Lumbar osteochondrosis

Osteochondrosis of the lumbar spine

According to medical statistics, lumbar 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 manifests itself in a variety of symptoms: pain of a different nature, restriction of mobility, tenderness of the lower body, and so on. Sh. In the absence of long-term treatment, degenerative processes spread to the spine, reducing the ability to work, then the patient may become disabled.

To prevent dangerous complications of lumbar osteochondrosis (LP) it is necessary to start complex treatment at stages 1-2 of the pathology. In advanced cases, when there are already irreversible changes in the disc or spine, surgery is performed. To prevent osteochondrosis of the lumbar spine and related complications it is necessary to conduct its prevention.

Development of lumbar osteochondrosis

To understand what LBP (lumbar spine) osteochondrosis is, you need to study the structure of the spinal column. It consists of the spine, between which are placed cartilaginous pads (intervertebral disc). The disc is covered with a solid fibrous membrane (annulus fibrosus) inside which is the nucleus. This structure has a cushioning function and makes the spine more flexible.

Help. The lumbar segment of the spine experiences tremendous stress every day as it can withstand the upper body. Therefore, osteochondrosis of the lower spine is diagnosed more often than cervical, thoracic.

During regular stress on the spine, the discs contract, lose a lot of fluid, decrease in height, and the distance between the vertebrae decreases. The cartilage membrane becomes fragile, microcracks appear on its surface, during which the bulb nucleus emerges. With further compression of the intervertebral discs, the outer membrane explodes and the body of the gelatin falls off, resulting in a hernia. Then there is abnormal mobility of the spine, the load on the adjacent segments of the spine increases.

A little later, bone formation (osteophytes) begins to form on the edges of the vertebral bodies. Thus, the body tries to stabilize the spine.

Doctors distinguish 4 stages of lumbar spine osteochondrosis:

  • 1 degree - disc problems begin, dehydration of the central part occurs, it flattens, cracks appear on the membrane. Has deleted the stream.
  • Grade 2 - Cartilage pressure, vertebrae approach each other, become more mobile, muscles and vertebral areas collapse. The pain arises.
  • 3 degrees - spine rash, hernias and subluxations occur. The pain increases, mobility is limited, lower body sensitivity is impaired.
  • Grade 4 osteochondrosis is characterized by the appearance of osteophytes, which can damage the spinal nerves and the surrounding spine. There is constant pain, acute neurological disorders and other complications, increasing the risk of disability.

The easiest way to cure lower back chondrosis (stage 1), but diagnosing the disease at this stage is very difficult. Grade 2 intervertebral osteochondrosis is treated using conservative techniques. Surgical intervention may be required in stages 3-4.

Help. According to statistics, OBO is more common in patients after 30 years. There are frequent cases of pathology development in people after 20 years. About 80% of 60-year-old patients experience the manifestations of this disease.

Reasons

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

  • Regular static or dynamic load on the lumbar segment. The risk group for developing osteochondrosis includes office workers, professional athletes (weightlifting), transfers, builders, etc. Sh.
  • Poor posture, prolonged inappropriate posture.
  • Genetic predisposition, anomalies in the formation of vertebral bodies. This category includes the youth program - spinal curvature caused by pathologies of the vertebral bodies.
  • Spinal cord injuries.
  • Hormonal imbalance, metabolic disorders, diseases of the endocrine glands that disrupt the metabolism of the lumbar segment.
  • Age-related changes in the body cause disc wear.
  • Bone tuberculosis, osteomyelitis (purulent inflammation of bone tissue), ankylosing spondylitis (inflammation of the spine and joints), rheumatoid arthritis, etc. Sh.

The disease is often caused by several reasons.

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

  • Excess weight.
  • Passive lifestyle, long sitting.
  • Regular consumption of unhealthy foods (fatty, fried foods, confectionery, semi-finished products, etc. ).
  • Lack of fluid, dehydration.
  • Congenital abnormalities in the structure of the spine, such as the extra spine.
  • Wear uncomfortable heels regularly.
  • Gestation period, then the load on the spinal column increases.
  • Training professional athletes or refraining from excessive sports in people who used to lead a passive lifestyle.
  • Smoking, frequent and excessive drinking.

There are many other factors that can lead to degenerative-dystrophic processes in the lumbar spine. For example, flat feet, frequent hypothermia of the spine, frequent stress, sleep disorders, etc. Sh.

Back pain shooting

Symptoms

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

Doctors distinguish reflex and compression syndromes (symptom complex) in OBOR. The first occurs when the outer membrane receptors of the discs, ligaments, and joint capsules are irritated, and the second is caused by compression of the nerve, blood vessels, and spinal cord.

