Lumbar osteochondrosis

According to medical statistics, back pain is caused by lumbar osteochondrosis in 80% of cases. This is due to degenerative-dystrophic changes in this segment, when the intervertebral discs and adjacent vertebrae are affected. Lumbar spine osteochondrosis (OBOP) is manifested in a wide variety of symptoms: pain of various types, impaired mobility, impaired sensitivity of the lower body, etc. With prolonged absence of treatment, degenerative processes spread to the vertebrae and reduce the ability to work. Then the patient can be handicapped.

To avoid dangerous complications of lumbar osteochondrosis (LP), you need to begin complex treatment in 1-2 stages of pathology. In advanced cases in which irreversible changes to the intervertebral disc or vertebra are already present, an operation is performed. Prevention is needed to avoid lower back osteochondrosis and its associated complications.

Development of lumbar osteochondrosis

To understand what is osteochondrosis in the lumbar spine, you need to study the structure of the spine. It consists of vertebrae between which cartilage pads (intervertebral discs) are placed. The disc is covered with a hard fibrous membrane (annulus fibrosus) in which the nucleus pulposus is located. This structure has a shock-absorbing function and makes the spine more flexible.

Help. The lumbar spine segment is exposed to enormous loads every day because it can bear 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 intervertebral discs contract, lose a lot of fluid, their height decreases and the distance between the vertebrae decreases. The cartilaginous lining becomes fragile, microcracks appear on its surface, through which the nucleus pulposus protrudes over time. If the intervertebral discs are compressed further, the outer shell tears and the gelatin body falls out, causing an inguinal hernia. Then there is a pathological mobility of the vertebrae, the load on the adjacent segments of the spine increases.

A little later, bone growth (osteophytes) begin to form on the edges of the vertebral bodies. This is how the body tries to stabilize the spine.

Doctors differentiate between 4 stages of osteochondrosis of the lumbar spine:

• 1 degree - problems start with discs, the middle part dehydrates, it flattens out, cracks appear on the outer shell. Has a cleared stream.
• Grade 2 - the cartilaginous lining sags, the vertebrae move closer together, become more flexible, the muscles and ligaments around the spine sag. Pain appears.
• 3 degrees - protrusions, hernias and subluxations of the vertebrae are formed. The pain increases, mobility is restricted, the sensitivity of the lower body is impaired.
• Grade 4 osteochondrosis is characterized by the appearance of osteophytes, which can damage the spinal nerves and adjacent vertebrae. There is constant pain, severe neurological disorders, and other complications, and the risk of disability increases.

The easiest way to cure lower back chondrosis (stage 1), however, it is very difficult to identify the disease at this stage. Grade 2 intervertebral osteochondrosis is treated with conservative techniques. Surgery may be required in stages 3-4.

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

reasons

To understand how to deal with PKOP (lumbosacral spine) osteochondrosis, you need to know the causes:

• Regular static or dynamic loading of the lumbar vertebral segment. The risk group for developing osteochondrosis includes office workers, professional athletes (weightlifting), movers, builders, etc.
• Bad posture, prolonged inappropriate posture.
• Genetic predisposition, abnormalities in the formation of the vertebral bodies. This category includes adolescent software - spine curvature caused by vertebral body pathologies.
• Injuries to the spine.
• Hormonal imbalance, metabolic disorders, diseases of the endocrine glands that disrupt the metabolism in the lumbar segment.
• Age-related changes in the body lead to intervertebral disc wear.
• Bone tuberculosis, osteomyelitis (purulent inflammation of the bone tissue), ankylosing spondylitis (inflammation of the vertebrae and joints), rheumatoid arthritis, etc.

A disease is often caused by various causes.

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

• Overweight.
• Passive lifestyle, prolonged sitting.
• Regular consumption of unhealthy foods (fatty, fried foods, confectionery, semi-finished products, etc. ).
• Lack of fluids, dehydration.
• Congenital disorders of the structure of the spine, for example an additional vertebra.
• Regularly wears uncomfortable heels.
• The pregnancy period, then the load on the spine increases.
• Abrupt refusal to exercise professional athletes or excessive sports in people who have previously led a passive lifestyle.
• Smoking, frequent and excessive drinking.

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

Symptoms

Symptoms of osteochondrosis of the lumbar spine are diverse and depend on the stage of the pathology and the location of the affected area.

