Osteochondrosis of the lumbar spine is a pathological change in the cartilage and bone tissue of the intervertebral discs in the lumbosacral spine. This change can be natural or the result of an unhealthy lifestyle. In old age, involutional processes of bone and cartilage tissue begin in all people. But when these phenomena are premature (appear in middle-aged people), then we are talking about pathological processes of the skeletal system. Pathology affects equally both men and women over 30 years old.
Lumbar osteochondrosis is the most famous and common disease of the spine, which is manifested by severe pain in the lumbar region. The disease develops as a result of metabolic disorders, which leads to inadequate nutrition of the cartilage and bone tissue, and waste products accumulate in the bone cells. This leads to pathologies of the intervertebral discs. In addition, their thickness and flexibility change, and then growths in the form of osteophytes (growth of bone tissue, which leads to narrowing of the holes for nerve endings) are formed on the vertebrae.
Reasons for the development of osteochondrosis of the lumbar spine
Osteochondrosis of the lumbar occurs much more often than osteochondrosis of the thoracic or cervical spine, because the lower back has the greatest load during walking and running, with prolonged sitting on a chair or lifting weights.
Since this anatomical site takes on the maximum load, its structure is very strong and reliable. The lumbar region consists of five vertebrae and connects the ribcage to the sacrum. Between them are intervertebral discs, which give the spine flexibility and mobility. In turn, the intervertebral discs consist of a jelly-like nucleus, which is located inside a hard annulus fibrosus. When osteochondrosis develops, the normal nutrition of the discs is disrupted, as a result they become thinner, lose elasticity, and the distance between them decreases. As a result, nerve roots are infringed, which leads to severe pain and even disability.
Thus, the reasons for the development of this pathology are:
- spinal injury;
- diseases of the endocrine, digestive and cardiovascular systems;
- intense physical activity (lifting weights, running hard);
- sedentary lifestyle;
- malfunctions of the hormonal system;
- flat feet;
- anomalies of the intervertebral discs;
- old age;
- inflammatory diseases of the joints, such as rheumatoid arthritis.
Risk factors for the development of the disease are:
- stoop and poor posture;
- wrong lifestyle;
- unhealthy diet, obesity;
- being in the wrong posture for a long time;
- hereditary factor;
- stress;
- hypothermia.
The main symptom of the disease is lower back pain. It can be felt immediately or after intense physical activity.
Other symptoms of lumbar osteochondrosis are:
- aching pain radiating to the lower back;
- increased pain after lifting weights, sneezing, coughing, moving the body;
- stiffness in the body after being in one position for a long time;
- persistent spasms of the back muscles;
- sudden painful sensation (lumbago) after hypothermia of the body;
- violation of sensitivity in the buttocks, thigh, lower leg and foot;
- paresis in the legs;
- chilliness of the feet;
- spasm of the arteries of the feet;
- excessive sweating;
- dryness and peeling of the skin in places of pain.
Osteochondrosis of the lumbar spine can be exacerbated by any awkward movement, for example, when moving or turning the body to the side. In this case, pain is noticed not only in the lower back, but also in the legs. There is also a strong spasm of the lumbar spasm, since in this way the body relieves the load on this part of the body. During an exacerbation, a person finds a comfortable position for himself in which pain subsides.
One of the complications of osteochondrosis of the lumbar spine is a malfunction of the genitourinary system. Sometimes there is increased urination and discomfort in the kidney area. Inflammation of the sciatic nerve and lumbodynia (pain in the lower back) can join the ailment.
Stages of osteochondrosis of the lumbar spine
Unfortunately, osteochondrosis is an incurable disease, and the process of destruction of intervertebral discs is irreversible. There are four degrees of development of osteochondrosis:
- The first degree, at which the jelly-like nucleus inside the disc changes and moves.
- The second degree is the period of destruction of the annulus fibrosus in the disc;
- The third degree, in which the annulus fibrosus ruptures and the jelly-like nucleus goes beyond it, which causes the formation of a herniated disc.
- The fourth degree is the period of development of degenerative processes of the vertebrae with the involvement of intervertebral joints and ligaments. Arthrosis of the intervertebral joints (spondyloarthrosis) develops.
First degree
It is characterized by painful sensations due to irritation of the nerve endings located in the annulus fibrosus and longitudinal ligaments. The patient feels pain and discomfort in the section of the affected disc. The pain can be sharp, acute or dull, is permanent and is localized in the lumbosacral segment. Very often it gives off to the leg, and sometimes it is felt only in the leg.
Irritation of nerve endings leads to the development of reflex syndromes. For this reason, a person does not always feel pain in the problem area, but far beyond it. Also, there is a violation of the robots of internal organs, the occurrence of reflex muscle spasm; circulatory disorders in the limbs and ligaments. Disruption of blood circulation and nutrition of tendons and ligaments, which leads to pain and induration at the sites of attachment to the bones.