There are reflex syndromes of lumbar osteochondrosis:

  • Lumbago. Shooting pain in the lumbar region with sudden movement or load. With the slightest attempt to move, the pain syndrome intensifies, so the patient freezes in one position. The muscles of the injured area are very tense, on palpation, the painful sensations are more sharp. These manifestations are related to the movement of the nucleus pulse inside the outer membrane.
  • lumbodinia. The excruciating pain develops over hours or days. Discomfort increases with movement, changing body position. It weakens when a person assumes a horizontal posture with a roller under the lower back. In this condition, the pain intensifies when lifting the right leg (Lasseg symptom). The degree of muscle tension is less than with lumbago. Lower spinal mobility is limited.
  • Lumbosialgia. Painful sensations (sharp or painful) extend from the lower back to the lower body. This sign increases during movement. The pain is relieved by resting on the back. The muscles in the affected area are tense, the pain syndrome is expressed by palpation.

Symptoms of compression syndromes depend on which part of the lumbar segment is damaged. Characteristic signs are associated with spinal nerve compression with hernias, osteophytes, displaced vertebrae. This condition is called radiculopathy, in which the pain increases with slight movement, the lower spinal muscles tense, and movement is restricted.

Clinical manifestations of

compression syndromes according to the damaged spine of the lumbar segment:

  • L1 - L3 - Pain and numbness in the lumbar region, front and inner thigh, the patient has difficulty bending / spreading the leg.
  • L4 - pain syndrome extends to the front of the thigh, running down to the knee (back). Sensitivity is violated in the same area.
  • L5 - Painful sensations radiate to the buttocks, the outside of the thigh, descending along the front of the lower leg to the inside of the foot and the big toe. Numbness is felt in the same area, making it difficult for the patient to bend the big toe.
  • S1 - The pain extends from the lower back to the buttocks, from the outside and back of the thigh, runs to the lower leg, to the outside of the leg. Numbness is felt in the same areas, the muscles of the lower leg are weakened, so it is difficult for the patient to stand on tiptoe.

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

Compression of the lower back blood vessels increases the likelihood of weakening of the leg muscles, numbness of the lower extremities, and decreased control of urination and defecation. Erectile dysfunction in men is impaired, while in women the main symptoms may be inflammation of the ovaries or uterus.

Diagnostic measures

To diagnose OBO, the doctor examines the patient, palpates the patient to determine muscle condition, and to determine the curvature of the spine. It is important to tell your specialist in detail about your symptoms to make it easier for him to diagnose.

Instrumental examinations to help detect interstitial osteochondrosis:

  • Lower spinal x-ray (forehead and lateral projection).
  • Computed tomography and magnetic resonance imaging.

X-ray allows you to evaluate the structure of the EPP. To detect abnormal mobility of the spine, X-rays are taken in positions of flexibility and extension. This study allows us to notice that the intervertebral disc is narrowed, the vertebral bodies are displaced, and osteophytes have appeared on their edges. However, this diagnostic method is considered obsolete.

Today, CT and MRI are increasingly used to diagnose degenerative-dystrophic changes in the spine. These highly informative examinations make it possible to assess the condition of the spine, discs, intervertebral discs, and spinal cord. With their help, the rash, the direction of the hernia, the degree of compression of the nerve bundles, spinal cord and blood vessels are revealed.

Treatment

Remedies for lumbar osteochondrosis

Medications for lumbar osteochondrosis

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

Treatment Objectives:

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

Complex therapy is recommended to achieve such goals. It usually starts with taking medication:

  • Muscle relaxants. They relax muscles, relieve pain and inflammation.
  • Nonsteroidal anti-inflammatory drugs. They have anti-inflammatory, analgesic, antipyretic action.
  • Antispasmodics. They help to stop smooth muscle spasm, pain.
  • Anesthetics. They are used as a therapeutic blockade in acute pain syndrome.
  • Glucocorticosteroids. They also help in overcoming pain. However, these drugs can destroy bones, so they are taken for a short time and only after a doctor's approval.
  • Soothing. They relieve neuromuscular tension, improve sleep.
  • Vitamins (group B, E, C, A). Restores the condition of the affected nerves, relieves pain.

Be careful. Nonsteroidal anti-inflammatory drugs are contraindicated in gastritis or gastric ulcer, as they further damage the mucous membranes of the gastrointestinal tract.

In case of exacerbation, the patient is given injections and after alleviating the main symptoms he / she takes oral medication.

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

The question of what to do in chronic lumbar osteochondrosis is quite relevant. If OBOP becomes chronic, the patient is prescribed chondroprotectors, drugs that restore blood circulation, and vitamin-based medications after the main symptoms have subsided. They help to restore innervation, normalize the blood supply to the affected area and prevent further development of pathology.

Treatment of lumbar spine chondrosis (stage 1) is carried out using chondroprotectors, which slow down the development of degenerative processes, accelerate cartilage regeneration. In addition, the patient is prescribed vitamin and mineral complexes. This form of osteochondrosis is the easiest to cure.