Doctors differentiate between reflex and compression syndromes (symptom complex) in OBOR. The former occurs when the receptors on the outer membrane of the intervertebral discs, ligaments and joint capsules are stimulated, and the latter when the nerve bundles, blood vessels and the spinal cord are compressed.

There are such reflex syndromes in lumbar osteochondrosis:

• Lumbago. Sharp lower back pain with sudden movement or exertion. At the slightest attempt to move, the pain syndrome intensifies, so that the patient freezes in one position. The muscles in the damaged area are very tense, with palpation the painful sensations become stronger. These manifestations are associated with the movement of the nucleus pulposus within the outer shell.
• Lumbodynia. The aching pain develops over several hours or days. The discomfort increases with movement and changes in posture. It is weakened when a person adopts a horizontal posture with a roller under the lower back. If you lift a straight leg in this position, the pain will increase (Lassegh's symptom). The degree of muscle tension is lower than with lumbago. The mobility of the lower back is limited.
• Lumbo sciatica. Painful sensations (sharp or painful) spread from the lower back to the lower body. This mark increases during the movements. The pain is relieved by lying on your back. The muscles in the affected area are tense, the pain syndrome is pronounced when palpating.

The symptoms of compression syndromes depend on which parts of the lumbar segment are damaged. The characteristic signs are associated with compression of the spinal nerves by hernias, osteophytes and dislocated vertebrae. This condition is known as radiculopathy, where pain increases with the slightest movement, muscles of the lower back are tense, and range of motion is limited.

Clinical manifestations of compression syndromes depending on 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 and descends to the knee (back). The sensitivity is disturbed in the same area.
• L5 - Painful sensations radiate to the buttocks, outer thigh, along the front of the lower leg to the inner part of the foot and to the big toe. Numbness is felt in the same area, it is difficult for the patient to bend the big toe.
• S1 - The pain spreads from the lower back to the buttocks, the outside and the back of the thigh and goes back to the outer part of the lower leg, the foot. In the same areas, numbness is felt, the muscles of the lower leg are weakened, making it difficult for the patient to stand on their toes.

There is a risk of several nerve bundles being damaged at the same time, e. g. B. L5, S1. As the hernia moves back, it can compress the spinal cord.

The compression of the blood vessels in the lower back increases the likelihood of weakening leg muscles, numbness of the lower extremities, and impaired control over urination and bowel movements. In men with OBO, erection is impaired, and in women, the main symptoms may be supplemented by inflammation of the ovaries or uterus.

Diagnostic measures

To diagnose OBO, the doctor examines the patient, scans the patient to determine the condition of the muscles and identify the curvature of the spine. It is important to give the specialist full information about your symptoms to help them diagnose.

Instrumental examinations help to identify osteochondrosis between the vertebrae:

• X-ray of the lower back (frontal and lateral projection).
• Computed and magnetic resonance imaging.

With

X-ray you can assess the structure of the EPP. To determine abnormal mobility of the vertebrae, X-rays are taken in flexion and extension positions. This study tells us that the intervertebral fissure has narrowed, the vertebral bodies have shifted, and osteophytes have appeared on their edges. However, this diagnostic method is considered out of date.

Nowadays, CT and MRI are increasingly used to detect degenerative-dystrophic changes in the spine. These extremely informative studies make it possible to assess the condition of the vertebrae, intervertebral discs, the intervertebral foramen and the spinal cord. With their help, protrusions, the direction of the hernia, the degree of compression of the nerve bundles, spinal cord and blood vessels are detected.

Treatment

MEDICINE FOR LUMBAR OSTEOCHONDROSIS

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

Treatment goals:

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

To achieve these goals, it is recommended to conduct complex therapy. It usually starts with taking medication:

• muscle relaxants. They relax the muscles and relieve pain and inflammation.
• NSAIDs. They have anti-inflammatory, analgesic and antipyretic effects.
• antispasmodic. They help stop smooth muscle spasms and relieve pain.
• anesthetics. They are used in the form of a therapeutic blockade for severe pain syndrome.
• glucocorticosteroids. They also help manage pain. However, these drugs can destroy bones, so they are only used for a short time and only with medical approval.
• sedative. They release neuromuscular tension and improve sleep.
• vitamins (group B, E, C, A). Restores the condition of the affected nerves, relieves pain.

Caution. NSAIDs should not be taken with gastritis or peptic ulcer, as they further damage the lining of the gastrointestinal tract.

In the event of an exacerbation, the patient is given injections and, after relieving the main symptoms, takes oral drugs.

