Elderly people, professional athletes, as well as those whose work includes long sitting or standing, are often exposed to various diseases of the musculoskeletal system. Irrational daily menu, physical inactivity lead to wear and tear, destruction of bones and cartilage. As a result, osteochondrosis of the lumbar spine occurs, whose symptoms and treatment depend on the personal characteristics of the organism, as well as the severity of the lesion.
According to the international classification of diseases from the 10th revision, this disease was assigned to M42. Sometimes patients are given cumbersome diagnoses, and coding simplifies the work of doctors. This short alphanumeric designation can be recorded in the medical history, ambulatory card. So what is lumbar spine osteochondrosis? What are the reasons for its appearance? What are the manifestations of the disease? This publication talks about everything.
Causes of lumbar osteochondrosis
Osteochondrosis of the lumbar spine often causes trauma and a light lifestyle. Among other things, one of the main roles is played by burdened heredity, just like the hormonal, chemical, psychogenic background of the body.
If parents have suffered from lumbar osteochondrosis, symptoms and treatment are likely to manifest and pass on to their children. By inheriting predisposing factors, offspring also risk coping with this disease.
Provocative factors include the following reasons for occurrence:
- Other diseases, such as digestive tract, liver, pelvis, nervous system;
- Jump towards slowing down metabolism;
- Shift of acid-base balance towards oxidation (acidosis);
- Reduced motor energy;
- Stress, nervous situations;
- Long awkward postures, incorrect postures.
Sacral osteochondrosis often occurs as a result of hypothermia, hormonal disorders or as a result of pathological congenital damage to the spine.
Symptoms of lumbar osteochondrosis
Signs of lumbar osteochondrosis are related to the fact that the spinal nerve fibers pass in the back inside the spinal canal. Depending on the localization, the severity of the defeat of some roots, the manifestations of the disease vary.
In osteochondrosis of the lumbar spine, the symptoms are as follows:
- Pain Syndrome- Most patients complain of lower back pain in osteochondrosis. The pain is local directly in the area of the fracture or radiates to the gluteal region, the sacrum of the leg on the side of the lesion;
- A sign of tension- the pain increases with a certain position, but when the position of the body changes, the pain abruptly disappears. The most commonly used test is named after the inventor - Lasegue's syndrome - the pain intensifies when the straight limb is raised and disappears when the leg is bent at the knee;
- Decreased or increased sensitivity- this symptom is directly related to damage to the radicular nerves, sensitivity is disturbed not at the site of pathology, but at a certain distance. The patient has hypoesthesia, hyperesthesia, or paresthesia, which is characterized by unusual projection sensations, such as goose bumps, tingling, and so on.
Often with lumbar osteochondrosis, motor activity decreases, which is associated with muscle atrophy of varying degrees. Under some circumstances there is a limitation of function, in other situations paralysis and paresis occur.
Also, lumbar chondrosis is associated with damage to the spinal vessels, with their irritation and spasm, vegetative changes appear. Blood circulation in the legs slows down, the lower extremities are constantly frozen, the skin is pale. Other organs in the lumbar region are often affected. Thus, bladder damage develops urinary incontinence or, conversely, delay.
Stages of the disease
- Lumbar osteochondrosis of the 1st degree is the initial type of pathology. It is characterized by a low density of intervertebral discs. The pain syndrome appears with a sharp turning of the body, after physical exertion or prolonged sitting.
This type of disease is common among drivers, office workers, athletes and people working in harsh climates. The pain is not characterized by acute attacks, but develops as an exhausting dull or painful.
At this stage, people are in no hurry to go to doctors, but use traditional methods of treatment, such as ointments, compresses. The situation leads to the fact that osteochondrosis of the lumbar or sacral spine passes into the second phase;
- Lumbar osteochondrosis of the 2nd degree - degenerative and dystrophic disorders of the spinal joints occur. The fibrous annular ring is compressed, as the nucleus of the pulposus grows and a protrusion (bulge) of the intervertebral disc occurs.
