Older people, professional athletes, as well as those whose work involves long sitting still or standing, are often exposed to various diseases of the musculo-articular frame. Irrational daily menu, physical inactivity lead to wear, destruction of bones and cartilage material. As a result, osteochondrosis of the lumbar spine occurs, the symptoms and treatment of which depend on the personal characteristics of the organism, as well as the severity of the injury.
According to the International Classification of Diseases of the 10th Revision, this disorder was assigned the code M42. Sometimes patients are given complicated diagnoses, coding simplifies the work of doctors. This short alphanumeric designation can be recorded in the medical history, outpatient card. So what is osteochondrosis of the lumbar spine? What are the reasons for its occurrence? What are the manifestations of the disease? This publication tells it all.
Causes of lumbar osteochondrosis
Osteochondrosis of the lumbar spine often causes injuries and a sluggish 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 the parents have had lumbar osteochondrosis, symptoms and treatment are likely to arise and be passed on to their children. Having inherited the predisposing factors, the offspring also risk facing this disease.
The provoking factors also include the following reasons for the occurrence:
- Other diseases, such as the digestive tract, liver, pelvis, nervous system;
- Jumps towards slowing metabolism;
- Shift of the acid-base balance towards oxidation (acidosis);
- Decreased motor energy;
- Stress, nervous situations;
- Long and uncomfortable postures, bad posture.
Often, sacral osteochondrosis occurs as a result of hypothermia, hormonal disturbances, or as a result of pathological congenital defects of the spine.
Symptoms of lumbar osteochondrosis
Signs of lumbar osteochondrosis are associated with spinal nerve fibers passing posteriorly into the spinal canal. Depending on the localization, the severity of damage to some roots, the manifestations of the disease differ.
With 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 zone of infringement or radiates to the gluteal region, the sacrum of the leg from the side of the lesion;
- Tension sign- pain increases with a certain position, but when the body position changes, the pain suddenly disappears. The most commonly used test is named after the discoverer - Lasegue syndrome - the pain intensifies when the straight limb is raised and disappears when the leg is bent at the knee;
- Decrease or increase in sensitivity- this symptom is directly related to damage to the root nerves, sensitivity is disturbed not in the place of the localization of the pathology, but at a certain distance. The patient has hypesthesia, hyperesthesia, or paraesthesia, which is characterized by unusual projection sensations, such as goosebumps, tingling, and so on.
Often, with lumbar osteochondrosis, motor activity decreases, this is associated with muscle atrophy of various degrees. In some circumstances, there is a limitation of functions, in other situations, paralysis and paresis occur.
In addition, 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 limbs constantly freeze, there is a pallor of the skin. Other organs located in the lumbar region are often affected. So, with damage to the bladder, urinary incontinence or, conversely, retardation develops.
Stages of the disease
- 1st degree lumbar osteochondrosis is the initial type of pathology. It is characterized by a low density of intervertebral discs. Pain syndrome appears with a sharp rotation of the body, after physical exertion or prolonged sitting.
This type of disease is common among drivers, office workers, athletes and people who work in harsh climates. The pain is not characterized by sharp attacks but develops as a dull or aching debilitating one.
At this stage, people are not in a 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 to the second stage;
- 2nd degree lumbar osteochondrosis - degenerative and dystrophic disorders of the vertebral joints occur. The fibrous vertebral ring is compressed, while the nucleus pulposus grows and protrusion (protrusion) of the intervertebral disc occurs.
Neuropathologists define the second stage of osteochondrosis as low back pain. In other words, low back pain occurs in the lower back when a heavy object is lifted suddenly or with other loads. This period lasts for many years, the phases of remission alternate with acute attacks of exacerbations;
- 3rd degree lumbar osteochondrosis: the protrusion of the pulp gradually increases, an intervertebral hernia is formed. The patient develops the entire palette of neurological status: constant pain, irradiation to the buttocks, abdomen, coccyx, legs, urethra, limitation of mobility.
The legend is used to locate the hernia. The diagnosis of osteochondrosis L5 S1 means that the bulging of the nucleus pulposus occurred between the 5th lumbar vertebrae and the 1st cross vertebrae;
- When therapeutic measures are not taken in time, all stages of development flow smoothly into the next stage. Lumbar osteochondrosis of stage 4 is characterized by the development of complications.
As a rule, drug treatment for severely developed pathology is not very effective. The neuropathologist is obliged to offer a radical method of action, that is, hernia surgery.
Methods for the diagnosis of osteochondrosis
To identify PPE osteochondrosis, the neuropathologist first performs an anamnesis, because the patient's complaints are one of the decisive 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 increases the sensation when stiffness appeared, whether the treatment was carried out, what it was and the like.
Instrumental diagnostic methods are necessarily used:
- General Rg graphic image of the lumbar spine: the spine is taken as a whole or its individual segments are photographed. More often than others, a targeting Rg-gram is performed on the basis of complaints, in which the doctor notes disc atrophy, decreased intervertebral space, the appearance of osteophytes, distension of the lumbar curve;
- Myelography: Contrast fluid is injected into the canal where the spinal cord passes through a lumbar puncture. The technique is used to determine the internal structure of the canal. Ordinary people consider the procedure difficult and dangerous for diagnosis, but apart from the contrast allergy, the puncture of the spinal canal practically does not threaten the patient. The puncture is performed at the point where the spinal cord is absent;
- Computed tomography- nerve root compression, pulp protrusion is determined, it is easy to see vertebral bodies, ligaments, vessels, soft tissues at close range on the monitor;
More precisely, sacral osteochondrosis is determined using electromagnetic waves, for this the patient is assigned an examination on an MRI scanner.
