Lumbar osteochondrosis is a neurological disease of the spine that affects people of all ages, in which degenerative-dystrophic changes occur in the lumbar spine. They affect the intervertebral discs, articular cartilage, bone tissue.
The cause of the disease is the serious stress that the lower back experiences daily - when walking, sitting, lifting weights. It is very important to start treatment of osteochondrosis as early as possible in order to avoid possible complications. Lumbar osteochondrosis is a rather complex disease that requires complex therapy, under the supervision of an experienced specialist.
Key Features
Lumbosacral osteochondrosis is a degenerative-dystrophic disorder in the articular cartilages of the spinal column, which are located in the lumbar spine. In other words, this disease means the destruction of the cartilaginous discs that are located between the vertebral bodies. The mobility of the vertebrae decreases, the distance between them decreases, compression (compression) of the nerve endings occurs.
The lumbosacral spine suffers more often than others due to the fact that it is on it that the maximum load falls. In 80% of patients who complain of back pain, doctors diagnose precisely osteochondrosis. The disease begins with the breakdown of glycoproteins in the connective tissue, it is these compounds that give it elasticity. The intervertebral discs are the first to suffer from this process.
Each disc consists of a nucleus and an outer annulus fibrosus. After the core dries out, the disc loses its elastic properties, and the fibrous ring cracks and delaminates. Through gaps in the ring, the nucleus can fall out (a hernia is formed).
As a result of these processes, the load on the vertebrae increases significantly, the body responds to this by a sharp increase in the formation of bone tissue in places of increased load.
Which vertebrae are affected
The lumbar region consists of five vertebrae: L1-L5, the fifth vertebra is attached to the sacrum. The discs between them are most often affected in osteochondrosis.
There are several types of lumbosacral osteochondrosis, they differ in the location of the vertebrae.
- Disease of the upper lumbar level (1, 2 and 3 vertebrae).
- Disease of the lower lumbar level (3, 4 and 5 vertebrae).
- Osteochondrosis of the sacrum (localized in the sacral bones). This type of disease is very rare.
- Fusion of the bones of the sacrum and vertebrae.
Stages of development of lumbosacral osteochondrosis
There are four stages (sometimes three are distinguished) of osteochondrosis of the lumbosacral region. Here they are:
- There are changes in the nucleus and its position.
- The destruction of the outer fibrous ring begins.
- After the ring breaks, the nucleus falls out.
- Destructive processes affect the vertebrae, joints, ligaments.
At the first stage of lumbosacral osteochondrosis, a person feels a certain discomfort and pain in the lower back. It can be acute or aching in nature. There is a spasm of muscles and blood vessels, problems in the functioning of organs.
Spasms of the vessels of the lower extremities can lead to atherosclerosis, dysfunction of the bladder.
In the second stage, due to the instability of the vertebrae, the back muscles are constantly tense. Patients complain of lower back fatigue, discomfort, and uncertainty.
In the third stage, the disc nucleus falls out of the fibrous ring and an intervertebral hernia is formed. Fragments of a dropped disc pinch the nerve roots that innervate the internal organs, muscles, and skin areas. As a result of this, a change in the sensitivity of a certain area develops, a burning sensation, numbness and loss of sensitivity may develop. Nerve compression can lead to loss of motor function or muscle atrophy.
According to the area in which there is a violation of innervation, doctors can say exactly where the spinal column is damaged. If fragments of the disc fall into the spinal canal, the spinal cord is pinched. This often disrupts the functioning of the pelvic organs and the motor function of the lower extremities.
At the fourth stage, there is a complete replacement of the disc tissues with dense connective tissue. There is some restoration of the supporting function of the spinal column, the pain subsides a little, but its mobility and elasticity are lost.
The above stages are conditional, because the development of the disease is very individual.
Symptoms: the body will tell
Symptoms can be conditionally divided into the main ones associated with changes in the spine and additional ones, which are associated with impaired innervation due to pinched nerves.
Main:
- pain and numbness in the lower back. At first, it can be temporary and manifest itself during physical exertion and movement. As they develop, they become permanent, can be sharp or aching, appear even when coughing or sneezing;
- fatigue and depression;
- decrease in the sensitivity of the lower extremities;
- impaired mobility of the lower back;
- curvature of the spine, lordosis.
Additional:
- sharp back pain;
- deterioration of reflexes;
- shootings in the lower extremities, lameness;
- muscle weakness;
- decrease in sweating;
- feeling of coldness in the legs.