Neuropathologists define the second stage of osteochondrosis as lumbago. In other words, lumbago occurs in the lower back when a heavy object is suddenly lifted or with other loads. This period lasts for many years, the phases of remission alternating with acute attacks of deterioration;
- Lumbar osteochondrosis of the 3rd degree - the bulge of the pulp gradually increases, an intervertebral hernia is formed. The patient develops a whole range of neurological status: constant pain, radiation to the buttocks, abdomen, tailbone, legs, urethra, limited mobility.
The legend is used to locate the hernia. The diagnosis of osteochondrosis L5 S1 means that the bulge of the nucleus pulposus occurred between the 5th lumbar and 1st sacral vertebrae;
- When therapeutic measures are not taken in time, all stages of development smoothly move on to the next stage. Stage 4 lumbar osteochondrosis is characterized by the development of complications.
As a rule, the treatment of seriously developed pathology is not very effective. The neuropathologist is obliged to offer a radical way of action, ie hernia surgery.
Methods for diagnosing osteochondrosis
In order to identify EPP osteochondrosis, the neuropathologist first takes a medical history, because the patient's complaints are one of the crucial values for an accurate diagnosis. During the conversation, the patient is asked questions about his health and condition - what and where it hurts, what is the duration of the pain, what intensifies the feeling when the stiffness appeared, whether the treatment was carried out, what it is like and the like.
Instrumental diagnostic methods must be used:
- General Rg-graphic image of the lumbar spine- the spine is photographed as a whole or its individual segments are photographed. More often than others, the target Rg-gram is made on the basis of complaints, in which the doctor notices disc atrophy, reduction of the intervertebral space, the appearance of osteophytes, smoothing of the lumbar flexion;
- Myelography- Contrast fluid is injected into the canal where the spinal cord passes through the spinal cord. The technique is used to determine the internal structure of the channel. Ordinary people consider the procedure difficult and dangerous to diagnose, but apart from the allergy to contrast, the puncture of the spinal canal practically does not threaten the patient. The puncture is made in a place where there is no spinal cord;
- Computed tomography- compression of nerve roots, pulp protrusions is determined, it is easy to see vertebral bodies, ligaments, vessels, soft tissues on the monitor;
Most accurately, sacral osteochondrosis is determined by electromagnetic waves, which is why the patient is given an examination on a magnetic resonance scanner.
Each tissue has its own incoming signal, the computer processes the data and displays the image on the screen. The doctor examines blood vessels, discs, bone processes, nerve fibers on a 1 mm incision. In this case, the patient has no harmful ionizing effects.
Treatment of lumbar osteochondrosis
Many patients are interested in the question: what to do with osteochondrosis of the lumbar region? Osteochondrosis of the lumbar spine is not always an indication for surgery. The main thing is that after a thorough examination of the patient, the usual therapeutic measures are sufficient.
Conservative therapy is reduced:
- On treatment;
- Physiotherapy procedures;
- Gymnastic exercises from exercise therapy.
Also for the treatment of osteochondrosis of the lumbar spine, manual therapy methods and methods from traditional medicine are used.
For the treatment regimen for osteochondrosis of the lumbar spine, the surgical method is offered to patients only in extremely severe cases, if conservative methods have not given the desired results.
Medications
Treatment of osteochondrosis of the lumbar spine is performed by a neuropathologist or a specialist vertebrologist. Before treating lumbar chondrosis of spinous processes, the doctor determines the stage and severity of pathological disorders.
Muscle relaxants are used to relieve pain, reduce cramps and inflammation. These drugs quickly restore the patient's mobility, relieve cramps, so that the pain passes.
In addition to a group of muscle relaxants, steroid hormones are sometimes used to eliminate swelling and inflammation.
Rehabilitation gymnastics
Treatment of lumbar osteochondrosis should be carried out in conjunction with exercise therapy methods. Exercise and gymnastics should be given the same attention as the use of medication.
The therapeutic effect of osteochondrosis are those exercises that relieve pain, strengthen the muscular framework, reduce compression between the discs - this slows down the further progression of the disease.
