Back or lower back pain is the most frequent complaint of patients in general medical practice. They rank second (after respiratory diseases) in terms of the frequency of medical care requests. 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 considered this condition as age-related changes in the spine, which it associated with the processes of natural aging of the human body.
Today, lumbar osteochondrosis is considered as a rather serious disease that occurs in people of all age groups. Currently, the incidence has a steady tendency towards rejuvenation, more and more often the disease is diagnosed in people under the age of 30 years.
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 who is more prone to the disease, is 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 spinal column and contribute to the development of osteochondrosis.
- Various congenital and acquired abnormalities in the structure of the musculoskeletal system - curvature of the legs and spine, flat feet.
- The presence of constant heavy physical exertion on the spine, in particular, 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 disorders.
The points listed above are the most common factors that create the prerequisites for the development of the disease.
Degrees of lumbar osteochondrosis
The 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 annulus fibrosus and longitudinal ligaments. The patient feels local discomfort in the part of the spine where the affected disc is located: acute pain or lumbago in the lower back (lumbago), dull pain of a constant nature (lumbodynia).
- Period of destruction of the annulus fibrosus. 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 feels symptoms such as constant fatigue of the muscles of the lower back, discomfort,
- The period of rupture of the annulus fibrosus and the exit of the nucleus pulposus beyond its limits with the formation of a herniated disc. The so-called radicular syndromes are observed, which are associated with compression of the nerve roots by dropped fragments.
- The spinal column is severely deformed. Human motor function is difficult. The main issue that needs to be addressed is the patient's disability. However, it must be emphasized that at this stage of the disease there is practically no pain. But this is not a signal to suspend the disease, quite the opposite.
- There is a pathological proliferation of bone tissue, which will further worsen the condition.
How to treat osteochondrosis of the lumbar spine will directly depend on the degree of the lesion; for this, medication, non-medication and surgical methods of exposure are used.
Symptoms of osteochondrosis of the lumbar spine
When osteochondrosis of the lumbar spine occurs, the main symptom is pain. The nature of pain sensations, the place of origin and the direction of propagation depend on which receptors receive irritation, that is, how gross are the changes in the disc and surrounding tissues, there is a protrusion or already a hernia, in which direction the protrusion has formed, and so on.
Let's list the main symptoms of lumbar osteochondrosis:
- Pain in the lumbar spine, aching in nature, aggravated by sudden movements, change of body position, prolonged stay in one position. Pain reduction occurs when taking a horizontal position;
- Along with pain in the lumbar spine, osteochondrosis can give a feeling of weakness in the lower trunk and legs, as well as loss of tendon reflexes of the lower extremities;
- Curvature of the lumbar spine 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 bend) and kyphosis (smoothing of the lumbar bend);
- If osteochondrosis has resulted in spinal cord clamping and dysfunction, the patient may have uncontrolled urine and stool.
Additional Features:
- coldness of the skin and numbness in the lumbar region, buttocks;
- dryness, peeling, blue skin on 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 intervention. Treatment of osteochondrosis can be carried out in hospital and at home.
Diagnostics
Diagnosis of osteochondrosis involves the use of various methods, primarily palpation of the lumbar spine.
To confirm the diagnosis, the patient is sent for examination using diagnostic equipment:
- Radiography helps to assess the condition of the spinal column and each vertebra separately. The integrity of the intervertebral discs and the spinal canal is also indirectly judged.
- The degree of damage to the nerve endings and the lining of the spinal cord is determined by tomography. And also assess 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 drugs and procedures will be required 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.
In addition, osteochondrosis can be complicated:
- sciatic nerve inflammation;
- 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 extremities.
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.
Treatment scheme for osteochondrosis is aimed at:
- elimination of the inflammatory process;
- reduction of pain in the lumbosacral region;
- strengthening muscles in the lumbar region, buttocks, legs;
- elimination of pathological muscle tension;
- improving 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 extremities.
Surgical intervention is only used in a few cases.
Medication
Such treatment of osteochondrosis of the lumbar spine includes taking pills, injections and external (ointments and gels) drugs. The drugs used to combat this disease relieve pain and stop inflammation.
Depending on the manifestations, the doctor may prescribe different pills for low back osteochondrosis:
- pain relievers (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, medications alone are not enough to treat osteochondrosis. Physiotherapeutic procedures are used to eliminate pain, relieve muscle spasm, and stimulate metabolic and recovery processes:
- amplipulse;
- phonophoresis;
- diadynamic currents;
- darsonvalization;
- magnetic resonance therapy;
- laser therapy.
Massage is prescribed when the main pain symptom is removed or during remission in chronic pathology. It serves to relax tense muscles. Very often combined with warming 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 carried out only by a specialist in this area of treatment, increases blood circulation in the spinal cord, replaces the displaced discs of the spinal column.
Remedial gymnastics
The whole range of physical exercises used in the diagnosis of lumbar osteochondrosis should help increase the mobility of the lumbar spine.
Remedial gymnastics will not be effective if the exercises are carried out from time to time. The main principle of exercise therapy is regularity. The constant implementation of a certain set of exercises will help eliminate destructive processes in the intervertebral joints.
Surgery
Usually, a doctor will only order surgery if serious complications develop. For example, an intervertebral hernia. The most common type of surgery is to remove 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 spinal column is widespread.