Second degree
At this stage, there is a characteristic instability and an increase in the mobility of the vertebrae, leading to persistent lubrication of the muscles. At the same time, it is difficult for a person to stand, he feels discomfort and pain in the lower back. Sometimes the lower back "aches", and the patient does not understand why.
Third degree
It is characterized by the prolapse of disc fragments, which are manifested by compression of the nerve roots. During this period, there is a violation of sensitivity in the zone of innervation of the compressed nerve. In addition, there are unpleasant sensations in the form of tingling, burning, numbness, as well as complete loss of sensitivity, which is accompanied by impaired motor function, sometimes leading to paralysis. In the affected area, muscle atrophy, thinning and reduction are observed. The zones where the above-described changes are observed eloquently indicate the place of the spinal lesion. A characteristic manifestation of the third degree is the appearance of the Lasegue symptom. It manifests itself as follows: when the patient is lying on his back, a straight leg up, there is severe pain in the lumbar region, which spreads along the back of the raised leg. When the legs are bent into the knees, the pain immediately subsides.
When fragments of intervertebral discs fall out into the lumen of the spinal canal, damage to the spinal cord occurs. Another syndrome, the so-called "horse tail", is manifested by impaired sensitivity and motor function of the legs, as well as the pelvic organs and the bladder.
Fourth degree
This period is characterized by the disappearance of pain and the restoration of the function of the musculoskeletal system. However, at the same time, there is a limitation of motor function. The spine, as it were, becomes wooden, as disc fibrosis develops and all its elements are replaced with dense scar tissue. At the same time, the intervertebral ligaments and joints are involved in the inflammatory process, and different degrees of the disease are also observed, which are manifested by polymorphism of symptoms.
How to treat osteochondrosis of the lumbar spine
Treatment of osteochondrosis of the lumbar spine is a very long and persistent process. And most importantly, for the successful treatment of an illness, a lot depends on the person himself. After all, he will have to radically change his lifestyle and get rid of many everyday habits, as well as work on his health for the rest of his life.
In the opposite case, even successful drug treatment will not be able to completely eliminate the deformity of the spine. In addition, after a temporary improvement, the symptoms will return with a new intensity and treatment will have to be started over. Although sometimes, even with the observance of the regime of physical activity, attacks of osteochondrosis occur.
Thus, the treatment of osteochondrosis is carried out in 3 ways:
- conservative drug treatment;
- non-drug;
- surgery.
Conservative drug treatment
Since osteochondrosis of the spine cannot be completely cured and is an irreversible process, the goal of conservative treatment is to eliminate symptoms and prevent further progression of the disease. Before starting drug treatment, it is necessary to minimize physical activity. In case of severe exacerbations, bed rest is recommended. This is sometimes more effective than medication.
To relieve symptoms of inflammation, use:
- NSAIDs (non-steroidal anti-inflammatory drugs). The drugs of this group effectively eliminate pain and inflammation in the vertebrae. Medicines can be in pills or injections.
- Glucocorticosteroids. These drugs are classified as steroid hormones. Injections with glucocorticosteroids are made directly into the joint cavity. Without fail, they are supplemented with B vitamins (B1, B6, B12).
- Sedatives. They are necessary to eliminate reflexogenic and associated psychogenic disorders.
- Anticonvulsants. Eliminate involuntary contractions of skeletal muscles.
- Antidepressants. The drugs of this group affect the level of neurotransmitters, as a result, the patient's mood improves, melancholy, anxiety and emotional stress disappear.
- Diuretic drugs. They are necessary for signs of radicular syndrome.
- Anticholinesterase drugs. Drugs of this group inhibit the activity of the enzyme cholinesterase, as a result, the conduction of nerve impulses increases.
- Chondroprotectors. Needed to prevent deformation of the vertebral discs and joints.
In an acute attack, novocaine blockade is prescribed (the introduction of anesthetic drugs directly into the affected area).
Symptoms of lumbar osteochondrosis in women manifest themselves differently than in men. In women, the menstrual cycle can be disturbed, as well as gynecological diseases can develop: inflammation of the ovaries and uterus (endometritis). Reproductive impairment may also occur. In this case, you need the help of a qualified gynecologist.
How to treat lumbar osteochondrosis at home
The main principle of home treatment is to eliminate symptoms that prevent a person from living a quality lifestyle.
The following treatment methods are used at home:
- Diet. Very often the cause of osteochondrosis is the accumulation of cholesterol and loss of vascular elasticity. In order to remedy the situation, it is necessary to adhere to a diet low in fat. Also exclude foods high in cholesterol from the diet: eggs, pork, rich broths, chicken skin. Eliminate alcohol and nicotine completely, reduce consumption of coffee and strong tea. They lead to vasospasm.
- Restoration of blood supply in the lumbar region. To do this, use both rubbing with medicinal ointments and compresses, and physiotherapy exercises, which can be performed at home.
- Orthopedic sleep aids. Since the spine is the axis of the human body, which undergoes enormous stress during the day, it needs proper rest. In this capacity, orthopedic mattresses and pillows act, which are able to give the spine the correct position during sleep.