Physiotherapy
In lumbosacral osteochondrosis, treatment involves the use of the following procedures:
- Drug electrophoresis;
- Laser and magnetic therapy;
- Magnetic current therapy;
- Darsonval;
- UV radiation;
- Diadine treatment;
- Shock wave method.
Manipulations include the use of means that use natural physical force: currents, light radiation, vibrations and so on. The treatment regimen, the duration of the physiotherapy course is determined by the attending physician.
Manual therapy
When a sick person asks a neurologist how to cure osteochondrosis of the lumbar spine with a manual technique, he is usually advised by a qualified specialist who not only affects the muscle tissue with his hands, but also puts the vertebrae in place.
In the case of lumbar chondrosis, this method normalizes blood and lymph circulation, removes muscle tone and deformation, and restores motor function. Chiropractors' hands reduce the purity of cramps, reduce back pain.
How is osteochondrosis of the lumbar region treated with manual techniques and is it possible to fully recover in this way? Manual therapy is prescribed only when degenerative processes have not disturbed the spinal tissues, ie no growths are formed on the bones. The need for procedures is determined by the doctor after Rg-diagnosis, CT or MRI.
Surgery
Treatment of lumbar chondrosis with surgery is performed according to certain indications, when the pathology is characterized by the following changes in the spine:
- The spinal canal narrows, the intervertebral discs constrict and destroy;
- Cauda equina syndrome develops - a massive bundle of nerves of the spinal cone innervating the pelvic region, the legs, is damaged;
- Loss of sensitivity progresses, there is a violation of the working capacity of internal organs;
- There is a risk of foot paralysis.
The operation is performed according to urgent or planned indications. The goal of surgical treatment is to relieve pressure and improve the condition of the spine.
Traditional medicine
Treatment of osteochondrosis of the lumbar spine by folk methods is best done in consultation with your doctor.
The National Pharmacy offers many medicines to treat the disease:
- Medicinal herbs, essential oils, flower extracts, plant roots;
- Animal products, such as snake or bee venom, badger, dog, sheep fat, boiled eggs and more;
- Iodine, turpentine and alcohol are used for warming, irritating effects.
Similar to drugs, chondrosis of the lower back is treated by folk methods only in the initial stage of the disease, while the symptoms are only removed, but the pathological changes do not disappear. Among other things, such treatment often has side effects, which is why a specialist consultation is required before using any prescription from traditional medicine.
The dosage of any folk remedy or medicine should be determined by a doctor.
Complications
Late stage lumbar chondrosis can lead to unpleasant consequences, including disability. In the background of dystrophy and degenerative disorders, narrowing of the spinal canal, stenosis develops. As a result of such changes, a chronic type of compression develops that interferes with normal blood flow, and root ischemia or cauda equina syndrome develops.In addition, diseases such as spondylosis and spondyloarthritis sometimes develop - the intervertebral discs age, lose their strength and cause withdrawal pain due to the disturbed structure of the spinal joints. Complications most often refer to the ridge of the lower part of the spine, where bone growths like the spine are formed.
In the third phase, as a complication of osteochondrosis, intervertebral hernias develop, diseases of the genitourinary system and other internal organs appear.
Preventive measures
Prevention of osteochondrosis of the lumbosacral spine is not of small importance. The lower back has the greatest load, so you need to be especially careful with your back. It is worth remembering that regular gymnastic exercises are the key to a healthy spine.
Weights should be lifted very carefully, avoiding sudden jerks. Men and women can carry burdens that are reasonable.
Sitting in the office, you need to monitor your posture, take a proper posture and sit on a chair with your back straight. It is good to get up every hour and walk around the room, do squats, turn the torso: this relieves the tension of the entire musculoskeletal system.
The trigger point massage is great. They are active or in latent form. Tripping points appear as a result of overexertion, strong stretching, repeated work, bending, hypothermia and other factors.
Knowing the reasons for the development of spasmodic areas, it is necessary to take measures to exclude their creation. Recently, the trigger point massager has gained popularity, it is better to prevent the appearance of painful lesions with a special device than to treat them long and expensive.