Depending on the localization of osteochondrosis, pains are observed in different parts of the body:
- with damage to 1-2 vertebrae - in the inguinal region;
- with damage to 3-4 vertebrae - in the lower leg and in the thigh area;
- with the defeat of the 5th vertebra - in the sacrum, lower back.
How is lumbosacral osteochondrosis diagnosed?
Diagnosis begins with a detailed survey of the patient. The doctor should carefully listen to the patient's complaints, find out the localization and intensity of pain, pay special attention to side symptoms (loss of skin sensitivity, impaired motor function).
The doctor must trace the development of symptoms over time, analyze the nature and effectiveness of previous treatment (or self-treatment). Also, the doctor should pay attention to the history, ask the patient about his lifestyle, working conditions, and previous diseases.
Particular attention should be paid to posture, possible curvature of the spinal column. Noteworthy is how the patient moves, the degree of muscle development.
The main diagnostic tool for lumbosacral osteochondrosis is radiography. MRI and computed tomography are successfully used.
Causes
The lumbosacral region has a number of unique features. The spinal cord ends at the level of the 12th thoracic-1 lumbar vertebrae. In the lumbosacral region there are fibers of the spinal nerves, which are collected in a bundle. The lumbar and sacral roots form the sciatic nerve.
The main feature of this section of the spine is a large load (dynamic and static), which he constantly experiences. This is why the lumbar discs wear out earlier.
Possible consequences
This disease is dangerous for its consequences:
- damage to the knee and pelvic joints;
- dysfunction of internal organs (problems with potency in men and reproductive organs in women);
- lumbago, sciatica and lumboischialgia;
- compression of the spinal cord, which leads to impaired reflexes;
- inflammation of the sciatic nerve.
Scientists still cannot answer what exactly causes this disease. Or rather, which of the factors has the greatest influence on its development. Some of the researchers believe that lumbosacral osteochondrosis is the price a person pays for walking upright. Indeed, this disease is not observed in animals.
The factors that cause this disease can be divided into external and internal. Here are the main reasons that cause it:
- serious spinal injury;
- heredity;
- flat feet;
- prolonged standing;
- posture disorders;
- sedentary lifestyle;
- excess body weight;
- unbalanced diet.
Who is at risk
No one is immune from this disease. Hereditary factors determine a greater or lesser predisposition to it. However, external factors and a person's lifestyle have a great influence on the likelihood of developing this disease.
Another cause of the disease is excessive physical activity and injury.
Proper nutrition is important for the prevention of osteochondrosis: food should contain all the necessary components, be rich in vitamins and microelements.
Treatment
Treatment can be surgical or conservative. If the disease is at the stage of the appearance of intervertebral hernias, then surgical intervention is indispensable. Conservative treatment includes the following methods:
- drug therapy;
- physiotherapy and spinal traction;
- massage and manual therapy;
- physiotherapy exercises.
Drug therapy includes anti-inflammatory drugs, pain relievers, muscle spasm relievers, and injection blockades. Chondroprotectors are also used, they reduce pain, promote the regeneration of damaged cartilage formations. In some cases, hormonal drugs are used.
Prevention
Basic principles for the prevention of lumbosacral osteochondrosis:
- prevention of excessive load on the lower back;
- strengthening the muscles of the back;
- maintaining correct posture;
- physical activity;
- proper nutrition;
- regulation of the rest regime;
- timely treatment of other diseases of the back.
Home Treatments
Exercises
There are quite simple exercises that a person can perform independently at home. They are used for both therapeutic and prophylactic purposes. Their main task is to strengthen the back muscles in order to partially unload the spine.
exercise therapy
Therapeutic exercise is one of the main ways to treat osteochondrosis. Exercise helps to strengthen the muscles, which takes some of the load off the spine. Improves blood circulation in tissues, including intervertebral discs. Therapeutic exercise helps to remove muscle tension, reduce pain.
Massage
Massage is an excellent treatment for lumbar osteochondrosis. It improves blood supply to tissues, reduces pain, relieves clamps, strengthens the muscle corset.
Instead of an epilogue
Summarizing the above, it can be noted that this disease is a real "disease of the century" that threatens any modern person.
Lumbosacral osteochondrosis gives a person excruciating pain, can turn into a disabled person. It is very difficult to treat this disease, especially in advanced form.
The positive point is that it is in the power of each of us to avoid the development of osteochondrosis. All you need to do is take care of your spine: do not put too much stress on it, watch your own weight, lead a healthy lifestyle, eat normally, avoid injuries.
If you have begun to notice the first symptoms of osteochondrosis, consult a doctor. In the initial stages, this disease is quite easily treated. Take care of your spine so that even in old age, movements bring you joy, not discomfort.