Lumbar osteochondrosis

According to medical statistics, in 80% of cases, low back pain 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) manifests itself in a variety of symptoms: pain of a different nature, limited mobility, impaired sensitivity of the lower body, etc. With the 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), you need to start a complex treatment in 1-2 stages of the pathology. In advanced cases, when irreversible changes to the disc or vertebrae are already present, an operation is performed. To avoid osteochondrosis of the lower back and associated complications, prevention is necessary.

Development of lumbar osteochondrosis

To understand what is lumbar spine osteochondrosis (lumbar spine), you need to study the structure of the spine. It consists of vertebrae, between which are placed cartilage pads (intervertebral disc). The disk is covered by a hard fibrous membrane (fibrous ring), within which is the nucleus pulposus. This structure has a shock absorbing function and makes the spine more flexible.

Help

. The lumbar segment of the spine is subject to a great deal of stress daily, as it can support the weight of the upper body. Therefore, osteochondrosis of the lower spine is diagnosed more frequently than cervical and thoracic.

With regular stress on the spine, the discs contract, lose a lot of fluid, their height decreases and the distance between the vertebrae decreases. The cartilaginous lining becomes fragile, micro-cracks appear on its surface, through which the pulposo nucleus protrudes over time. With additional compression of the intervertebral discs, the outer shell breaks and the gelatinous body falls, forming a hernia. Then, there is pathological mobility of the vertebrae, the load on the adjacent spine segments increases.

A little later, bone growth (osteophytes) begins to form at the edges of the vertebral bodies. Thus, 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, becomes flattened, cracks appear on the outside. It has an unlit chain.
• 2 degrees - the cartilaginous lining yields, the vertebrae become closer to each other, become more mobile, the muscles and ligaments around the spine yield. The pain appears.
• 3 degrees - protrusions, hernias and subluxations of the vertebrae are formed. The pain increases, 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, 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 with conservative techniques. Surgery may be necessary in stages 3-4.

Help

. According to statistics, OBO is most often detected in patients after 30 years. Cases of development of pathologies are frequent in people over 20 years old. Approximately 80% of 60-year-old patients suffer from manifestations of this disease.

Reasons

To understand how to deal with PKOP osteochondrosis (lumbosacral spine), you need to know its causes:

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

An illness is usually caused by several causes.

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

• Excess weight.
• Passive lifestyle, sitting for long periods.
• Regular use of unhealthy foods (fatty, fried, sweet, semi-finished products, etc. ).
• Lack of liquid, dehydration.
• Congenital disorders of the spine structure, for example, an additional vertebra.
• Wear uncomfortable heels regularly.
• The gestation period, then the load on the spine increases.
• Abrupt refusal to train professional athletes or excessive exercise in people who previously led a passive lifestyle.
• Smoking, drinking frequently and in excess.

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

Symptoms

The symptoms of osteochondrosis of the lumbar spine are diverse, depending on the stage of the pathology and the location of the affected area.

Doctors distinguish between reflex and compression syndromes (symptom complex) in OBOR. The former arise when the receptors on the outer layer of the discs, ligaments and joint capsules are irritated, and the latter, when the nerve bundles, blood vessels and spinal cord are compressed.

There are these reflex syndromes of lumbar osteochondrosis:

• Lumbago. Acute pain in the lower back with sudden movement or effort. At the slightest attempt at movement, the pain syndrome intensifies, so that the patient freezes in one position. The muscles of the injured area become very tense, on palpation, the painful sensations become more pronounced. These manifestations are associated with the movement of the nucleus pulposus within the outer shell.
• Lumbodynia. Acute pain develops for several hours or days. Discomfort increases with movement, change in body position. It is weakened when a person assumes a horizontal posture with a roller under the lower back. When lifting an extended leg in this position, the pain intensifies (Lassegh's symptom). The degree of muscle tension is less than in the lumbago. Mobility of the lower back is limited.
• Lumboischialgia. Painful sensations (acute or painful) spread from the lower back to the lower body. There is an increase in this signal during movements. Pain is relieved by resting on your back. The muscles in the affected area are tense, the pain syndrome becomes pronounced on palpation.

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

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

• L1 - L3 - pain and numbness in the lower back, front and inner thighs, the patient has difficulty bending / unfolding the leg at the knee.
• L4 - the pain syndrome extends to the front of the thigh, goes down to the knee (back). In the same area, sensitivity is disturbed.
• L5 - painful sensations radiate to the buttocks, the outer part of the thigh, descend along the front of the leg to the inside of the foot and the big 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, outside and back of the thigh, goes down to the outside of the leg, foot. In the same areas, numbness is felt, the leg muscles are weakened, so it is difficult for the patient to stand on tiptoe.