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

The question of what to do with chronic osteochondrosis of the lower back is very relevant. If OBOP has become chronic, after alleviating the main symptoms, the patient is prescribed chondroprotectors, drugs that restore blood circulation, drugs based on vitamin B. They help restore innervation, normalize blood supply in the affected area and prevent the further development of the pathology.

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

OTHER CONSERVATIVE TECHNIQUES

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

• Ultrasound therapy relieves pain and inflammation and normalizes blood flow in the damaged area.
• Detensor therapy is a safe traction of the spine based on the weight of your own body, after which the muscle tone normalizes and mobility improves.
• Magnetotherapy reduces pain and inflammation in the muscles around the spine.
• Reflexology (inserting needles into bioactive points on 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 the compression of nerve bundles, improve the nutrition of the intervertebral discs and restore the structure of the spine.
• Electrophoresis enables medical solutions to be delivered through the skin to the bone and cartilage tissue.
• Drasonvalization improves blood circulation, metabolic processes, relieves 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 medical approval before performing.

TREATMENT WITH SOFTWARE AT HOME

If you are wondering whether it is possible to treat OBO at home, contact your doctor. When the specialist has given permission, begin therapy, which usually consists of the following:

• diet. If lumbar osteochondrosis is caused by impaired blood circulation or metabolism, 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, tonics (tea, coffee). Drink filtered water, compotes, herbal teas.

• To restore blood circulation, exercise or use 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 strengthens the muscle corset and relieves the diseased spine. The complex for each patient is put together individually by a doctor or instructor.
• Self-massage of the lumbar spine. However, ask a professional how to do it correctly.
• Use folk remedies in the form of rubs, compresses, baths, etc.
• The needle applicator is a plastic plate with many thorns that improves blood circulation, metabolic processes in the damaged area, muscle pain and relaxation.

And at home, too, you can use lotions with herbal cookings and plasters.

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

Remember, however, that home treatment can only be done with the approval of your doctor.

SURGICAL TREATMENT

Surgery for lumbar osteochondrosis is prescribed when conservative techniques have long proven ineffective. Surgical intervention is also indicated for involuntary urination, bowel movements, 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 neighboring vertebrae.
• Facetextomy - removal of intervertebral joints that pinch the spinal nerve.
• Laminectomy is the removal of the lamina that covers the spinal canal that compresses the spinal cord.
• Discectomy is the total or partial removal of a 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. There is a risk of complications after the operation: spinal cord injuries, nerve bundles, broken grafts, infections, etc.

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

complications

Without suitable therapy, the risk of such complications of lumbar osteochondrosis increases:

• slipped disc, pinched nerve root or spinal cord.
• Persistent inflammation increases the likelihood of radiculitis (inflammation of the nerve roots).
• Sciatica (an inflammatory lesion of the sciatic nerve) that causes severe pain and numbness in the lower extremity.
• If the blood supply to the spinal cord is impaired, the likelihood of compression myelopathy increases (compression of the spinal cord through various formations: bone fragments, hernias, tumors, hematomas).
• Cauda Equina Syndrome - compression of the roots of the lower spinal cord, which leads to an impairment of the functionality of the intestines, pelvic organs and lower extremities.

To avoid such complications, you must start treatment as early as possible.

Prevention

To avoid lumbar osteochondrosis, follow these rules:

• Lead a moderately active lifestyle (walk more often, exercise regularly, sign up for a pool).
• If you are sitting down, warm up every 1, 5 hours.
• Sleep on an orthopedic mattress.
• Avoid excessive physical exertion, only lift weights from a semi-squat position, and put a special belt on your lower back beforehand.
• Buy orthopedic shoes.
• Eat properly, take vitamin and mineral complexes as prescribed by your doctor.
• Learn to relax.
• Try not to get hypothermic.
• Treat diseases that can cause OBO in good time.
• Give up bad habits.

If you follow these recommendations, you can avoid degenerative changes in the spine and improve your health.

Most important

If you experience symptoms of lumbar osteochondrosis, contact your doctor immediately. Self-treatment can make your condition worse and cause complications. Lumbar chondrosis (stage 1) is treated with exercise therapy, physiotherapy and chondroprotectors. In later stages, drugs, massages, manual therapies, etc. are used. If there is no positive dynamic for a long period of time or if neurological symptoms appear, the doctor may prescribe surgery. The patient must carefully follow the doctor's recommendations to speed recovery.