Lumbar osteochondrosis

According to medical statistics, low 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) manifests itself in a variety of symptoms: pain of a different nature, limitation of mobility, impaired sensation of the lower body, etc. With the prolonged absence of treatment, the degenerative processes spread to the vertebrae, which reduces the work capacity and then the patient may be disabled.

To avoid dangerous complications of lumbar osteochondrosis (LP), you need to start complex treatment in 1-2 stages of the pathology. In advanced cases, when there are already irreversible changes in the disc or vertebrae, an operation is performed. In order to avoid osteochondrosis of the lower back and associated complications, it is necessary to carry out its prevention.

Development of lumbar osteochondrosis

To understand what is osteochondrosis of the lumbar spine (lumbar spine), it is necessary to study the structure of the spine. It consists of vertebrae, between which cartilage pads (intervertebral disc) are placed. The disc is covered with a tough fibrous membrane (annulus fibrosus), within which is the nucleus pulposus. This structure has a shock absorption function and makes the spine more flexible.

Help. The lumbar segment of the spine is under tremendous stress on a daily basis, as it can support the weight of the upper body. Therefore, osteochondrosis of the lower spine is diagnosed more often than cervical, thoracic.

With regular stress on 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. With increased compression of the intervertebral discs, the outer layer ruptures and the gelatinous body falls off, resulting in a hernia. Then there is a pathological mobility of the vertebrae, the load on the adjacent segments of the spine increases.

A little later, bony growths (osteophytes) begin to form on the edges of the vertebral bodies. Therefore, 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 becomes dehydrated, flattened, cracks appear in the outer layer. It has a current erased.
• Grade 2: the cartilaginous lining sags, the vertebrae move closer to each other, they become more mobile, the muscles and ligaments around the spine sag. Pain appears.
• 3 degrees: protrusions, hernias and subluxations of the vertebrae form. Pain increases, mobility is limited, lower body sensitivity is impaired.
• Grade 4 osteochondrosis is characterized by the development of osteophytes that can damage the spinal nerves and adjacent vertebrae. There is constant pain, serious 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. Second-degree intervertebral osteochondrosis is treated with conservative techniques. Surgery may be required in stages 3-4.

Help. According to statistics, OBO is most often detected in patients after the age of 30. There are frequent cases of the development of pathology in people after the age of 20. Approximately 80% of 60-year-old patients have manifestations of this disease.

Reasons

To understand how to treat PKOP (lumbosacral spine) osteochondrosis, 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), movers, builders, etc.
• Bad posture, prolonged inappropriate 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 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 disc wear.
• Tuberculosis of bones, osteomyelitis (purulent inflammation of bone tissue), ankylosing spondylitis (inflammation of the vertebrae and joints), rheumatoid arthritis, etc.

A disease usually has several causes.

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

• Overweight.
• Passive lifestyle, sitting for a long time.
• Regular consumption of unhealthy foods (fats, fried foods, confectionery, semi-finished products, etc. ).
• Lack of fluid, dehydration.
• Congenital disorders of the structure of the spine, 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 sports in people who previously led a passive lifestyle.
• Smoking, drinking frequently and excessively.

There are many more 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.

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

There are such reflex syndromes of lumbar osteochondrosis:

• Lumbago. Shooting pain in the lower back with sudden movements or efforts. At the slightest attempt to move, the pain syndrome intensifies, which is why the patient freezes in one position. The muscles of the damaged area are very tense, with palpation, the painful sensations become more pronounced. These manifestations are associated with the movement of the nucleus pulposus within the outer layer.
• Lumbodynia. Persistent pain develops over several hours or days. Discomfort increases with movement, change in body position. It weakens when a person adopts a horizontal posture with a roller under the lower back. When lifting a straight leg in this position, the pain increases (Lassegh's symptom). The degree of muscle tension is less than with lumbago. The mobility of the lower back is limited.
• Lumboischialgia. Painful sensations (sharp or aching) extend from the lower back to the lower body. There is an increase in this sign during movements. The pain is relieved by resting on the back. The muscles of the affected area are tense, the pain syndrome becomes pronounced on palpation.

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 pain increases with the slightest movement, the lower back muscles tighten, and mobility is limited.

Clinical manifestations of compression syndromes according to the damaged vertebrae of the lumbar segment:

• L1 - L3 - pain and numbness in the lumbar region, front and inner thigh, the patient has difficulty bending / bending the leg at the knee.
• L4: pain syndrome extends to the front of the thigh, descends to the knee (behind). In the same area, sensitivity is altered.
• L5 - Painful sensations radiate to the buttocks, outer thigh, down the front of the lower leg to the inner foot and the big toe. In the same area, numbness is felt, it is difficult for the patient to bend the big toe.
• S1 - pain spreads from the lower back to the buttock, the outer and back of the thigh, down to the outer part of the lower leg, the foot. In the same areas, numbness is felt, the muscles of the lower leg become weak, making it difficult for the patient to stand on tiptoe.

There is a risk of damaging several nerve bundles at the same time, eg L5, S1. If the hernia moves backward, it can compress the spinal cord.

Compression of the blood vessels in the lower back increases the likelihood of weakening of the leg muscles, numbness of the lower extremities, impaired control of the urination and defecation process. In men with OBO, the erection is affected and in women, the main symptoms may be complemented by inflammation of the ovaries or uterus.

Diagnostic measures

To diagnose OBO, the physician 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 detect intervertebral osteochondrosis:

• X-ray of the lumbar area (frontal and lateral projection).
• Magnetic and computerized resonance imaging.

