. Physiotherapeutic procedures are used to eliminate pain, relieve muscle spasms and stimulate metabolic and recovery processes:
- amplipulse;
- phonophoresis;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main painful symptom is removed or during remission in chronic pathology. It serves to relax tense muscles. Most often combined with warm-up procedures or a visit to the sauna. This will help increase the relaxing effect on muscle tissue and stimulate blood circulation.
Manual therapy, which is performed only by a specialist in this area of treatment, increases blood circulation in the spinal cord, replaces displaced discs of the spine.
Corrective gymnastics
The full range of physical exercises used in the diagnosis of lumbar osteochondrosis should help increase the mobility of the lumbar spine.
Corrective gymnastics will not be effective if the exercises are performed from time to time. The main principle of physical therapy is regularity. Constant implementation of a certain set of exercises will help eliminate destructive processes in the intervertebral joints.
Surgery
Usually, a doctor prescribes surgery only if serious complications develop. For example, an intervertebral hernia. The most common type of surgery is the removal of the damaged disc (discectomy).
This operation is considered the most productive method in this case, but at the same time it is prescribed only if other methods of treatment do not bring results within six months. In addition, the method of microsurgical and endoscopic treatment of the spine is widespread.