Despite the prevalence of opinion, spinal osteochondrosis is not considered part of the aging process. The elastic discs between the vertebrae are responsible for flexing and extending the back, like shock absorbers. Over time, they wear out and no longer provide the full range of motion. With age, daily stress on the spine and accidental injuries, including minor ones, can damage the discs in the back and lead to osteochondrosis of the lumbar spine.
Who is affected by this lumbar disease?
In most cases, the first symptoms of osteochondrosis of the lumbar spine occur at the age of 11-12. The disease manifests itself vividly at the age of sixteen, but the most severe course and frequent complications occur between the ages of 15 and 20.
Children under 15 rarely have severe forms of osteochondrosis, which is somehow related to the excellent condition of their musculoskeletal system in general, and the spine in particular. In addition, the disease takes time to develop and takes five years on average.
Fortunately, these diseases are much easier to treat in children than in adults.
Symptoms
Reflex syndromes
- Neck pain- neck pain manifested in different ways (pulling, tingling, shooting), sensation of "creeping" in the cervical muscles, as well as decreased mobility and flexibility of the neck.
- Low back painis a sharp, sharp pain in the lower back, which may be accompanied by numbness or swelling. Instead of the word "low back pain" the words "lumbodynia" or "lumboischialgia" can be used.
- Thoracalgia- pains of various nature in the chest, shoulder blades and ribs, which are constantly present or occur during body movements.
Compression syndromes
The onset of pain syndrome in osteochondrosis of the lumbar spine is due to:
- Compression of root structures (radiculopathy).
- Compression of the spinal cord (myelopathy).
- Spinal cord injury due to insufficient blood supply.
- Narrowing (stenosis) of arteries and veins (compressive-vascular myeloischemia).
Methods for detecting disease
Differential diagnostics
Not all disorders can be diagnosed with a simple laboratory test. Many conditions cause similar symptoms. For example, many infections cause fever, headache, and fatigue.
Many mental disorders are caused by:
- sadness;
- concern;
- sleep problems.
Differential diagnosis identifies possible disorders causing symptoms. Typically, this diagnosis is based on several tests. These tests can rule out conditions and / or determine if further testing is needed.
Differential diagnosis is used to diagnose physical or mental health problems that cause similar symptoms.
Differential diagnosis is also commonly used in the field of psychiatry / psychology, where two different diagnoses can be made to a patient who has symptoms of different diseases. For example, a patient diagnosed with bipolar disorder may also be differentially diagnosed with borderline personality disorder, given the similarity of the symptoms of both conditions.
Who is diagnosed most often?
While the disease was previously diagnosed in patients after 45 years, today about 27% of adolescents suffer from osteochondrosis of one degree or another.
A huge spread of the disease is understandable: children began to spend a lot of time in a sitting position, also because of the computer and the Internet. It's bad? Time will tell, but the fact remains: the payment for a sedentary lifestyle is high and osteochondrosis is far from the worst disease that can occur with such a lifestyle, but it is the most common (after obesity).
How to define a disease and its degree?
First
In a normal state, the intervertebral discs constantly regenerate, but it happens that the process slows down and a disease such as 1st degree osteochondrosis occurs.
There are many reasons for this:
- obese;
- metabolic disorders;
- immunocompromised and so on.
Unfortunately, the instability of pain of a given degree of disorder is affected by the fact that many people neglect diagnosis and treatment and try to cure the pain on their own. To do this, use ointments and various tinctures. But this is the biggest mistake.
First degree lumbar spine osteochondrosis can be cured quite easily by contacting a good specialist and performing a series of simple actions.
Grade 1 osteochondrosis is a compaction of the intervertebral cartilage in the lumbar region. The main symptom at this stage is a slight pain when turning or bending. Sometimes the symptoms are more acute and short-lived due to sudden movements or significant exertion.
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A pronounced symptom of the disease is pain in the lumbar region, which increases with any movement. The pain can radiate further up the spine.
With osteochondrosis, pain can radiate to the lower limbs.
The second stage of osteochondrosis is characterized by such intense pain that it also occurs when coughing.
Additional symptoms are associated with pinched nerve endings:
- The sensitivity of the lower limbs changes. The main signs: pain, numbness in the legs, high or too low sensitivity of the skin of the lower limbs.
- Limited mobility. A person suffering from osteochondrosis (grade 2) notes that as the disease progresses, it becomes very difficult to move.
- Increased fatigue and constant sleepiness. The patient has chronic fatigue, accompanied by irritability. This symptom is explained by the pain syndrome that constantly bothers the person.
- Problematic urination and pain in the kidney area.