Other conservative techniques

In case of acute chronic disease (osteochondrosis) 1 - 2 degrees, the following treatment processes will help you to stop the following treatment:

  • Ultrasound therapy relieves pain and inflammation and normalizes blood circulation to the affected area.
  • Detensor therapy is a safe traction of the spine due to the weight of your own body, after which the muscle tone is normalized and mobility is improved.
  • Magnetotherapy reduces pain and inflammation in the muscles of the spine.
  • Reflexology (inserting needles into bioactive points on the body) speeds up blood circulation, relieves inflammation and swelling.
  • Manual therapy (impact on the doctor's affected area) and massage to normalize muscle tone, reduce compression of nerve sutures, improve nutrition of the intervertebral discs, and restore spinal structure.
  • Electrophoresis allows the solution to be delivered through the skin to the bones and cartilage tissues.
  • Drasonvalization improves blood circulation, metabolic processes, reduces pain, restores skin sensitivity.

There are many more effective procedures that can help improve a patient's condition in 5-15 sessions. The main thing is to get the doctor's consent before performing them.

Software treatment at home

If you are wondering if OBO can be treated at home, talk to your doctor. If allowed by a specialist, then start therapy, which usually consists of the following:

  • Diet. If lumbar osteochondrosis is caused by impaired blood flow or metabolism, exclude fatty, fried, spicy foods, eggs, etc. Sh. . Fill the menu with fresh vegetables, fruits, lean meats, fish, dairy products. Avoid alcohol, tonics (tea, coffee). Drink filtered water, compotes, herbal teas.
  • Applicator for the treatment of osteochondrosis
  • To restore blood circulation, exercise or apply cleansers and compresses.
  • Sleep on an orthopedic mattress on a low pillow. If you have a sedentary job, buy a chair with a backrest that will support your spine. From time to time wear special corsets or belts.
  • Exercise therapy can help you strengthen your muscular corset from a loaded spine. The complex for each patient is determined individually by a doctor or instructor.
  • Self massage in the lumbar region. However, ask a professional how to do it right.
  • Use folk remedies for washing, compresses, baths, etc. Sh. In the form of
  • Needle applicator is a plastic plate that has many tips, improves blood circulation, metabolic processes in the injured area, reduces muscle pain and relaxes.

and also at home you can use lotions with plant decorations, plaster.

Help. A novelty in the treatment of osteochondrosis is the massage bed, which is suitable for even the most disorganized patients.

However, keep in mind that you can only treat at home with your doctor's permission.

Surgical treatment

Lumbar osteochondrosis surgery is prescribed if conservative technique has been ineffective for a long time. Surgical intervention has also been shown in cases of involuntary urination, defecation, and cauda equina syndrome (lower spinal nerve entrapment).

The following surgical methods are used to treat OBO:

  • Spondylosis - fusion of the surrounding spine.
  • Facetextomy - removal of the intervertebral joints that bite the spinal nerve.
  • A laminectomy is the removal of a laminate that covers the spinal canal, which compresses the spinal cord.
  • A discectomy is the complete or partial removal of the intervertebral disc that causes the nerve root or spinal cord to contract.
  • Correctomy - removal of the body of the spine and surrounding cartilage pads. The empty space is then filled with a bone graft and the 3 vertebral segments are combined.

Help. After surgery, there is a risk of complications: spinal cord injuries, nerve bundles, broken grafts, infections, and so on. Sh.

After treatment you will need to undergo rehabilitation to speed up your recovery.

Complications

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

  • Herniated disc, stretched nerve root or spinal cord.
  • Prolonged inflammation increases the likelihood of sciatica (inflammation of the nerve roots).
  • sciatica (inflammation of the sciatic nerve) in which there is severe pain and numbness in the lower extremity.
  • In case of circulatory disorders in the spinal cord, the probability of compressive myelopathy 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 functioning of the intestines, pelvic organs and lower extremities.

To prevent such complications you need to start treatment as early as possible.

Prevention

Follow these rules to prevent lumbar osteochondrosis:

  • Live a moderately active lifestyle (walk more often, exercise regularly, sign up for the pool).
  • For sedentary work, warm up every 1. 5 hours.
  • Sleep on an orthopedic mattress.
  • Avoid excessive physical activity, lift weights only from a half-crushed position, and before that put on a special belt on your back.
  • Buy orthopedic shoes.
  • Eat right, take vitamin and mineral complexes as prescribed by your doctor.
  • Learn to relax.
  • Try not to get hypothermia.
  • Treat diseases that can cause OBO in a timely manner.
  • Give up bad habits.

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

Most important

If you notice symptoms of lumbar osteochondrosis, then contact your doctor immediately. Self-medication can make your condition worse and cause complications. Treatment of lumbar chondrosis (stage 1) is treated with exercise therapy, physiotherapy and chondroprotectors. In the later stages, medicines, massage, manual therapy, etc. are used. Sh. In the absence of positive dynamics for a long time or the appearance of neurological symptoms, the doctor may prescribe surgery. The patient should strictly follow the doctor's recommendations in order to accelerate recovery.

13.09.2020