Radiography allows you to evaluate the structure of PPE. To detect abnormal mobility of the vertebrae, X-rays are taken in flexion and extension positions. This study allows us to notice that the intervertebral fissure has narrowed, the vertebral bodies have been displaced and osteophytes have appeared on 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 the vertebrae, discs, intervertebral foramen, and spinal cord. With its help, protrusions, the direction of the hernia, the degree of compression of the nerve bundles, the spinal cord and blood vessels are detected.

Treatment

MEDICATIONS FOR LUMBAR OSTEOCONDROSIS

The treatment of EPP osteochondrosis lasts from 1 to 3 months to 1 year. The success of therapy depends on the patient himself, who must strictly follow the doctor's recommendations. With self-medication, the patient's condition usually worsens.

Treatment objectives:

• Stops or mitigates software symptoms.
• Identify the cause of the disease, try to exclude it from life.
• Eliminates the inflammatory process.
• Restore blood circulation, metabolic processes in the lumbar spine.
• Try to improve the condition of the damaged cartilaginous lining, stop further degenerative changes.

To achieve these goals, complex therapy is recommended. It usually begins with taking medications:

• Muscle relaxants. They relax muscles, relieve pain and inflammation.
• NSAIDs. They have anti-inflammatory, analgesic, antipyretic effects.
• Antispasmodics. They help stop smooth muscle spasm, relieve pain.
• Anesthetics. They are used for severe pain syndrome in the form of therapeutic blockage.
• Glucocorticosteroids. They also help you cope with pain. However, these drugs are capable of destroying bones, so they are taken for a short time and only after a doctor's approval.
• Sedatives. They relieve neuromuscular tension, improve sleep.
• Vitamins (group B, E, C, A). Restores the state of the affected nerves, relieves pain.

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

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

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

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

The treatment of chondrosis of the lumbar spine (stage 1) is carried out with the use of chondroprotectors, which slow down the development of degenerative processes and accelerate the regeneration of cartilage. Also, the patient is prescribed vitamin-mineral complexes. This form of osteochondrosis is the easiest to cure.

OTHER CONSERVATIVE TECHNIQUES

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

• Ultrasound therapy relieves pain and inflammation and normalizes blood flow to the damaged area.
• Tensioner therapy is a safe traction of the spine due to the body's own weight, after which muscle tone is normalized and mobility is improved.
• Magnetotherapy reduces pain and inflammation of the muscles around the spine.
• Reflexology (insertion of needles into bioactive points in the body) accelerates 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 compression of the nerve bundles, improve the nutrition of the intervertebral discs and restore the structure of the spine.
• Electrophoresis allows the administration of medicinal solutions through the skin to the bone and cartilage tissues.
• Drasonalization improves blood circulation, metabolic processes, reduces pain and 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 doing them.

TREATMENT WITH SOFTWARE AT HOME

If you are wondering if OBO can be treated at home, talk to your doctor. If the specialist has given permission, begin therapy, which usually consists of the following items:

• Diet. If lumbar osteochondrosis is caused by blood flow or metabolism disturbances, exclude fatty, fried, spicy foods, eggs, etc. from the menu. Replenish the menu with fresh vegetables, fruits, lean meats, fish, and dairy products. Give up alcohol, tonic drinks (tea, coffee). Drink filtered water, compotes, herbal teas.

• To restore blood circulation, exercise or apply rubs 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 special corsets or belts from time to time.
• Exercise therapy will help strengthen the muscular corset and relieve some of the burden on the diseased spine. The complex for each patient is compiled individually by a doctor or instructor.
• Self massage the lumbar region. However, ask a professional how to do it correctly.
• Use home 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 also at home you can use lotions with decoctions of herbs, plasters.

Help. A novelty in the treatment of osteochondrosis is a massage table suitable for even the most disorganized patients.

However, remember that home treatment can only be done with your doctor's permission.

SURGICAL TREATMENT

An operation for lumbar osteochondrosis is prescribed if conservative techniques have proven ineffective for a long time. And also surgical intervention is indicated for involuntary urination, defecation and cauda equina syndrome (pinching of the nerves of the lower spinal cord).

The following surgical methods are used in the treatment of OBO:

• Spondylodesis: fusion of adjacent vertebrae.
• Facetextomy: removal of the intervertebral joints that pinch the spinal nerve.
• Laminectomy is the removal of the lamina that covers the spinal canal that compresses the spinal cord.
• Diskectomy is the total 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 must undergo rehabilitation to speed up your recovery.

Complications

In the absence of adequate therapy, the risk of complications of lumbar osteochondrosis increases:

• Herniated disc, pinched nerve root or spinal cord.
• Prolonged inflammation increases the probability of developing radiculitis (inflammation of the 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 compression myelopathy (compression of the spinal cord by various formations: bone fragments, hernias, tumors, hematomas) increases.
• Cauda equina syndrome - compression of the roots of the lower spinal cord, leading to impaired functionality of the intestines, pelvic organs, and lower extremities.

To avoid these complications, you should start treatment as soon as possible.

Prevention

To avoid lumbar osteochondrosis, follow these rules:

• Lead a moderately active lifestyle (walk more often, exercise regularly, join a pool).
• For sedentary jobs, warm up every 1. 5 hours.
• Sleep on an orthopedic mattress.
• Avoid excessive physical exertion, lift weights only from a half squat position, before that, put on a special belt in the lower back.
• Buy orthopedic shoes.
• Eat right, take vitamin-mineral complexes as prescribed by your doctor.
• Learn to relax.
• Try not to be 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.

The most important thing

If you notice symptoms of lumbar osteochondrosis, see your doctor immediately. Self-treatment can make your condition worse and cause complications. Lumbar chondrosis (stage 1) is treated with exercise therapy, physical therapy, and chondroprotectors. In later stages, medications, massages, 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 an operation. The patient must strictly follow the doctor's recommendations to speed up recovery.