Third
By the time the patient reaches stage 3, his posture has changed dramatically. In more advanced cases, bone deformation occurs. In this phase of osteochondrosis of the lumbar spine, there is also an evident deterioration of the patient's general physical and / or mental state and a profound loss of energy.
The third stage is characterized by the appearance of narrowing of the intervertebral foramen against the background of previous changes. Hernias of the intervertebral discs are formed, the vessels of the neck and muscles are damaged. The patient has dizziness, pain in the back of the head.
Fourth
The end stage occurs when the intervertebral disc degenerates and the disc space is destroyed. In this phase the thinning of the disc reaches its maximum or, even worse, disappears completely. Postural imbalance is acute, and movement and flexibility are extremely limited.
Osteochondrosis of the stage 4 of the lumbar spine is often characterized by severe pain and a higher degree of deterioration in physical and / or mental condition. There is also a permanent loss of growth and energy levels. Stage 4 is generally considered irreversible.
Consultation of the doctor
Which doctor should I contact?
When independent methods of treatment cease to produce an analgesic effect, the patient begins to ask the question: which doctor treats osteochondrosis? The first person you can go to to treat lumbar spine osteochondria is your local therapist. But in this situation, he plays the role of a supervisor, as he will not be able to prescribe a full treatment - this is not his specialization.
Most likely he will send you to a neurologist. It is this specialist who will conduct the necessary research and help build a treatment program. The therapist may also refer you to a vertebrologist. This doctor deals directly with diseases of the spine.
Scales and tests
Quality of life assessment
Such a generalized characteristic as quality of life is particularly important for a group of patients with comorbid conditions, as they can influence the effectiveness of treatment. This is particularly important for comparing the results of different studies, economic analyzes and for understanding the problem as a whole.
Methods for assessing quality of life include:
- Oswestry quality of life questionnaire.
- Roland-Morris questionnaire.
- Stratford scale.
- Quebec Back Pain Scale - A questionnaire on how back pain affects your daily life).
Pain scales
Pain is an unpleasant sensation and emotional experience associated with tissue damage. Its purpose is to allow the body to respond and prevent further tissue damage.
Methods for assessing pain syndrome include:
- Won the Korf chronic pain rating scale.
- McGill Pain Questionnaire.
- Verbal pain scale.
Evaluation of the treatment result
- McNab's subjective rating scale.
- Patient satisfaction scale.
- Prolo scale of functional and economic results.
- Lumbosacral results scale.
- Nurik Scale.
Hardware test
X-rays
X-rays provide detailed bone structures in the spine and are used to rule out back pain resulting from:
- Spondylolisthesis.
- Tumors.
- Cracks.
Calcium in the bone blocks the penetration of X-rays and the image of the bones is perceived as a shadow on the film. X-rays provide excellent visibility of all details because the bone is made up mostly of calcium. However, nerve discs and roots do not contain calcium, so X-rays do not capture images of these structures. X-rays, therefore, cannot be used to diagnose a lumbar disc herniation or other causes of a pinched nerve.
X-rays should not be performed on pregnant women.
Complications and possible consequences
Complications and possible consequences of osteochondrosis of the lumbar spine include:
- Radiculopathy is a condition characterized by a disease of the nerve roots.
- Muscle weakness - Common symptoms include fever, fatigue, flu-like symptoms, paraesthesia, weight loss, and changes in consciousness.
- Neurogenic bladder: problems with the nerves that control bladder and urination
- Damage to the lower motor neurons.
- Raynaud's phenomenon is a condition in which spasms, narrowing of the capillaries of the fingers and toes occur.
- Pain in the neck, back, leg.
Treatment
Treatment may vary depending on the severity of your symptoms and how much they restrict your daily activities.
Here are some of the treatments your doctor may prescribe based on your pain level:
- Non-surgical treatment- not all patients with osteochondrosis require surgery. For mild to moderate pain, more conservative treatments.
- Spondylodesis- surgery in the treatment of osteochondrosis.
Prevention
Prevention of osteochondrosis of the lumbar segment consists in eliminating the risk factors that lead to this disease. Elimination of factors is the main preventive measure.
Physical activity is normalized, the back muscles are strengthened, the maximum load on the lower back is prevented, the development of diseases leading to low back pain is prevented, all this is a prophylaxis to prevent the symptoms oflumbar osteochondrosis.
Moderate exercise, lifestyle changes, and good nutrition can help prevent painful and disabling symptoms.
If you notice symptoms of osteochondrosis of the lumbar spine, do not tighten and seek immediate medical attention. A disease detected over time is easier to treat and proceeds without consequences.