Each fabric has its own input signal, the computer processes the data and displays the image on the screen. The doctor examines the vessels, discs, bone processes, nerve fibers with a cut of 1 mm. At the same time, the patient does not receive harmful ionizing effects.
Treatment of osteochondrosis of the lumbar spine
Many patients are interested in the question: what to do with osteochondrosis of the lumbar region? Osteochondrosis of the lumbar spine does not always have indications for surgery. The main thing is that after a thorough examination of the patient, the usual therapeutic measures are enough.
Conservative therapy is reduced:
- To medical treatment;
- Physiotherapy procedures;
- Gymnastics exercises from physical therapy.
Also for the treatment of osteochondrosis of the lumbar spine, methods of manual therapy and methods of traditional medicine are used.
For the treatment regimen of 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.
Medication
Treatment of osteochondrosis of the lumbar spine is carried out by a neuropathologist or the narrowest 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 spasm and inflammation. These drugs quickly return mobility to the patient, relieve spasms, then the pain disappears.
In addition to the muscle relaxation group of drugs, steroid hormones are sometimes used to remove swelling and inflammation.
Corrective gymnastics
Treatment of lumbar osteochondrosis should be carried out in conjunction with physical therapy methods. Exercise and gymnastics should receive the same attention as using medications.
The therapeutic effect of osteochondrosis are those exercises that relieve pain, strengthen the muscle structure, reduce compression between the discs - this slows the further progression of the disease.
Physiotherapy
In lumbosacral osteochondrosis, treatment involves the use of the following procedures:
- Electrophoresis with drugs;
- Laser and magnetotherapy;
- Treatment with magnetic currents;
- Darsonval;
- UV irradiation;
- Treatment with diadines;
- Shock wave method.
Manipulations involve 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 patient asks a neurologist how to cure osteochondrosis of the lumbar spine using a manual technique, he is usually advised by a qualified specialist who, with his hands, not only affects the muscle tissue, but also puts the vertebraein place.
In case of lumbar chondrosis, this method normalizes blood and lymphatic circulation, eliminates muscle tone and deformation and restores motor function. Chiropractor's hands reduce the purity of spasms, reduce back pain.
How is osteochondrosis of the lumbar region treated with manual techniques and is it possible to heal completely in this way? Manual therapy is prescribed only when the degenerative processes have not disturbed the tissues of the spine, that is, no bone growths have formed. The need for procedures is determined by the doctor after Rg-diagnostics, CT or MRI.
Surgery
Treatment of lumbar chondrosis by surgical intervention is carried out according to certain indications, when the pathology is characterized by the following changes in the spine:
- The spinal canal narrows, the intervertebral discs are compressed and destroyed;
- Cauda equina syndrome develops: a massive bundle of nerves in the spinal cone, which innervates the pelvic region, the legs, is damaged;
- Loss of sensation progresses, there is a disturbance in the working capacity of internal organs;
- There is a risk of foot paralysis.
The operation is performed according to the emergency or scheduled 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 the doctor.
The People's Pharmacy offers many remedies to cure ailments:
- Medicinal herbs, essential oils, flower extracts, plant roots;
- Products of animal origin, such as snake or bee venom, badger, dog, sheep fat, hard-boiled eggs and more;
- Iodine, turpentine and alcohol are used to warm up the irritating effects.
Similarly to drugs, chondrosis of the lower back is treated with folk methods only at the initial stage of the disease, while the symptoms are only eliminated, but the pathological changes do not go away. Among other things, such treatment often has side effects, which is why a specialist consultation is required before using any recipe of traditional medicine.
The dosage of any person or drug should be prescribed by the doctor.
Complications
Lumbar chondrosis in the last stage can lead to unpleasant consequences, including disability.
Against the background of dystrophy and degenerative disorders, a narrowing of the spinal canal is formed, stenosis develops. As a result of such changes, a chronic type of compression is formed, which interferes with normal blood flow, root ischemia or cauda equina syndrome develops.
In addition, diseases such as spondylosis and spondyloarthrosis sometimes develop: the intervertebral discs age, lose strength and pull pains appear due to the disturbed structure of the vertebral joints. Complications most often concern the ridge of the lower spine, there are spinal-like bone growths.
In the third stage, as a complication of osteochondrosis, intervertebral hernias develop, diseases of the genitourinary system and other internal organs appear.
Preventive measures
The prevention of osteochondrosis of the lumbosacral spine is of no small importance. The lower back has the greatest load, so special attention should be paid to the back. It is worth remembering that regular gymnastic exercises are the key to a healthy spine.
Weights must be lifted with the utmost care, avoiding sudden jolts. Men and women can carry loads within reasonable limits.
Sitting in the office, you need to keep track of your posture, assume the correct posture and sit in 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 body.
The trigger point massage is fantastic. They are active or are in a latent form. Trigger points appear as a result of overexertion, strong stretching, repetitive work, bending, hypothermia, and other factors.
Knowing the reasons for the development of spasmodic areas, it is necessary to take measures to exclude their formation. Recently, a trigger point massager has gained popularity, it is better to prevent the appearance of painful outbreaks with a special device than to treat them for a long and expensive time.