There is a risk of damage to several nerve bundles at once, for example, L5, S1. If the hernia recedes, it can compress the spinal cord.

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

Diagnostic measures

To diagnose an 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 tell the specialist in detail about your symptoms to facilitate the diagnosis.

Instrumental examinations will help to detect intervertebral osteochondrosis:

• Radiography of the lumbar region (frontal and lateral projection).
• Computerized and magnetic resonance imaging.

The

X-ray allows you to assess the structure of the EPP. To detect abnormal mobility of the vertebrae, radiographs are taken in the flexion and extension positions. This study allows us to notice that the intervertebral fissure has narrowed, the vertebral bodies have dislocated and osteophytes have 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 make it possible to assess the condition of vertebrae, discs, intervertebral foramen and spinal cord. With their help, lumps, the direction of the hernia, the degree of compression of the nerve bundles, spinal cord and blood vessels are detected.

Treatment

MEDICINES FOR LUMBAR OSTEOCHONDROSIS

Treatment of EPP osteochondrosis lasts from 1-3 months to 1 year. The success of the 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:

• Stop or reduce the symptoms of the software.
• Identify the cause of the disease, try to exclude it from life.
• Eliminate the inflammatory process.
• Restores blood circulation and metabolic processes in the lumbar spine.
• Try to improve the condition of the damaged cartilaginous lining to prevent further degenerative changes.

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

• Muscle relaxants. They relax your muscles and relieve pain and inflammation.
• NSAIDs. They have anti-inflammatory, analgesic and antipyretic effects.
• Antispasmodics. They help to 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 to deal with pain. However, these drugs are capable of destroying bones, so they are taken for a short time and only after the 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.

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

In case of exacerbation, the patient receives injections and, after the relief of the main symptoms, starts taking oral medications.

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

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

The treatment of chondrosis of the lumbar spine (stage 1) is performed with the use of chondroprotectors, which delay the development of degenerative processes, accelerate the regeneration of cartilage. In addition, vitamin and mineral complexes are prescribed to the patient. This form of osteochondrosis is the easiest to cure.

OTHER CONSERVATION TECHNIQUES

In case of acute chronic illness (osteochondrosis) of 1 - 2 degrees, the following treatment procedures will help to stop your development:

• Ultrasound therapy relieves pain and inflammation and normalizes blood flow in the damaged area.
• Detector therapy is a safe traction of the spine due to the weight of the body itself, after which muscle tone normalizes and mobility improves.
• Magnetotherapy reduces pain and inflammation of the muscles around the spine.
• Reflexology (insertion of needles into bioactive points on the body) speeds up 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 the compression of nerve bundles, improve the nutrition of intervertebral discs and restore the structure of the spine.
• Electrophoresis allows the distribution 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 to 15 sessions. The main thing is to get a doctor's approval before doing them.

TREATMENT WITH SOFTWARE AT HOME

If you are unsure whether it is possible to treat OBO at home, consult your doctor. If the specialist has given permission, then start therapy, which usually consists of the following points:

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

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

And also 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 treatment at home can only be done with your doctor's permission.

SURGICAL TREATMENT

An operation for lumbar osteochondrosis is prescribed if conservative techniques have been ineffective for a long time. Surgical intervention 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 to treat OBO:

• Spondylodesis - fusion of adjacent vertebrae.
• Facetextomy - removal of the intervertebral joints that compress 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 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, compressed nerve root or spinal cord.
• Prolonged inflammation increases the likelihood of developing radiculitis (inflammation of nerve roots).
• Sciatica (an inflammatory lesion of the sciatic nerve), in which there is severe pain and numbness in the lower limb.
• In case of impaired blood circulation in the spinal cord, the likelihood of myelopathy by compression increases (compression of the spinal cord by various formations: bone fragments, hernia, tumors, hematoma).
• Cauda equina syndrome - compression of the roots of the lower spinal cord, which leads to impaired functionality of the intestines, pelvic organs and lower extremities.

To avoid such complications, you need to start treatment as soon as possible.

Prevention

To avoid lumbar osteochondrosis, follow these rules:

• Lead a moderately active lifestyle (walk more often, exercise regularly, swim in a pool).
• For sedentary work, warm up every 1. 5 hours.
• Sleep on an orthopedic mattress.
• Avoid excessive physical effort, lift weights only in the half squat position, before placing a special belt on your lower back.
• Buy orthopedic shoes.
• Eat well, take vitamins and mineral complexes as prescribed by your doctor.
• Learn to relax.
• Try not to become hypothermic.
• Treat diseases that can cause OBO in time.
• Give up bad habits.

By following these recommendations, you can prevent degenerative changes in your spine and improve your health.

Most important

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